Health Insurance Hell

The irony is that if things go just right, you'll have wasted your money

My business, which a couple of friends and I started in 1976, and I have owned outright since 1980, is now down to just one employee. Me.

Independence Blue Cross, who has had the honor and privilege of insuring my health — and my business — for around 30 years, has just alerted me, through their management-cum-billing vendor CBDI Inc., that in a few days it will be the annual “Open Enrollment” period. That’s when I get to choose — lucky me — whether to continue with my existing plan, or whether or not to choose another, less expensive version.

I say less expensive, because I can’t imagine paying more than I’m paying now. [SIGNUP]

I am 62 years old. I’m in reasonably good health, although God knows I’m certainly far, far less than a perfect physical specimen. In 2010, I had two regular visits with my physician, some lab work here and there, no trips to the ER or stays in a hospital. I have prescriptions for three drugs: Nexium every day for maybe-I-shouldn’t-have-eaten-that heartburn, a statin every day for a pesky-but-borderline cholesterol level, and a medicated shampoo for the heartbreak of dandruff. My current health plan with Indy Blue is good; I don’t deny it. I have small co-pays for visits to the doctor, my pharmacist, and complete hospitalization. My out-of-pocket medical costs this year will equal less than $500, knock on wood.

And, if I had no insurance, and had paid retail for everything, this being one of the years I didn’t need a colonoscopy, the doctors, the labs, the drugs, still, I would have spent less than $4,000 for all medical costs.

But … by the time I make my last 2010 payment, on or before December 15th, I will have paid more than $1,300 a month, or $15,926.04 to cover my reasonably healthy ass for just this year. In other words, I spent four times as much in premiums than I received in benefits. I spent four times as much in premiums than I would have paid without any health insurance at all. And that does not include the almost $1,000 in dues to the Greater Philadelphia Chamber of Commerce, an organization in which I not only don’t participate, or take advantage of their various programs (“Join us for Chilean Wine Night at the Union League”) but in fact, I don’t even like, as they seem to be the business arm of the Tea Party. But centuries ago I had my little company join the Chamber to get the group rate at Indy Blue. Yes, I went looking for a bargain and met the Devil. And now I’m tap-dancing on the way to Group Health Benefits Program Hell.

I understand the concept of insurance. It’s a risk. You pay your premium to cover your car, your kids, your house, your jewelry, your business, your life and your health and you pray that it’s cash lost, that you’ll never need to call your agent. Yes, the irony of insurance is that if things go just right, you will have wasted your money.

So here’s my conundrum: I’m in this holding area, the hallway between being over 60 and not yet 65, thus not eligible for Medicare. This is the age where I should be concerned about having more, not less, coverage, but I’m also at an age where I have lessened my work load, creating less income and more time to hurt myself while strolling in the park or looking for a lost golf ball. Do I continue to spend more to hopefully need it less? Or do I cut down on my premium costs — say by 50% — and hold on until I’m 65?

Yes, it may be “Open Enrollment” for me now until December 3rd, but it sure feels like it’s Open Season on me all year ’round.