Tuesday, February 19, 2008

More Insurance Vocabulary...kinda like ELV's, WTF are they about?

More crappy terms you need to know if you choose traditional Health Insurance:

Lifetime Maximum Benefit (Proper Definition): The maximum amount of money that the plan you've purchase will pay over your lifetime.

Lifetime Maximum Benefit (BMK's Definition): What you're worth dead. ;)

Chances are you'll never get here. You need to have one of the Biggies, like diabetes, kidney failure, cancer, or anything that's ongoing, but just doesn't kill you out-right.

Authorization (Proper Definition): An "OK", typically over the phone from the Hospital or Doctor's office, for a procedure you require.

Authorization (BMK's Definition): The worst fucking thing about HMO's and some PPO's.

HMO's are NOTORIOUS for this shit. "Oh, I'm sorry, but that procedure is not on our list of authorized procedures. You can't get the healthcare that your Doctor believes is best for you. Good luck!"

Here's a scenario: You're at the Hospital, ER usually, and either you, or the $12.50 an hour receptionist has to call the 800# on the back of your insurance card. A nurse-practitioner answers, and is usually paid for keeping expenses down. So, they're not too keen to authorize lots of tests and diagnostics.

Now, admittedly, there's a lot of useless medicine done. A even greater waste is tests that have nothing to do with the medical complaint. Why?

Lawyers. Docs don't like getting sued by some ambulance chasing attorney for malpractice. So they perform CYA medicine. That's Cover Your Ass for those playing at home.

What to do?

1. Don't buy a plan that requires an authorization for ANYTHING.
2. Use Minor Emergency, and Minute Clinics whenever you can.
3. Get an HSA, and write off your medical expenses.

Tomorrow, the worst word known to man, and woman: The C Word. Yep....


(Dirty minded bastards!)

No comments:

Post a Comment