The No. 1 Mistake People Make When Shopping for Health Insurance

Frank Lalli has chronicled his experience with the health care system in the New York Times op-ed piece “A Health Insurance Detective Story.” He has since become The Health Care Detective™ in a variety of publications and media outlets, including regular commentary on news and health for National Public Radio’s Robin Hood Radio. Throughout his thirty-plus years of experience in editorial and journalism, he has worked as an investigative reporter for Forbes, served as editor of Money and George magazines, appeared as a specialist on Today, Good Morning America, and Nightline, and is currently the special health correspondent for Parade. Lalli was named one of the top 100 business journalists of the twentieth century by TJFR, and has won the three most prestigious prizes for excellence in financial journalism: The John Hancock, the University of Missouri, and the Gerald Loeb awards.

MedicalConcept_400Choosing a health plan from the myriad of providers out there is a difficult task. The sea of deductibles, premiums, and co-payments is overwhelming for even the most detail-oriented among us. So where should you focus your attention? Find out how to pinpoint the true cost, and value, of any plan in my book Your Best Health Care Now: Get Doctor Discounts, Save With Better Health Insurance, Find Affordable Prescriptions.

A couple I know, who don’t want to be identified, claimed for years that they had great health insurance. They loved the fact that the plan had no premium charges and therefore didn’t cost them a dime upfront. “That works for us,” the wife said happily and often.

And the health plan did work for them, until the husband came down with a mysterious illness that baffled the doctors in his plan’s limited network. One physician whom the couple was counting on for a diagnosis spent months ordering costly tests and then said, “I’m sorry, there is nothing I can do for you.”

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by Frank Lalli

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Without a referral to the right specialist, the husband ended up spending more than a year and a lot of money bouncing from one ineffective provider to another: from doctors, to chiropractors, to acupuncturists. He didn’t get diagnosed until he signed up for a better plan, with premium costs and a skilled physician who steered him to the right specialist at a major teaching hospital. The specialist knew immediately that he was suffering from inclusion body myositis (IBM), a rare autoimmune disease that leads to severe weakness of the arm and leg muscles.

“We wasted two years when I could have been getting treated,” the husband told me.

As that story illustrates, the most common mistake people make shopping for health insurance is focusing on the plans’ premiums rather than on the overall cost and quality of the insurance. It’s only logical that when insurers collect little or no money from customers up front through premiums, they look to control costs by reducing benefits and their provider networks. In the end, the plan’s limitations can cost you no limit of headaches and expenses.

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