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The Devil in the Details

Today being Martin Luther King day, it was a slow day. Late in the day I spoke with a longtime customer and friend of mine today from Northern Colorado who was calling to ask about an offer he had received. It was from a health insurance company I had never heard of, so I went to their web site which said they were licensed as an Agency in Colorado.

The premium was surprisingly low and the benefits sounded quite good on the surface. Of course, that is just what the companies marketers were trying to accomplish. Generally, if it looks to good to be true it is and the reason why the plan was so affordable was all found by my trained eye in the details of the plan overview.

This plan had caps on daily hospital benefits they would pay and no out of pocket limit on how much you might have to spend for surgical fees. So while they would pay no more than $1000 a day for hospital fees, you would be out of pocket for 20% of the surgical fees – however much that might be. So, if a surgery cost a $100,000 you would be responsible for $20,000, PLUS any excess hospital fees over the maximum $1000 day they would pay.

There were several other areas where the company did an outstanding job of limiting their financial exposure. Plans like this really concern me, as the average consumer often only looks at the plan’s premium, deductible and copays.

The Internet it great for researching plan options, but it still pays to get on the phone with your local heath insurance broker to find a good quality plan. While the premium on the plan reccomended may not be the cheapest, the cheapest product is seldom the best value.

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