Tuesday, May 31, 2011

The Wild Wacky World of Insurance: Part One

Why should I have insurance?

a means of guaranteeing protection or safety

The economy has stretched everyone these days.  Gas prices are a record high, food prices continue to increase and insurance premiums have done nothing but go up as well.  It can be tempting to just not get insurance at all, or to cancel.  However, all it takes is one illness that goes from bad to worse, and you’ll wish you had insurance.  We have an example for you.  But first, ever wonder, where did insurance come from?

 How does insurance work and what do all those terms mean?

When you join an insurance plan, you essentially enter into a contract with the plan.  Your physician also separately enters into a contract with your insurance plan.  That relationship between you, your insurance plan and your physician is what determines how much you pay for office visits, tests, and more. 

There are a lot of terms to know when dealing with insurance.  For some of the common terms, visit our blog on EOBs here http://blogs.eastsidefamilyhealth.com/2011/05/understanding-insurance.html

What’s the big deal about not having insurance?  I rarely get sick!

We all live in a world where accidents happen.  Germs are everywhere and we have no ultimate  control over how our body responds to everything it’s exposed to.  Sometimes we do silly things, like miss the potato and cut our finger instead.  Life is unpredictable.  Health insurance provides reassurance that when Murphy does come to visit, you have a way to get the care you need, and to be able to afford it much better than if you don’t have insurance.

Insurance premiums do continue to rise and it can sometimes be a strain on the wallet, but let me present it to you this way – I will let the numbers do the talking.

Say you wake up one morning, with right sided abdominal pain and you have no insurance.  Your doctor is great about giving a discounted rate for your office visits, but that does cost $75.00 when you arrive to the office (you have also called in sick to work, since the pain is so bad you are doubled over).

While there, the doctor tells you that you may have appendicitis.  The only way to know for sure is an ultrasound or CT scan.  Those tests range from $150-$1500.  If your physician checks your blood, so you’ll get a bill from the lab.  Tests there also have a range from $10 to $300, depending on how many and which tests.  Oh, and the CT / ultrasound confirms it – you have appendicitis!  You’re sent to the ER for hospital admission and surgery, lest you risk your life by not going.  The cost of the ER visit, the labs, the surgeon, assistant surgeon, anesthesiologist (assuming you don’t want to be awake during surgery), the medication you’re given, the anesthesia you’re given…. I think you get the idea. It sure does add up!

A case of appendicitis may run you at a minimum of $2-3,000 and depending on the severity, etc. could go all the way up to $20,000.  Now compare that to the cost of insurance….  Remember the opening definition for insurance?  “A means of guaranteeing protection or safety.”   While you cannot guarantee a life free of mishaps, at least with health insurance, you will can rest easy knowing you are protected financially.

Now, there are so many options for insurance plans.  Do not let the search for the perfect one be so daunting for you!  There are resources available and questions to help you in your search.  Look out for our next blog addressing what some of those are.


Dr. Frank Marinkovich owns and operates Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Visit them online at Eastside Family Health Center or call them at (425) 899-2525.
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