Tuesday, November 26, 2013

How to select the health insurance plan

As I run a lot of errands for my father-in-law while he was in hospital, I got to understand the big differences between insurances.
While he stayed in hospital for a week and we were there 24/7, we just got the chance to talk to the doctors for 2 or 3 times shortly. We didn't see any written diagnosis at all.  The hospital just called us 4 hours ahead to discharge.  The insurance company ordered the hospital to discharged him at midnight and moved him to a rehab center. There were no phone numbers/emails or any form that we can communicate with the doctors at all. For one month now, we still could not get a copy of all CT/Xrays or medical record at all even after we have submitted all the required paperwork.

At the rehab center, the doctor only sees him every other week. Still no phone numbers and emails. We are like walking in the dark and don't know what to expect and what have happened.

Comparing my experiences with my doctors, it is really a nightmare.

I usually can see any doctor on the same day or the other day if my issue is very urgent. If I am travelling, I just email my doctors and get responses right away. They call back immediately and fax/email me all the information I need. I can access all my medical records online since 2006 and compare the difference of the results easily. I am not an expert about how to select health insurance. But I think the following tips are really helpful and important:

1. Never buy the cheapest one or just buy what your friends buy. Do the research and know what you need. See if the doctors you see or like are in the network. The hospitals you use or may use is in the network. Personally I really love Palo Alto medical foundation. It has great doctors, good tools to browse records and communicate with the doctors.

2. Do the simple calculation about how much one pays for the regular checkup, and most importantly the worst case scenario. Don't let the 80% or 90% coverage fool you. The more meaningful part is the out of pocket' maximum, and deductibles.

3. The rule of thump: never use a HMO. It is just evil. For my father-in-law's case, the good doctors we know are all out of his insurance network. We don't mind to pay a visit of a doctor. The insurance would not pay a penny for any drugs/service that is ordered by a out-of-network doctor. It is just so evil.

Remember, networking is very important. If you find a great doctor, you are in his/her doctors' network. My family doctor referred me to a PT. She is great. I have chronicle backpain, stomach pain and have seen different doctors. After the first treatment from Carol from OrthoSport, my pain went away and I had the first sound sleep for years. Bowen's pediatrician was introduced by my OB and she is very detail oriented. For any questions/problems that a new mom has, she will explain or provide a solution. 

3 comments:

  1. Xiaoqin, can you share the name of your OB/Ped? :)

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    Replies
    1. Most of doctors in PAMF are quite competent.

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  2. There is a nicer blog about the scenes behind the windows about hospitals and doctors:
    http://piaw.blogspot.com/2013/12/review-unaccountable.html

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