Sunday, August 09, 2009

Health Insurance Is Available for Less Than $100 Per Month in GA, Including Dental and Vision

We keep hearing that health insurance is so expensive that 40-50 million Americans cannot afford it. I have argued before that since most Americans seem to be able to afford cell phones, laptops, iPods and cable TV, they can probably afford health insurance.

Here's another example on how affordable health coverage can be, this time using the
Blue Cross Blue Shield website for the state of Georgia and getting a quote for a 25-year old male living in Atlanta:

The "Tonik" plan offers the following services (including dental and vision coverage, $20 office visits, physician choice, etc.) for only $97.46 per month (there are other cheaper plans, this is a midrange plan):

  • Network: PPO
  • Deductible: $5,000
  • Coinsurance (after deductible): 100%
  • Physician Office visits: $20 copay for first 4 visits, then plan pays 100% after deductible.
  • Drug Coverage: $10 generic / $30 preferred / $50 non-preferred.
  • Physician Choice: Yes
  • Dental Care: $0 for cleanings, exams and x-rays. You pay 20% for minor restorative procedures like fillings after $25 deductible.
  • Vision care: Plan pays $50 toward a routine eye exam, glasses or contact lenses and you'll pay the rest.
  • Professional Services (X-ray, lab, diagnostics, etc.): Plan pays 100%
  • Outpatient Care: Plan pays 100%
  • Hospital Inpatient Services: Plan pays 100%
  • Emergency Care: Plan pays 100%
  • Physical/Occupational Therapy, Chiropractic Services: Plan pays 100%
  • Preventive Care : Plan pays 100%
Is that really so unaffordable that a government takeover of health care is justified?

Originally posted at Carpe Diem.

29 Comments:

At 8/09/2009 10:27 PM, Blogger Jason Gillman said...

Imagine if they were able to market competitively elsewhere...

The states restrict competition because they cannot enforce some actions on companies without nexus..

Perhaps making enforceability more possible opens up to the competition?

 
At 8/09/2009 10:43 PM, Blogger vakeraj said...

It isn't about the government providing health care, Mark. It's about power, pure and simple. Federal power. Another pillar of support for Democratic politicians, much like their other two pillars, Social Security and Medicare.

Sooner or later, Atlas will shrug.

 
At 8/09/2009 10:49 PM, Blogger pakurilecz said...

"The states restrict competition..."

actually I believe that it is federal regulations that restrict the sale of health insurance across state lines. If states truly restrict competition then why can I living in Virginia buy auto and life insurance from a company based in Texas?

one suggestion for healthcare reform is to allow health insurance to be sold across state lines just like auto, house, fire, life et al

 
At 8/09/2009 11:18 PM, Anonymous Anonymous said...

Maybe I'm missing something here but paying $1200 a year for a policy on a presumably healthy young man who still has to come up with $5000 in deductible charges hardly seems like the deal of the century. It's little more than catastrophic insurance and expensive at that. With a median income of about $48,000, how many people can afford to spend 1 pre-tax dollar in 8 on insurance and deductibles?

And if he were unlucky enough to not be a healthy young man but had a pre-existing condition, he wouldn't be able to get a policy at any price.

The system is unsustainable and has to be changed.

 
At 8/09/2009 11:22 PM, Anonymous Anonymous said...

Try qualifying for this plan if your father died of a heart attack at aged 52

 
At 8/10/2009 12:46 AM, Anonymous Anonymous said...

I have been looking into finding an individual policy for my family so that we can go strictly into self-employment, instead of our mix of "working for others" and self-employment. "Work for others" is done simply for the group health insurance at this point. No dental, $10,000 deductible, no regular visits paid for, prescriptions are included in the deductible . . . about $800/month. This does not foster entrepreneurship. In all fairness, my oldest child (age 24) does have a policy similar to that described here in the blog for $112/month. She would need a loan to pay the deductible if she were hospitalized, but I would call it adequate coverage at an excellent price. If only we were all young and healthy.

 
At 8/10/2009 6:12 AM, Blogger Colin said...

Dental is the ultimate form of dumb insurance. Insurance should be for emergency and catastrophic developments -- how many dental interactions are either? Dental care is mostly about maintenance. If you brush, floss and go for regular checkups your chances of needing a major procedure are pretty low. It should be paid for entirely out of pocket.

 
At 8/10/2009 6:38 AM, Blogger Walt G. said...

I don't live in Georgia; I live in Michigan. The quick quote was $900.72 per month for me and my wife using Michigan's Blue Cross Website. That's $830 per month more than our average cell phone bill.

I don't mean to be critical and I don't like the idea of a national health care system, but we have many members who have taken the GM buyouts giving up their health care that seriously underestimated their future income requirements. Some are trying to get their jobs back just a couple years after they retire.

I realize that all people buying health care insurance aren't in the 40-60-year-old range; however, most people will not be able to buy health insurance for $100 per month (the median age of the U.S. population was 35.3 years in 2000).

Obviously, health care cost is a huge problem. I don't like the idea of national health care, but our U.S. companies are competing in the global marketplace with other countries that do not directly burden their companies with that cost. I guess the answer to this problem is whether the U.S. will be a leader or a follower in the health-care delivery system.

 
At 8/10/2009 7:12 AM, Anonymous Anonymous said...

"...U.S. companies are competing in the global marketplace with other countries that do not directly burden their companies with that cost."

Mandating company-sponsored health insurance coverage was one of the worst things that could've ever happened to healthcare.

I've been paying 3% of my salary in government healthcare premiums (along with everyone else) my entire working life. That would be $1500 per year on a $50K salary. Under the current government plan, if I were to become very sick today, the government would cover exactly $0 of my medical expenses despite 25 years of uninterrupted payment of those premiums.

If the government wanted to provide the kind of leadership that Walt is talking about, they would convert Medicare taxes into compulsory premium payments for private catostrophic coverage. Most Americans would end up with a nice "bank" of Medicare funds when they were older, which could be drawn against to pay for increases in premiums.

Government would then only need to have a program to assist low income people that developed catastrophic medical problems early in life, which is a helluva lot less people than every man, woman, and child in the U.S.

 
At 8/10/2009 7:33 AM, Blogger 1 said...

"The system is unsustainable and has to be changed"...

Oh I totally agree but have to wonder if federal government intrusion into the medical market place isn't driving up the cost of premiums...

Doesn't health insurance bought by individuals and companies have to in part cover the costs of medical care given to the indigent, care mandated by various federal judges over the last few decades?

 
At 8/10/2009 11:52 AM, Anonymous Sgillesp said...

1) How nice for a young man in Georgia. Try it in NY or NJ and it quickly becomes more like $250/month - for a huge deductible?
2) you don't say how much the maximum payout is: one of the policies we looked at for our 25-year-old son had a maximum payout less than what he would pay in a year!
3) The idea used to be that we all paid into insurance so that when we were older and sicker we would not be overwhelmed. By changing the rules so that younger people pay less, older people are automatically priced out of the market.
4) You also don't address what happens if that mythical 25-year-old buys his insurance after having been uninsured for a while. For the first 18 months, anything he seeks care for will be challenged as having been something he might have had before he was insured, will be considered pre-existing and uninsurable - not only now, but into the future! So the real situation is that he will pay his $100/month for a year-and-a-half before he can be sure of having anything covered.

The reason we need health insurance reform is because private health insurers exist to make money for their stockholders; their interest is in denying care, not providing it. I don't want my health care to be considered an inconvenient cost to a company that would rather take my money and give it to Wall Street. I'd rather pay it into a single-payer system and demand transparency.

 
At 8/10/2009 12:29 PM, Blogger NoWhining said...

"I'd rather pay it into a single-payer system and demand transparency."

I looked in the dictionary under "Contradiction in Terms"...I found this statement.

 
At 8/10/2009 12:45 PM, Anonymous EscapedWestOfTheBigMuddy said...

But wait. This is, like, insurance: you know, a bet you win when something horrible happens to you.

Don't you know that "medical insurance" actually means "comprehensive health plan", and that nothing else will do?

Aside: in reality this plan is a mixture of a very basic health/dental/vision service plan and a catastrophic medical insurance plan. Not a bad deal, but it won't satisfy the people who thing that they have some kind of "right" to arbitrary amounts of medical support.

 
At 8/10/2009 12:45 PM, Anonymous Anonymous said...

This is sick .. You pay 5000+1200 from your pocket apart from the copays. THis will sound good only to people like this prof who gets great benefits from employer.

 
At 8/10/2009 12:53 PM, Anonymous Anonymous said...

pakurilecz,
Each state sets insurance requirements (health, auto, etc). For example, If you live in North Carolina you can't get a Texas auto policy etc. Now you can get a policy from a company based in Texas but they have to have a license to operate in North Carolina and the policy has to be a North Carolina one (meet minimum payouts etc).

The problem with health insurance is that companies lobby the state health insurance commission to mandate coverage for certain things such as chiropractic visits, acupuncture, etc . You can't get a policy in a state that doesn't have the minimum coverages set by the state. That drives up costs.

 
At 8/10/2009 12:54 PM, Anonymous Anonymous said...

Having a high deductible is a good thing, people use less health care.

 
At 8/10/2009 1:01 PM, Anonymous Anonymous said...

A $5,0000 deductible? Not surprising. This sort of coverage is what the poor were receiving years before - now it's just starting to creep into "middle America," whose nostagalia yearns for the '90s when they had 100% coverage, no out-of-pocket premiums. You get what you pay for in America.

Get used to it, it's not going to get better. Oh well, at least Walgreens has retail health clinics incase someone has cancer, or needs an appendix taken out - ha-ha!

Bubbly Optimistic

 
At 8/10/2009 1:14 PM, Blogger 1 said...

"I don't mean to be critical and I don't like the idea of a national health care system, but we have many members who have taken the GM buyouts giving up their health care that seriously underestimated their future income requirements"...

These folks made their beds (none of them were children, right?) now its time for them to sleep in them...

"I don't want my health care to be considered an inconvenient cost to a company that would rather take my money and give it to Wall Street"...

Apparently you've never visited a VA hospital, right?

 
At 8/10/2009 1:35 PM, Blogger Walt G. said...

1: I just provide information to our membership. For some reason, some people do not listen to me :)

I can't advise anyone that they can get monthly health care coverage for less than the price of a monthly cell phone plan. I am not saying it can't happen--just don't count on it. Figure on a grand or so. If it's less, you'll have some extra money in your monthly budget.

Of course, everyone's situation is different. But the more you have, the more you have to lose.

 
At 8/10/2009 2:08 PM, Anonymous Anonymous said...

"...private health insurers exist to make money for their stockholders; their interest is in denying care, not providing it."

Whether we are talking about current government healthcare or current government retirement plans, it is the government that continually raises the bar for qualifying coverage. It is the government that continually reduces the "benefits" of the program.

 
At 8/10/2009 3:49 PM, Blogger AAA said...

not everyone as health as you are and there so many people that are not accepted at all due to health conditions; Mark stop thinking about your self and you iphone; I am sure those who have lap tops and iphones are able to afford heatlh insurance; FYI: i phone costs 200.00 - 16.66 per month not

 
At 8/10/2009 4:49 PM, Anonymous Anonymous said...

"...not everyone as health as you are and there so many people that are not accepted at all due to health conditions..."

That is actually a reason to oppose government run healthcare, at least drawn up by this administration. Ezekiel Emanuel (Rahm Emanuel's brother) is advising the President and Congress on national healthcare, and he has written and lectured on the pros and cons of various methods of allocating (PDF) limited healthcare resources. Some considerations he evaluates at the link inlcude "life-years saved" and "instrumental value" (social usefulness).

 
At 8/10/2009 8:11 PM, Blogger moneybagzz said...

Here's a free market innovation for you that you are unlikely to find in Canada or the UK:

http://www.nytimes.com/2009/08/08/health/08patient.html?nl=your-money&emc=your-moneyema4&pagewanted=all

Executive Summary > people serving as medical billing advocates can step in where insurance companies obfuscate and deny coverage.

 
At 8/11/2009 4:50 AM, Anonymous Insurance Agency in san Diego said...

hi, Nice and informative.

 
At 8/11/2009 9:01 AM, Blogger 1 said...

Hey Walt G...

No I get what you're saying but sadly times have changed and unions haven't acclimatized themselves to the changes nearly quick enough...

Your comment: "I am not saying it can't happen--just don't count on it"...

NO disagreement amigo, just ask anyone over the age of forty even if he or she is in pristine physical and mental condition...

Through TWU union contract I spend $2400 per year on my own health/dental insurance and I'm glad I get it for that price...

The problem is as you probably know is that COBRA insurance will be easily twice that and only for a limited period of time...

"Of course, everyone's situation is different. But the more you have, the more you have to lose"...

True and I think this is in part one of the reasons people are loath to vote with their wallets when it comes to health insurance...

 
At 8/11/2009 12:48 PM, Anonymous luagha said...

Keep in mind that with this plan, even though it has a $5000 deductible you also get the bargaining power of Blue Cross/Blue Shield on your side. You are paying them to handle the negotiations between you and the hospital of all of those $15 aspirins and $900 x-rays. That is a serious time and effort and requires the bargaining power of an insurance company to handle.

 
At 8/11/2009 2:54 PM, Anonymous Anonymous said...

luagha,

Bargaining Power? You got that right! Especially when you've got Linda Peeno-types scrolling through your health records. Pre-existing condition? Now that's bargaining power!

 
At 8/23/2009 1:09 PM, Blogger Envy said...

Interesting topic, everyone responding should take the time to read this new health care reform bill (it took me two weeks). If you're half as smart as you think you are you'll realize that this has nothing to do with health care.
We need reform, not gov't intervention.

 
At 2/25/2010 9:02 AM, Blogger S.L. Williams said...

Typical to most comments and commentators on health care, you come at the issue with preconceived notions, use data selectively to argue your point of view and have no real concept of what is happening on the ground with patients, providers and payers.

In your post regarding the $100 premium rate in Georgia, you don't even pay attention to the facts that are on your page. You cite a plan with a $5,000 deductible. Of course it's going to be affordable. But if you need much care, the cost is really $500 a month, making it much less affordable except to young and healthy 18-25 year olds, which is probably who the plan is designed for. My guess is that if you go to the Blues of GA web site, you will find other plans that are far more expensive if you are older or have pre-existing conditions, depending upon how the state regulates the Blues.

The other thing that you don't understand or choose to ignore is the subsidy that is involved in the funding of individual insurance. In many states, regulators keep individual coverage artificially low and allow the Blues particularly to subsidize the low rates by charging group plans more. In this way, it raises the cost of group insurance a small amount so that individuals can have more affordable coverage.

But as group rates escalate, more and more groups drop coverage and fewer groups are left to fund the subsidy. As those who offer insurance to their employees pay more and more they shift cost to workers. This has the effect of making care less and less affordable to them and they are delaying or avoiding care because they cannot afford it.

This is only one problem of moral hazard in health care and insurance. There are many more. It is unfortunate that people with advanced degrees continue to contribute to the superficial analysis of health care. You should stick to whatever specialty area your degrees are in and avoid topics which you don't have a clue about.

SLW

 

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