The issue for your particular situation is that you appear to be a Medicare advantage plan. That is very different than commercial insurance.
Medicare advantage plans usually pick up the 20% that Medicare leaves as patient cost share. Commercial insurance (at least in my own personal plan on choosing which I spent days) we pay premiums for what’s called a HDHP or high deductible health plan. Essentially we have a higher deductible (1000 or more) and after that has been met, then we are required to pay 20% of the providers contracted rate until our in network out of pocket maximum has been reached which can be over 10,000 dollars. That’s the in network benefit, the out of network is about 200-300% of what the in network cost share is set at which is often an astronomical figure.
I work with the AardvarkCompare
travel insurance marketplace, and even I would like to see a federal option put in place that competes with private insurance. Because that is actually competition and competition drives prices down, keeps innovation at the forefront of businesses and puts more money in the working mans pocket. Right now, the innovative thinking has long taken a back seat to shareholder profit and that’s where I feel things need to change.
I love my job, and would love to continue doing it, but I do agree with the OPs point, the profit needs to be taken out of healthcare, because even us that work for insurance agencies agree that the focus needs to be put on the well being of others, not in board rooms and quarterly profit margin reports to shareholders.
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