High deductible health insurance is supposed to be all the rage and the answer to the health insurance situation in America. Here's how it is supposed to work; the deductible is set really high usually $5,000 per family. In exchange you get a very low monthly premium. You set up a HSA account. HSA is Health Savings Account. Some accounts allow you to invest in stocks and mutual funds, deposits can be pre tax or tax deductible. Your employer may or may not put a set amount per month into your HSA. There is a $5000 per year cap on contribution to your HSA account. You can make a one time roll over from a qualifying account (traditional IRA...). The money in the HSA account is always yours and you can build it up over time and use it for retirement health coverage.
To use the insurance you get an insurance card (just like any other insurance card) and a Debit card from your HSA account holder.
Supposedly you go to the doctor and give them both cards, your provider submits the amount for the visit to go against your deductible and takes the deductible out of your HSA account via the debit card. You can even buy over the counter drugs and "wellness" products with your debit card. What could be better?
Too good to be true? you ask?
Yep!
Here's what really happens; So I took the HSA plan at my employer this year and rolled over $4000 from my IRA so it would be fully funded (my employer puts in $1000/year). My share of the monthly Premium is $90 for the family coverage. Far less than the $390 share for the PPO plan.
My first experience using the insurance was at the Chiropractor. When I walked in and handed them both cards, the person behind the desk looked puzzled. I figured maybe she didn't quite understand and I started explaining. She cut me off mid sentence and told me she knows what it is but why would change from the coverage I had before for this crap? I was now puzzled. She told me this was going to be a paper work nightmare for me.
Uh oh, you mean I don't just give you both cards and you do your thing? Nope. She started to explain that if they submit it to my insurance, the charge will be $120. It would take the insurance company 30-60 days to get back to them about how much they can really charge and then I would get a bill within 90 days that I would have to pay immediately or if went past 90 days it would already be in collections for the original $120 regardless of what the insurance said was ok to charge and would be considered delinquent. Oh my!
The other option, use the HSA card alone and pay $45 and submit to the insurance carrier myself. Ok charge me the $45 I'll just send the papers you give me in myself. So I pay the $45 and then send the receipt into the insurance carrier and then...nothing. No "we got you claim" "we are processing"...
So I call the insurance. The response? "YOU CAN'T DO THAT!" It turns out, it must be submitted electronically and they need to take their cut from the bill first. But I saved you $75 I say. "IT DOESN'T WORK THAT WAY!" Ah crap.
So the next month I go back to the Chiro and hand them both cards. The same person behind the desk is confused. So I explain and she says "OK, but I'm telling you..."
The following month I go back to the Chiro, different person behind the desk. "You have an unpaid balance of $120" so I explain the whole thing again. The response, "we usually don't treat people with unpaid balances but you've been a client for a long time. If you pay for this visit up front, we'll see you." I ask $45 or $120? "Depends on if you want us to submit it or not. " Well I just explained that I can't submit it myself without the proper process" $120! This sucks!
The next month I still hadn't seen a response from the insurance carrier so I skipped the appointment. Mind you this is past 60 days since the first visit. A week later I see the response from the insurance carrier. $120 applied to your deductible, Please pay provider $120. HUH!?! I thought they were supposed to discount it. Now I'm out $240 out of my HSA account when I should have been out $90.
I go back to the Chiro two months late and get the original person behind the counter. She smiles and says "you know that you are nearly 90 days past due and we are just about to send this to collections?" Yes, I hang my head in shame and hand her the card, not cards. Going forward I will not submit the Chiro stuff to the insurance and will just pay cash out of the HSA account. Of course now it won't apply to my deductible. So if I ever hit my deductible. I will be out all the money I paid to the Chiro again.
AHHHHHHHH!
It gets worse. My child had strep like symptoms. So I take him to his usual doctor who is part of the biggest provider in this area and hand them both cards (surely they have their act together and my Chiro is just too small to "get it"). The person behind the desk hands me back the debit card and says, "we can't charge you now, we don't know what it will be". OH CRAP! Not again! OK, I say, what is your cash charge? "$167, but that's just for the visit, any tests are extra" WHAT!?! With my old carrier it was $80 per visit. "that was a PPO that had a deal with us" But if I pay cash, I"m saving you money by you not having to submit this and bill, and collect. Can't I just pay the $80? "Nope". OK then deal with my insurance.
68 days later. I get a bill from the health care provider. Please pay $20 now this is 60 days past due. $20? what happened to $167? Oh that's still pending insurance response. So I write the debit card number on the back of the bill and send it in. 30 days later I get a call on my cell phone from a number I don't recognize. Yep, you guessed it. It's a collection agency. Asking for $187. It can't be, can it. I ask, What was the date of service. The collectors response, " we don't have that information, you owe $187." I explain that I think this is for my son and explain that I sent in $20 a few weeks ago and that I still hadn't seen a bill that says the $167 had cleared the insurance that I need to pay it. "well then this is something different, you owe $187 pay it or we will report it to the credit reporting agencies." But I don't think I owe it, I say, can you prove that I didn't pay the $20 or that this is a different charge. What was the date of service? "are you going to pay this or not?" How do I know that this isn't a scam? I can't just give you my debit card number because you call and tell me I owe you $187. If you had said $167 I would pay it. "Sir, do you know what happens when this is reported to the credit agencies?" I sure do, having a developmentally disable child I nearly went bankrupt paying for his treatment and had bad credit for years and had to dig my way out of it and now have great credit. Can we please work this out? "no, you owe $187, unless you pay it, we will file." So I gave him the debit card number.
2 weeks later I get a bill from the health care provider. Paid $20, please pay $167 this is 120 days past due!
WHAT!?! I call them and tell them I paid their collections agency $187. The confused person on the phone asks why I would pay more than I owe? I explain the whole conversation and tell her that I'm still steamed about this and will take my business elsewhere. She apologizes and explains that the outsourced collections agencies can take up any account over 90 days past due that is published on list but sometimes the information about who paid who what is not timely.
Great. Just great. Another good idea ruined by a bureaucracy.
And we think it will be better when the Government is running health care.
Right.
These big companies are getting to be just like the government. Too big that they just get in the way of themselves.