I've read up through everything on this site as instructed by my husband, the insured, because it concerned him about our coverage. It became very apparent that this website is a great example of why we have such difficulty establishing successful solutions to such major issues in this country.
First, I am very pleased with Mega and the customer service, agent representation, and all documentation and correspondence we have received with the company for illnesses, accidents, and for wellness coverage. We have gotten what we are paying for and what we were represented to get and, as I am very thorough in my investigative process, it still took us 6 months to sign up and leave our security with BC/BS of Florida. And, our agent, while a salesperson in all senses of the word, I should know as I was in in-house sales for 7 years and know all the training and tactics used, was professional and courteous and other than an occasional phone call, once every two months to get a final decision, was never what I would deem annoying or pressure oriented.
With BC/BS we were with an agent who only sold BC/BS. We started with a premium that began for my self-employed husband and daughter at $124.00/mo.By the time we were with them for 3 years, it had increased up to $264.00/mo. Unfortunately, we did experience all the complaints issued above, from doctors submitting outrageous bills to get the most they could from the insurance, then us getting smaller amounts billed to us that weren't covered by the insurance and hadn't met the deductibles yet that we had to pay. I also had to assist one doctor's office to get paid by helping the process along at BC/BS. But, I expect that with any company sometimes.
I am employed full-time and can't afford to have my spouse and one child under my company's insurance plan as my coverage paid by my employer is over $400/mo. And my spouse and family (whether one or six children) would've been an additional $600/mo. Which is what my co-workers all pay. I'd gladly opt out and go with Mega, but it has been requested by my co-workers to please stay in as I'm one of the 'healthy ones', no claims in 7 years, and help the group to keep their premiums lower. So, I have a yearly review of what's out there, including AFLAC, that we decide on every year and feel pretty well informed by our independent agents for the company.
I have very good advisors and people who really are out for the best of everyone involved. This is our structure. We have set up an HSA with my full-time company. We contribute from payroll deduction the maximum out-of-pocket to stand for the just in case. It is my understanding that the allowable expenses are my deductible and any expenses for my family members not covered by their plan.
Also, I have an AFLAC deduction with it's yearly maximum being placed in another account that I have to use before the year is up, or I lose it which can be used for any of the listed medical expenses reimbursed. Good incentive to 'force' me to stay informed and on top of the game with receipts.
So, we're covered in several ways to help with the deductibles and expenses that might exceed both our medical coverages. And, we have an accountant who helps make sure we don't mistakenly double-dip or misrepresent any of our expenses on taxes. It works pretty darn well and helps keep premiums down and in place for catastrophic expenses. And, our hospital says it's excellent insurance, and it was my husband's physician was the one who prompted us to get better insurance and was very pleased with our choice, and our pharmacies have no problem with our coverage.
So, my point being, what we pay is our responsibility. Our health is our responsibility. And, I'd much rather see all the energy and intelligence and expertise of the people I have read to, in essence, meet at the table and come up with a simplified solution to suggest to their companies, physicians, hospitals, and laboratories that the consumer will understand and feel confident in than to take so much valuable time and energy defending and attacking the companies and agents. Don't publish a book that no one will read as you probably have 2 minutes to present to the average consumer. Don't waste money on lobbyists or legislation on government sponsored programs. And, a free e-mail can circulate through this country as quickly as a super-bowl ad and people will get on board, just look at the energy put into voting for the contestants on American Idol. Please, make a forum to focus all this amazing energy to convince people:
1) Your health and your situation is your responsibility. Take care of yourself instead of finding all the ways and people responsible for your victimization of your poor health.
2) For your particular situation, here is the best way to situate yourself to cover yourself for medical and accidents.
3) How can we take the great ideas come up with and implement without government regulation.
I'm a Systems Analyst. It is my job to identify problems, implement a committee of involved and effected people, structure a way of making a process, getting feedback on the suggested solution, and then, implement the solution. Open end debates turn into support groups and blame game sessions. Faith helps alot, by the way. This is what I teach my children and can only hope they get planted in places that they get to do this and quietly effect positive change where they are at.
Maybe I'm idealistic, but if it can be done on an individual basis, maybe the best thing we need as a group is gat a 'check-up from the neck-up' and that usually is 'FREE'.
Disclaimer: this also applies to 'Global Warming', 'Social Security', 'Taxes', etc., etc., etc.
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