When I have found several limited benefit plans that cost less and appear to have no deductibles?

Limited benefit plans have become increasingly common on the individual market and may seem appealing to those who feel that a high deductible is cost-prohibitive.  Before turning to such a plan, however, there are some very important factors to consider.
First of all, most limited benefit plans only pay a flat amount for covered surgeries, often based on the schedule for Medicare Allowance.  The trouble is, the actual surgery is just a small part of the cost of a medical stay.

For example, appendectomy surgery typically costs about $2,500 for the actual surgery; however, the hospital bill can range from $25,000 to $40,000, because of all the auxiliary costs involved (overnight stay, anesthesia, surgical equipment, assistant surgeon, services of support staff, etc.)  This means that, at best, the limited benefit plan will pay a few thousand dollars towards the surgery, hospital stay, and anesthesia, leaving the patient with potentially tens of thousands of dollars in unpaid medical bills.
While you may be able to negotiate the bill down somewhat, the fact is that even relatively minor surgeries and conditions will prove to be a considerable financial burden.  The rhetorical question thus becomes: would you rather have to pay a deductible up front and be liable for a few thousand of the initial costs?  Or have first dollar coverage with no deductible, but risk severe financial hardship once you receive bills for all of the items you didn’t consider in the first place?

If your main concern is a severe illness such as cancer, heart attack or a serious accident, the answer is obvious.  Limited benefit plans are not insurance, nor do they purport to be acceptable substitutes.  They give the illusion of coverage, but that mirage will quickly disappear in the hour of need.

If you have unknowingly purchased one of these plans and want actual major medical coverage instead, please visit our website at  HYPERLINK “http://www.selectedbenefits.com/” Selected Benefits or call us Toll Free at 866.270.6209. We’ll be happy to review your current plan and point out the pitfalls so you know exactly what you have at all times.