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Saturday, November 14, 2009

Doctor, Doctor, Give Me The Bill!

My health insurance company has decided to high-tail it out of the state of Maine. As I understand it, this was just not a profitable market for them. Boo-hoo. (They should talk with my plumber!) In any case, this means finding a new health insurance plan. Yes, I have medicare, but as you other golden oldies out there know, medicare does not cover everything...some things it doesn't cover at all! It is necessary to have some type of supplemental coverage to avoid bankruptcy in the event of illness, injury, or medical emergency.


I was a sales rep for Humana, the company that's leaving Maine, before I retired so I have some working knowledge of the field. There are many options out there, and it can be quite a task to wade through all the ads and brochures we seniors get bombarded with every fall. After all the browsing, and then meeting with a broker who represents several different companies and their plans, I finally made a decision.


I selected an HMO (Hospital Maintenance Organization) plan which includes coverage for my gym membership. I am cautiously optimistic about my choice. It does include lower co-payments for doctors visits, plus some dental and optical coverage.


The trade-off for the lower costs is that you must go to doctors and hospitals on their list. My doctor and hospital are on their list-- I'm good to go there. I say I'm cautiously optimistic, because HMO's in general have had bad press in the past. Rumors abound about what is covered and what isn't, so I can only wait until January when the new plan kicks in to find out the truth.
I do hope I've made the right choice!

15 comments:

Steven Anthony said...

OH IM SORRY! My mom had hummana, and when she got sick we had trouble because the treatment centers would not accept it as a secondary inssurence...it was a mess, health care, is the last thing you want to think about when u r sick......

I hope it all works out for you;)
peace

Happy Hour...Somewhere said...

Buying health insurance is such a drag. I am self employed and always hunting for a new plan. I calculated the other day that I pay about $2600 in premiums with a $5000 deductible before anything kicks in...and I mean anything. So, I would need to spend $7600 a year before my insurance would pay. I'm beginning to think that maybe going bankrupt is cheaper~!

I hope your plan works out well. The devil is in the details as they say.

jules said...

Health insurance can be so confusing. As long as your primary care doctor goes, as long as he participates with your HMO hopefully things should be good. I think Medicare has a 135 deductible and sometimes the secondary picks it up. I bet you can easily find that out ahead of time. As for the optical insurance, if you see an opthamologist (medical dr) for your eyes instead of an optometrist, medicare will cover 80%. More than likely less than what you would pay at an optometrist with a separate vision plan.

Good luck!

Jen said...

I find the literature on these plans very confusing....why can't they have RESONABLE increases so we don't have to change every year!! Good luck with your plan.

Vodka Logic said...

A very scary prospect the closer i get. When I started my job 23 years ago health ins. was FREE...not anymore.

Good luck, for the most part I have had good luck with HMO's

Kim said...

Boo on your insurance company! At least you found something else. Here's to hoping it's better than what you had! Dealing with insurance and all the ins and outs of it gives me a headache. Although I love the cartoon you posted, hilarious!

Tam said...

Good luck with the new plan. I think HMOs are getting better. Hysterical cartoon!!

ethelmaepotter! said...

I've had three different HMOs in the past 23 years, and never had a problem with any of them. (The only reason I changed was the same as yours: plans decided to pull out of our area.) The low copays are great, the care I receive is superb, and overall cost is very reasonable, compared with those of my friends who do not use HMOs.
HMOs get a bad rap, but honestly, I hope I never have to use anything else!

lakeviewer said...

We had Kaiser Permanente for decades, in California, and had no troubles. Where we live now, it's too far to any HMO. So, we are hooked up to a much more comprehensive Medicare advantage.


In a few months, after the Senate and the House Bill are reconciled, we'll have to review our medical insurance plans.

Helene said...

We're totally getting screwed by our insurance company so we're changing our plan. It's a shame we have to keep such a close eye on all the charges because they'll take you to the cleaners if you don't pay attention to every nickel and dime!

I hope it works out well for you! The cartoon was priceless....love your sense of humor!

singedwingangel said...

So grateful my mom has Tricare for life and Medicare.. both have been awesome about all of he medical bills being paid. That was one great thing about being retired military family...

Cole said...

I love the cartoon!

Unknown Mami said...

Good luck. I just hope they are cheaper than the plumber.

My name is PJ. said...

I sure hope it turns out well for you, Eva. I got a big laugh out of your graphic today!

Corrie Howe said...

Love the cartoon. I hope that your change in insurance works for you. Maine. Wow! That is the only corner of the United States I have been yet. I've been to Alaska, Hawaii, California, Florida, Oregon, up and down the east coast, but no higher than NY. Maine is on my list of "most do."