Saturday, July 21, 2012

Inequality in insurance compensation

I have often wondered why there are such inequalities in insurance compensation. What I am referring to is why is dental coverage so different than general healthcare coverage? Also, why are prescription medications so different from medical care received at hospitals.

Dental care is just as important for good health as general health care. One thing is that flossing is important in cardiac care some how. I don't know how this works but flossing is important. Oral cancers cause death and are usually found by dentists. I just find it ridiculous that dental coverage is so infrequently offered and the coverage is so poor. This is from the point of view from some one who just paid a $600+ dental bill for two fillings and two checkups - one for each of us. And we are on the Federal Blue Cross program which is supposed to be one of the best around.

Also, why are medications taken orally in pill form covered so differently than infusion type medications given in the hospital. So if you get an infection and are hospitalized and get IV antibiotics, its basically covered. But if you get a prescription for regular tablet antibiotics, you are hit with the big copay? It doesn't make sense. Especially with the recent advances in cancer treatments.

So you have cancer you go for chemo infusions and they take hours. Each chemo round costs an easy $10,000+. You go every couple of weeks. That's expensive but your insurance probably charges you a regular $20-$30 copay if you are lucky. Then you switch to an oral chemo which is a pill form that you take often - maybe every day or whatever they tell you. These are a premium brand name pill and you are hit with a big fat copay. My insurance would charge me $95/refill at the mail order pharmacy and a lot more if I got it at my local drug store. And if you got three different pills that would be three times the price. That adds up each month.

So finally here in Massachusetts there is a bill slowly making its way through the legislation that would require insurers to cover chemotherapy equally, whether IV or oral pill form. I would love to see this adopted nationally and applied to all prescription medications.

And have my dental care covered equally. (Yes, I floss every day.)

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