By George Smith
If you feel the need, skip this column today because it’s about a really boring subject: Insurance.
Many people – virtually everyone who is not associated with the industry in some way – think they understand insurance. They are wrong – double-dog dead wrong.
Take life insurance for example. You buy insurance in order to give someone (or some entity) money if you die. Did you get that? It’s just like you’re in Las Vegas and you are gambling: You are betting the insurance company that you are going to die and they are betting you are not going to go toe’s up … at least not soon.
It’s death’s version of the dollar slots.
And like all legal gambling edifices, the odds are in the house’s favor.
Insurance companies have truckloads of information that you, the insured, do not have. Actuary tables going back to the days of Moses tell agents when the average person – based on an incredible array of data – is going to go bucket-kicking. While they do not become giddified if a customer lives to be 112 (with coverage more than likely dropping the older you get and premiums more than covering the cost of the policy over time), they do get a twinge of sadness for anyone dying young with a $500,000 policy after making two payments.
It’s just human nature.
Of course, like any professions from physicians to news employees, there are good and bad insurance agents. There are no bad doctors, newsies or insurance agents or companies in the Marshall area and that comes from personal experience. Other towns are not so fortunate.
At this particular moment in my life, I have insurance: Car (three), an ATV, homeowners, personal property, life insurance (2), travel insurance for an upcoming trip and health insurance (Medicare and a supplemental policy).
Realizing this is a Yikes! moment.
We pay out X-dollars a month in various forms of insurance and, get this, hope we don’t need any of it. On one hand, you have to have it in case you need it; so, in effect, most people are betting there will be no wrecks, that vandals don’t attack the insured property with Magic Markers, that no one dies, that burglars hit somebody else’s house, that an upcoming trip goes off smoothly, that any health issues are minor ones.
Checking on one insurance policy recently – medical – the total amount billed for a relatively minor operation (one night stay) was $82,000-plus. The primary and secondary insurance companies paid $29,800; I paid $350, leaving a balance of about $53,000. I did not pay that nor was I ever billed.
That amount was written off after negotiations between the two insurance entities and some medical company and hospital minions. So, either the hospital and staff and the doctor and helpers decided to be generous to a senior citizen or they were satisfied with what they were paid.
So, then, why is the cost so high in the first place?
Many people have become exponentially smarter since access to Google entered our lives. The Billing Advocates of America website (BAA) has tons of information for the uninformed, confused or for folks simply looking for facts rather than conjecture.
Many doctors, according to the site, do not know how much they will get paid when they see a patient, because 1) They don’t process their own billing and 2) insurance companies pay based on internal algorithms.
When doctors, or their agent, send a bill, they will typically add to the actual cost to ensure they get adequate payout. Of course, the insurance companies know this but it makes no matter since they are using their internal figures based on their calculations on what a procedure is worth.
Here’s the rub. A cash customer normally gets billed at the same high rate that is send to the insurance company. Say wha…..?
(Here’s where this column becomes worth the time it takes to read it.)
Cash patients, armed with this information, can attempt to negotiate the bill with the doctor or staff in an attempt to lower the cost to what the insurance company pays. The same goes for hospital and other medical service agencies.
If you have insurance, an annual talk with your agent will keep you apprised of industry changes that could prove beneficial. As insurance and medical costs increase, it is imperative that consumers get as familiar with the rules of the game as possible.
Check out billadvocates.com and similar sites for the best information.
Now that we’ve covered that topic, let’s turn to another riveting subject in which we all have a vested interest: Solid waste disposal ….
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