Is the Health Insurance System Designed to Drive Us Crazy?

Not thinking twice about your health insurance coverage is just fine as long as you don’t experience any major problems that lead to excessive out-of-pocket costs. On the other hand, something like a heart attack or cancer treatment could make it abundantly clear just how convoluted our system is. It can lead one to wonder if health insurance is purposely designed to make us all crazy.

Pull out your health insurance manual and take a look. You will enjoy hours of reading about provider networks, out-of-network costs, annual deductibles, co-pays, and on and on. It is no wonder so many people find picking a health insurance plan extremely hard. They cannot understand the language. They do not understand what plans offer or what they are getting for the money spent.

According to Dallas-based BenefitMall, even insurance brokers don’t always fully understand the policies they sell. That says something about our health insurance system.

Losing Coverage in Colorado

Some residents in the Denver, Colorado area are facing the prospect of either losing their health insurance this year or having to find new doctors. Why? Because the two insurance companies that provide products through the state’s exchange were unable to reach a new agreement with Denver area providers.

A local Denver TV station reports that UCHealth providers are not part of the network for 2021. Subscribers to the Anthem plan will now have to choose new providers within the HCA HealthONE network or get their insurance elsewhere. To say that subscribers are confused is an understatement.

Consumers do not understand why health insurance companies and provider networks fail to reach agreements. They don’t understand why a health insurance carrier even insists on consumers getting services from a specific network. None of it makes sense them. In fact, none of it makes sense to anyone other than insurance carrier executives.

If a storm damages your roof enough to trigger an insurance claim, you have the right to have the repairs done by any contractor you choose. Your insurance company doesn’t get dictate that to you. All they can determine is how much of the damage they will cover. So why doesn’t the same thing exist in health insurance?

Complaints Against Healthcare Ministries

Confusion with healthcare coverage is not exclusive to traditional carriers. High deductible plans engender their share as well. And of course, healthcare ministries offer products that are completely unlike traditional health insurance. They create a lot of confusion among subscribers who do not bother to read the fine print.

In Connecticut, officials are looking into two healthcare ministry companies that have been the subject of an excessive number of complaints in recent years. Most of the complaints allege that consumers did not know they were not purchasing health insurance when they signed up. It was only after their claims were rejected that they figured it out.

As in most other states, healthcare ministries are not insurance companies or insurance providers. They are not subject to state or federal insurance requirements. Nor do they make any guarantees about covering medical claims. Unfortunately, too many subscribers don’t know what they are getting when they sign up with a healthcare ministry.

More Confusing Than It Has To Be

From traditional health insurance to healthcare ministries to Medicare and Medicaid, the way we pay for medical services is more confusing than it has to be. No other industry in the world is as complex. A careful analysis of our system forces anyone with a critical mind to wonder if the system is purposely designed to be confusing. It sure looks that way.

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