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I don't want free preventive care. I am smoker so any private insurance will penalize me through the roof, which Medicare doesn't. No, I don't want a free stop smoking program either. I also currently live in Florida where insurance (lot of older people) is sky high.
Lots of older people (those eligible for Medicare) in S Florida are in the Advantage plans. And no, there is no penalty as a smoker. The only health restriction for enrolling in them is no end-stage renal disease.
anyone could opt out - someone mentioned joining a health sharing group, Im a member of one and so far have been really happy with it - we (household of 2) have the premium plan and it costs us $299 a month and we are responsible for the first $1000 and after that the group picks up at 100% - very effective discounting process
so much of health care costs are so inflated to begin with, I used to do health insurance recoveries several years back and had to read the contracts the insurers had with providers - that $10,000 ER charge isnt going to result in $10,000 coming into the provider, typically they will have a case rate or discounted fee of service. Perhaps it adjusts to $2,000 then $8,000 is adjusted and then the rest will depend on the patient responsibility. Problem is that the industry is so built to deal with the 3rd party system that its hard to understand, what if you as the patient can get the same cost as the what the insurance pays?
To be fair also, there are providers who do and some who are moving completely away from the insurance fiasco and moving to private and group pays. I don't think you will find too many people who wouldn't want laws to change to help remove restrictions that pushed people with pre-existing conditions etc off polices, but there are reasonable ways to approach that and unfortunately there was too much politics involved in what I think theoretically was a good idea to help people.
I digress, you can look up the self pay patient blog online for cool info and I am a member of a health sharing group (I opted out of this mess) and can speak to my experience, its a great concept.
anyone could opt out - someone mentioned joining a health sharing group, Im a member of one and so far have been really happy with it - we (household of 2) have the premium plan and it costs us $299 a month and we are responsible for the first $1000 and after that the group picks up at 100% - very effective discounting process
so much of health care costs are so inflated to begin with, I used to do health insurance recoveries several years back and had to read the contracts the insurers had with providers - that $10,000 ER charge isnt going to result in $10,000 coming into the provider, typically they will have a case rate or discounted fee of service. Perhaps it adjusts to $2,000 then $8,000 is adjusted and then the rest will depend on the patient responsibility. Problem is that the industry is so built to deal with the 3rd party system that its hard to understand, what if you as the patient can get the same cost as the what the insurance pays?
To be fair also, there are providers who do and some who are moving completely away from the insurance fiasco and moving to private and group pays. I don't think you will find too many people who wouldn't want laws to change to help remove restrictions that pushed people with pre-existing conditions etc off polices, but there are reasonable ways to approach that and unfortunately there was too much politics involved in what I think theoretically was a good idea to help people.
I digress, you can look up the self pay patient blog online for cool info and I am a member of a health sharing group (I opted out of this mess) and can speak to my experience, its a great concept.
You have me more interested in switching to a health sharing group now! Thanks for your input. I may look into joining one this year instead of waiting.
You have me more interested in switching to a health sharing group now! Thanks for your input. I may look into joining one this year instead of waiting.
Sure - I can send you some information to the group I am a member and even walk you through some details if its of interest - not for everyone but definitely been great for us and a lot of folks here in the past year.
Being a member of a qualified organization will exempt you, it was written into the law - we will just fill out that portion into the taxes at the end of the year and thats it - no fine and full control of you healthcare
Being a member of a qualified organization will exempt you, it was written into the law - we will just fill out that portion into the taxes at the end of the year and thats it - no fine and full control of you healthcare
It is an interesting concept. Will all the doctors and hospitals in your area accept it as an insurance equivalent?
Interesting. Like most things in Switzerland, this also appears to work well. But there are vast differences between the US and Switzerland, and what works there would not necessarily work here.
There are some similarities to our plan. The one that jumps out at me first is that Switzerland allows premiums to be up to 8 percent of a person's income. Also, these additional optional costs don't count toward that 8 percent and are not eligible for a subsidy: complimentary medicine, routine dental care, half-private or private ward hospitalization, etc. I guess what "complimentary medicine" means is that your prescription drugs aren't free unless you pay an upcharge for your insurance.
ALL insurance plans in Switzerland require the consumer to pay a portion of the costs of their treatment in addition to the premiums. Everyone buys a comprehensive insurance plan within three months of moving to Switzerland and everyone pays full price - no subsidies.
Another thing that people need to remember is that in most of Europe - including Switzerland, unless you pay for additional insurance, you don't get a private or semi private room. You get place on a ward, often with 40 or more other people. No private bathroom, TV, and wall of windows, that's for sure. You get a fabric sheet you can pull around your bed but it won't block the sounds or smells on the ward - snoring, moaning, talking, farting, vomiting...you get to lay there and listen to all of it. It's definitely a different experience from the one Americans are used to...but then, you get what you pay for.
However, in Switzerland and some other European countries, you can pay for an additional insurance company that allows you to have a private or semi private room, among other things.
Employers do not pay any of the costs of health insurance in Switzerland. Everyone foots the entire bill themselves, unlike the US. In the US, only ONE TENTH of the population buys their own insurance. Why Switzerland Has the World's Best Health Care System - Forbes
The US is #1 in health care costs per individual, Norway is #2, and Switzerland is #3, so their plan doesn't do much to actually reduce healthcare COSTS. This is pretty important to know. But the median wealth per individual of Switzerland is much higher than that of the US - Switzerland is a very wealthy country and it also does not have the illegal immigration issue that the US has, or the widespread issues of poverty within various minority groups. These factors play a huge role in healthcare and healthcare costs.
there are vast differences between the US and Switzerland, and what works there would not necessarily work here. Switzerland is a very wealthy country and it also does not have the illegal immigration issue that the US has, or the widespread issues of poverty within various minority groups. These factors play a huge role in healthcare and healthcare costs.
Yes. Switzerland has a very homogeneous population of only 8-9 million people that really can't be compared to that of the U.S. And it's doubtful that many Americans would go along with their very regressive tax system.
It is an interesting concept. Will all the doctors and hospitals in your area accept it as an insurance equivalent?
For our organization we have a card like you would for insurance (individual, group pay etc), present it and it contains all the membership data, reimbursement amounts and the payerID. The payer ID is where the bills are submitted electronically - this is the discounting clearing house and this organization also does the same thing for hundreds or thousands of different groups, self funded insurance companies etc across the country. I was told before I joined that around 95% would just take the card, verify your information and DOB etc and then move you along in the process as usual, 4% would pick up the phone and call the number on the back and verify eligibility or ask a question, 1% would call and want to negotiate beyond the reimbursement schedule - the provider relations department will negotiate it all for you so that all parties are satisfied.
I had my annual wellness visit and I was in the 95% category when I walked in, they verified DOB etc and make a copy and I walked out with a superbill after the visit was complete. My wife was the 4%, they updated her information over the phone when she made the appointment - they didnt have the physical card to look at so they made a quick call to verify eligibility and that was it, maybe 1-2mins expired for the call so it was pretty quick. We went this week to our first widwife appt and it was just handing the card over (they are all in the same large major medical provider so the information was already on file).
Its all electronic and you can see it when you log in online and see the status of the bill, including the original charges, discounted charges, new charges and how much of a responsibility you have. Providers are getting paid within 30 days and you can see when they receive payment including the check number online - you will also receive a statement to keep for your records.
Let me know if you have any more questions - I hope this is helpful
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