July 5, 2006 by bob.

Q. I like the plan you have proposed but I am concerned about the $200 prescription drug deductible. The plan I had before only had a $50 deductible. I have called that carrier and they told me I can keep the drug plan for only $17 per month. How much will it lower the premium on the new plan to eliminate drug coverage? If it cannot be eliminated I think I will keep the old drug plan and use it until I have $200 in drug charges for the year.

A. The Rx cannot be carved out of the new plan. I have seen the benefit under your old plan and the new Rx benefit, even with a higher deductible, is much better.

There is no rule against having two Rx plans, but why would you want to? If you keep the old Rx plan you will pay $204 per year ($17 x 12) PLUS pay the first $50 in drug charges before you get into the copay. If you forget about the old Rx plan and just put the $17 per month into a savings account you will have accumulated your deductible under the new plan.

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July 5, 2006 by bob.

Q. I am looking for a plan for my family with low doctor & drug copays. We don’t take medication now, but I want to make sure my medicine will be affordable when I need it. I go to the doctor once a year, maybe twice but I can’t afford to pay $200 or more just to see a doctor. I also want a low deductible, $500 but no more than $1,000 and I don’t want to pay a lot of money. Can you help me?

A. The plan you are looking for is what most people want. If you ever find it, let me know because I have a huge list of people looking for the same.

If you can’t afford to pay $200 to see the doctor twice a year you have problems that cannot be solved by insurance. Most people really don’t need doctor visit insurance, what they really need is car accident insurance, or heart attack insurance, or cancer insurance.

Taking care of the small things in a health insurance policy is nice but terribly expensive if you want the carrier to cover these items.

The plan you describe will cost your family at least $1000 per month. For your $1000 you can go to the doctor 6 times per year under a copay; after that you pay out of pocket. Your medicine will cost $30 after you have satisfied the $200 Rx deductible. A major illness or accident will cost you $4,000 plus copays.

As an alternative, you might want to consider a plan that discounts things like doctor visits & prescription drugs. An office visit will run somewhere around $60 - $70; meds will be discounted around 30%. A major illness or accident will cost you no more than $5,000 and your monthly premium is $250.

So which plan makes more sense?

Paying $1,000 per month and never using the plan or paying $250 per month? The choice is yours.

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