We have Kaiser HMO, and it is very nice to not have to pay anything but a co-pay. It's certainly no frills, though.
I think HMOs are the most cost-effective private insurance, so much so that I turned down conventional 80-20 insurance at work and they pay me directly what they would have paid for me.
Also solves the "which provider pays?" paperwork hassle.
Nightmare scenario, yesterday client with Kaiser AND 80-20 coverage racked up thousands in hospital bills, Kaiser paid, then rescinded payment because there was another insurer, and the other insurer refused coverage because the claim was not made w/in 180 days. Now the hospital is suing.
No problem, we'll just include it in the bankruptcy and let the insurers and the hospital figure it out without the client as the fall guy.
Not saying that insurance claims easy to deal with, far from it, not for anybody, patients, providers, insurers.
But convenience is not the issue here, communication is a problem that can be solved with technology, not trashing the system. |
