COPD treatment

TA | July 29, 2009

Q: I am trying to find out if any healthcare policies exist out there for someone with COPD. My father has become disabled and had just been approved for disability benefits, but there is a two year wait for Medicare coverage. He has COPD so he has to make regular visits to his doctor. I have and still do work closely in the insurance industry, so I am aware of the scams out there. If you can advise me of some policies that are out there, I know the cost is not going to be reasonable, but he needs some sort of assistance until he is eligible for Medicare.

A: Supplemental health insurance is readily available in almost all situations today but commercial insurance policies must be designed to prevent the cost of claims for pre-existing conditions from exceeding the amount collected in premium especially early in the policy. In other words the insurance must cost more than the amount expected to be paid out in claims. So if your primary goal is to cover the cost of treating COPD on a cost-effective basis, then insurance is unlikely to be useful. Insurance is not financially effective in a situation with a significant baseline cost of treatment. Insurance is far more useful in covering the risk of medical issues that do not currently exist but could be financially devastating if they do occur.

A non-insurance approach (if assets are available) or a welfare-based insurance (if assets are deleted) is likely a better option for the COPD treatments. You may be aware that positive results have been recently reported for cost-effective self treatment of COPD as reported by the American Thoracic Society and others in this field. From our perspective (not as medical experts), it appears that these self-treatment options may become the standard form of treatment for COPD as we are increasingly forced to find additional ways to reduce our health care costs.

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