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Trade Talk: Now's the time to make prudent health choices

Open enrollment for most employer-sponsored health insurance plans is under way or nearing, and we all need to make good choices because mistakes can cost thousands of dollars.
by Paula Burkes Published: October 10, 2012
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Open enrollment for most employer-sponsored health insurance plans is under way, or about to be, and now more than ever we all need to make good choices because mistakes can cost thousands of dollars.

A couple of real-life reasons

If you're married, be sure to thoroughly research your and your mate's coverage — and choose the most cost-effective plan or combination. A co-worker lost some $28,000 over the past four years because, along with our employer-sponsored health insurance, she had her husband carry his coverage at $7,020 a year. The mother of a special-needs child, my co-worker thought she was being prudent carrying both policies, but after many runarounds — where reps with her husband's insurer repeatedly told her “we‘re coordinating with your primary insurance” — she finally was told that her husband's “non-duplicating policy” paid only if ours didn't pay on the claim. In other words, his paid out nothing!

What's more, she — save for a life-changing event like divorce (which they actually considered) — couldn't cancel her husband's policy, and owed premiums until this open enrollment period, where she could change her elections.

Last week in my dental hygienist's chair, I was, well, open-mouthed to learn her family of four recently paid $1,800 a month in premiums for health insurance with her husband's former employer, and that insurers wouldn't cover her husband because he took ongoing meds for kidney stones, didn't scoff about her son's spina bifida but charged $100 more to cover her daughter who suffers from acne. Though insurers, upon passage of health reform, can't turn down children with pre-existing conditions, they can, and did, charge more for her daughter who needed pricey meds and cream that insurers deemed cosmetic.

Lastly, a book author and source I met on a phone interview this week told me he shopped around for an in-network gastroenterologist to perform a recent colonoscopy that — with the passage of the health reform law — should, as a preventive care event, have been covered at no cost to him. But after his procedure, he was billed $4,000 because the procedure, unbeknown to him, was performed at an out-of-network facility.

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by Paula Burkes
Reporter
A 1981 journalism graduate of Oklahoma State University, Paula Burkes has more than 30 years experience writing and editing award-winning material for newspapers and healthcare, educational and telecommunications institutions in Tulsa, Oklahoma...
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