The health insurance company will see you now

Maryalene LaPonsie | December 22, 2010

What if your affordable health insurance turned out to not be so affordable? That's a dilemma facing countless individuals, particularly those with pre-existing conditions. High deductibles, co-insurance and co-pays can do more than hurt your wallet. They can also hurt your health. Consider two examples from health insurance giant UnitedHealthcare.

Health insurance companies as doctors

Diabetics took notice when UnitedHealthcare recently switched classifications of the popular insulin drug NovoLog, according to The Los Angeles Times. Changing the medication from Tier 1 to Tier 3 has the effect of more than tripling the co-pay for certain plan subscribers. What was once a $20 drug for consumers turned into a $70 drug, overnight.

The company encourages affected consumers to consider using HumaLog-- a similar medication that is making the switch from pricier Tier 3 to cheaper Tier 1. While NovoLog and HumaLog are both insulin medications, they are not identical. Perhaps most disturbing about these reports is the idea that an insurance company can effectively trump doctor's orders by creating financial incentives through medical coverage for consumers to request certain medications.

An October announcement from UnitedHealthcare also appears to shift control over patient care to the insurer. The company is working with five oncology practices to provide lump sum payments for chemotherapy treatments. Rather than pay for treatments as they occur, physicians will select a standard chemotherapy regimen for each cancer patient. The doctor is free to change treatment at any time, but UnitedHealthcare will pay no more than the agreed cost for the initially selected regimen.

In a press release, UnitedHealthcare touts the chemotherapy payments as a way to "improve quality and health outcomes." But really, who are they kidding? Patients can have unforeseen allergies or intolerable side effects to certain chemotherapies. It's a stretch to say that tying doctors to one plan of attack is in the patient's best interest. Sure, the doctor can change treatments at any time, but cancer care is expensive and - let's face it - physicians have bottom lines to think about too. To say nothing of the fact that the UnitedHealthcare plan locks patients out of promising new therapies that have yet to become the standard of care. When shopping for low cost health insurance, find a plan that not only pays your bills but also leaves you and your doctor in charge of your health care.

Tags : pre existing conditions, affordable health insurance, health care

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