| Author |
Message |
    
Arsenal
Citizen
Username: Arsenal
Post Number: 81
Registered: 8-2004
| | Posted on Sunday, March 26, 2006 - 1:40 pm: | 
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My sister is looking to move to another company and their health benefits they provide are major medical up to $2Mil max. lifetime. Is this a lot? Right now she has no set limit [at least that I am aware of], but she really likes the company and wants to move. Thoughts? |
greenetree
Supporter
Username: Greenetree
Post Number: 7062
Registered: 5-2001
| | Posted on Sunday, March 26, 2006 - 1:55 pm: |
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That's fairly common. If she has no limit where she is now, I'd be pretty surprised. That is more than sufficient unless she has a catastrophic illness or medical injury. Also, I'm not sure if the limit includes Rx, but if she takes expensive meds for a chronic illness, that is also a consideration. Remember that the limit applies to what the company spends; her out-of-pockets & copays don't count.
Even a catastrophic illness won't necessarily max her out. My mom has been undergoing cancer treatment for 13 months and is under $50k for her lifetime cap. She has had 9 hospitalizations, but all relatively "cheap". Cancer wipes out your lifetime when you start getting into major surgeries, bone marrow transplants, etc. (none of which she's had). Traumatic injuries with specialized care, rehab, etc. Expensive prostheses. That sort of thing is what eats up the limit.
If your sister uses her major medical for her auto policy coverage, any medical claims for injuries that she suffers in an accident would go against that limit, too.
The other thing is to consider her age. Assuming that there is some level of Medicare left when she reaches 65 (or whatever the limit will be at that point), if she is still working for a large company, her employer will be her primary and Medicare will be her secondary. Medicare picks up (most) of what the primary doesn't. At least that's how it works right now.
The joint private/Medicare coverage is quite complex (and I am now a quasi-expert) so it needs to be checked out carefully. |
Arsenal
Citizen
Username: Arsenal
Post Number: 82
Registered: 8-2004
| | Posted on Sunday, March 26, 2006 - 2:05 pm: |
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greentree-
Wow and thanks. Concise and very helpful. I don't know about the Rx and great point on the auto policy coverage.
Do these companies send an annual statement advising how much of the limit is left? |
greenetree
Supporter
Username: Greenetree
Post Number: 7063
Registered: 5-2001
| | Posted on Sunday, March 26, 2006 - 2:13 pm: |
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The companies don't tend to track it, the insurance companies do. Sometimes, next to the line on any EOB you receive after a doctor's visit that tells you your spend towards lifetime cap, along with how much you've spent towards this year's deductible, etc. She can always call the insurance company and ask. |
Eats Shoots & Leaves
Citizen
Username: Mfpark
Post Number: 3160
Registered: 9-2001
| | Posted on Sunday, March 26, 2006 - 2:19 pm: |
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GT--you are amazing. You should become the Ann Landers of the medical consumer world. Jane Brody ain't got nuthin' on you. |
greenetree
Supporter
Username: Greenetree
Post Number: 7064
Registered: 5-2001
| | Posted on Sunday, March 26, 2006 - 2:35 pm: |
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ESL - why, thank you. Believe me, I wish that I could parlay this into some sort of paying patient advocacy gig. The problem is that people who need someone to advocate for them are spending all their money elsewheree.
I must correct myself, tho. Mom is under $150k, not $50k. Makes a big difference. |
Arsenal
Citizen
Username: Arsenal
Post Number: 83
Registered: 8-2004
| | Posted on Sunday, March 26, 2006 - 4:12 pm: |
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Again thanks for the information. Just what I was looking for.
I might, however, disagree with the paid advocacy gig. As you are well aware those medical bills are practically gibberish for most of us and I recall one of those finance magazines listed a patient advocate was one of the most promising fields. I have no idea where to get started, but the need is becoming great. Again, many thanks. |
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