[TriLUG] OT: NC insurance options

[Abhi Muthiyan]

For those of you looking for affordable doctor visit, there are a few options
- http://nciap.org/ is a clinic in Raleigh. They have fixed, published
prices for visits ($45 for office visit). In addition, they have tie
ups with specialists for discounted services. I have used them and
like the service.
- http://directpayhealth.com/ is a network of doctors, who have
published rates for services. Someone may have mentioned this in an
earlier discussion.

- Before buying meds, compare the prices in different stores
http://www.goodrx.com/. Prices vary a lot.
Always ask you doctor if there is a generic equivalent for any prescribed drug.

Looking for insurance:
- http://www.healthcare.gov/index.html is good place to start. It is
like Kayak for health insurance. You specify the family members and it
will give you comparison quotes. I see several policies starting from
$250 for a family of 3. This number will go up once you plug in your
details on the insurance site.

What I found was, for my family BCBS wanted about $12,000 per year,
before they would pay for visits and medications. This $12K is split
up between deductible, premium and co-pay.
- $10K deductible, $2K in annual premium, $0 co-pay after deductible
- $5K deductible, $7K in annual premium, $0 co-pay after deductible
BSBS presented about 10-12 different variations, based on the same $12K number.

Found similar calculations for friends who got their own insurance.
The number $12 varies depending on the individual situation.

Sometimes minor conditions raise premiums significantly. For example,
if you have history with certain medications like blood thinners or
anti-diabetic, the penalty levied is pretty heavy, even for a one time
event. Even if that event was 10 years ago. My wife's individual
premium is about double that of mine. Both of us are healthy and visit
the doctor once a year. She was prescribed one of the anti-diabetic
drugs 8 years ago.

You do have the option to appeal your premium within the insurance
company and all the way to NC Dept. of Insurance.

BTW, BCBS has a special policy for pre-existing conditions and high
risk group. This is relatively affordable and you won't hear about
this unless you push for it.

The hardest part is comparing insurance policies. There are so many
variations in there.
In the Affordable Care Act (Obamacare), one of the provisions is for
Insurance companies to make it easy for consumers to compare insurance
policies. (http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/march/health-insurance-transparency-under-the-affordable-care-act.aspx
- summary)
Not the most popular provision with the insurance co.

Also, ACA adds restrictions when insurance companies raise premiums by
more than 10%.

Isn't there a website that lets patients compare their own policies
and premiums?

--
Abhi Muthiyan
c: 919-649-6465
http://twitter.com/abhivm