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KOK Edit: your favorite copyeditor since 1984(SM) KOK Edit: your favorite copyeditor since 1984(SM) Katharine O'Moore Klopf

Saturday, April 01, 2006

Not an April Fools' Day Joke ... Maybe

At long last, I'm writing with an update on my health insurance woes—and it's good news. (You've all read my health care horror stories—here, here, here, here, here, and here—and many of you kindly offered advice and sympathy.)

You may recall that GHI was discontinuing the plan I qualified for as a member of a independent business owners' association. The monthly premium, which my husband Ed and I paid in full ourselves, was $930. The plan with which GHI is replacing its old one costs between $1,100 and $1,400 a month for family coverage; we can't afford either price.

After an exhaustive search, I found a plan, with a broker's help, offered by HIP called HIP Classic. Under it, family coverage premiums are $737 a month, a visit to a doctor's office costs us a copayment of $30, and prescription drug copays are $10 for generics and $20 for brand names. The reason that the premiums are so much lower is that the copayment is $500 for each hospital stay and $100 for each emergency room visit.

The good news, in addition to the lower monthly premiums, is that instead of our having to come up with enough money to write a check for the entire premium at the end of each month (because the insurance was not offered through anyone's employer), the premiums will now be deducted from my husband's weekly paychecks in equal amounts, making it much easier to budget. And no, my husband's employer isn't helping with the cost of the premiums; because the company employs fewer than 10 people, the money to do so just ain't there. At least the premiums will still count toward our medical deduction on our income tax forms.

But in view of the mess that is the U.S. health care system, it is highly appropriate that our coverage under this new plan begins today, April Fools' Day.

Updated 4/6/06, 1:47 p.m.: Here's an additional, belated April Fools' Day joke—GHI is buying HIP, so I'm sure the company will screw up HIP. What's more, we get to continue using the evil Express Scripts for mail-order medications. When we were HIP members just over 2 years ago, members could go to drugstores, where they could watch a live pharmacist and ensure that their prescriptions weren't lost. Now everybody's in mail-order hell.


Anonymous said...

It's great news! But if you hadn't been so persistent you wouldn't have found this plan, and that's just wrong.

Katharine O'Moore-Klopf said...

It is wrong, Anon. There are so many Americans without affordable access to basic health care. It's a crime.

Anonymous said...

I'm so glad you found something for your family, Katharine. A big myth about health care in this country is that the uninsured are all poor people without jobs. Not so, as your situation proves!


Anonymous said...

I'm not sure what is going on with the blog, but thank you for telling me. It looks ok on my different computers-maybe it is a blogger problem?
Anyway, I'm sorry! We've been taking it easy with the serious discussion lately, you're not missing much!!!!
I'm not sure why but we get a little bit silly over there. Diversions. Escapism, maybe! I posted on cartoons recently for example- I'm pretty young at heart I guess. Health Insurance is a bit of a nightmare for many people, I cannot believe it costs that much!-lily

Anonymous said...

I'm curious what you think of the proposed Massachusetts legislation requring health care for all. I haven't looked at it too much since I don't live there. Have you? If so, would similar legislation in NY State have helped you out, or would you still make too much money to get much help?

Katharine O'Moore-Klopf said...

Thanks for the writing assignment, Anon. ;-) I'd already been vaguely wondering the same thing, but now I'll have to study the Massachusetts plan and write about it to figure out what I think of it. (That's the way my mind works.) Watch for a post on the issue soon.

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