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It depends on which specialities. Some like anesthesiology. Medicare pays roughly 33% of what private insurance pays. My brother out in Los Angeles. He's lucky to get around $15/unit for Medicare patient. And gets $50-60/unit for private.
General surgery usually gets 60 cents on the dollar from Medicare what compared to what private insurance pays.
The bottom line is if your payer mix is more than 30% Medicare (plus throw in another 10% medicaid). That's the borderline payer mix whether how much in the black vs red you will run your practice.
Than you got roughly 10% of your own patients who refuse to pay their deductibles after insurance. That's another mess in itself.
Your whole post just shows how absurdly inflated the cost of health care has become in America.
Asking for deductibles upfront would solve that other mess, but then guess what; folks can't afford
their deductibles because the cost of services, esp. tests have become so inflated.
e.g compare cost of an angiogram in Canada vs one here in the states.
So many reasons why we need single payer universal health care. Let me count the ways...
Start with quiting the insurance game.
Your whole post just shows how absurdly inflated the cost of health care has become in America.
Asking for deductibles upfront would solve that other mess, but then guess what; folks can't afford
their deductibles because the cost of services, esp. tests have become so inflated.
e.g compare cost of an angiogram in Canada vs one here in the states.
So many reasons why we need single payer universal health care. Let me count the ways...
Start with quiting the insurance game.
Physician costs/income only make up 8% of total health spending in the USA.
Only the UK spends less money on physician incomes than the USA as a percentage of total health spending.
That shows you where the problem is.
The issue is if you start cutting the spider web that is the health industry. Unemployment will skyrocket to 15% easily from the CEO to the Janitors.
We were planning on traveling in our retirement years but out of network policies are almost $900 a month
Americans are among the most mobile people on earth, but ObamaCare may soon start freezing them in place. Millions are losing their health insurance policies and being forced onto the ObamaCare exchanges, where most plans only provide local medical coverage.
More hyperbole and arm waving from the right about something (devastating the travel industry) that will never happen. Maybe my employer is cheap but I have not seen a policy that covered out of network in at least 10 years. Single payer would solve this problem too. People on medicare are free to live where they want and travel where they want without being concerned about health care should they get sick on their trip. Must be nice. FWIW, all the BCBS policies on my exchange have nationwide networks. They cost more than the narrow network plans as you might suspect. But it is nice to have that choice to pick a plan that suits your needs. Like I said, few employer plans offer out of network anymore.
More hyperbole and arm waving from the right about something (devastating the travel industry) that will never happen. Maybe my employer is cheap but I have not seen a policy that covered out of network in at least 10 years. Single payer would solve this problem too. People on medicare are free to live where they want and travel where they want without being concerned about health care should they get sick on their trip. Must be nice. FWIW, all the BCBS policies on my exchange have nationwide networks.
Several posts back you claimed that HMO/PPO didn't cover out of network so well and that parents sending their kids off to college were screwed with limited to no out of network.
And I've always had a PPO that covered out of network to a certain degree and still have today.
But just because you don't have one doesn't mean no one else does.
Several posts back you claimed that HMO/PPO didn't cover out of network so well and that parents sending their kids off to college were screwed with limited to no out of network.
And I've always had a PPO that covered out of network to a certain degree and still have today.
But just because you don't have one doesn't mean no one else does.
Now you claim the opposite ?
Your point is? That is exactly what I am saying with the post I think you are referring to - out of network has been limited to dead for some time in most policies. The right wants to make it sound like it is something new in Obamacare when it is a long-running trend in employer plans as well. "To a certain degree" is not national coverage, I don't think. You can't travel around the US and see any doctor you want for a cold. National coverage is rare anymore. Emergency care out of network is a requirement of the ACA and the ACA sets a standard for reimbursement that may help prevent balance billing as well.
Your point is? That is exactly what I am saying with the post I think you are referring to - out of network has been limited to dead for some time in most policies. The right wants to make it sound like it is something new in Obamacare when it is a long-running trend in employer plans as well. "To a certain degree" is not national coverage, I don't think. You can't travel around the US and see any doctor you want for a cold. National coverage is rare anymore. Emergency care out of network is a requirement of the ACA and the ACA sets a standard for reimbursement that may help prevent balance billing as well.
That's a pretty sad notion that you run to the doctor for a cold.
Most people just consider ER coverage when they travel and that is covered out of network no matter what plan you are on and that's been standard since before Obamacare got signed.
That's a pretty sad notion that you run to the doctor for a cold.
Most people just consider ER coverage when they travel and that is covered out of network no matter what plan you are on and that's been standard since before Obamacare got signed.
The ACA made changes that set a minimum standard for reimbursement on emergency care. Often, insurers would low buck providers of emergency care out of network. Now, they must pay according to certain rules and that is expected to help prevent the widespread practice of balance billing patients for out of are emergency care. ACA does not go anywhere near far enough to stop the balance billing game though - one of its failings/capitulations to the medical industry.
More hyperbole and arm waving from the right about something (devastating the travel industry) that will never happen. Maybe my employer is cheap but I have not seen a policy that covered out of network in at least 10 years. Single payer would solve this problem too. People on medicare are free to live where they want and travel where they want without being concerned about health care should they get sick on their trip. Must be nice. FWIW, all the BCBS policies on my exchange have nationwide networks. They cost more than the narrow network plans as you might suspect. But it is nice to have that choice to pick a plan that suits your needs. Like I said, few employer plans offer out of network anymore.
Wow, Ponderosa, it has taken many months and thousands of posts, but I am sure glad you see it our way now. I would correct your post in one respect: "But it WAS nice to have that choice to pick a plan that suits your needs."
The Anti-Choice crowd passed Obamacare, it took away the policies we liked that suited our needs, and now you recognize how wonderful choice is. And don't bother to insult my old plan, that would only reveal ignorance and/or bad faith.
For the very limited remaining choice, I bought one of those higher cost national network BCBS plans you talk about because that is what I need. I am still kind of fried about the doubling of out-of-pocket limits to more than $12,000, and the increase in deductible to $5,000, and the 50% (50%!) coinsurance. And a bunch of those Obamacare taxes, hidden and explicit, will cost me thousands more--they are double dipping on me.
It sure is gratifying to have you endorse the idea of choice in buying health insurance plans, even though you are a little late.
Wow, Ponderosa, it has taken many months and thousands of posts, but I am sure glad you see it our way now. I would correct your post in one respect: "But it WAS nice to have that choice to pick a plan that suits your needs."
The Anti-Choice crowd passed Obamacare, it took away the policies we liked that suited our needs, and now you recognize how wonderful choice is. And don't bother to insult my old plan, that would only reveal ignorance and/or bad faith.
For the very limited remaining choice, I bought one of those higher cost national network BCBS plans you talk about because that is what I need. I am still kind of fried about the doubling of out-of-pocket limits to more than $12,000, and the increase in deductible to $5,000, and the 50% (50%!) coinsurance. And a bunch of those Obamacare taxes, hidden and explicit, will cost me thousands more--they are double dipping on me.
It sure is gratifying to have you endorse the idea of choice in buying health insurance plans, even though you are a little late.
I have not wavered one iota in my position. Obamacare is the first time I have ever had choice in buying health insurance. Like most Americans my working years were covered by an employer policy and I took what they offered and what they offered was one plan fits all. Individuals have always had choice, but I am willing to bet most of them would rather have had group plans with the limitations.
I have not wavered one iota in my position. Obamacare is the first time I have ever had choice in buying health insurance. Like most Americans my working years were covered by an employer policy and I took what they offered and what they offered was one plan fits all. Individuals have always had choice, but I am willing to bet most of them would rather have had group plans with the limitations.
Did your employer mandate you enroll in its plan as a condition of employment ? If not, you've always had choice. By imposing minimum mandates on individual and small group policies, Ocare has restricted choice.
You might prefer an exchange policy in your state over what previously was offered, but choice in many states and counties isn't the same. It's worse.
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