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Insurance

HOW TO FIND OUT IF YOUR PLAN IS ANY GOOD

When Superman wrote his resume, he highlighted the fact that he was able to leap tall buildings in a single bound. On my resume, I boast that I have leapt FROM a tall building in a single bound. Perhaps leapt is too strong a term. It might leave the impression I leapt on purpose. Technically, I fell. Some would say two stories does not constitute a tall building. They might change their minds if they were led to the edge of a roof and asked to leap from that height. I never said that I made the leap without injury, and I never-EVER said that I proposed doing it again.

Although I cannot live up to Superman's other qualifications, in the privacy of my home, I still profess to my wife that I am the "Man of Steel". She allows me to delude myself. That's how she gets me to take out the trash and rotate the tires on her car. She insists that a "man of steel" should be capable of such marvelous feats - and I am.

You might think a man who professes the abilities of a comic-book super-hero would not be concerned with health insurance. In truth, he has every reason to seriously consider his health coverage. Everyone knows Batman can get hurt, and what happens to Plastic man when he gets tied into a knot? These guys need GOOD insurance, and their policies get tested every day.

Some experts, most notably insurance agents, advocate merely reading a policy to ascertain its quality. You do not buy a car that way. Why not take your insurance for a test drive? Unfortunately, this means that you, as the policy holder, must get hurt while under coverage. I do not recommend leaping from a tall building. An injury of lesser magnitude will prove just as instructive. What the policy does and does not reimburse will soon become apparent.

I learned some interesting things about my policy after breaking my heels. First, I needed prior approval to get into a hospital that was not within my insurance company's calling circle. This seemed a minor detail until I had to plead with my caseworker to get prior approval retroactively. Another problem: I not only had a deductible, I had to pay 20 percent of the hospital bill. This turned out to be a sizable pile of cash. (It would not be easy to fit all the one dollar bills into a wheel barrow.)

I am not complaining. The insurance company had "disclosed" to me the terms of the policy at signing. Like many contracts, the terms did not sink in until I was confronted with meeting my end of the agreement.

My reason for getting a policy with a co-pay provision was, of course, economic. I figured on saving some money. I had not counted on the fact that I might seriously hurt myself. A young man who has not seen much of death has a belief in his own immortality. I always believed that I was agile and perceptive enough to avoid an injury. I was mistaken. There is not much a man can do to save himself when he is accelerating at a rate of 32 feet per second and the earth is rapidly obscuring his vision.

I cannot fault the insurance company. It lived up to the terms of the agreement. There were only two times I questioned their willingness to do justice: they refused to pay for physical therapy bills sent to them from "Inga's House of Swedish Massage", and they should have picked up my cable bill for the few months I was unable to work. ESPN is an essential ingredient in a man's recovery from catastrophic injury.

As it was, the total hospital bill was twice as much as the cost of the addition. Six days of constant surveillance, terrible food and painful procedures hardly seemed worth the expense. I was so drugged that afterward I could only recall half the ordeal. There was a compensating factor to my stay at the hospital: they were adding a new wing during my internment. I got to yell out the window at the construction workers. The crane operator even thanked me for my advice on the placement of a few I-beams. If you ever go to Harborview in Seattle, you can take a look at some of my handiwork.

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Insurance:
Evaluating Plan
Coverage
Wheelchairs
Disability
Lawsuits

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About the Author:
W.J. Rayment built an addition on his house, and in the course of the project learned from his many mistakes. This on-line compendium is his effort to help you learn from his experience. The advice and stories are often humorous, sometimes silly, but always informative. for yourself or as a gift for family or friends.

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