There's No Free Lunch!

Let’s talk about caveat emptor, let the buyer beware. Any way you define it there is no free lunch! I’d like to share with you how a friend of mine was invited to a free lunch by an insurance professional. By the time lunch had ended, my friend found she had committed to and purchased an HMO insurance policy. What my friend failed to see was the big picture. She had purchased an HMO that the retirement community she lives in did not accept, nor did many doctors. When this was purchased, she was in good health. However, as you can imagine, she soon found herself in a medical crisis having had a stroke.

Upon discharge from the hospital, it became apparent her insurance choice had many limitations, including the choice of physicians and rehabilitation/ skilled nursing centers. You might think this is not a major concern. However, when you are in your elder years and you have gone to a primary care physician for many years and your insurance won’t allow you to keep that physician of your choice, it is a major concern. There are questions you must ask. We have choices, but recognize that the free lunch WILL cost you in other areas. It’s a trade off. Whether purchasing less expensive homeowners, auto or health insurance, there is always a trade off! Make decisions while looking at the big picture. My friend saw the cost efficient premium and not the big picture. The big picture being…
Physicians ~ Ask to see a list. Ask to see an updated list. Is your physician on it?
Specialists ~ Can you see only certain ones? Are they in your area?
Rehabilitation ~ Could you or would you be discriminated against due to age? Would there be a limit to the number of rehabilitation days?
Equipment ~ DME, Wheelchairs, beds, are these covered? How much?
Home Health Services ~ What agencies can you use? Are there a limited number of visits allowed?

Sometimes we need to stop and think before we commit to or purchase something that can impact our lives! Peace of mind is so important. As a nurse case manager, I deal with clients’ insurance everyday. I work with the best, the worst, and the in between. Trust me when I say there are always limitations and loop holes. Make sure the policy purchased fits your needs and that of your family. Please understand I can not and will not debate HMO over PPO.
So, the next time you are offered a free lunch, take time to savor the dessert and take a good look at the big picture.