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Return to Article: Consumer-Driven Care

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  I am a civil servant but also a retired Navy dependant and have Tri-Care Prime as my medical plan, however Tri-Care does not authorize things like shoe inserts, chiropractor services, massages, weight loss programs and some procedures such as extracorporeal Shockwave therapy. If the military facilites are not seeing civilians due to cutback of staff, and Tri-care will not cover care needed, I am at a loss of what I could do to receive the care I need without paying 100% of the cost. I do not need a regular health care plan. I was looking for a health plan that would supplement Tri-Care before the open season ended but have been unable to find a supplement plan. What does other people do who have Tri-Care? Is there a supplement plan that I don't know about? Thank you.

  jo ann hart Posted November 30, 2007 2:15 PM
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  The health savings account sounds great when there are no problems, possibly when one is young. Our only major expenses for decades was the birth of our 2 daughters. But, in the last couple of years with a gall bladder operation, 3 cancer surgeries, a pulmonary embolism, and a brain tumor those med savings acct. seems like pocket change! You'd better dump them and get real insurance when you pass 50 or so. Just one of my meds is over $1K per month and I only take it twice per week. There's a reason they're offering these plans...it's in THEIR benefit. The USA has poor medical care when compared to similar countries and we pay twice the cost. The solution is medical care like the French have...check it out, we raised our kids there as civilian employees and we know. Plz comment only if you have over 10 years abroad as a civilian.

  kmp Posted November 22, 2007 11:18 PM
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  I don't think Linda even read the article. In Maryland with Aetna you will pay $67/month for single HDHP insurance. In return Aetna deposits $62.50/ month ($750/year) into a savings account for you. If you spend less than $750/year on drugs, copays etc. then all of your expenses are essentially FREE!(Not counting your premiun payments of course). What you don't spend rolls over to the next year. Plus, you get two FREE dental cleanings and two FREE doctor visits each year. How can you beat that!

  The only reason not to use one of these plans is if you know that you will have over ~$1500 of medical expenses each year. Regular insurance is probably better for you.

  As for Medically destitute, I always get the Aetna rate for my doctors visits. Of course, I choose a doctor that takes Aetna Insurance.

  Happy with HDHP Posted November 9, 2007 8:30 PM
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  There is no way in the world I will do this plan. It is much cheaper for me to have a HMO with no deductible, $15 copays, and $0 for hospital stays at $169 pp. Plus I have a regular flex spending account for $5000 that takes care of the rest. I think it is a ripoff. Oh yeah, I am furious that our health insurance increased over 50% this year come January. Still not high enough to get me to switch though.

  Sabrina Posted November 5, 2007 6:25 AM
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  Linda, I think you mis-read the article. You are exactally the kind of person these health plans are designed around. Why pay for covereage you don't need or use. Most High Deductible or Consumer Driven plans cost $1000's less than standard plans. The $2900 you talk about is not a deductible anyway. It is like the FSA. You decide how much to deduct from your pay check, tax free, to pay for uncovered expenses like band-aids and co-pays. And besides, most plans cover the first $1500 of the usual $3000 deductible (half that for singles). You would probably have zero out of pocket any given year.

  Happy HDHP Consumer Posted October 26, 2007 1:18 PM
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  The biggest challenge to consumer driven heath care is the reality that the price you will pay to a Dr/Dentist/Hospital is higher, often by a factor of 50%, than if you are covered by an insurer.

  I got a primer on this when I added dental coverage this year. Same dentist we'd been using for 20 years - and we picked the only insurance he accepted. Always paid our bills at the conclusion of the visit. Without insurance - $100 for a routine visit. With insurance - $65 for the same services. Only difference - the insurance contract didn't let him charge the additional $35.

  So much for uniform pricing for similar services. Without that, how can the "consumer/patient" ever expect thier health care choices to save money?

  Medically Destitute Posted October 25, 2007 10:23 AM
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  I will definitely drop this plan and look for another or opt to have no insurance at all.

  I am healthy and my visit my doctor's office approximately 5 times out of the entire year which does not total $2,900 co-paymments. I will be paying a higher fees. So I will drop this plan when all areas start with this new plan.

  It is bad business for corporations digging deeper into our pockets. We get a 3% raise and here you come stilling it from us.

  Well I will not play this game anymore. There are other avenues to select from.

  Linda Chamberlain Posted October 25, 2007 8:08 AM