patrick.net

Sounds like basic "major medical" versus comprehensive. When I was growing up our family was under my Dad a very basic major medical plan. Meaning it was just for serious stuff. If you just needed new glasses well you bought new glasses out of your pocket. It is a bit silly now that I think about it, that I have a "vision plan". I mean I only buy new glasses and contacts every 3 years or so and I stock up at that time. I'm under comprehensive at my employer now. It has a good side that you are more likely to get checked before something gets serious. It has a bad side that all the costs become abstracted and you don't really notice it until you go comparing you yearly fees for full-service HMO versus what you describe.

I have a high-deductible ($1700/yr) plan with BC/BS. I like it. I don't pay the uninsured sucker rates, rather the in-network rates for their doctors.

I had to have walk-in urgent care at a hospital plus two quick follow-ups with a specialist -- the total billed was $800, the amount allowed by BCBS was $450 and the amount I had to pay was $400.

Monthly premiums are $220 (compared to $500+/mo for non-deductible). Everyone should have to join this plan, even the nutty libertarians.

Also, two years ago I had an encounter with the emergency room. $7000 billed, $3200 allowed, $400 out-of-pocket.