Here Are Some of the Crappy Insurance Plans That May Soon Be Legal Again
“Core Benefits” disappeared last night from a healthcare bill intended to replace the Affordable Care Act. If it passes, health plans will no longer be required to cover the cost of maternity services. Or hospitalization. Or an ambulance. Or prescription drugs. This means that those terrible health plans from around 2010 may be back!
The insurance plans offered by employers were usually pretty good if you were lucky enough to offer them. But if you needed to buy insurance yourself or worked for a stingy employer like McDonald’s, your plan might cover very little.
The aforementioned plan, Value Health USA , only costs $ 91 a month, and at first glance, it doesn’t look like such a bad deal – there is no deductible, and if you need surgery, you will be paid up to $ 10,000. But the benefits are universally limited, at just $ 500 per day of hospitalization, although the average cost in 2010 was over $ 1,600 . You get $ 125 for emergency care, but the average cost was $ 969. The company has offered additional coverage for emergency room visits for an additional $ 20 per month if you plan to receive emergency care. Plan well because Value ER only covers two emergencies a year.
Of course, the above plan does not apply to any pre-existing medical conditions, prescription drugs, maternity services, mental health services, or alcohol or drug abuse treatment or screening. Your mammograms, vaccines, or whatever are not really covered. “Don’t assume that expenses not on the list are covered,” they say in small print.
Maybe you want to shop around. Okay, what about the “good” plan from Assurant ? This kind of covers the operation, but it only costs $ 250 a year and only if the operation is performed during a visit to the office. There is zilch for anesthesia, hospitalization, ambulance or emergency travel. Or try the Standard Plan from IHC : They’ll give you $ 150 a year for prevention and $ 100 a day if you’re hospitalized, but little else. Even X-rays or blood sampling are not covered by the plan.
All prices are in 2010 dollars, so $ 100 then equals $ 110 today . Health care costs have been growing faster than inflation , so even if these exact plans come back, they are likely to be much more expensive.
If you bought such a plan in 2010, don’t feel like you would have realized its limitations. Many people have been burned by minimum pay plans, not understanding their limits or not understanding how much hospitals can charge them. Consumer Reports warned of such plans , but acknowledged that many people have little choice in buying better.
Most individual plans in 2010 covered less than 60 percent of your health care — in other words, they are worse than the “bronze” level, which is currently the minimum for sale. Last week, the Congressional Budget Office said that we are unlikely to go back to those days , because the core benefits still exist, so plans should still cover most of the important things. With the new amendment to the bill, this promise is not.
Can states draw up their own lists of key benefits? Of course, some did the same in the days before the ACA. Most states have chosen not to require mental health care, maternity care, or other benefits that are now on the brink of death. And without these mandates, it would be impossible to find a plan that you can afford to cover basic health care. In 2009, the National Women’s Law Center found that only 13 percent of plans available to women in their 30s covered maternity services. Of course, these plans cost extra money and many women simply cannot afford them .
You would be in the same boat if you needed mental health care, drug addiction treatment, or any other expensive condition that insurers would not want to touch upon. If you don’t want to go back to those days, call your representative .