Two Simple Facts about Health Insurance for 2014

I believe that health insurance is really important. 

You just can't predict when something will happen and you need it. Say, for example, you get breast cancer and need surgery and chemo. It's expensive. Really expensive. Like maybe $100,000 worth of expensive.

Fact #1 -

Just having insurance saves you a lot of money. 

Insurance companies limit what hospitals and doctors can charge you. So, for example, if my memory is correct, the hospital charges for my mastectomy (hospital charges for the surgical suite and the hospital stay excluding the surgeons' fees) were about $10,000. But, just because I had Blue Cross insurance, the charges were discounted down to less than $3,000. 

Here's another example. A few months ago I saw my primary care doctor for an office visit and lab tests. The total charge was about $250. But with the insurance discount, the doctor was happy to accept a total payment of $80 (80% from insurance and 20% from me). But, without insurance, the charge would have been $250! So, just by having insurance, you get a huge discount -- about 66%! 

There's a lot of noise right now about Obamacare (mainly negative) and I hope everyone is willing to look beyond rhetoric and understand facts. It's a little hard to do right now in states which did not set up their own exchanges (such as Tennessee) because the healthcare.gov website is not operating as it should. Since January, 2014 is the earliest date to start this insurance, there's no rush yet.

The good news: some information is already available from insurance agents who sell health insurance. 

Fact #2 - 

If you get marketplace insurance through an agent (vs. directly through the healthcare.gov website) you won't pay higher rates.

Agents can get the rates and explain the offerings available both on and off the marketplace. There are 5 companies offering insurance through the marketplace (aka the exchanges). And, just to give you a idea of how someone who understands insurance can help you muddle through the data, my pal Eric Jans (who specializes in health insurance) told me there are 54 different offerings from Blue Cross in the marketplace. And even more plans are available off the marketplace!

Ask Every Woman You Know This Question

Some of you may know that I (Susan) was diagnosed with breast cancer 7 years ago. 

I never felt a lump and I'm embarrassed to say that I had gone 4 years between mammograms. It turns out that the cancer was there on the 4 year old mammogram, but it was missed. And, apparently, that happens a lot. 

Please don't do what I did. A mammogram found the cancer and a breast MRI saved my life. At the time of my diagnosis, I had two tumors in one breast and the cancer had spread to one lymph node. Not so great. So I had a double mastectomy, chemo and 4 additional reconstructive surgeries. The treatment was not fun, but I'm still here. 

So, if you are old enough to do so, please get a mammogram every year. It increases the likelihood that something bad will be found sooner rather than later. If you have insurance, you don't even need a doctor's order to schedule a mammogram. And if you don't have insurance, there are a number of programs in Nashville to provide no cost or low cost mammograms.

Here's my request to you. Ask every woman you care about the following question:

         What was the date of your last mammogram?

A couple of years ago, we had pink banners in our windows at The Mall at Green Hills and I asked every customer -- male or female -- to give me their last mammogram date or to commit to asking an important woman in his or her life that question. A few months later, I got a call from a woman (the wife of a physician who had health insurance and who had skipped mammograms for a while) thanking me for giving her a hard time about not having had a mammogram. She went for one and found out she had cancer. That was a goosebump moment.

Mammograms really can save lives. Wearing pink ribbons is fine, but asking that one question can actually help someone you care about stay alive longer. Do it!