Three Share Works in Tennessee
The state that flirted with bankruptcy under TennCare is now proving that limited benefits insurance can work. The cost $150 per month – split evenly among the individual, the employer and the state. Beneficiaries get up to 12 primary care visits, limited hospital stays, generic-only prescriptions and a maximum overall benefit of $25,000. The new program, called CoverTN, is challenging three conventional assumptions:
- That catastrophic insurance is socially more important than noncatastrophic coverage.
- That people can manage small medical expenses better than large ones.
- That limited benefit insurance has little social value.
"What we're finding is that even in health care, when people know that there are limits, they work to manage their costs."
- Of 15,000 enrollees, only four exceeded the $25,000 spending limit and only three (2/100ths of 1%!) exceeded the hospital inpatient limits.
- Although 4% exceeded their quarterly pharmacy limits, they can cut their personal, out-of-pocket costs in half by paying for drugs at CoverTN prices.
Full story is here.
These are very interesting results. Everyone just assumes that catastrophic care is expensive because patients rarely have any control over decision-making.
When they are managing their own money,expenses rarely exceed $25,000. I assume no statistical test was done, but these results have to be statistically significant.
It sounds as though catastrophic coverage is overpriced. Whether it is worth owning depends in part on whether one has assets worth protecting.
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