First off, and this is kind of an aside that I will be looking into further this afternoon, my friend Don who admittedly has been nicknamed by my son "doomsday Don" warned me about the body bag business being in a boom. Seems they can't keep up with orders. This I took with a grain of salt and kind of forgot about until just now when I saw a comment from JK Brady on my recent blog alluding to the same thing. Who is ordering the damned body bags and why? I did a google search just now as "body bag business". The link provided in the prior sentence is from that search. There were a LOT of results from the search and like I said I'll be going back presently to study further.
But what I was really curious about today after several days of rather heated "debate" (more like argument that seems to go no where) is what kind of health coverage YOU have if any.
Is it provided by an employer?
Do you have to pay part of your premium on your employer provided care? If so do you feel the amount you pay out of pocket is reasonable?
And do you receive "quality coverage"? In other words would you say you're satisfied that you and your family are well protected?
For those that are self employed (for example Mary T. Kelly and husband Nick) what are your experiences with health care insurance?
Some of you I know are disabled in some way or another and possibly can't work and are maybe on some kind of government assistance. Are you able to see a doctor and how would you rate the care you receive?
Some of you like myself may feel priced out of the market altogether. Cap'n Parrotdead wrote his story yesterday. These are the kind of experiences I'm curious about. Good bad or indifferent.
I'm not looking for rates or any of that today. I'm genuinely curious about YOU and your experiences with the health care industry.
About me? Practically straight out of high school I went to work for UPS. Back then health care coverage was pretty much a non issue. Everyone that had a job had it and most was paid 100% by the employer. I had phenomenal coverage that included mental health: I mean everything was covered (except they wouldn't pay for womens birth control... now they had no problem at all with paying every penny of prenatal care right through delivery but no damned contraception!).
Back then it seems it wasn't so outrageously expensive for health insurance. Employers provided it as a matter of course. Something terrible has happened since then and from what I can tell it's something motivated by greed and corruption that has put us where we are today in America.
Bottom line though I never ever used the insurance. I was healthy, and yeah I suppose I'm quite lucky but even to this day I don't even get colds or flus (speaking of flu I would think twice about the flu vaccinations that will be going around this fall... but that goes back to the body bag discussion).
My last "straight job" ended in April of 2000. My ever too generous employer offered coverage for myself for free. To cover my family which was just a wife and a healthy boy was hundreds a month. My salary was $34000 which came to about $525 a week after taxes. As I remember the family coverage was right around $500 a month.
Since then I've had no health insurance. It costs too damn much.
Once again if you have a story to tell good or bad the Trigster is curious.


Salon.com
Comments
I get health insurance through the State of Ct. Retirees Union.
I pay $13 a month in premiums. My co-pays are $15. Drugs $3 generic, $6 non-generic. If I lose this coverage in the current health market, I would be deemed uninsurable. I ache for those who don't have insurance. One of my sons is in this situation, another is on Title 19 and Medicare. I gave much to receive these benefits, but these[my] benefits are an example of the true disparity in healthcare. And yes, I'm for change and coverage for all, even if that affects my insurance.
Monthly premium: $545.62
Co-Pay: $30
Drug: $ rated of prescription non-generic or generic
Deductible: $5,000
No Dental or Eye
I am paying through the nose for little or no real coverage - maybe, Mr. M can adopt me!
send the papers. I'd be happy to as long as you do the cooking. :-)
Doomsday Brady thanks for getting me on the body bag search. Disturbing it is!
George $5000 deductible huh, and a pretty darned stiff premium. This is already getting interesting...
I also pay out of pocket to go to a natureopath and pay for supplements and acupuncture. I'm a firm believer that there is only so much that mainstream healthcare can do for us; the rest is up to us to be in charge of our own health: diet, exercise, supplements, alternative's like acupuncture, massage, etc. Mainstream healthcare is all about treating an illness once you have it. I try to work on preventing the problems from ever occurring. Interesting questions you pose.
peece,
dj
diabetes type II, many orthopedic injuries and the fact that I'm old. Yes I'd be very screwed. But as I said, the common good must transcend the individual.
The PPO plan has a $20 co pay for PCP visits and $35 co pay for specialists.
There is a vision plan and prescription benefit. The presciption benefit has a tiered charge for generics and non generic medication.
Premium cost is low $80 per pay period which is off set by the deductible. The plans from my last two employers were quite different.
I also have a FSA health care spending account which is pretax money which I must use within the calendar year or lose at the end of the year. This reimburses my copays and deductibles.
All the plans I particpated in are different and are confusing.
My agency picks up 70% of the premium. My 30% share is currently costing me $70 every 2 weeks. One of the conditions the Office of Personal Management puts in the contracts is that service cannot be denied for pre-existing conditions.
I picked a Bluecross/Blueshield plan. Not much dental, optical, or mental health coverage, but basic medical is good. There is a co-pay and a (usually) small fee for drugs.
In the past year, I've had a cardiac catheterization, 3 out-patient surgeries, and 6 weeks ago spent about 10 days in the hospital having 4' of bowel removed. My total cash outlay is probably under $2,000. The recent hospital stay was around $38,000 - my bill was $200 (plus $500 for 2 weeks of Lovenox after I was released - Bluecross only covered $1,000 for the Lovenox).
When I retire, I'll be able to keep the insurance and as best I can tell, Uncle Sam will continue to pay 70% of the premium.
I am very lucky and very grateful to have this!
DJ damn you got it good man, but once again like you said, what would it cost for the same on your own?
Mustard you would be riding in the same boat as Parrotdead. Wow.
mamoore very good point. Stress and other mental health issues lead to poor physical health. Hmmm
Dr. Blevins, a perplexing situation it sounds like, screwy yet typical.
But congrats for being covered some kind of way at least.
Dog glad to see you have what seems like decent coverage for the moment.
My wife had some great insurance through her Union though so at least one of us is protected.
http://open.salon.com/blog/gmgaston/2009/08/09/what_healthcare_reform_needs_is_good_old_common_sense
P Hahn, do you have 10G in the bank to cover your deductible in case of a medical emergency? Man o man.
Because we're a self-funded plan, our benefit trust board gets to decide what's covered and what's not and so far we've been pretty quick to respond to patients' actual needs. Every year, though, we have long meetings trying to figure out how to keep premiums low and still cover what we want to cover. (We have decided to shoot employees who are actually sick or hurt.)
My husband gets the handy-dandy government insurance which pays 70 percent of the premium. Somewhat like Steve only different, he isn't allowed get care from the IHS despite spending every waking hour there, but he does anyway.
Anyway, my point: We have good coverage because we both have good jobs and can backstop each other's plans.
Medical $350.60(I can reduce that to $205.00 per month if I want to pay an $1800 deductible per person)Then it woulde be Medicare 80% and me 20% the rest of the year.
Company pays 164.40
Dental $69.44
Total $420.04 per month. I also pay $15.54 for some group life insurance by choice.
Eye Care...no premium but 40% discount on frames and $50 for basic frames. $70 for bifocals.
Under medical we each have a $300.00 deductible.
After that Medicare pays 80% and we pay 20% of what is left over until our out of pocket reaches $1500 each.
From 1966 to 1984 I paid no monthly premiums. I never had dental coverage until 1992.
I believe the reason we pay more is because our company has to pay more and the cost of all medical care has gone up quite a lot in the last 10-12 years.
My premiums actually go down this year by $100 a month.
Over the years I have had Blue Cross and Blue Shield and 2 different HMO's. No problems with care. Early on the HMOS had packed offices then they must have learned how to manage better because long waits went down over the past 5-10 years.
Most of my health problems have been since 2001(Stents, Kidney Disease, Heart Disease, etc) but my only complaints have been getting some bills corrected.
You though my friend have "slipped thru the cracks"
Blackflon, Medicare? Is that not a government run program?
Sounds like you're fairly well covered.
Meanwhile my 23 year old son has no health insurance whatsoever.
And one of my daughter-in-laws is killing herself at a job at an insurance agency so that her family can be covered.
Another daughter-in-law with cancer is depending on medicaid.
I want a single payer system. I think insurance is a scam.
A single payer system won't cure all our ills, but it would do the minimum necessary to make sure people can take care of a crisis.
So about 2 months ago we signed up for an HSA compatible policy where we're paying about $471 a month with a $5000 deductible and no prescription coverage. We're putting money into the HSA to help pay for potential medical bills, but to be honest it now makes me second guess a trip to the Dr. unless it is dire as I have to pay the $100+ office visit/tests/prescriptions rather than the $40 copay I had before. I'm also hesitant to get prescriptions since I'm not paying a $10 copay for those either. The ones I can get in a generic form I'm going to get at Walmart because they offer that $4 program - but for more expensive stuff I may skip across the border rather than pay $270 a bottle.
I used to think the pre-existing conditions thing just meant you wouldn't be covered for those conditions. No, it means I can't get even catastrophic coverage.
It's a life changer. I've become paranoid about activities I used to love, from rollerblading to a casual bike ride. Catastrophe has taken on a whole new meaning.
I do favor single payer insurance, or a bland concept like France. I would favor it even if I end up paying more for my monthly expenditure.
The coverage for basic stuff was pretty good, and was theoretically good if you encountered something like kidney stones. I say theoretically because nearly everyone who encountered anything but basic Dr. visits ended up fighting with the insurance company for about 6 months or more in order to make sure it got covered.
I once had an unneccessary surgery to remove my gallbladder, recommended by a doctor. Now, I no longer believe doctors, anyway.
Iamsurly you and your husband are fairly well positioned but yet feeling the squeeze it seems
helloshelied you like myself would be defunct as a member of this kinder and gentler society if a catastrophic illness or injury happened
Bill good to see you and glad you have some good coverage. Interesting to know that you would be willing to compromise it for the better treatment of the rest. Thanks
Owlie good point. You think you have insurance until you file a claim. Then they fight about paying it. Would be bad for profits to just up and pay for actual coverage. And oh no, needless to say your significant other won't be covered. Couldn't do that.
Yes, my ex is raking it in working for the military.
Taking care of yourself only goes so far even if you don't think about what the actions of others may do to you.
My mother did her best to have a healthy lifestyle - she's had breast cancer plus a serious stroke that left her aphasic and mostly paralyzed on one side. For much of her adult life she had diabetes (not now for some reason) and her cholesterol numbers are through the roof - genetics, not lifestyle.
To date, no one has identified any lifestyle issues as causes for the 2 life-threatening blood clots I've experienced.
Trying to stay healthy is a good thing, but it isn't a guarantee that you'll have good health or won't need medical care.
We all need to read as much as we can about HealthCare reform. As you post is showing, those that have coverage are paying entirely too much for what coverage we have. And God forbid if we have to submit a claim... then our cost goes into a tailspin - or worst, we are dropped!
Hells Bells the word I will highlight from your comment is "erode"
Tai, who is covering and taking care of you're lovely Aunt Sheila?
And Mark makes a good point Tai, sometimes genetics override all our best efforts of living a healthy lifestyle.
Ain't right it seems.
And this just in, I received a PM from our own Freaky Troll, who has plenty of cake but absolutely no HC insurance.
A single mom... afraid to speak up, and speak loud.
And, afraid not to...at the same time.
I have VA care, at 40 percent service connection. There is zero money premium, but a terrible "buy in" cost. 8 bucks co pay for prescriptions, and covers everything that they feel like doing.
I pay through the nose for the Medicare because the VA facilities are way too centralized, and getting emergency transport to the VA is out of the question.
I'd love to get rid of the 92 buck medicare premium, but may need it at some point.
-Markin, and even Cap'n.
Zuma you're a veteran which is a good place to be as far as healthcare I think. Thanks for visiting and weighing in.
Tai we all learn a lot around here don't we...
http://open.salon.com/blog/jk_brady/2009/08/09/flooding_the_healthcare_debate_with_dixie_cups
I move to this wonderful right to work state called Florida over 27 years ago and during that time, I doubt that I've been covered more than three years total. We could very well be the king of small business down here. You can't really make much of a living working for anyone because the pay scale is so friggin' low, so most people start a small business, hoping to build a better life. Of course the cards are stacked against you from day one with insurance cost, license fees, fiscal responsibility, credit checks, municipal fees from every town, etc. This causes a great deal of competition in the construction field. Doing high quality work rarely enters the equation. It's all about the bottom line.We are a Red state so it's all about who you can screw to get ahead and the first people to get screwed are the employees. Many small business have less than 10 people so they aren't even required to off health coverage of any kind. Those companies that do offer coverage, offer token coverage at best with outrageous deductibles high rates and copay or they would get priced out of the market, so they offer minimum at best so they can compete with all of the guys that don't have to comply.
It makes offering any decent coverage a death sentence to the business. The best way to get coverage is to work for a large business and there really aren't that many of those or to work for the government were the coverage is great, but the pay is shit for the most part. That's my story and I'm sticking to it.
Co-pay is $15 for an office visit. I believe the deductible is $400 per person. (We've been lucky and haven't really had anything that has exceeded the deductible for several years.) My dental insurance covers up to $1,000 per year, and my vision insurance covers up to $400 per year. Three-tier prescription plan ($10/$25/$40).
The health insurance premiums premiums paid by my employer have risen at least 10% per year for the last several years. (The premium this year for employee/spouse coverage is around $15,000.) At the bargaining table, it has come down to keeping fully-paid health insurance instead of salary increases. (I did get a $300 salary increase this year, though!)
If I retired before age 65 (fat chance), the current arrangement is that my health insurance would continue to be fully paid by my employer until I reach age 65 and go on Medicare.
I have very generous benefits, and I am thankful for them. However, I worry about my brother, who is 50, self-employed, and a very hard worker. He cannot afford health insurance.
Trig I am so glad you are healthy. You need insurance.
In the past when my first husband lost his job for being stupid I worked at my job for free after insurance premiums for two years as he was diabetic and I couldn't afford to lose my house!
I for one would love to keep my insurance the way it is except for the cost and everyone else to have the same wonderful care I get.
Oh yeah in the past 30 years I have had to change Dr's. 5 times and I now have one I love and crap I don't want to be told to change again. Please can I keep her?
Oh yeah and one more thing we at the school have been told our insurance premiums are high because teachers use there insurance!!!!! Huh!
All the people who are against a single payer governement run program for everyone should read this. Sounds like the best programs (both in coverage and cost) are all the government ones.
Good thing I'm healthy! The only serious injury I ever had was the result of an injury I sustained at work, and my surgery and VIP level of rehab/physio therapy didn't cost me one red cent.
I rather fail to see why this model couldn't be ramped up to include all the citizens of the U.S.A., but I guess I suffer from lack of imagination.
:-S
I've been without insurance between jobs, though, and currently if it weren't for me, Mr. Remedy would be without insurance after his April layoff.
We're an aging populace. Health Care costs are bound to go up. I have no problem, and would fully support, the government providing some base level of health insurance for the entire population. However, it seems to me that this base level would then become what all but the very well off would have, as employers would stop offering health insurance because we'd all be covered by the government, although not very well, and any other type of health insurance would become wickedly expensive since it would be so "unnecessary".
If there is a way to have government insurance for all without throwing private insurance out the window, then that would be great.
The problem with healthcare in America is that it is now mostly for profit. It's run for the shareholders - not for the people who need healthcare. About the only way to correct this would be for Congress to pass legislation that would - in essence - tell the shareholders to get fucked. Since congress critters depend on lots and lots of money coming into their hands every day for their re-election runs - it'll never happen. The K street types will just keep feeding them the strings-attached money.
Emma those of us who aren't jealous of what you have in Canada should be. I am. Thanks.
Jeannette good for you. I guess I would be the equivalent of your brother.
Dorinda thanks for the well wishes. As long as I can see my kid get a decent start in life I'm not that concerned for myself. So I really don't care that much about health coverage for me personally. If I got cancer I'd probably refuse chemo or radiation. $685 a month seems pretty darned steep. For me that would be very near to impossible. Like another house payment.
I hope you the best.
Hoop Jr. tick tock your on the clock huh. counting down towards none at all...
Lunchlady 2 sounds like quite a conundrum...wow
Ablonde so Hawaii has it's own little socialized medicine thing? and yeah, thank God you're healthy same as I.
spuds you and me too... there's a charity type clinic I've used before. it's cash up front but like a 1/10th the cost and you might see a nurse practitioner instead of a doc but they always did me right. once again though, for non life threatening issues.
VR first of all I'm happy for you. Second like you say, why couldn't your company be used as a model for the rest of the country? good luck to your Mr. in his new career path.
Existence I do believe that is exactly what is "on the table" although I don't have a good enough attention span to study every single detail like some have.
I also purchase a supplementary Medicare policy that pays all other costs, such as deductibles and copays. The premium for that is $162/mo. My prescription drug plan (with donut hole) costs $23.10. Since I almost never take prescription drugs, I don't even need this, but if I cancel now and try to get it again later, it will cost more.
I have to shop each year to get the lowest priced supplemental and prescription plans, or they get jacked up to much higher premiums.
Even though these are exceptionally good rates, the combined cost of medical (not "health") insurance is about 30% of my SSDI income.
Prior to disability, I had very "good" PPO-type coverage from an employer, or as Michael's domestic partner. Those premiums were subsidized by the employer, and the cost was roughly comparable to what I now pay, plus deductibles and copays.
Until making the changes I made in early 2007, I have been an extremely expensive insured in the past several years (probably $100K + some years), and I have to say that by far, Medicare offers the best coverage with the least hassles (denials & appeals). The fear of a guvment run health plan is completely unfounded.
Basically, I keep my healthcare costs down by not going to the doctor and trying not to get hit by a bus.
BTW...Dorrien, my "English mum" (an old lady I met when I was in school over there back in 2000 and who I visit whenever I go over) is very devoutly Baptist, very proudly English, very worried about the influx of Muslim immigrants to her country, very into the "Left Behind" series and end-time Christian prophecy--you know, someone who, if she were American, the right-wing over here would probably think is one of their own...she can't get over the fact that some Americans DON'T want socialized medicine. She just can't wrap her mind around it. For her it's part of the national public good, like using taxes to pay for the army or roads or public schools. She was eleven years old when the NHS was created, and somehow it didn't manage to turn her into an unpatriotic pinko atheist commie weirdo.
so whoa MarkinKentuckiana you're saying our congress is corrupt?
me too...
RIF good to see ya here. "Medicare offers the best coverage with the least hassles (denials & appeals). The fear of a guvment run health plan is completely unfounded."
Thanks my friend.
Leeandra I am on your "Dorrien"s side. Funny how we ridiculous we look to someone over there.
I consider myself one of the fortunate ones, however. :)
I spent 18 years in the outskirts of DC and paid attention to what the congress critters were doing.
Most of them aren't directly for sale (there are exceptions). What the lobbyist money does is buy access.
Health insurance in its purest form can be viewed the same way. Most common medical procedures can be shopped around for with the consumer making trade-off choices between how much they want to pay and how good of service they want.
As it is, I pay more annually for my auto insurance and homeowners insurance than I do for my high deductible health insurance plan... although my employer does likely pay a much higher portion for the health insurance. Combined, I am certain that the health insurance costs more than the others. But, I also contribute to an Health Savings Account tax free.
Markin to my eyes it seems those who buy "access" might as well being writing legislation themselves. Am I completely off track? The ones with the money make the rules and the government (as it has been for quite a while at least) is a cardboard cut out put up to appease the people at least a little bit while the corporations get every last little bit they can off of us while giving the least possible back in return. And not just in terms of the HC industry (subject for another day maybe)
McGarret50 seems like you fairly much have it by the tail.
I just stepped off the deck where my buddy gave me two hits of the best health care available. Marijuana...Wow! If every greedy vampire out there would smoke two hits a day and back off the martinis I wager they would chill a bit. It's good for the MENTAL health and I hope Obama provides me a small sack each month once we get this health care thing rolling.
Sometimes that's exactly what happens - but, not always. Constituents do still count! A letter to your congress critters does count - especially if it's a real letter, not an email or "click the button on a web site". A letter takes time and effort and that's recognized.
Everyone - the more letters to your Congressmen and Senators supporting health care reform, the better!
One of the reasons lobbyists have the influence they do is that so many Americans are complacent (or apathetic) - don't care, don't pay attention - just take it for granted we're the greatest nation on earth and they don't have to work to maintain it.
The lobbyists have a lot of clout, but they don't completely run things. There are some ethical, moral, congress critters.
Thanks for visiting my post. Yes, we have health insurance. We've always had HMOs because truly we couldn't afford the premiums on the other less limited policies. And we have always been treated extremely well. I think this is because we have chosen our primary physician with care and have stuck with them. THEY make the decisions on what we get or don't get. They've been good people.
Anyway, presently, we are covered by an HMO through Rich's large university employer. Our children are covered as well. I think that now we pay more than half of the premium (this didn't used to be so). The university covers the other half. It's a bit of money a month out of Rich's paycheck, maybe $450. Our co--pays have gone up from $10, to 15 a visit. We don't have a deductible. Our meds are covered but not generously. We have a health savings account (pre tax dollars) that we use to pay the additional on medications that insurance doesn't cover. In the last year, medications have cost us thousands. My husband had total hip replacement the June before this one. Major meds.
At present, I have a neck condition and am having physical therapy. For each visit I pay $15 (which I pay with my medical savings account).
WE just hope that one of us will always be able to work, at least until the age of 65 for a company that has major medical.
You have read about the situation with my eldest child and his intended. Sucks. I worry myself sleepless every night.
denese
There is something about general medical care, hospitals and such, that just does strike me as ethically correct if it is profit. Even some of the cancer treatment protocols that may prolong life (albeit in a miserable form of existence), seem not driven by a goal of cure but by a goal of prolongation (often of misery). The ethics of profit driven medicine give me the creeps.
It is a can of worms, but the thing is, we are not without highly efficient and functioning models to learn from, and to adapt to fit the specific needs of our own country. We are NOT in a position of having to invent the wheel from scratch. There are plenty of working wheels out there for us to study and form our own design from. If only people (gop'ers largely) would get their heads out of their asses and realize this there might be hope for the future of our country.
Otherwise eventually the US will experience what I like to call a "medical bubble explosion" that will make the real estate bubble burst a chewing gum pop in comparison to Hiroshima.
She used to have insurance through the local Bar Association, but the plan was canceled by the insurance company. If lawyers can't negotiate an insurance plan, then who can? WTF!
But I'm still dealing with an insurance company. If I have a problem, I can never talk t the same person twice. There are a lot of errors. I've been fighting to get a physical therapy bill paid for last year, and the insurance claims they paid it and the PT claims they didn't and I have to pay.
I doubt that we will be offered this same plan next year. The costs are just too high because some providers, especially the outpatient surgery center, charges for a 20 minute procedure what you would expect to pay for a day in ICU. Some healthcare providers are still demonstrating their inability to get the issue of costs.
Next year, I will be eligible for Medicare because I'm on Social Security Disability. I'm not sure that will help much, but at least I know I'll have something.
I have chronic hepatitis C and severe arthritis. I have degenerative disc disease and my spine looks like someone punched it out from the side -- it's bowed out and collapsed. I get what must be some of the best care in America. I share my doctors with the local sports teams -- the 49ers, the Giants -- as well as athletes who prefer my doctors. I was kept waiting the other day because someone from the Pittsburgh Pirates needed to be squeezed in with my doctor.
I also have acupuncture, chiropractic, and physical therapy that includes cranio-sacral work and pilates. Anyone who's met me can testify that I seem practically normal and can do all kinds of things like cook, dance a little, go hiking or motorcycle riding with my new hip, my new ACl, my knees shot up with lubricant, my back pain controlled with cortisone, my ankle ligaments tightened etc. If I get a new pain or dysfunction, or a patch of fatigue, I can get some help.
Intensive, high quality medical treatment works. I fear the day I'll lose it. If my husband loses his job, it's gone from one day to the next. Then I'll sit in front of the TV and pop pills.
Co-pays went from $5 to $15 over 7 years, med co-pays were about the same the last 2 years. She only worked at jobs that had group medical ins 'cause she couldn't get it on her own.
She is deeply grateful for Medicare, has access to all the same doctors and medical groups as she had before, and wishes everyone else could get similar. Medicare overhead runs to 3% versus 30+%
for private health insurance companies, not to even go into their denials of coverage after they collect premiums.
~rocco and rusty (who don't have any health insurance)
He works for a French company and we have a BC/BS plan with 3 or 4 levels. I think we take the one someplace in the middle and have a copay on sick visits and prescriptions. All preventative care is at no charge. (Well, no charge beyond the $500/month paid for the coverage - remember that we are a family of 7)
BUT ... last year they put forth a LiveWell Initiative. Basically if half of the people that work in his plant do the initiative there are insurance benefits. So if half of the folks (& insured family memebers) get their check ups and work toward lowering their BP or controlling their diabetes / wear a little step counter while at work and chart the amount of steps they take / agree not to smoke ... basically if half of the folks improve their health there would be some kind of payoff.
When the initiative was complete, Hubs had like 75% participation and our health insurance premium dropped 18% right off the bat. They follow through another year, and it goes up to 25% discount.
So I guess that even though the corporation is somewhat tied to the rates BC/BS charges, they are willing to take over some of the cost for healthy workers/families with the end result being that preventative care and monitoring will actually reduce their costs in the end.
All in all, I give the company an "A" on this, but BC/BS is very difficult to work with. Often claims have to be filed 2 or 3 times before they pay the doctors in their PLAN ...???
I am uninsured. We are self pay. The kind of care we get is not typically dependent on the kind of insurance we have, but rather, the doctor we see. I have been on the insurance merry-go-round long enough to know that general health care does not seem to be affected as far as options once inside the exam room. Though I have been refused a certain type of procedure twice (once b/c my insurance would not pay for it and my offer to pay out of pocket was stiff armed due to ins co denying further treatment if I did that. And once because I had a idiot doctor who didn't even know as much as I did - had never heard of certain conditions and thus obviously had no idea how to go about diagnosing it with the procedure I requested). My kids' pediatrician is a genius! Smartest doctor I've ever met. We owe him $ and won't be able to see him again until we cough up some cash. He usually wipes the slate clean after 7 months of no economic improvement (we have only owed him $150 one other time). I'm not holding out for a clean slate; we are just too broke to even think about paying him at present, but of all the docs I've seen this one is very deserving of what we owe him and then some.
I have noticed the doctors that are so obviously in the hip pocket of the insurance companies, generally suck - don't provide quality care because they see their day as a pinball machine - he's gotta hit X amount of bumpers to rack up enough cash to please the insurance folks who will then shower some wealth his way - sorta like the mafia. The Docs who are in bed with pharmaceutical Co.s are pretty easy to pick out as well. They are as bad as a street dealer pushing pills for every damned thing that ailes you rather than finding the cause and fixing it - it pays (the doc) better to cover it up with meds until it becomes a major problem - at which time you don't have insurance anymore or maybe someone deems your condition not worthy of treatment, and *tells you* they guess (b/c medicine is not an exact science and cannot always be accurately predicted) they guess any treatment to save you or make you well is a "waste" and "perhaps you're better off not having tests and surgery but taking the pain killer [instead]." This video clip
http://www.youtube.com/watch?v=U-dQfb8WQvo
worries me, b/c while I'd like to believe he is talking about getting doctors to stop screwing around with wild goose chase tests (when they really know or have a damned good idea what is wrong and none of the tests they are going to run is going to uncover it but will lead to more tests and eventually - 3 years down the road he will "discover" your problem. But that isn't what he is talking about. He is taking the idiodic practice so common today of testing the RH factor in one's blood when they patient has all the symptoms of Lupus, but then twisting that into a "if it's to hard to diagnose, Adios!" scenario. Now if anyone has had something wrong with them beyond cold, flu and the common stuff, you will know how long it took to get a diagnoses and treatment or a cure. Angrymom on OS went the gamut of tests and it took a long while to get a diagnoses. My sister had a serious problem that NO DOCTOR could figure out - she even saw a doc that specialized in hard to diagnose illnesses. Three years she suffered major pain. Finally I asked her for all the TMI details and in 20 minutes I had it. She had a fistula - a hug one. She went to the doc and TOLD him what she had and WHERE it was located and I'll be damned, He found it. WTF??? When is the education of doctors going to start heavily encompassing more than the common cold and appointment of Gatekeeper of the Holy Grail of Amoxicillin?
I do worry that if some serious illness were to occur, we'd be shit outta luck b/c no one would be willing to work out a cash pay plan for something that will end up costing hundreds of thousands of dollars. However, I *do* think Medicaid has an option for obtaining it for the treatment of a specific and costly illness, though I suspect one would have to jump through flaming hoops and perform circus tricks to get it - then *keeping* it for the duration of treatment would become a full time job: "Are you sure you're still broke? How much money did your household make last month? Who paid your bills? If you paid your bills you don't need this assistance (somehow homelessness in exchange for healthcare is an acceptable result in their minds). I will need a letter from the payer of your bills signed, dated and notarized by noon tomorrow or your case will be closed. I will also need a copy of those bills and statements from your bank, employer, landlord and utility companies showing receipt of payment and an official, notarized copy of your great, great maternal and paternal grandparents' birth certificates, SSNs, the brand of toilet paper you use and a lock of hair from your first born child by noon tomorrow. NEXT!"
Ok, I'm done. ;-)
Right now, I don't have any have health insurance.
I don't know how Group Health can justify 20% increase in 2 years. But at my age, I am not going to go without insurance. I didn't really want to change my coverage, but my small business has suffered in this economy and changing plans was my only option for staying covered. It's not hard to imagine moving to Canada, it's only 35 miles from my house.
"Is it provided by an employer?"
I have always been covered by insurance either through my father's plan, my former husband's, or through my own employer.
There was maybe a 6 month stretch when I left teaching years ago, that I was not covered.
"Do you have to pay part of your premium on your employer provided care? If so do you feel the amount you pay out of pocket is reasonable?"
When I was teaching, the district paid part of the premium and I paid the rest for me and my son. The premiums were not cheap. My main gripe, is that I had to pay the same amount with only one child, as my co-workers paid who had five or more in their family. I always felt like my premiums were subsidizing theirs.
"And do you receive "quality coverage"? In other words would you say you're satisfied that you and your family are well protected?"
Yes, I feel like my basic coverage is quality for just the two of us. It does not, however, include dental or vision which would add another $100 per month to the existing premium, which is $256.00/mo. Adding another family member, they "say" would be nominal, since mine is considered the "Family" plan.
I will say, that the $2000.00 deductible to achieve 100% coverage is steep.
I have always had insurance via employer except (ironicallyh) when I worked for a certain avian insurance company. I am covered now via spouse who has a state job and it pays pretty much 100%. A preferred provider plan, it is pretty good. I will find out today as I seek another preferred provider out-of-town as I hate the provider in town in this specialty.
What worries me is that the Daughter is not covered at all now that she is 23 and not in school. There is a big gap there in coverage around the nation.
But then the premiums kept going up and up. Sometimes every few months, it seemed. And this was at a time when the economy was getting worse, including my business.
Then I had high-blood pressure and it seemed the premiums were rising to fast and too quickly. The deductible went up to a whopping 5000.00. As an artist, I always made enough to cover the bare necessities. By December of last year, the monthly premium had almost doubled (154.00) from what it was initially (85.00) and I just couldn't afford it.
I've now lost the business and I have no health insurance.
I've recently gotten a part-time job and will be eligible for some health coverage after I've been there for 3 months, but the out-of-pocket cost will eat into the meager part-time paycheck, so what's the point?
My last doctor wanted all kinds of stuff from me--a complete physical, blood work, colonoscopy, etc. which he said should all be done at my age (56). Yea, right. And who's going to pay for it??? I haven't been to a dentist in ages even though I need a couple of crowns. Right now I'm putting away a bit of money to finally go to the eye doctor for a much-needed new pair of glasses.
I'm betting on health care coverage by the end of the year. If it doesn't come and our own government can't get it fixed, I'm afraid I'll give up on the USA for good. I already tell my younger cohorts and relatives to think about living in other countries. My only regret in life is that I didn't when I had the chance.
Trig, have you (or anybody) investigated the insurance offered by freelancersunion.org ?
Rated
I pay 35 dollars to see a P.A. for maybe five minutes every three months to get my meds renewed. While there the staff weigh me, take my BP and temp, and occasionally listen to my heart. So far, I am within the expected parameters for being alive.
The P.A. always scolds me for the fact that I have not had the preventative maintenance that a woman my age should be getting. She gives me the uninsured persons menu of ala carte tests and screenings, but they are still out of price range and what if they find something? Then what?
Luckily we are a relatively healthy family. Actually- scratch that- we tend to have mysterious conditions that the doctors could never figure out. I am thankful for the coverage we hav, but at the same time I really hate the fact that we are completely at the mercy of our employment status. Single payer couldn't come soon enough.
We both have pre-existing conditons that will not allow us to purchase indiviual policies when it runs out--high blood pressure (controlled by meds). As for myself, MVP (mild), scoliosis, and major depression caused by his lay-off.
We are screwed.....
I am disabled, have Medicare A&B, which comes with a $96/monthly premium. Anything that is not covered by that is picked up by the state. My prescriptions come with a $3 copay which is a godsend.
Without my prescription drug coverage my prescription costs would easily total $2500 monthly, so $3 is pretty good IMHO.
My hub took early retirement, has Medicare A&B, a drug plan with $10 copay. Fortunately he remains healthy and is not on any daily prescriptions.
Em has no coverage and has to apply for sliding scale payments at the clinic that sees her regularly. She has no drug coverage and really gets walloped by those costs, when and if she can afford the script. She applies where ever there is help to be had, but she's got a huge expense with her scripts.
My son is disabled and has the same coverage as I do.