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      Tuesday, June 09, 2009


otherstuff
09:54 AM - 06/09/2009

The topic: Insurance.  Blech.

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I got a notice from our health insurance provider that our rate is going up to $404 in July. 

Brian starts checking other places online.  I like our provider, it’s Aetna.  We have a PPO.  We don’t go to doctors often, we don’t hit ER for sniffles and sneezes.  We weren’t raised that way.  The last time Brian went was when he had chicken pox.  The last time I went was when Charlie bit me and I went to Urgent Care, not ER.

Aetna covers yearly physicals for both of us (which we’ve not taken advantage of) and covers my yearly gyno exam 100%.  And I mean 100%.  I don’t pay anything for the mammogram, the lab tests or the doctor’s visit.  That visit I had last month cost close to $800.00 when everything is added up and I don’t pay anything, no co-pay at all.  Nice.

So, we get rates for Anthem and BC and BS and this place and that.  The agents send these rates to Brian’s email.  Only one doesn’t send the rate.  He wants a face to face meet.  Red flag.  I told Brian “he’s a salesman and that’s why he wants to meet, to high pressure you”.  He ended up coming to the house on a Saturday.  He talked a good story and he left with checks, totaling over $500.00.  A membership in the NASE.  And first payment for the health care. 

After he left, I started comparing policies.  Crap.

I tell Brian “for less money with Aetna, we have a $5,000,000.00 lifetime cap.  This other company, $1,000,000.00 for less coverage.  With Aetna, we have a $5,000.00 cap on prescriptions.  With the other company, it’s $1,000.00.”  We get a lot less coverage for a fair amount more money.  And I told Brian I didn’t care for the hoops we’d have to jump through to get things paid.  I was liking this company less and less each website I checked out. 

The next day (Sunday), I emailed the agent via Brian’s email and posing as Brian, requested the checks back. I said “please mail them back and if you can’t, I’ll pick them up Tuesday.”  We didn’t hear from the agent.  Brian called him Monday and left a message.  “I’m picking up material in the Los Angeles area tomorrow and will stop by your office to pick up the checks since it’s on the way”. 

He calls Brian back “sorry, already sent the checks in, let me see what I can do with the rate”.  Okay, this guy is going to lower the rate to match what we’d pay Aetna. What else could he possibly take out of what little was covered?   Because everything was done with riders.  You want cancer coverage? That will be an extra $$ per month.  You want urgent care coverage? That will be an additional $$ per month. It was like buying a car, but having to pay extra to get an engine and tires and seats and a steering wheel.  All things that should be included in basic coverage, were not.

We already knew we weren’t going to deal with him.  He called while we were on our way up to Disneyland and Brian listened, said “let me think about it”.  There was no thinking needed.  The answer was no.

A couple of nights later, Brian said “put stop payments on those checks; I don’t want to have to fight to get the money back once they’ve got it”.  I did.  At a cost of $30.00 each.  Good for six months.

This morning, the phone rings.  It’s from the NASE.  They want to speak to Brian.  He’s not home. Are you his wife?  Yes.  She tells me who she is.  I told her we didn’t want their service, that I’d sent a message to the agent the next day asking for our checks back. She said “oh, I’m sorry, that hasn’t come through yet, I’ll take care of this”. 

Guess who is very, very glad they spent $60.00 to save months of hassle?

I called our old agent this morning and told him what had happened.  He told me that years ago, the guy who ran that company had called him, asking him if he wanted to be the top agent, overseeing all other agents, in California. Before he accepted, he told the owner “send me a copy of your policy”. The insurance company owner hemmed and hawed, but finally sent one.  Our agent read it over, called the owner back and said “I can’t in good conscience sell this.”  The agent compared HealthMarkets to Shaklee or Amway.  A pyramid company. 

I’m really, really glad we decided not to go with them.  Because you just know something bad might have happened.  And their deductible isn’t on a yearly basis, but a per incident basis.  What you’ve paid out of pocket to reach your deductible doesn’t build up with HealthMarkets.  So, if you have a gallbladder operation and it costs $20,000.00 (I have no idea what it costs, I’m just hypotheticalling number and surgeries here) and you reach your yearly $8,000.00 for the year, the heart attack you have six months later, well, you’ve already paid your total out of pocket deductable. But not so with HealthMarkets. Since it’s per incident, you still have to come up with another $8,000.00.  Of course, I’ve way oversimplified it here, there’s the co-pays, the percentages of coverage and other things to be considered, but there’s that “per incident” vs “per year” basis. 

What a PITA.  You know? Makes my head spin.


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07:26 AM - 06/09/2009

The topic: It’s TUMMY TUESDAY #139!

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click for a larger pic

And here’s Opie, caught on camera during a cat bath. In the back, is his sister, Daniece.  I have no idea what caught their attention, but I’m glad it did. 

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If you’ve got a Tummy Tuesday blog entry, feel free to post the link in the comment section or trackback to this entry. And if you put a link back to this page, then more kitties will get to show off their tummies!


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lisaviolet is seventy something, married with no kids, takes care of lots of cats, likes taking photographs, loves Southern California weather and spends altogether too much time avoiding her responsibilities.

In her spare time, she makes pretty things to sell in her store.

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