Obamacare is making everyone more savvy about health insurance terms, but we’re still stuck because we don’t have real numbers for what a particular medical service, product or procedure will cost us in those instances when we actually need health care (as opposed to checkups).
Today as consumers, we should have this information in order to make informed choices because the complexity of health plans and the numbers of different medical codes used are all utilized to determine what providers can get for providing specific services, what insurance companies will pay for specific services and we’re being expected to pay for more and more.
The best information we could have is the same list of codes, or if codes are not standardized, a handbook of procedures provided by our health insurance companies where we could look up and tally the costs of such individual treatments by our zip codes for an average price it will cost us under our plan.
This information is available to insurance companies, they use coding, allowed charges, reasonable and customary charges in a specific geographic area all the time, they simply do not provide that information to patient consumers until after-the-fact or in a piecemeal fashion.
These handbooks should be required from all insurance companies so that patients can use them and look up what service, product or medication they’re using and calculate their average costs based on zip code as provided by the health insurance plan and then plug those costs into the specific variables of their plan depending on whether they choose a bronze, silver, gold or platinum plan.
Knowing what it costs and what is covered is the ONLY protection consumers have against an industry that has an adversarial position to the very people who pay for the product…We want and pay for health insurance for coverage in the event of a medical need and insurers want to prevent paying for as much as they can.
Tally manuals provided to consumers based on metrics already collected, calculated and used by insurance companies is the only way we can make progress in determining our costs and should be part of any plan to better equip consumers to manage uncontrolled medical costs and ever-shrinking health insurance coverage.
