Saturday, August 08, 2009

Health Insurance Redux

The other day I chided Rep. Condotta for his attack on insurance benefits for public employees; today's mail brought more ammunition.

My district offers 12 different insurance plans, which in and of itself might be a problem. Today I got a packet about our upcoming benefits fair that contained a spreadsheet comparing all of the plans that we offer, showing what the co-pays are, deductibles, benefits, etc.

I'm on the Group Health $15 Copay Plan, which is by far the most expensive of the Group Health plans but looks reasonable when compared to Premera. Go down to the lines about "Hospitalization" and "Outpatient Surgery" and you'll see why the thought of one of Rep. Condotta's high deductible plans terrifies me:

Hospitalization
$15 Copay Plan: $300 maximum copay, then covered in full
$500 Deductible Plan: $1,000 maximum copay, then covered at 80% after deductible is satisfied.

Outpatient Surgery
$15 Copay Plan: $15 copay
$500 Deductible Plan: $100 copay, then covered at 80% after deductible is satisfied.

I've talked before about my profoundly deaf daughter. Her left ear works for now with a hearing aide, but her ENT doctor has said that she could easily be a cochlear implant candidate if her hearing degenerated any farther. Given that the surgery and equipment can cost $50,000 a shot, even 80% coverage would still mean that I'm out $10,000 (or, 5 months of take-home salary) to pay for the procedure.

NYC Educator has been doing some incredible writing about health insurance, the health care industry, and how it all relates to teachers. My project for back to school, before I speak to the membership, will be to line up our health plans with the state offerings and see if they compare. If they do, maybe that's the way we go. If they don't, then we keep doing what we're doing.

It's going to be a fight either way.

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