No one likes deductibles and premiums going up, but the Blue Cross Blue Shield model is flat out wrong.
Before I get to the stunt BCBS is pulling, let me say that I have defended insurance companies in the past just to be fair; therefore, check out “Why This Health Care Video Is Wrong“- as much of the hype presented in the video debate is doesn’t hold water.
Now, back to BCBS. We (policyholders at work) new changes would be coming September 1, so no big deal. We make adjustments to what we want to include, discontinue or change in our plan once per year and then the changes a happen later.
What happens is the plan will change, but benefits are on a calendar year – January 1 through December 31 – as stated by the specialist for our company’s policy. BTW, the company is a huge customer of BCBS, so many people are affected. The difference this time in deductibles is that BDBC is only honoring the deductibles for nine months – not the whole year.
Here’s how the deductible works for 2010 and 2011, and their practice is outrageous.
The deductible for 2010 for me is $1,000 per person in my plan and will change to $2,000 for the next year. However, I was told by the Blue Cross Blue Shield specialist that BCBS is no longer using the $1,000 deductible and an extra $1,000 is required for the remainder of the year. Okay, I’m not real happy with this, so I asked if the extra $1,000 goes towards the 2011 policy and now we are on a fiscal year. Here’s the kicker…
Effective January 1, all new deductibles go into effect; therefore, a new $2,000 deductible starts again.
Having described the events, here’s what can happen to me.
In August, I had knee surgery which cost me an out of pocket amount of $1,000 cumulative. However, I may still need a follow up surgery that could happen by the end of the year, costing me another $1,000 when it shouldn’t. As a result my, $1,000 surgery would be $2,000 and if I wait until January, then the surgery would cost $3,000. In addition, right now my therapy is no longer under the fully paid deductible and I am out money for the rehab as well, when I shouldn’t be. Worst case, I could be out as much as $4,000 in just a few months depending on what transpires this fall and early next year.
Even if you do not have BCBS, check your company. If so, check it out. They will be hearing more from me and the State may too.
