The $950,000 Baby

BabyYou know how new parents all think their kids are priceless? It turns out there may be a price tag after all for that little bundle of joy.

Try $950,000 on for size!

A Canadian woman, who was six months pregnant, went to Hawaii for a vacation. They checked with their doctor and after he cleared it, they bought medical insurance that would cover her while she was in the states in addition to the insurance that they already had in Canada.

As luck would have it, Mom’s water breaks, and out comes the baby, 3 months early, while they are in Hawaii!

Here is where it get’s interesting.

Between the hospital and neonatal care, the bill was $950,000.

The couple, having not one but two insurance policies, thought they were all set.

They were not.

The US company agreed to pay $12,000 citing the pregnancy as a pre-existing condition?!? The Canadian insurance company agreed to pay $20,000.

The Canadian couple is on the hook for the remaining $918,000!

Moral of the story…if you are traveling out of the country check in with your insurance company to see what may and may not be covered.


Motorcycle Helmets

I have always wanted a motorcycle. There is something alluring about cruising around with the wind in your hair and the open road in front of you. What has stopped me from getting said motorcycle is fear. Fear of crashing and the subsequent injuries that come along with it.

Inexplicably not every state in the US requires helmets to be worn while riding a motorcycle. Currently only 19 states require helmets. 19!!!! What on earth are the other 31 waiting for? Is it even arguable that wearing helmets makes a difference?

The government estimates that the US could have saved $1.5 billion if people were wearing helmets when they were in an accident. The CDC has noted that in states where there is an option on helmets, helmet use goes down and deaths go up. 2012 saw close to 5,000 motorcycle deaths, a 9% increase from 2011.

With all of this being said Michigan decided to repeal their helmet law last year, requiring only those under 21 to wear one. Want to guess what happened?

For the two years prior to the change the average medical claim for a motorcycle injury was $5140. After the change…$7,257, a 34% increase.

Now look I am sure that the vice president of the Motorcycle Riders Foundation is a really nice guy but what he says here is just ridiculous. The vice president dismissed the study, saying the insurance industry views helmets as ‘‘the silver bullet that’s going to change the landscape of motorcycle safety.’’ He said insurers are upset because ‘‘ life has gotten more expensive for them and they have to pay out more.’’

First off if I was an insurance company and I had to pay out more because you didn’t want to wear a helmet, I would be ripped…never mind upset!

As a chiropractor, I have seen the devastating effects that closed head injuries cause. These injuries could have been avoided or at the very least a lot less severe if the people had been wearing helmets.

If you are riding a motorcycle this summer or thinking of getting one, please, please, please wear a helmet. Your loved ones and even your insurance company will thank you for it!

A Sneaky New Change in Insurance

November is a big month for renewing insurance plans.  A lot of patients come into the office with insurance questions and over the years I have become fairly adept at reading insurance plans.  It used to be very simple, what was the co-pay, did I have prescription coverage and what sort of flexibility did I have if I am in a jam somewhere far away?

Now the categories have gotten much more complicated.  Take a look at some of the areas of concern:

  • Co-pays…now $25 and up is the norm.  Many plans also charge upwards of $45 for a specialist…
  • Deductibles…do you need to meet a deductible before the plan will cover anything…is it a hospital only deductible?
  • Out of Pocket Maximum…these can range from nothing to $5,000 per individual
  • Prescription coverage…are name brands covered or must you get generic?  Is there a prescription deductible…different co-pays for different levels of drugs.
  • In network vs out of network…go to the hospital and have an x-ray taken…the x-ray is covered but is the radiologist who is reading it?  That makes for a nice surprise when that bill shows up at home.
  • Plan limits… Did you know there may be a lifetime maximum of how much the plan will cover?
  • Service limits…love your chiropractor, how many visits will the plan cover?
  • Lastly co-insurance…this one is nasty with a capital N.

The new thing in insurance plans is co-insurance.  Allow me to explain how that works.  You go to the hospital for a procedure, let’s say a gall bladder removal.  Total cost of said procedure is       $20, 000.  You pay your co-pay and head home.  Two weeks later a bill shows up in the mail for $7000.  7 GRAND!!!!  Welcome to your 35% co-insurance.  Now every plan is not that bad; I have seen this range from 10%-35%, but as you can imagine, this could get expensive.

You must be very diligent when picking your insurance plan.  Please check all of the categories above, especially the co-insurance category before making your decision.

If you have any questions please hit the contact us tab and we will be very happy to help you.  If you are local to me, please bring the plan sheet over to my office and I will gladly walk you through your options.

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Get out the Vote!

First off, please accept my apologies for the space between posts.  Between the holidays and the start of high school hockey I have slacked here…no more I promise.  For those of you who are interested I coach a high school hockey team and you can follow our progress either through our website ( or follow us on twitter where we live update the games between periods (

While I have always refrained from talking politics in the office, I feel very passionately about the upcoming Massachusetts state election on January 19th, 2010.  The two candidates are:

Martha Coakley

Scott Brown,

This election will be crucial in the health care debate.

Ms. Coakley in a word is for the health care plan that is being voted on, while Mr. Brown in a word is against this plan.

While I don’t judge and do not want to turn this into a political debate, I would encourage everyone to take a few minutes out of their day and research both the pros and cons of the current health care plan that is being proposed.

For sure there are no easy answers.  While most people would agree that more people under insurance care is better, others would ask how are we going to pay for this.  These are all issues that you should research before you head to the poll on the 19th.

Given how close the health care vote is sure to be, many national political pundits believe that the winner of the Mass election may be the swing vote in whether or not this plan gets passed, it is imperative that we get out and show not just the state, but the entire country that we care and are passionate about electing our leaders.

Please do your homework and get out and vote on the 19th!