We are looking for a plan to use until I hit Medicare age in a few years. Someone suggested Sidecar. It is not really a health insurance company but rather is a fixed indemnity company. We have talked through the theoretical risks—for example, care is more expensive than the amount assigned. Anyone heard about it or better yet tried it? TIA!
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Following! I’m paying $770/month for poor insurance coverage. So ridiculous.
From a specialist office perspective, these plans do not cover much, or at least the ones I have dealt with. For example, you come to our office for allergy testing, or for your asthma, which including breathing test; an indemnity plan will only cover up to a certain amount for the visit, usually $100 or so. Most of our patients at that point will go with self pay as it will be cheaper as the indemnity plans MIGHT pay $100 or so, when the remaining charge can be several hundred dollars more depending on the services received. As we can not split a claim to have the office visit separate from the testing so that the office visit goes to insurance, the patient will just self pay for the entire visit; this actually saves them money for this one visit. Obviously, this isn’t always true and depends on the provider and type of care. If one has the money to pay for the visits (money that was saved by paying a cheaper premium,) maybe it is worth it. I just think that at the age many of us are here, I would worry about additional costs.
Here is are a couple of simple articles that might help you decide:
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It seems to have some examples of what it pays versus what it believes the average provider cost is. Of course, there may be providers that cost substantially more, so the risk of that is on the patient and unlimited. There seem to be some categories where it pays little (try the maternity care examples):
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I’m guessing that anyone who is a couple of years away from Medicare isn’t looking for maternity coverage🙄
I would wonder about things like joint replacements, and general medical care.
My deductible with Anthem is so huge that I pretty much pay for everything, anyway. I am not looking forward to the bills for my broken wrist. Ugh.
But you should get the Anthem negotiated rates instead of full cost for your wrist injury. To me that is the benefit when you have a high deductible plan.
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I hope so. I will report back when o get the bills.
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I have a high deductible plan, and my kidney stone surgery was a heck of a lot less than “MSRP” with the negotiated group rate. I didn’t meet the deductible … without insurance, I would have met the deductible several times over. Yes, I know that people without insurance can try to negotiate a cash rate, but I’ll take my high deductible insurance over none any day.
We have a high deductible Blue Cross/Blue Shield plan. We’ve had it through DH’s employer for many years. Each year the deductible creeps up. It’s currently $5K per person. We don’t have any co-pays for prescriptions so we just have to pay for them unless or until we hit the deductible. Supposedly we get the benefit of the BC/BS “negotiated rates.” But I’ve noticed that in the last year, those BC/BS negotiated rates are terrible. I am far better off using GoodRx. I just picked up a bunch of prescriptions that would collectively cost me $230 using the Blue Cross rates and $41 if using GoodRx. That’s just one example but it’s a consistent pattern.
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Our deductible has gone from $3500 to $7000 over the past couple years, but our negotiated rates are still pretty good. Prescriptions, though … yikes. Since we are unlikely to meet the deductible now, I also use GoodRx for non maintenance drugs. Thank goodness insurance plans are no longer allowed to block pharmacies from allowing people with insurance from using discounts.
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I get my one prescription through Costco Pharmacy online. It’s a third of the cost through Anthem. No membership cost, either.
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