Healthy Story: Even those with group coverage have a coverage story

People without health insurance, or with individual (and usually expensive) coverage they pay for themselves think that getting coverage through you employer is the holy grail. But even having coverage through your employer is not without its frustrations.

Take FellowAllergySufferer (I'll call him FAS.)

He's insured at a small company here in the valley. But like every other small company, this one is always looking for ways to save money on the health benefit expenditures. And for this company that has meant changing carriers twice in the last three years. Blue Cross to Blue Shield, and then back again...each time because the carrier threw in incentives to win their business.

Well, FAS has just a teeny problem with all this changing around. Can you guess...?

See, when you change carriers, you change formularies. And, just like me, certain allergy medications work a lot better for him than others.

Sounds like his symptoms are more severe than mine, hampering his ability to even be at work sometimes, and certainly his productivity at other times. (Although I sit here sneezing as I write this, so it's definitely slowing down my typing!)

So, boom! They switch carriers, and suddenly the one medication that really helps him isn't on the list. He's not going to switch medications, and it's $80 out-of-pocket per month.

Do the math.

That is like a nearly $1000 pay cut. You know for most working people that would definitely be seeing their income head in the wrong direction.

Bummer.

Comments

[Stephanie]

Health Insurers have very skillfully convinced all of us that if you have health insurance, your health is ENSURED! Why else would they erect those billboards picturing a smiling lady on a bicycle at a fruit stand (or a smiling retired couple strolling hand-in-hand, or a smiling young mother gazing at her newborn...)

Your $7K/year in family premiums is buying a fantasy lifestyle--"if you carry OUR policy, this wonderful life can be yours!" No fine print, no referrals, no third-tier drug lists to clutter up the vision. Yeah, right....