The May issue of Consumer Reports examines so-called individual plans that are often used by the self-employed.Î¾ Nancy Metcalf with Consumer Reports says individual insurance has become expensive and difficult for people who have a less-than-perfect medical history.
"People have absolutely no idea how much health insurance really costs.Î¾ If they've been working for a company, they've probably been paying anywhere from 15 to 25 per cent of the true costs for years."
Ed: "What are some of the things that you might see—the 'red flags'?"
"Well, the biggest red flag is if it's a policy that says right on the top of it that it's a limited benefit policy or not major medical insurance, do not buy it."
Metcalf says disclosure requirements about coverage gaps are weak or nonexistent, making it difficult to figure out what a policy covers until the consumer is faced with hospital bills the plan won't pay.
"Never ever buy a policy that says — and they're often worded this way — 'we cover 100 per cent of hospitalizations' — in tiny print —'up to schedule,' which means they'll pay $1,000 a day to be in the hospital.Î¾ We find policies that only cover hospitalization and don't cover outpatient care.Î¾ Again, a bad idea.Î¾ Increasingly, for example, cancer care is done on an outpatient basis."Î¾Î¾Î¾
Metcalf says the confusion comes about because health insurance is regulated by the states, not the federal government.Î¾
Ed Mayberry, KUHF Houston Public Radio News.