Thursday, June 23, 2011

Insurance Deductible

I am sure that with the dawn of "Obamacare" this will all become pointless, and we have not long to wait to be held in the warm embrace of a federal single payer medical system, but if not I have a couple of thoughts about deductibles.

It occurred to me because I usually have a slate of doctor appointments this time of year. I let things go until after school ends and then I do a physical and there are sometimes other tests and follow ups and the like. I've been distracted lately so this hasn't happened this year and while I was considering that I had the vaguest thought about how I hadn't used any medical services this year to date and so if I went in I would have to pay.

As a side note, I am fairly sure this is why we have deductibles. It isn't anything to do with money management or billing. They are there to keep us from consuming services such that we get to the point where the insurer has to pay.

But that's another post.

After considering that bit I had two thoughts. Number One: I would like to prepay 100% of my deductible at the top of the cycle. I would then like to never see a bill or an EOB ever. This would simplify my life as I wouldn't have to keep track of where I was in the amount, I wouldn't get bills from my provider, and I wouldn't get thousands of paper mailings from my insurer that say "THIS IS NOT A BILL." I think the insurer would like it too as they wouldn't have to send me thousands of pieces of paper that say "THIS IS NOT A BILL" and they'd get to hold my money. Win-win I think.

If I don't spend my entire deductible in a given cycle they just apply it to the prepayment for the next cycle. If they want to charge me a fee for this accounting I would prefer they didn't, but probably could stomach 10-20 dollars (one would hope getting to hold the entire amount for a year might offset the need for a fee).

Number Two: I would like to set the rollover date for my cycle. As it stands now the reset of my deductible is tied to the annual calendar, resetting in January. This means the time it is most in my interest to use medical services is in December as I am most likely to have paid off my deductible and be into house money. As is the case for what I assume would be a lot of people I am very busy in December. It's the last week of class, and then I have finals and semester reviews and then there's all these holidays and family and travel. I'm busy. Like I started saying, I use the most of my services in June and July. Based on that I would like my deductible cycle to reset in September.

Truth be told I think if they do the actuarials on this they'll find it doesn't cost anything. All things being equal I don't believe I would consume makedly more services in this scenario. Mostly I think it would just make me feel better about the whole thing. But for the sake of argument lets say there are people that watch where they are in the cycle and in the deductible and do cram in visits prior to the annual reset. If everyone resets in January then this must mean that there is a surge in service in December. This would have to put an unnecessary strain on health providers and on insurance companies. Spreading the cycle reset around the calendar would even out this demand. Again, win-win.

Being that I don't run an insurance company I am sure I probably miss a critical feature of this discussion. But it'd be nice to think they could make this benign change just because it would make my life more pleasant.

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