Health Insurance-Is a one million lifetime max per person enough?

Question

I asked this question in the health category and got no answers. I thought I would try here.

Our current plan has no lifetime max per person, which is great but the premiums are high. I'm thinking of changing to a plan with a 1 million lifetime limit per person. I'm wondering how much one major illness or accident can cost approximately. I know it depends but if you have had experience or work in the health industry I'd appreciate your thoughts.

I also don't necessarily plan to be with the current plan or a new plan for more than about 15 years.

The current plan also has no hospital stay day limit, the cheaper plan limits you to 120 days a year. That seems like a lot of days, but I have heard of people being hospitalized for 5 months. Thanks in advance for your answers.

Answer 1

The previous poster is correct. Part of your answer lies in who is to be insured. Certainly your health and the health of the other in your family needs to be considered. If you are older , have any potentially catastrophic condtions,or have children (of any age), the plan you are on now would probably give you greater peace of mind. I worked in a Trauma Center and having seen some of the innocent victims of accidents or critically ill patients and how their insurance (or lack of) affected their treatment and recovery was sometimes heartbreaking if not downright wrong.

Just my 2 cents worth, but if possible, stick with the better plan. You'll sleep better knowing that you can't bargain with disaster.

Answer 2

At the rate of health care inflation 1 million isn't what it used to be and will be less next year.

If the present policy is causing hardship changing and hoping many be necessary..Remember, the purpose of insurance is to cover what you can not afford.  It may be cheaper to raise the deductible on your current policy and or opt for slightly higher co pays.  

It your decision,but if I were in your shoes I'd hang on to the present policy if at allpossible.

Answer 3

Wow, your current plan sounds great!  I think most policies have the million-dollar lifetime limit.  I always think about this and wonder whether it's enough, but then when you stop to think about how much a million dollars really is, it's hard to imagine anyone exceeding that under normal circumstances.  Even if you were in the hospital for 5 months, it wouldn't come near a million dollars.  

I have heard of situations where the limit was exceeded.  One example would be Christopher Reeve, the movie actor who was paralyzed when he was thrown from a horse.  He required months of hospitalization and rehab., followed by 24-hour care in his home, and at some point years after the injury, his insurance ran out.  So I know it's possible, BUT I think statistics would dictate that the chances of the average person having a catastrophic situation like that are pretty low.  Even people who have cancer and need repeated surgeries don't exceed their million-dollar limit.  And as far as the number of hospital days, nowadays hospitals won't LET you stay longer than the bare minimum.  If you're in there for 120 days you're in pretty bad shape.  Again, it's not likely to happen.  So I feel pretty safe with this type of plan.  If you're really worried about it, you can always buy a supplemental plan for long-term care, in-home nursing or rehab., or disability.  If you're young and healthy the plans aren't that expensive.

I'm not an insurance expert by any means; these are just my thoughts on the subject.  I hope I helped!

Answer 4

I have a friend with Cancer and his drug treatments cost $50,000 per month. So far he has lasted 8 years. Fortunately he has not lifetime limit on his plan. Situations like his are rare but possible.

Answer 5

I used to work for one of the largest health insurers in my region.

Most of the employers who offered benefits through our company had either a $1 million or $2 million lifetime max.  (There were also employers who selected no lifetime max, and a few who selected policies with smaller amounts than $1 million.  But $1M or $2M were the most common.)

It was rare to see a person hit their lifetime max.  (I saw between 100-200 patients files a day - multiply that over the course of the 2 years that I worked there and I saw a *lot* of patients information.  But I only saw 5 people's files that had hit their lifetime max.  2 of them were burn victims...at least one of the others was an organ transplant patient.)

Even though it was extremely rare for me to see someone hit their lifetime max, the consequences were devastating for those who did.  Obviously burn victims and organ transplant patients require a lot of ongoing care for an extended period of time.  Once you hit your lifetime max, you're done on that policy - not another dime will be paid from that policy.  It was very unfortunate.

One thing you should confirm with the insurer - does the amount of the lifetime max go by the insurer's discounted amount with the provider?  (that's the way it was with the insurer I worked for)  That does make a difference - a hospital's bill can be $100K, but the insurer may have an arrangement with the hospital to discount that bill to $60K.  It makes a difference - even if you're having very expensive treatments, its better to have the discounted amount accumulating towards your lifetime max.

Should you go with a policy that has a lifetime max?  Insurance is all about measuring the level of risk that you're willing to take - only you can decide that.  But hopefully the information I've given has at least helped you think through what you want to do.

Answer 6

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