I’ll summarize here for those who do not have time to read this, and please do include JC’s remarks in the comment section regarding payment of costs for people below poverty level to be better informed. What I found is that we are basically being sold catastrophic policies where we are on the hook for the first $6,350 of medical costs. If you have that much in costs, you can ignore all policy features except monthly premium. Go for the cheapest. The more expensive policies are an attempt to buy down the $6,350, but it’s a trap, as you end up spending more in medical expense plus premium than you would otherwise spend with a higher deductible and lower premium. If you have ongoing costs, go cheap.
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I was looking over the available policies on the Colorado Health Exchange, and it is very confusing, as it is designed to be. There are differing co-pays, co-insurance and deductibles. So I decided to do a side-by-side comparison, and selected twelve plans with varying monthly premiums, the low $430 (Kaiser) and the high $1,049 (Access Health Colorado). Bear with me here, as it will for a while seem confusing, but in the end be stone-cold simple.
There’s no way of anticipating what kind of health coverage anyone will need in a given year, so I decided to compare policies based on what might be typical for someone my age. I have an annual physical, blood tests, office visits, lab fees, an MRI and out-patient surgery, some physical rehabilitation after surgery, and ambulance and two ER visits, and a two-day hospital stay. I’ve done nothing but visit doctors for minor ailments (one knee surgery, outpatient) for decades, but am assuming that this year, SHTF. The total costs I imagined I would incur: $14,275.
Continue reading “It’s not complicated. It’s just deliberately confusing.”



