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Robert Trigaux

Indecipherable health coverage: Why Tampa's Thomas Bosso's fighting fees

ThomasBossorealtorTampa Wake up and good morning. Read any fine print lately? Ever really read your health insurance policy? And if you have courageously read it, would it really make any difference in actually understanding what it says?

Well, some senior members of Congress think something needs to be done about it. They are exploring legislation that would force insurers to provide "coverage facts" boxes similar to the nutrition information that appears on food packages.

Deciphering health insurance policies is explored in today's Wall Street Journal  (subscription required), which comes with a tale of a Tampa man who found out the hard way that health plans are often impenetrable and the limits of coverage obscure.

According to the Journal, Tampa real estate broker Thomas Bosso, 56, bought a plan from Assurant Inc. two years ago partly because he thought everything would be covered completely after he paid a $3,500 annual deductible, which is the amount a person has to lay out before the insurer starts paying for care. (Photo courtesy of Thomas Bosso.)

Instead, he told the Journal, he's been peppered with unexpected bills for thousands of dollars tied to a knee-replacement surgery last December. He hired Healthcare Advocates Inc., a Philadelphia firm that represents consumers on insurance issues, to help him fight the fees. Said Bosso:

"It's like you need to go to Harvard to understand what your insurance company is going to pay or not pay. It's ludicrous."

Hmmm. Sound familiar? Bosso told the Journal he never read the full 76-page description of his plan before he picked it, but relied on a summary and an insurance agent's advice. As for Assurant -- or simply insert the name of your health insurance firm here -- it says it "strives to provide clarity so that our customers can make informed coverage decisions."

-- Robert Trigaux, Times Business Columnist

[Last modified: Tuesday, June 1, 2010 12:25pm]

    

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