What’s the lifetime maximum benefit on your health insurance? Do you know? Bob at InsureBlog has written a good article that should have all his readers scrambling to pull out their policy details and find out. When my father was hospitalized a few years ago with a bad case of peritonitis brought on by peritoneal dialysis, his medical bill was nearly half a million dollars. Puts a lot of the fine print on your health insurance policy into perspective when someone close to you has that sort of a claim. A friend had a baby earlier this spring, nine weeks premature. The little girl spent the first seven weeks of her life in NICU, and although the bills haven’t arrived yet, I’m sure they won’t be small. It doesn’t take much to go from being a healthy person to a person with eye-popping medical bills.
Our Humana policy has a $5 million lifetime max. A lot of the health insurance policies we sell in Colorado also have $5 million caps, although there are still several that cap at $2 million. But over the years, we’ve spoken with clients who have policies with lifetime maximums well under $1 million, or annual maximums of only $100,000 or so (doc, could you just put my severed leg on ice, and I’ll be back in January to get it reattached – my health insurance has an annual max…)
I really don’t think that health insurance should have lifetime benefit maximums. It seems to defeat the purpose of health insurance. I think this would be a perfect place for a government back up plan. Perhaps all private health insurance could cover up to $5 million, and then for the tiny percentage of patients who need coverage beyond that amount, a government catastrophic insurance policy could kick in. We don’t need health insurance to cover the small stuff. Pretty much everyone can come up with $100 for a visit to a doctor, or $30 for a generic drug (those who can’t probably qualify for Medicaid). Covering stuff like that is not the point of health insurance. But if you end up needing 100 doctor visits a year, and high-end drugs, and weeks in an ICU, you shouldn’t have to worry that your health insurance is going to run out.
This could be a good compromise between the people who are calling for government-run universal health care, and those would would prefer that the entire system be privately operated. The government policy could be there just for the catastrophic situations, to keep people from being denied organ transplants or other high-dollar treatments. But private health insurance could be used to cover the less expensive care. However we go about it, we ought to have a better solution for people who have run out of health insurance benefits than bake sales and coffee tins with holes in the lid.
