If you have a $500 per person deductible, and the plan only pays 80% of COVERED expenses, then you would be out !!!!$5908!!!! a year before it pays the first penny. >>
While most plans do have a $500 per person deductible and a lot of them pay 80% after that, not everything falls into that category. A lot of things don’t fall into the deductible category. For instance, on our plan, allergy shots are 100% covered without a deductible. A lot of times, certain tests and lab work are covered before the deductible. Also a lot of plans have a co-pay amount before you reach the deductible amount – our’s has a $15 co-pay for Doctor appointments and a $25 prescription co-pay.
Health care is very expensive. Our premiums are $104 bi-weekly and DH’s employee picks up a portion of them. However, we receive more than the premiums back in benefits just on my asthma/allergy shots alone. My allergy shots cost $26 weekly (fully covered, no deductible), $300 quarterly medicine charge – allergy shots have to be special ordered and put together for each person (fully covered, no deductible), Doctor charge to rewrite prescriptions when they expire once a year – $250 (fully covered – no deductible), 4 monthly prescriptions total $375 monthly – $4,500 yearly (no deductible – co-pay $25 each or $1,200 per year out of pocket for us).
Last month I had a UTI, we paid $40 ($15 office visit – $25 co-pay for antibiotic). The total bill was $200 including lab work which insurance paid all of. All of these charges are on the same person before the $500 deductible.
My DH has been trying to get a diagnosis on something else for 2 months. So far, we have paid $720 out of pocket (including the $500 deductible) but the insurance bills processed so far have exceeded $5,000.00.
I know that the constant deduction from your paycheck may seem like wasted money – and it was for us for years. But please think carefully before dropping health insurance. Everyone gets sick eventually and there is no faster way to undo years of frugal living and hard work.
It doesn’t just happen to old people, my DH is 37.