My shopping experience

I was once fake-employed in order to qualify for a group insurance policy for me and my wife through Aetna. Because my “employment” was in Colorado, and we lived in Montana, there were no networks available, and all of our coverage was with doctors of our own choosing. (Aetna limits which doctors you can see in Colorado.)

I did what health insurance and “free” market apologists said I should do with regard to my wife’s knee – I shopped it around. She needed a total knee replacement. I called Bozeman Deaconess to see how much it would cost, they couldn’t say. I called Aetna to see how much they would cover, they couldn’t say. But they did say this: They would only cover the primary surgeon, and not the assistant. I told the hospital about that, and they said they didn’t care, that they don’t do surgery without an assistant on hand. Since we were not in the network, we’d have to pay deductibles, co-pays, the assistant surgeon, and anything else the insurance refused to cover for any reason. Our exposure was open-ended, and so decided not to have the surgery at that time.

So we were smart consumers, and did just what Aetna wanted – we didn’t have the surgery on their watch.