Health Insurance is an Evil Necessity

This post is mainly for people living in the US where health insurance companies are ruling and deciding the lives of millions of Americans.  I’m not going to attempt to explain the reasons for their existence, merely trying to share my experiences.

In Europe, health insurance is optional, although it is becoming more widely used where people are seeking faster assistance with certain health issues.  But, most Europeans have access to somewhat free health care which is paid for by the higher taxes they pay.

When we moved to the US, we were introduced to the dark world of health insurance.  Suddenly we had to pay a substantial sum of money, monthly, to these insurance moguls.

It’s hard to say which is better than the other, and understanding the actual reimbursement process is where we need Harvard or MIT graduates to develop fancy flowcharts and calculations.

In short, you pay north of $800 per month, and some pay $1500, for a family to be covered.  The money you pay will help cover some of the medical bills you might encounter, although the mathematical formula for co-pay and percentages is yet to be documented for the layman.

When my son had his adenoids and tonsils removed, and subsequent ICU stay for a few days, we received a bill around $48K.  Thankfully the insurance covered $45K, and we paid the difference of $3K.

HOWEVER, we would still receive bills from other providers and services we had encountered as part of his ordeal, and they kept coming for several weeks afterward; ER visit, anesthetics, blood tests, rental of some equipment and other interesting items.

When I was hit with heart issues, we also received several bills, and bills just kept coming.  Again, from various services connected with my hospital stay; ER check-in, ambulance (x2), hospital, CAT scan, some medication and a visit by a cardiologist who happened to be out-of-network.

My point of this story is to be prepared for all the bills that will come, and keep coming for some weeks after you have been released from the hospital.  It can be mentally hard to accept that your life is just measured in invoices and $$ signs, but you just have to focus on getting better.

Most hospitals have excellent repayment options, and some will even negotiate the final price with you as if you are at the Black Friday sales.

Each invoice the insurance company reviews is assessed based on many criteria, and they determine coverage based on their secret formulas.  They decide what is needed to save your life or what treatments they are willing to cover.  This, in turn, determines your success rate and potentially your quality of life.

The conundrum is that you need health insurance, and they know it.

I would strongly encourage you to carefully review what your insurance covers, and compare them with other insurance companies.  You need to select the insurance plan that suits your family, and your finances.  It is your life!

We chose Aetna and have had ok experience.

Which health insurance do you have?  Would you recommend it?  What are your views on health insurance?


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