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Old Dec 19, 2011, 05:45 AM
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Perna Perna is offline
Pandita-in-training
 
Member Since: Sep 2006
Location: Maryland
Posts: 27,289
Insurance is for in case one gets ill (or has a car accident, or a tree falls on your house in a storm, etc.). They are able to charge you a reasonable amount each month because you usually do not need it. You get 10 people in a work group, say, and year-to-year the plan changes, depending on how much it is used. If the group is relatively healthy, the plan costs less but if there happened to be lots of claims last year, this year the price will go up.

So, you can see why dental and mental health insurance can't work very well; it costs X amount to go to the dentist and therapist/psychiatrist but all the people who want that particular insurance, need it; if you don't go to the dentist, don't have a mental health problem you aren't going to want to spend money on that; for example, I don't have vision insurance, another elected insurance that only those who want to use it elect it. So, there is no way the "extra" amount needed to pay the office people for managing the insurance can be there, the insurance company can't make any money to run the business and pay its workers, even if you had to pay premiums exactly as much as necessary to pay the doctor or provider.

It's the same problem if you have a wholly medical illness when you apply for insurance, a pre-existing condition; how can an insurance business take you on if you are a known cost? With you working for a company; you would make the company's insurance go up for everyone, in order to cover you.

But that is why company insurance is having to get out of the mental health coverage area because the new laws are making it not possible for them to carry that kind of insurance because there is no profit in it and a business has to have profit, if only to pay its workers and its rent, etc. The Obama care ideas sound good but you can't legislate the statistics of who gets ill and how much it will cost. It is like a few years ago when the idiot California legislators tried to regulate the power companies; you end up with the rolling blackouts they had. Politicians trying to tell a business how to run, how to do its business, you can't get there from here.

My state has rules and a state insurance I'm on that has to take people with pre-existing conditions or who otherwise can't get insured elsewhere (I'm obese and retired but not yet 65 so can't buy Medicare yet) but it is very expensive and that's with a $1,500 deductible. In a sense they have to charge me what statistics says it will cost if I get sick, even though I am relatively healthy. I have to have the insurance though in case I have a major illness; like my husband points out, we can pay for a broken arm but not a heart transplant :-) But that's why one buys "insurance", in case. I am able to pay so I have to pay more for only slightly better insurance (more choices of doctors, etc.) so that some of my premium can pay for those who are not as able to pay in my state. The "group" I am in is the already ill or in-betweens, like me, who aren't working or who are self-employed, etc.

I would talk to your company's insurance person and see if they have suggestions of what you can do; they know the business and what's out there and regulations and what your choices might be or who to ask to find out.
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Last edited by Perna; Dec 19, 2011 at 05:57 AM.
Thanks for this!
dillpickle1983