Another Year, Another Bait-and-Switch

Every January, the counter is reset for deductibles (which is the out-of-pocket expense that a patient must pay before the insurance company will start paying).  This is one of the significant features of the high deductible plans offered by the the GOP in the health savings accounts.  The premise is that the more one pays personally, then the lower the insurance premium because the carrier will have lower expenses.

One of the ploys used to keep premiums down is to raise the annual deductible. For example, a PPO plan may have had a $1000 deductible 5 years ago and to try to maintain the annual premium cost, this year's amount is $2500. The personal expense is now additional $1500.

Another ploy is to raise the copay amounts used when a patient goes to the doctor. This is the amount that a patient is responsible for and then the insurance company will pay the rest of the charges based upon the insurance company's fee schedule. Again, in order to keep the premiums down, the copay may have been $10 five years ago and is now $25. If a patient goes to 10 doctor visit per year, there is an increase of $150 of personal out-of-pocket expenses.

This is part of the shift to patients having to pay more and what people are feeling in their wallets. It is a subtle and gradual shift until one day, when reality hits that a person is paying more out of their own pocket.

 

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