Tuesday, May 5, 2009

As major carriers change their "DME" costs, it's time to check the fine print of your employee health benefit plans

If you own a company, and several of your employees are diabetic, it's a good time to review your health insurance policy and have your representative explain the "DME" function of it.

In the health insurance industry, a "DME" pays for the medical strips that diabetics use to test their blood levels. Until recently, the DME coverage had a cap of $2500. Now, the cap has been dropped to $500 with most carriers. With an average expense of $300 per month for these strips, the DME coverage is now going to provide almost two months of coverage.

Diabetics are not the only ones impacted by the change in coverage. If you have an accident like injuring your knee playing softball and the doctor prescribes a special brace, the typical cost for one is about $1500.

There are some solutions to this coverage. The insurance carriers will tell you that it will cost you an increase of four-percent for the entire policy to continue with the higher level of DME coverage of $2500 per person. However, the better solution is to ask your insurance professional about a MERP or a medical expense reimbursement plan. That way, when a worker needs his or her diabetic supplies or a knee brace they can have the MERP pay the costs over $500.

The insurance companies know that most of their customers will never read the fine print on topics like the DME. So, executives need to either read their policy or more importantly, hire an insurance agent that understands these unique clauses in their policy. Better yet, an intelligent insurance broker can provide them with the alternatives to provide a more effective type of coverage for their work force and their families.

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