I have not been able to find an insurance carrier that offers a health insurance policy that really fits my needs. I have come to the conclusion that none such are out there but thought I would throw it out to the AMAC membership for your input.  

I am 65. My wife is 64. We are both very healthy with no serious medical issues. Between the two of us we have been to the doctor about five or six times in the last five years.  We realized some years ago that we were spending much more on premiums than we received in benefits but felt like we needed to continue with the coverage just in case the Big-event occurred. Eventually, the cost of full coverage insurance was just no longer affordable for us. We began looking for coverage that would protect us from any Major-medical event (that would force us to sell our home and move in with the kids) but leave it to us to deal with the less threatening day-to-day doctor bills and medications.

The best we have been able to come up with is a high-deductible, catastrophic policy which is more affordable than full coverage but I still think there ought to be other options available. We pay $580 per month (almost $7000 a year) for coverage which doesn’t kick in until we have spent $10,000. At that point it pays 50% of everything until my total payout has reached $15,000 (plus the $7000 in premiums) at which point it pays 100%. That doesn’t seem too bad except that my deductible starts all over at the first of every calendar year.  If we had two years of major medical expenses in a row we would be putting out up to $44,000. (I have a niece with similar coverage whose chemotherapy treatment for breast cancer spanned into the new year so that she had to pay the deductible twice before the policy began to pay.)  

What I had hoped to find was a policy that looked at each different Major-medical disease as a distinct event and cover the full treatment of the event. For example, if I was diagnosed with prostate cancer, that would be viewed as a Major-medial event and the total cost of treatment would be covered regardless of the duration time of the treatment. Ditto; heart disease, diabetes, and so on, with no deductible for the Major-medical. Anything not a Major-medical would be my own responsibility. I would expect to pay up front for all diagnostic tests prior to determination of the disease, with the expectation of being reimbursed by my Major-medical policy if a disease covered under the policy is discovered.

Is anyone aware of any such plans? If any member of AMAC happens to be associated with any insurance providers, what do you think the market prospects of such coverage might be.  I know that Obamacare hanging out there for us  yet to “learn what’s in it” probably would not recognize such coverage as meeting the fascist-standard-of-the-day but we still have to keep hoping for something better. I would prefer that improvements in the insurance industry be found within the market-place, not Congress. 

 Any input will be appreciated.