Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
The advice that I can give everyone is this...when your policy comes, or for those that obtain health insurance at work, please, please read the Summary Plan Description (SPD)...the small print. Please read before you enroll during your open enrollment. Please call the open enrollment/benefits people, or for those insured individually,call your agent first, then the insurance company's customer service, and then if you're still not satisfied, call your state's Department of Insurance. If you choose a plan with a high deductible, plan on how you are going to pay for your medical bills before meeting that deductible. Take your Pharmacy plan documents, the one which shows you what goes under each tier of reimbursement and ask your doctor to prescribe a generic form of your meds if one is available. THIS IS YOUR JOB! DO NOT ASK YOUR DOCTOR TO GUESS WHICH IS GENERIC UNDER YOUR PLAN! They have better things to do. If you have been so lucky to get some coverage under your employer, plan on how you are going to pay for premiums for 18 months while you have to go on COBRA. Calculate what is your share, add your employer's share, and multiply this by 102%. The 2% is the administrative cost of COBRA. That is mostly uniform across insurance companies. Most of the time, individual private coverage is cheaper (by leaps and bounds) than COBRA but know what that cost is and fund it appropriately BEFORE you ever need it.
There are private insurance to be had for pharmacy. Walgreen's for example has its own Rx insurance which you could use to coordinate benefits with your Rx plan.
Know which benefits can be covered under a different plan - medical under dental, dental under medical, vision under medical, Rx under medical, medical under Rx....blah blah blah.
GOOGLE is your friend. Read read read statutes in your state that pertain to your particular situation. Arm yourself with knowledge...if you are in the right, the insurance company cannot deny you what is due you, but that is only IF you do your own homework and plan.
When your finances allow you to save for a little, truly evaluate your risk position and risk tolerance. If your credit is good, have a credit card with 0% interest and use this only for this purpose.
There are victims of circumstance, and victims by choice. Try not to be the latter.
Have you ever been ill enough to actually make a large claim on your health insurance? Do you have any idea of the cost of maintaining health insurance through a COBRA? Have you seen the list of medications offered at Walgreens?
My dad had the best Blue Cross insurance available. Both he and my mother were in a very bad car accident. My dad was killed instantly and my mother was in an intensive care unit for 3 months and a rehabilitation unit for another three followed by 6 months in a nursing home learning to walk again.
All this time, the insurance company sent 2 letters/week to her house saying they would not pay because her hospital stay extended beyond the extent of her injuries. (She was in the intensive care on a ventilator at this time). Sure enough, the insurance company did not pay the bills and the hospital put a lean on everything she had left as a widow. We (her children) had to fight the insurance with a grievence and an appeal since mom was unable at the time. This took an enormous amount of energy and time.
Plan all you want but you may still find yourself screwed. Especially if no one can go to bat for you while you are too ill to fight the SOBs.
Again... You might want to tone it down a little. Sounds like you're spinning out of control.
No, she is not "spinning out of control". She is intelligently and eloquently describing a growing problem of the dysfunctional healthcare system in the US.
No, she is not "spinning out of control". She is intelligently and eloquently describing a growing problem of the dysfunctional healthcare system in the US.
Apparently you haven't been reading her posts.
I can understand her frustration, but her points are lost behind her screaming and yelling.
My dad had the best Blue Cross insurance available. Both he and my mother were in a very bad car accident. My dad was killed instantly and my mother was in an intensive care unit for 3 months and a rehabilitation unit for another three followed by 6 months in a nursing home learning to walk again.
First, very sorry about your parents. Second, why didn't their car insurance cover the difference? Many car insurance policies subrogate to the medical insurance first, and kicks in after they quit paying.
Man.. you all have a reading comprehension problem
I was paying $856/month in one state for me and my son.. he had to come on with me as a minor..
I MOVED to get away from high costs.. and reduce cost due to my reduced income!! HOWEVER .. THe plans I can get and combinations of the plans are almost the SAME..
ANd THE DEDUCTABLES ARE HIGHER!!! MY deductable under my $500/month plan I believe is $2000 and combination of husband and son $2000.. so that's $5000 out of pocket on top of almost $800/month in premiums..
GEEZ people..what part of INSURANCE PREMIUMS ARE RIDICULOUS DO YOUNOT UNDERSTAND..
aNd about a gazillion posts back I did say that i found one for my hsuband and son seperate from mine but that it STILL EQUALED what I was paying for insurance every month back in NY !!!!!!!!!
AND the point is that WHILE I MAY BE ABLE TO AFFORD IT there are many out there WHO CAN'T.. or is it that somene is actually compassionate for other people and this ridiculous cost that is beyond your comprehension!!! I'm not only angry and upset about it for myself.. but what about people who find themselves in MY position who CAN'T AFFORD IT!!!
TM:
What do you estimate your monthly medical expense to be? Not your premium, not your copay, but the actual cost of the medical services you incur, including doctors, lab, Rx, etc? Do you think you utilize $12K a year in actual costs? If you do, then you really can't complain about the premium. If you don't, then drop current plan and purchase a catasrophic plan. Pay for the rest out of pocket. Quit focusing on the premium and instead foucs on the cost of the services you utilize.
I can understand her frustration, but her points are lost behind her screaming and yelling.
Jojahn - you are a johnny-come-lately to TM's posts. I have said this before, read her millions of posts here so you can understand where the other posters' frustrations with her come from.
Yes I have an idea of what COBRA premiums are. I have said that I have lost my job three times. I don't purchase COBRA for that reason. I shop individual plans.
Yes I have had a large expense. I have also posted in this thread that I had breast cancer...just last year, and after the lumpectomy, 33 days of radiation. Do you have any idea of how much radiation is daily? I went to network providers...had to drive further, but yes my share was 20%, and they waived that.
We do have very high limits for auto insurance. They will cover expenses to passengers due to uninsured drivers. It isn't that expensive.
I am covered for accident through work. I elected to cover the rest of my family.
My limit is $5 million for my lifetime, and I can choose for an extra $3.52 in premiums to waive that lifetime maximum.
Knowledge is power. If you don't know/understand what you're fighting the insurance company over, you'll lose. That was the intent of my post.
BTW, what is an anaesthetist? Is that the same as an anaesthesiologist?
P.S. I wasn't talking about the cost of Rx at Walgreen's. I was talking about a Rx insurance through Walgreen's that you could purchase as a supplement to medical insurance. It appears that you are only reading what you want to read, and not really understanding the posts. This is exactly what TM is guilty of many times in her posts.
Have you ever been ill enough to actually make a large claim on your health insurance? Do you have any idea of the cost of maintaining health insurance through a COBRA? Have you seen the list of medications offered at Walgreens?
My dad had the best Blue Cross insurance available. Both he and my mother were in a very bad car accident. My dad was killed instantly and my mother was in an intensive care unit for 3 months and a rehabilitation unit for another three followed by 6 months in a nursing home learning to walk again.
All this time, the insurance company sent 2 letters/week to her house saying they would not pay because her hospital stay extended beyond the extent of her injuries. (She was in the intensive care on a ventilator at this time). Sure enough, the insurance company did not pay the bills and the hospital put a lean on everything she had left as a widow. We (her children) had to fight the insurance with a grievence and an appeal since mom was unable at the time. This took an enormous amount of energy and time.
Plan all you want but you may still find yourself screwed. Especially if no one can go to bat for you while you are too ill to fight the SOBs.
WOW.. what a story..
Blows my mind that the extent of her injuries didn't warrant her hospital stay.. yet she was on a ventilator.. There you go.. some pencil pusher checking the balance sheet to make sure that the profiteers get their profits!! DISGUSTING.
First, very sorry about your parents. Second, why didn't their car insurance cover the difference? Many car insurance policies subrogate to the medical insurance first, and kicks in after they quit paying.
The medical bills were in excess of one million dollars! She needed multiple surgeries, was in an intensive care 3 months, arrested a couple times, etc...
I don't think many auto insurance policies cary medical that high. Mine is for $20,000.
Jojahn - you are a johnny-come-lately to TM's posts. I have said this before, read her millions of posts here so you can understand where the other posters' frustrations with her come from.
Yes I have an idea of what COBRA premiums are. I have said that I have lost my job three times. I don't purchase COBRA for that reason. I shop individual plans.
Yes I have had a large expense. I have also posted in this thread that I had breast cancer...just last year, and after the lumpectomy, 33 days of radiation. Do you have any idea of how much radiation is daily? I went to network providers...had to drive further, but yes my share was 20%, and they waived that.
We do have very high limits for auto insurance. They will cover expenses to passengers due to uninsured drivers. It isn't that expensive.
I am covered for accident through work. I elected to cover the rest of my family.
My limit is $5 million for my lifetime, and I can choose for an extra $3.52 in premiums to waive that lifetime maximum.
Knowledge is power. If you don't know/understand what you're fighting the insurance company over, you'll lose. That was the intent of my post.
BTW, what is an anaesthetist? Is that the same as an anaesthesiologist?
P.S. I wasn't talking about the cost of Rx at Walgreen's. I was talking about a Rx insurance through Walgreen's that you could purchase as a supplement to medical insurance. It appears that you are only reading what you want to read, and not really understanding the posts. This is exactly what TM is guilty of many times in her posts.
I may be a "Johnny come lately" but what I have read about health insurance from Tritsansmommy makes rings true.
Yes, I know what radiation costs. I also have had breast cancer with surgery, chemotherapy, and 6 weeks of radiation therapy. I have often wondered about how women who could not afford health insurance manage when they notice a "lump". I am well covered with health insurance but I too often have seen what happens to people without. One woman came to the operating room with breast cancer so progressed, her breast was totally disfigured. Often a credit card or prepayment is required before someone without health insurance can see a doctor unless it is the ER.
I have seen the list of drugs included in Walgreens drug benefit. Most are offered cheap and are generic. There are newer and much more effective drugs than those offered. Did you see Lipitor on the list? How about Lexapro or Imitrex? Their plan is mostly a PR program.
An anesthetist is a nurse who does anesthesia. We have 3 years of post graduate education after a minimum of 1 year experience as an RN in an intensive care. We do all the same things as an anesthesiologist except we cost less. Happy Thanksgiving!
jojahn - from one survivor to another, best wishes!
I am sorry for your parents' plight. I don't think that even with some form of universal/nationalized healthcare that issues of catastrophic magnitude will be addressed. There just isn't enough money to go around for everyone to be supported completely at the tune of a million dollars. We can only plan for the worst, and hope for the best.
The company I used to work for had 18 hemophiliacs being managed at $1 million each year for the Factor VIII drugs. I'm sure there are more hemophiliacs out there but not everyone can be covered without limits even by a national healthcare/insurance system. There are 5 million morbidly obese individuals in the US, all wanting and waiting for funding of gastric bypass surgery at $30K each, that is excluding the cost of bringing down their weight to a level that is safe to operate on, and excluding the cost of any complications or inpatient admits post-op, or PT and OT sessions during and after. That also excludes all the tummy tucks or removal of excess skin elsewhere that is covered by private insurance, following the surgery. Fertility treatments result in multiple births, almost all are preemies. The cost of each NICU baby exceeds a $100K each, and so forth and so on. I just don't know at what point increasing taxes for everyone will cover everyone, or if someone will make a decision on what is life threatening and should be treated first. It just is a very thin line.
TM had responded to my post and said that if her $800 premium went up to $900 that UHI is not really working. I'm sure that for someone whose premium went down from $1200 to $900, it is. That alone shows me that no matter what is done, there will always be people for whom it won't be acceptable. Somebody has to pay more for somebody to pay less. The people who will have to pay more for others to pay less are not going to be happy. TM has already illustrated that in her response.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
