Despite the cheery marketing, the health insurance industry is full of exploitation and abuse, as companies look out for their shareholders while screwing over patients and providers. But we wanted to know: Is there anything folks can do to protect themselves from corporate insurers’ worst practices?
David Lipschutz, the Associate Director of the Center for Medicare Advocacy, told The Lever that it’s difficult to offer blanket advice. “The system is so patchwork and convoluted that there are so many caveats depending upon what coverage you have and where you get it,” he said.
Tim Faust, author of the book, Health Justice Now: Single Payer And What Comes Next, agreed, noting that the United States has offloaded responsibility for maintaining health coverage onto individuals. “You must be the captain of your own paperwork and cross all the t's and dot all the i's,” he said, noting that this becomes “really hard to do if you're sick or working two jobs.”
The health insurance industry relies on obfuscation and inaccessibility to hoard profits, while spending huge sums lobbying against meaningful reform. Insurance executives make fortunes by denying care and passing on major costs to patients, making sick people fight to survive.
A 2022 survey found that 41 percent of adults have medical or dental debt. Some experts predict that health care affordability is about to get even worse, as labor and supply chain issues stress an already tense system. Insurance premiums keep going up.
Everyone knows someone who’s struggled with a claim denial, difficulty finding a provider, or encountered a surprise bill — it’s the norm, not the exception.
While the odds appear stacked against you, there are things you can do to lessen your chances of a health insurance nightmare. The difference between a bad plan and a good plan, after all, could save you thousands of dollars — and potentially your life. Here’s what we found:
I've noticed the negative commentary about Medicare Advantage in the past here but never read any of the articles. I started but didn't finish this one. I wonder how many of the critics of it writing these articles are actually seniors and using or have used Medicare Advantage? I have and do. If a person is in good health, like myself, and not in need of expensive care, they offer a lot of "advantages." But these writers never point out any of them and just discuss issues that don't concern themselves with people who have the choice to make and who would not receive these advantages like free gym memberships, free over-the-counter meds and health products, home health visits, and other health benefits they would not otherwise receive. The Lever is starting to piss me off with some of its one-sided and arrogant positions, and I'm starting to wonder if I want to resubscribe when my subscription ends.
I am just now going on Medicare December 1, 2023. I don’t want an Advantage plan but can see the benefit for a healthy person. The one shown to me is $0/month and limited to $5K out of pocket per year so if for some reason we need it that means we will pay 10K in a year’s time. While using it a MRI costs $250, an ambulance ride for an emergency costs $275 and a 3 day hospital stay costs just around $1000 and a surgery cost $300 out of pocket. Drugs are covered but we still pay a lot out of pocket for those as well and they don’t count towards the 5K. cap. That is a lot of money for a retiree. With regular Medicare and a supplement the cost is the same price you now pay for Medicare plus another $140-$160 out of pocket per month. We may need a drug plan at $50/month. That will still save a person who uses healthcare quite a few thousand dollars a year. The problem is these insurance brokers get paid to steer us towards these advantage plans. So they do.