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First, am I correct in thinking that nobody has a preexisting condition?
No, but they didn't ask - this was a very basic quote generator. My girl has a broken back from an accident that happened when she was 18. She had surgery to alleviate some of the pressure on her spinal cord about a year and a half ago, and that's pretty much all they can do for her. The bone is broken in a way that it can't be pinned or otherwise repaired. At this point, all they can do is prescribe a couple of different meds, both of which are on all the pharmacies' $4/month prescription list (thanks Wal*Mart!).
So basically, yes, there is a preexisting condition, but there's nothing they can do about it anyway, so not covering it is not a big deal.
Quote:
Originally Posted by Bagger
Office Visits: $35, 2 per year per person
Specialists: $35, 2 per year per person
I assume that would be 2 per year for each of the 4 of you? The two adults and two children.
That's how I read it, yeah. Again, I haven't read the fine print, which I always do when signing up for anything of substantial cost (the finance guys at the car dealerships hate me for it - I also verify their monthly payments )
Quote:
Originally Posted by Bagger
Annual Deductible: $5,000, $2,500 per person, two persons max
There's 4 people being covered... what do they mean by two persons max? What about the other 2?
I'm not completely sure, but I read it as meaning that they'd only be charging the deductible on two people, and the others would be covered without a deductible. That's probably the biggest question I have with the quote, and I haven't looked into precisely what it means, yet.
Quote:
Originally Posted by Bagger
Coinsurance: 20% after deductible
What's coinsurance? You pay 20% of the bill after the $5000?
Is crossing State lines on the table from either party pertaining to health insurance reform?
Yes, I believe it's in the Republican plan. Greatday started a thread about it that's gone on for about a zillion pages, and I read it in his summary of the plan. I haven't independently verified it, though.
What I found was that as long as you're not wanting every single nickle and dime covered, the plans are actually pretty affordable. You do, of course, have to look at the details and really understand what it is you're signing up for, but then, shouldn't you always do that when you're entering into a contract? I would think that would be particularly important when dealing with something as significant as your health. I say this because a big part of the argument for some form of government run health care is that the insurance companies try to weasel out of providing care, and often the care in question isn't covered by the plan. Most people don't read what they sign...
Here's the basics of the plan that best fits our situation. We may or may not purchase this plan in the next month or two - I need to do some more shopping around. The comparison tool I used this afternoon was eHealthInsurance.com. The quote is for two adult smokers and two teenage boys.
Office Visits: $35, 2 per year per person
Specialists: $35, 2 per year per person
Coinsurance: 20% after deductible
Annual Deductible: $5,000, $2,500 per person, two persons max
Rx: Generic: $15 copay, no brand name coverage
Annual out of pocket limit: $3,000 per person + deductible
Lifetime Maximum: $3,000,000 per person
Out of network coverage: Yes
Out of country coverage: Yes, emergency only
Primary Care Physician Required: No
Specialist Referral Required: No
OB/GYN: Basics are 20% coinsurance after deductible
Emergency Room: 20% coinsurance after deductible, $500 copay if not admitted
Lab/X-ray: 20% coinsurance after deductible if performed within 2 weeks of surgery
Outpatient Surgery, Hospitalization: 20% coinsurance after deductible
Maternity: Not covered
Cost: $306.94 / month
There are some things in the list I'd like to see tweaked, but it's really not that bad of a deal. It's certainly not indicative of a "crisis." Would it be a free ride if there was a major accident or illness? No. Would it bankrupt us? No. There's enough coverage there to ensure that we'd get the care we need, and we'd just have to tighten our belts for a while.
NO NO NO! BOLOGNA! That's not what your premium will be. You haven't applied yet. Before you get approved, The insurance company is going to send you to have a physical and they will have all of your medical records pulled. They will take everything in your history into consideration. Even the fact that your kids are in a smoking household. That's just an online "quote." I've shopped them before. Who is the carrier?
You both are smokers! What's your BMI? Are you or your kids overweight. Health insurance providers love that antiquated BMI chart.
You will not be approved by any of their carriers. The private insurance company will refer you to your state for insurance.
If it's so affordable, why don't you already have aprivate family plan? IMHO you're way too nonchalant in this post.
We may disagree (a lot) on some of the specifics, but I wholeheartedly applaud that post. Please gather some like-minded people and take the GOP back. Please?
If you're interested in comparisons, take a gander at the German model. Private companies (yes, really!), but they're non-profits and regulated.
The quote is for two adult smokers and two teenage boys.
Cost: $306.94 / month
Not possible. Which company? Even an HSA with a $10,000 deductible would be at best $800 a month, especially with 2 smokers and 2 teenagers. Is this Midwest or Mega? See if your claims are paid when you actually get sick.
Quote:
Originally Posted by swagger
Would it be a free ride if there was a major accident or illness? No. Would it bankrupt us? No. There's enough coverage there to ensure that we'd get the care we need, and we'd just have to tighten our belts for a while.
Okay. I see. I'm a licensed Health Agent, so that is why I made the above comment. However, I stopped selling this type of plan to families because if someone has a heart attack or gets cancer, he loses his home. The whole point of having good coverage is to be insured for the worst possible scenario, including disability. I recently visited a man who had a heart attack and was stuck with $70,000 (his share of the bill) Imagine being out of work, recovering from a heart attack and you get a bill for $70,000. You think this is a good plan?
1 out of 3 people will be diagnosed with some kind of cancer. Do you want to take a risk? Do you want to gamble that your spouse or child won't get seriously ill? Health reform isn't just about lowering premiums, it's about saving lives. The USA is #29 out of the 30 industrialized countries in infant mortality. We are almost dead last in life expectancy. That should bother every American.
Quote:
Originally Posted by swagger
convinced that there is no "health care crisis" in this country.
2 smokers? When you get lung cancer, let me know how you feel about your plan. Tell me there's no health care crisis when you check into a homeless shelter.
By the way, if your post isn't completely fabricated (which I suspect it is) then I suspect you give up smoking. If you need to "tighten your belts" to pay for health care, that would be the first step I'd suggest.
Last edited by justNancy; 08-04-2009 at 05:45 PM..
NO NO NO! BOLOGNA! That's not what your premium will be. You haven't applied yet. Before you get approved, The insurance company is going to send you to have a physical and they will have all of your medical records pulled. They will take everything in your history into consideration. Even the fact that your kids are in a smoking household. That's just an online "quote." I've shopped them before. Who is the carrier?
This I agree with. I've had companies where I shopped for group rates for employees and less than $400 a month for a family just won't happen.
Not to be rude but get back to us when you have a written proposal and policy in hand.
Also, with databases the insurance companies have access to you don't need to tell them about preexisting conditions... they already know. They know more about you than you do.
As a lot of you may know (it's been mentioned a few times in here), I'm self employed and we currently have no health insurance. The last time I priced it was about a year ago, when we started our business. The plans I was looking at then were all over the map, as we weren't sure how fast the business would take off and how much money we'd have to spend on insurance.
With all the talk about health insurance these days, and with all the threads going here discussing the "health care crisis" we are or aren't experiencing and the alleged outrageous cost of plans for those whose employers aren't bearing the brunt, I decided to take another look at the options available and their cost.
What I found was that as long as you're not wanting every single nickle and dime covered, the plans are actually pretty affordable. You do, of course, have to look at the details and really understand what it is you're signing up for, but then, shouldn't you always do that when you're entering into a contract? I would think that would be particularly important when dealing with something as significant as your health. I say this because a big part of the argument for some form of government run health care is that the insurance companies try to weasel out of providing care, and often the care in question isn't covered by the plan. Most people don't read what they sign...
Here's the basics of the plan that best fits our situation. We may or may not purchase this plan in the next month or two - I need to do some more shopping around. The comparison tool I used this afternoon was eHealthInsurance.com. The quote is for two adult smokers and two teenage boys.
Office Visits: $35, 2 per year per person
Specialists: $35, 2 per year per person
Coinsurance: 20% after deductible
Annual Deductible: $5,000, $2,500 per person, two persons max
Rx: Generic: $15 copay, no brand name coverage
Annual out of pocket limit: $3,000 per person + deductible
Lifetime Maximum: $3,000,000 per person
Out of network coverage: Yes
Out of country coverage: Yes, emergency only
Primary Care Physician Required: No
Specialist Referral Required: No
OB/GYN: Basics are 20% coinsurance after deductible
Emergency Room: 20% coinsurance after deductible, $500 copay if not admitted
Lab/X-ray: 20% coinsurance after deductible if performed within 2 weeks of surgery
Outpatient Surgery, Hospitalization: 20% coinsurance after deductible
Maternity: Not covered
Cost: $306.94 / month
There are some things in the list I'd like to see tweaked, but it's really not that bad of a deal. It's certainly not indicative of a "crisis." Would it be a free ride if there was a major accident or illness? No. Would it bankrupt us? No. There's enough coverage there to ensure that we'd get the care we need, and we'd just have to tighten our belts for a while.
I do agree that some things could be done to reduce the cost of health care, but I am, and always have been, convinced that there is no "health care crisis" in this country. Despite all the propaganda being thrown about these days, I still haven't seen anything that even comes close to convincing me that the Federal government should get involved. It's not their job, plain and simple, and if they're going to be sticking their hands into an industry that represents as much as 1/6 of our economy, they're going to have to provide a heck of a lot of proof that it's absolutely necessary. If the states want to experiment with some sort of UHC or mandatory coverage ideas, such as Massachusetts has, more power to 'em. I'm all about states' rights, and they have the right to do stuff like that. The Feds don't. It's not their place, and they absolutely should not get involved.
Great..where do you live?
Have you applied and looked at the "questionaire" of medical history.. that is if you live in a state where insurance is medically underwritten.
I live in PA. I have ONE option for insurance. For myself, as an individual.. just me.. $333/month. Copays for doctors was , I believe $40 for specialist, $25 for primary care and a $1500 deductible. Drugs were on a tier program starting at I believe it was $20. My insulin, I believe , is at a higher tier than the bottom.. so I believe it would have been $35/vial.
Oh. . and in NY I had a similar type plan for me and my son for $850 for each of us.
I had to search for a plan that covered maternity.. especially since I'm a diabetic with what is considered a higher risk pregnancy.
If you have to fill out the form asking about medical history because the policy is medically underwritten..you'll be surprised at what is considered "pre existing" and cause for denial of coverage based on the underwriting.
Are you doing this as a "small business" or straight out individuals. My $850 /month was a "small business" because I had "employees". However, if I didn't have that and was straight up individual it would have been much more.
Oh and that $850 figure was about $750 the year before.. it rose $100 in one year a month.
Insurance is cheap if you are not sick or have never had a condition whatsoever. BTW.. that includes Asthma.. oh and have you read the threads about those that have previously had skin cancer that was completely cured and removed.. yet as a result they are now deemed uninsureable?
Not possible. Which company? Even an HSA with a $10,000 deductible would be at best $800 a month, especially with 2 smokers and 2 teenagers. Is this Midwest or Mega? See if your claims are paid when you actually get sick.
Okay. I see. I'm a licensed Health Agent, so that is why I made the above comment. However, I stopped selling this type of plan to families because if someone has a heart attack or gets cancer, he loses his home. The whole point of having good coverage is to be insured for the worst possible scenario, including disability. I recently visited a man who had a heart attack and was stuck with $70,000 (his share of the bill) Imagine being out of work, recovering from a heart attack and you get a bill for $70,000. You think this is a good plan?
1 out of 3 people will be diagnosed with some kind of cancer. Do you want to take a risk? Do you want to gamble that your spouse or child won't get seriously ill? Health reform isn't just about lowering premiums, it's about saving lives. The USA is #29 out of the 30 industrialized countries in infant mortality. We are almost dead last in life expectancy. That should bother every American.
2 smokers? When you get lung cancer, let me know how you feel about your plan. Tell me there's no health care crisis when you check into a homeless shelter.
By the way, if your post isn't completely fabricated (which I suspect it is) then I suspect you give up smoking. If you need to "tighten your belts" to pay for health care, that would be the first step I'd suggest.
I must spread he kudos before I can give you any again. Great post.
That's just how they get their leads. It's like the car ads that say $99 down, $99 a month. How many people do you know who pay $99 a month for a car?
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