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The problem with a catastrophic plan is that there is no negotiated rate with providers and hospitals. So if you (or your wife or child), say get pneumonia, and spend a week in the hospital, the bill is the full retail rate, say 20K. Your catastrophic plan pays 5K after you pay your 15K deductible/co-pay (amounts are just for example).
If you are covered by a "regular" plan, the hospital and provider charges are negotiated and capped. So in the above example, the bill is 5K and you pay your deductible and co-pay based on the 5K bill, so maybe you pay $500.
You are almost better having no insurance than catastrophic in this example, because then you can negotiate with hospital/providers and try to at least pay the "medicare" allowed charges (which might be 1/3 or so of the full retail rate). Once your catastrophic plan picks up the bill that door is closed.
I experienced this first hand. We were young and healthy; it was my 18 year old son that got the pneumonia.
I don't roll those dice any more.
Last edited by charlesbahn; 11-03-2014 at 05:29 AM..
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