Big Lies

[David Horn]

(02-16-2017, 07:50 AM)Mikebert Wrote: Question for Classic,

You purchase your own insurance and have for years.  Until a few years ago you were in the old market, and you favor going back to that.    Suppose you or a dependent experienced kidney failure and had to get a new one (The is has happened to three people I know, so its not super uncommon).  For the rest of their lives they will have to take anti-rejection meds that I understand run like 30K annually.  

So if this happened to you, assuming your premiums were less than 30K, you would become a continuous loss to the insurance company for the rest of the time you had a policy with that company. I assume that private plans like yours have a fixed duration and you have to sign up again when the plan expires. Why would they agree to insure you?  Why would anyoneinsure you, unless they could charge more than 30 K in premiums?

Surely you must have researched this.  What would happen if this happened to you?  I honestly don't know. I have had a corporate plan for my entire working life.

Most policies of that type have caps that prevent excess losses by the insurer.  Caps can be rather low for plans that cost less, so a plan with a lifetime cap of $500,000 would run up against the cap just paying for the kidney.  $1,000,000 caps were common; $10,000,000 were rare.  The ACA has no cap.