KCOM and Insurance

[John DO]

I've noticed several people asking about insurance in various threads, so I thought I would share my experience searching for the deal.

Obviously, the first decision is whether you want good coverage for daily medical care or just the minimum coverage to satisfy the school's requirements. Since my understanding is that we receive routine care at NE Regional for a nominal fee ($15 per visit, I believe), then I opted for minimum coverage and sought out lowest premiums. Several students I have met carry Fortis, which is cheap, but has a tricky clause that limits per incident payouts, which means that you better hope you don't have a major accident that ends up costing over $100,000. Golden Rule (www.goldenrule.com) offers a similar plan that does not cover doctor visits (which ARE provided by NE Reg), but also does not limit per incident amounts. It covers up to $3 mill regardless. The plan is called Basic Plan; they also offer Plan 80 and Plan 100, which are similar, but have lower co-pays. I also checked out Blue Cross Blue Shield, which offered good insurance (similar to SOMA), but was more affordable than comparable plans. Their lowest cost plan was RateSaver (www.bcbs.com).

Trust me, I have checked out every insurance carrier in this area and online. By far, the most helpful agent I found was Jason Kimble (573-638-3870), with offices in Jeff City, Columbia, and Princeton. He carries many ins companies and found that Golden Rule was the lowest price for what I wanted.

If you've got the dough and want good coverage, go for it. However, if you're like me and hurting for money, check out these resources!

Hope they help--I wished someone would have shared with me when I was searching, so here you go.

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[Popoy]

Any thoughts on the SOMA health,dental,vision insurance?

 

[John DO]

The major medical seems to be good coverage, but who can afford it? Oh yeah, the single students! Unfortunately, I am married with two kids and I am poor! Since my housing costs, etc, are higher, I must make concessions somewhere, so ins is it! The vision is misleading, btw; we acccepted this insurance at the last optical shop i worked at and we kind of chuckled when people fell for buying it (the same plan is available as a stand-alone purchase in some areas)! I was kind of surprised that SOMA doesn't offer at least one plan of effordable minimum coverages, since they are supposed to be for students. AMSA offers a couple of plans, but I don't believe they meet my school's requirements, and they aren't that affordable, either.

 

[Popoy]

really?! It's costly?!

I am married with no children yet and I called SOMA up and we only would have to pay $2490 for both of us with full coverage for health, vision, dental with the %age off with certain procedures.... Is this costly?

This is all new to me and I sincerely appreciate your feedback... What other types of coverage should I look into, if you have other suggestions?

Thanks so much!!!

 

[John DO]

Well, as i mentioned before, the SOMA insurance appears, for the most part, to be good coverage, but do you have redundant coverage? For example, our routine care is covered by the school's adjacent medical center at $15 per visit. I think that is better than most co-pays. If you receive care like this regardless of insurance, but then you pay 2500/yr for a 20% co-pay, did you improve your position any? Your excellent %age is nice to have in case of a severe accident, but my low-cost insurance covers that. For the most part, vision insurance is a joke, because very few actually PAY for your eyeglasses (they usually offer a discount, like SOMA). How often do you actually buy glasses? Although once a year is recommended, most people buy them every two years. How much will you pay over that period to receive a one-time 20% discount (usually what it turns out to be). In fact, the particular insurance SOMA offers is through Cole Vision, the company that owns Pearle Vision, Sears Optical, etc. Having worked at Pearle Vision before, I know that, if you use this insurance, you are not allowed to take advantage of any of the "temporary" offers that are always being run, so you often pay more for your glasses than you would have if you hadn't had the "insurance." Dental is the same; although it is nice to have the coverage, how much do you pay for your coverage? Probably, you will save money here, but I play the odds.

Insurance is nice to have for piece of mind. Without insurance, you may have to pay; with insurance, you definitely have to pay. If you were to put that 2500/yr in the bank, I would venture to guess that you would have plenty to cover your routine expenses, plus some. I think major accidental is important to have, though. You would be glad to have it when the unthinkable happens!

My stance may be unusual and not for everyone, but I can't justify throwing money away.

 

[Hskermdic]

FYI It costs $15 to go to the clinic at school. You can then send that bill into SOMA and get $12 of the dollars back. Not a bad deal at all. the insurance coverage for SOMA while a pain (because you have to pay first and then send in receipts) is helpful. The Pharmacy at school gives students a good deal on the prices and that combined with the SOMA insurance picking up most of the cost is nice as well.

The SOMA surance isn't ideal. I feel like it is a paperwork nightmare. I am still trying to get paperwork straightened out with them from a knee surgery a year ago. Part of the problem this year was that SOMA switched which company manages their plan this year which means learning a new way of doing things and doing more stupid paperwork. (Maybe this is how they are helping to train us to handle the paperwork hassles of doctors)

 

[John DO]

thanks, carrie!

 

[Popoy]

Thanks John DO and Carrie... Both your insights have been very valuable and helpful in my decision to choose which type of insurance to go for.... I've noted them all to heart and if anyone else can give me their two cents then by all means please do.... Thanx!!!