# 100% Insurance Coverage **URL:** \ **Category:** Factual Questions\ **Created:** [September 24, 2004, 10:57pm UTC](https://boards.straightdope.com/t/100-insurance-coverage/265958 "2004-09-24T22:57:56Z")\ **Posts on this page:** 4\ **Page:** 1
**Author:** ![Mr.Slant](https://avatars.discourse-cdn.com/v4/letter/m/c57346/32.png) [@Mr.Slant](https://boards.straightdope.com/u/Mr.Slant)\ **Post date:** [September 24, 2004, 10:57pm UTC](https://boards.straightdope.com/t/100-insurance-coverage/265958/1 "2004-09-24T22:57:56Z")
Right now I am the proud named insured of a fine 80/20 insurance plan through my employer. My employer pays 80% of UCR charges, I pay the other 20% of the charges. Out of curiousity, are there companies out there that would be willing to write a policy for the other 20% of my charges? My wife has a bad habit of getting sick often often to make the 20% more actual cash dollars annually than I’d like. Even if I wound up paying slightly more than the other 20%, it’d be nice to know I wouldn’t have to worry about abrupt bumps in my budget. ---
**Author:** ![picunurse](https://avatars.discourse-cdn.com/v4/letter/p/7bcc69/32.png) [@picunurse](https://boards.straightdope.com/u/picunurse)\ **Post date:** [September 24, 2004, 11:03pm UTC](https://boards.straightdope.com/t/100-insurance-coverage/265958/2 "2004-09-24T23:03:10Z")
We have a co-op/hmo. All we pay is a $5.00 co-pay for office and ER visits. The co-pay is $50.00 for hospitalization. I think $200.00 for surgery. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 24, 2004, 11:47pm UTC](https://boards.straightdope.com/t/100-insurance-coverage/265958/3 "2004-09-24T23:47:00Z")
A \*typical \* plan works like this: Medical expenses are paid at 100% by the insured until the deductible is met. Further medical expenses are paid according to a coinsurance %age (80/20, for example) until the “stop loss” amount is met. The balance of medical expenses are paid at 100% by the insurer. Policies exist with 90/10 & 100% coinsurance. They get pretty spendy, however. Of course, “spendy” is a relative term if you & your doctor are on a first name basis and he’s candid enough to refer to you as “his BMW payment.” Availability of different plans varies widely from state to state due to a number of factors–shop around, pal, the grail is out there! As an alternative to a 100% plan, consider a lower deductible (increases the premium) a lower “stop loss” amount (increases the premium) or a supplemental policy, possibly called “Hospital Income” or something similar. The “Hospital Income” policy is set up to pay a stated amount for every 24 hour period you are hospitalized (say, $125). It may also have a provision to pay 5 times that amount if you go to the ER and are treated (so, you slice open your thumb and get stitches–ka-ching, $625 brass in pocket to put toward your deductible & coinsurance, or to buy flowers & beer with, or whatever–no strings attached, and NON TAXABLE(federal) because it’s an insurance benefit.) 🙂 These policies are cool because they can allow you to save money on your Major Medical policy by using higher deductibles & higher stop losses & less-favorable coinsurance %ages (Which really aren’t less favorable: If you have a $5,000 stop loss, that’s your stop loss regardless of whether you get there by paying 50% or 20% of your medical bills.) Often, the savings you realize by these modifications to your Major Medical plan are substantially greater than your outlay for the Supplemental Insurance. I am not licensed to sell insurance in any state. ---
**Author:** ![Mr.Slant](https://avatars.discourse-cdn.com/v4/letter/m/c57346/32.png) [@Mr.Slant](https://boards.straightdope.com/u/Mr.Slant)\ **Post date:** [September 25, 2004, 12:02am UTC](https://boards.straightdope.com/t/100-insurance-coverage/265958/4 "2004-09-25T00:02:55Z")
> [@Inigo Montoya](#): > > A \*typical \* plan works like this: > > Medical expenses are paid at 100% by the insured until the deductible is met. > Further medical expenses are paid according to a coinsurance %age (80/20, for example) until the “stop loss” amount is met. > The balance of medical expenses are paid at 100% by the insurer. > > Policies exist with 90/10 & 100% coinsurance. They get pretty spendy, however. Of course, “spendy” is a relative term if you & your doctor are on a first name basis and he’s candid enough to refer to you as “his BMW payment.” > > Availability of different plans varies widely from state to state due to a number of factors–shop around, pal, the grail is out there! > > As an alternative to a 100% plan, consider a lower deductible (increases the premium) > a lower “stop loss” amount (increases the premium) > or a supplemental policy, possibly called “Hospital Income” or something similar. > > The “Hospital Income” policy is set up to pay a stated amount for every 24 hour period you are hospitalized (say, $125). It may also have a provision to pay 5 times that amount if you go to the ER and are treated (so, you slice open your thumb and get stitches–ka-ching, $625 brass in pocket to put toward your deductible & coinsurance, or to buy flowers & beer with, or whatever–no strings attached, and NON TAXABLE(federal) because it’s an insurance benefit.) 🙂 > > These policies are cool because they can allow you to save money on your Major Medical policy by using higher deductibles & higher stop losses & less-favorable coinsurance %ages (Which really aren’t less favorable: If you have a $5,000 stop loss, that’s your stop loss regardless of whether you get there by paying 50% or 20% of your medical bills.) Often, the savings you realize by these modifications to your Major Medical plan are substantially greater than your outlay for the Supplemental Insurance. > I am not licensed to sell insurance in any state. Thank you. I am now investigating “Hospital Income” policies.