'Underinsured' Face Financial And Coverage Problems

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'Underinsured' Face Financial And Coverage...

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Joy125

Posted Thursday, July 02, 2009 3:36 AM

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Last Login: Yesterday @ 8:09 PM
Posts: 2,354, Visits: 4,116

NEW YORK TIMES

Insured, but Bankrupted by Health Crises

By REED ABELSON
June 30, 2009

Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system.

Too many other people already have coverage so meager that a medical crisis means financial calamity.

One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.

. . . At St. David’s Medical Center in Austin, where he went for two separate heart procedures last year, the hospital’s admitting office looked at Mr. Yurdin’s coverage and talked to Aetna. St. David’s estimated that his share of the payments would be only a few thousand dollars per procedure.

He and the hospital say they were surprised to eventually learn that the $150,000 hospital coverage in the Aetna policy was mainly for room and board. Coverage was capped at $10,000 for “other hospital services,” which turned out to include nearly all routine hospital care — the expenses incurred in the operating room, for example, and the cost of any medication he received.

In other words, Aetna would have paid for Mr. Yurdin to stay in the hospital for more than five months — as long as he did not need an operation or any lab tests or drugs while he was there.

. . . . UnitedHealth drew criticism last year for selling policies with sharply limited coverage through AARP, the advocacy group for older people. One of the plans capped reimbursement for an operation at $5,000, for example, although many procedures cost at least several times that amount. After Senator Grassley began investigating its sales practices, UnitedHealth agreed to stop offering the limited AARP plans.

To read complete article see:

http://www.nytimes.com/2009/07/01/business/01meddebt.html?ref=politics

________________________________________________________________________

I have learned that the greater part of our misery or unhappiness is determined not by our circumstance but by our disposition. MARTHA WASHINGTON

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Grandpavan

Posted Thursday, July 02, 2009 1:22 PM

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Last Login: Today @ 1:52 AM
Posts: 4,500, Visits: 3,621

Insurance provides no more than what you pay for, and on average it provides even less because it has to pay for administration. If you want more coverage you have to buy more expensive insurance. Cheap insurance is easy to get but read the fine print. It won't cover much. God bless.

Age 82, diagnosed RA 12/2001, married since 1952, 4 sons no daughters, 4 grandsons 1 granddaughter. Doing well on Methotrexate and Remicade.

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