01-31-2011, 08:44 AM
Location: Brisbane, Australia
309 posts, read
811,786 times
Reputation: 242
Another "I know nothing, I'm moving to DFW from the UK" type questions - sorry! I will sign up for one of the medical insurance plans that my employer offers but the whole medical insurance thing seems to be so complicated over there compared to what I am used to here.
I have read and researched about the differences between the different types of offerings in terms of EPO, PPO, HSP etc as well as learning about the terms of deductibles and co-payments but am not a whole lot wiser
So to go back to basics, without taking any benefits from a medical plan into account, please can someone enlighten me as to approx. how much a "standard" visit to the Doctor's office costs, say to renew a prescription or to have an annual asthma check up is? Currently I only go to the Dr about once a year for an annual review of the asthma medication I take and then my medication is on a repeat prescription for another year. My husband has visited the Dr twice this year about a bad neck/shoulder pain and she prescribed him some medication. I understand that these sort of visits to the Dr (non emergency) would be paid for until the level of the deductible has been reached but without knowing how much such a visit costs it is hard to work out whether to go for a higher deductible/cheaper monthly payment or lower deductible/higher monthly payment plan would suit us!
I see that there are various websites (mainly Canadian) that offer precription medication on sale over the internet. If you know what medication you should be taking (and assuming it works fine and doesn't need adjusting) can I just buy it over the net without having seen a Dr first?
Thanks in anticipation of your knowledgable input!
01-31-2011, 10:25 AM
Location: Mostly in my head
19,855 posts, read
65,811,151 times
Reputation: 19378
Cost depends on what type of doctor seen: specialist or general practioner. If you have any chronic conditions that might get worse in a different climate (asthma, arthritis), get a lower deductible.
01-31-2011, 11:23 AM
Location: Fort Worth, north TX
425 posts, read
995,427 times
Reputation: 285
For a basic office visit, (without insurance), you're looking at approximately $100 at least. If they include tests etc., you're looking upwards from $200+
Since living in the US (from Australia - another country with socialized medicine), I've always chosen the HMO option, so that I didn't have to worry about the deductible - I pay $20 out of pocket for a doctor's visit, and between $10 a $30 for a prescription drug and that's it. Because we so rarely go to the doctor, we would never hit our deductible if we were in a PPO.
I'm not in the medical profession, but as far as I am aware, you cannot legally get prescriptions (even online) without seeing a doctor first.
01-31-2011, 11:34 AM
Location: Keller, TX
295 posts, read
949,097 times
Reputation: 57
HMOs are becoming harder to even choose if your health plan is provided through work. Chances are, you'll end up in a high deductible plan where you pay your expenses with an HSA account. In general, family doctors will charge you $100, pediatricians a bit more (about $120 with Cooks Childrens) and specialists even more $200+. Medicine is also something to think about. Depending on your plan, there are expensive medicines. I bought an antibiotic last week for $116 with plan (without plan I think it was $178). So keep that in mind.
01-31-2011, 11:35 AM
Location: Fort Worth, TX
1,379 posts, read
6,425,035 times
Reputation: 356
Generally...(or how it works for us) is that your health insurance is offered through your employer (in both your and my case - its hubby's). You have a choice usually from a few different types of plans.
For us, we had PPO or HMO. My husband pays a portion and his employer pays a portion. Children are dependents and will add to the cost of the plan. We have had both plans.
PPO usually you don't have a copayment, the monthly fee out of hubby's check is less, but if you have to go to the hospital and have to have surgery, then you pay a percentage of the bill from the hospital up to a specific amount yearly. Ours was up to 3500.00. I didn't "pay" anything at the time of being seen for yearly appointments, kids well checks etc. I didn't have to pay a copayment when the kids were sick, but they had a yearly deductible of 300.00. The appointments were about 120.00 per appointment and I got an invoice in the mail from the provider to pay.
An HMO is a network of doctors. Essentially you have a family doctor and they refer you out to their "in network" doctors and hospitals. You can use Out of Network doctors or specialists, but you will have to pay more and that is usually a percentage or you are notified of those costs during enrollment.
Our HMO was more than the PPO, but it could be potentially less (in the long run) if you use it alot with specific illnesses. (asthma, allergies come to mind). The fee is taken out of your hubby's check and then you pay a copayment (from 15-35) an appointment.
You will get an outlay of each particular cost (Ambulance, ER, Xrays, etc) during enrollment.
Prescriptions are filled through pharmacies either through grocery store pharmacies, corner pharmacies (Walgreen's and CVS) are the popular ones here. They are also covered through insurance.
When you figure out an area, come on back here and let us know and we all can give you some names of some of the doctors we have seen.
01-31-2011, 11:53 AM
Location: Mostly in my head
19,855 posts, read
65,811,151 times
Reputation: 19378
That's one bad thing about HMOs. You need a referral from your Primary Care Physician to see any specialists. And you can only see doctors in their "network." I have never liked that type of plan, personally. I want to see the best available, whether s/he is in the network or not.
01-31-2011, 12:25 PM
Location: Brisbane, Australia
309 posts, read
811,786 times
Reputation: 242
Wow - confusing! Please can I recap how I think it works....
I sign up for a medical plan thru my employer (Guingirl, it is my job that is bringing us to USA my hubby gets to be house husband for a while!) deciding between a higher monthly cost and lower deductible or vice versa. Whatever the deductible is I have to pay for general office visits to the GP up to limit of the deductible, i.e. if the deductible is $1,000 annual then I pay for say 10 GP visits (assuming a $100 per visit cost for the sake of this calculation)? After that the cost of any further standard GP visits are paid for by the plan plus a co-payment by myself? In the event of an emergency / hospitalisation etc then once the remaining deductible is paid by me, the rest of the cost is paid for by the plan?
I'm not sure that my employer is offering an HMO scheme, I think it is a choice between an EPO, PPO and HSP (as jcamber suggests this can be linked to an HSA). What I need to try and understand is how to balance keeping the monthly cost down (as initially, and for an unknown period of time depending on work permit approval and hubby being able to find a job, my salary is our sole income) and taking a view that generally neither of us have to date been sickly people - yes I know that is an unknown in the future. If I chose to find my own medical plan e.g. An HMO type offering, is it likely to be any less expensive than choosing a plan thru my company schemes? This whole thing seems to be a complete gamble, mind you I suppose you can say the same thing for any insurance, always seems expensive when you don't need it but a godsend on that one occasion when you do!
Thank you for your patience whilst I try and understand the pros, cons, implications and the gamble between cover and expense!
01-31-2011, 12:35 PM
Location: Ohio
15,700 posts, read
17,039,578 times
Reputation: 22091
Quote:
Originally Posted by
Tigerlily64
I see that there are various websites (mainly Canadian) that offer precription medication on sale over the internet. If you know what medication you should be taking (and assuming it works fine and doesn't need adjusting) can I just buy it over the net without having seen a Dr first?
Thanks in anticipation of your knowledgable input!
You still need a Drs. prescription to obtain drugs from Canada.......you just have to mail them the script. I am not sure if you can fax the script or not.
Several of my friends save a lot of money getting their scripts from Canada. They called the toll free number for the pharmacy, the pharmacy sent them a packet of info, then they mail in their scripts.
I recently found out Canada also has generic meds that are not available in the U.S. too.
If you do not have good presciption drug coverage, Canada is the way to go.
01-31-2011, 12:41 PM
Location: Brisbane, Australia
309 posts, read
811,786 times
Reputation: 242
Quote:
Originally Posted by
Annie53
You still need a Drs. prescription to obtain drugs from Canada.......you just have to mail them the script. I am not sure if you can fax the script or not.
Several of my friends save a lot of money getting their scripts from Canada. They called the toll free number for the pharmacy, the pharmacy sent them a packet of info, then they mail in their scripts.
I recently found out Canada also has generic meds that are not available in the U.S. too.
If you do not have good presciption drug coverage, Canada is the way to go.
Yes I saw that they do a generic alternative to the asthma med that I am prescribed here in the UK. It has exactly the same active ingredients in the same formula but is just "unbranded" and therefore considerably cheaper. Worth consideration I think as I woul have a prescription, not trying to obtain drugs illegally!
01-31-2011, 03:00 PM
37,315 posts, read
59,844,229 times
Reputation: 25341
once you see what your company offers consider what you are most likely to need
if you and your husband are healthy with no chronic illness/condition like severe allergies/asthma, diabetes, high blood pressure, IBS, and you normally DON'T get ill
and you don't have children now and don't plan to
you might want to take the plan that costs the least and mainly covers major medical costs the best--like accident/injury or illness like appendicitis
this is something you should be discussing with your human resource person at your company and your co-workers
they are likely to have first hand experience of how well/poorly the plans work in the real world...
while your human resource person is presenting the plan in the best light--the co workers know the real deal...
adding children to the plan usually sees your costs and your employer's double
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People in Group quarters - Local jails and other confinement facilities (including police lockups) (%)
People in Group quarters - Military disciplinary barracks (%)
People in Group quarters - State prisons (%)
People in Group quarters - Other types of correctional institutions (%)
People in Group quarters - Nursing homes (%)
People in Group quarters - Hospitals/wards, hospices, and schools for the handicapped (%)
People in Group quarters - Hospitals/wards and hospices for chronically ill (%)
People in Group quarters - Hospices or homes for chronically ill (%)
People in Group quarters - Military hospitals or wards for chronically ill (%)
People in Group quarters - Other hospitals or wards for chronically ill (%)
People in Group quarters - Hospitals or wards for drug/alcohol abuse (%)
People in Group quarters - Mental (Psychiatric) hospitals or wards (%)
People in Group quarters - Schools, hospitals, or wards for the mentally retarded (%)
People in Group quarters - Schools, hospitals, or wards for the physically handicapped (%)
People in Group quarters - Institutions for the deaf (%)
People in Group quarters - Institutions for the blind (%)
People in Group quarters - Orthopedic wards and institutions for the physically handicapped (%)
People in Group quarters - Wards in general hospitals for patients who have no usual home elsewhere (%)
People in Group quarters - Wards in military hospitals for patients who have no usual home elsewhere (%)
People in Group quarters - Juvenile institutions (%)
People in Group quarters - Long-term care (%)
People in Group quarters - Homes for abused, dependent, and neglected children (%)
People in Group quarters - Residential treatment centers for emotionally disturbed children (%)
People in Group quarters - Training schools for juvenile delinquents (%)
People in Group quarters - Short-term care, detention or diagnostic centers for delinquent children (%)
People in Group quarters - Type of juvenile institution unknown (%)
People in Group quarters - Noninstitutionalized population (%)
People in Group quarters - College dormitories (includes college quarters off campus) (%)
People in Group quarters - Military quarters (%)
People in Group quarters - On base (%)
People in Group quarters - Barracks, unaccompanied personnel housing (UPH), (Enlisted/Officer), ;and similar group living quarters for military personnel (%)
People in Group quarters - Transient quarters for temporary residents (%)
People in Group quarters - Military ships (%)
People in Group quarters - Group homes (%)
People in Group quarters - Homes or halfway houses for drug/alcohol abuse (%)
People in Group quarters - Homes for the mentally ill (%)
People in Group quarters - Homes for the mentally retarded (%)
People in Group quarters - Homes for the physically handicapped (%)
People in Group quarters - Other group homes (%)
People in Group quarters - Religious group quarters (%)
People in Group quarters - Dormitories (%)
People in Group quarters - Agriculture workers' dormitories on farms (%)
People in Group quarters - Job Corps and vocational training facilities (%)
People in Group quarters - Other workers' dormitories (%)
People in Group quarters - Crews of maritime vessels (%)
People in Group quarters - Other nonhousehold living situations (%)
People in Group quarters - Other noninstitutional group quarters (%)
Residents speaking English at home (%)
Residents speaking English at home - Born in the United States (%)
Residents speaking English at home - Native, born elsewhere (%)
Residents speaking English at home - Foreign born (%)
Residents speaking Spanish at home (%)
Residents speaking Spanish at home - Born in the United States (%)
Residents speaking Spanish at home - Native, born elsewhere (%)
Residents speaking Spanish at home - Foreign born (%)
Residents speaking other language at home (%)
Residents speaking other language at home - Born in the United States (%)
Residents speaking other language at home - Native, born elsewhere (%)
Residents speaking other language at home - Foreign born (%)
Class of Workers - Employee of private company (%)
Class of Workers - Self-employed in own incorporated business (%)
Class of Workers - Private not-for-profit wage and salary workers (%)
Class of Workers - Local government workers (%)
Class of Workers - State government workers (%)
Class of Workers - Federal government workers (%)
Class of Workers - Self-employed workers in own not incorporated business and Unpaid family workers (%)
House heating fuel used in houses and condos - Utility gas (%)
House heating fuel used in houses and condos - Bottled, tank, or LP gas (%)
House heating fuel used in houses and condos - Electricity (%)
House heating fuel used in houses and condos - Fuel oil, kerosene, etc. (%)
House heating fuel used in houses and condos - Coal or coke (%)
House heating fuel used in houses and condos - Wood (%)
House heating fuel used in houses and condos - Solar energy (%)
House heating fuel used in houses and condos - Other fuel (%)
House heating fuel used in houses and condos - No fuel used (%)
House heating fuel used in apartments - Utility gas (%)
House heating fuel used in apartments - Bottled, tank, or LP gas (%)
House heating fuel used in apartments - Electricity (%)
House heating fuel used in apartments - Fuel oil, kerosene, etc. (%)
House heating fuel used in apartments - Coal or coke (%)
House heating fuel used in apartments - Wood (%)
House heating fuel used in apartments - Solar energy (%)
House heating fuel used in apartments - Other fuel (%)
House heating fuel used in apartments - No fuel used (%)
Armed forces status - In Armed Forces (%)
Armed forces status - Civilian (%)
Armed forces status - Civilian - Veteran (%)
Armed forces status - Civilian - Nonveteran (%)
Fatal accidents locations in years 2005-2021
Fatal accidents locations in 2005
Fatal accidents locations in 2006
Fatal accidents locations in 2007
Fatal accidents locations in 2008
Fatal accidents locations in 2009
Fatal accidents locations in 2010
Fatal accidents locations in 2011
Fatal accidents locations in 2012
Fatal accidents locations in 2013
Fatal accidents locations in 2014
Fatal accidents locations in 2015
Fatal accidents locations in 2016
Fatal accidents locations in 2017
Fatal accidents locations in 2018
Fatal accidents locations in 2019
Fatal accidents locations in 2020
Fatal accidents locations in 2021
Alcohol use - People drinking some alcohol every month (%)
Alcohol use - People not drinking at all (%)
Alcohol use - Average days/month drinking alcohol
Alcohol use - Average drinks/week
Alcohol use - Average days/year people drink much
Audiometry - Average condition of hearing (%)
Audiometry - People that can hear a whisper from across a quiet room (%)
Audiometry - People that can hear normal voice from across a quiet room (%)
Audiometry - Ears ringing, roaring, buzzing (%)
Audiometry - Had a job exposure to loud noise (%)
Audiometry - Had off-work exposure to loud noise (%)
Blood Pressure & Cholesterol - Has high blood pressure (%)
Blood Pressure & Cholesterol - Checking blood pressure at home (%)
Blood Pressure & Cholesterol - Frequently checking blood cholesterol (%)
Blood Pressure & Cholesterol - Has high cholesterol level (%)
Consumer Behavior - Money monthly spent on food at supermarket/grocery store
Consumer Behavior - Money monthly spent on food at other stores
Consumer Behavior - Money monthly spent on eating out
Consumer Behavior - Money monthly spent on carryout/delivered foods
Consumer Behavior - Income spent on food at supermarket/grocery store (%)
Consumer Behavior - Income spent on food at other stores (%)
Consumer Behavior - Income spent on eating out (%)
Consumer Behavior - Income spent on carryout/delivered foods (%)
Current Health Status - General health condition (%)
Current Health Status - Blood donors (%)
Current Health Status - Has blood ever tested for HIV virus (%)
Current Health Status - Left-handed people (%)
Dermatology - People using sunscreen (%)
Diabetes - Diabetics (%)
Diabetes - Had a blood test for high blood sugar (%)
Diabetes - People taking insulin (%)
Diet Behavior & Nutrition - Diet health (%)
Diet Behavior & Nutrition - Milk product consumption (# of products/month)
Diet Behavior & Nutrition - Meals not home prepared (#/week)
Diet Behavior & Nutrition - Meals from fast food or pizza place (#/week)
Diet Behavior & Nutrition - Ready-to-eat foods (#/month)
Diet Behavior & Nutrition - Frozen meals/pizza (#/month)
Drug Use - People that ever used marijuana or hashish (%)
Drug Use - Ever used hard drugs (%)
Drug Use - Ever used any form of cocaine (%)
Drug Use - Ever used heroin (%)
Drug Use - Ever used methamphetamine (%)
Health Insurance - People covered by health insurance (%)
Kidney Conditions-Urology - Avg. # of times urinating at night
Medical Conditions - People with asthma (%)
Medical Conditions - People with anemia (%)
Medical Conditions - People with psoriasis (%)
Medical Conditions - People with overweight (%)
Medical Conditions - Elderly people having difficulties in thinking or remembering (%)
Medical Conditions - People who ever received blood transfusion (%)
Medical Conditions - People having trouble seeing even with glass/contacts (%)
Medical Conditions - People with arthritis (%)
Medical Conditions - People with gout (%)
Medical Conditions - People with congestive heart failure (%)
Medical Conditions - People with coronary heart disease (%)
Medical Conditions - People with angina pectoris (%)
Medical Conditions - People who ever had heart attack (%)
Medical Conditions - People who ever had stroke (%)
Medical Conditions - People with emphysema (%)
Medical Conditions - People with thyroid problem (%)
Medical Conditions - People with chronic bronchitis (%)
Medical Conditions - People with any liver condition (%)
Medical Conditions - People who ever had cancer or malignancy (%)
Mental Health - People who have little interest in doing things (%)
Mental Health - People feeling down, depressed, or hopeless (%)
Mental Health - People who have trouble sleeping or sleeping too much (%)
Mental Health - People feeling tired or having little energy (%)
Mental Health - People with poor appetite or overeating (%)
Mental Health - People feeling bad about themself (%)
Mental Health - People who have trouble concentrating on things (%)
Mental Health - People moving or speaking slowly or too fast (%)
Mental Health - People having thoughts they would be better off dead (%)
Oral Health - Average years since last visit a dentist
Oral Health - People embarrassed because of mouth (%)
Oral Health - People with gum disease (%)
Oral Health - General health of teeth and gums (%)
Oral Health - Average days a week using dental floss/device
Oral Health - Average days a week using mouthwash for dental problem
Oral Health - Average number of teeth
Pesticide Use - Households using pesticides to control insects (%)
Pesticide Use - Households using pesticides to kill weeds (%)
Physical Activity - People doing vigorous-intensity work activities (%)
Physical Activity - People doing moderate-intensity work activities (%)
Physical Activity - People walking or bicycling (%)
Physical Activity - People doing vigorous-intensity recreational activities (%)
Physical Activity - People doing moderate-intensity recreational activities (%)
Physical Activity - Average hours a day doing sedentary activities
Physical Activity - Average hours a day watching TV or videos
Physical Activity - Average hours a day using computer
Physical Functioning - People having limitations keeping them from working (%)
Physical Functioning - People limited in amount of work they can do (%)
Physical Functioning - People that need special equipment to walk (%)
Physical Functioning - People experiencing confusion/memory problems (%)
Physical Functioning - People requiring special healthcare equipment (%)
Prescription Medications - Average number of prescription medicines taking
Preventive Aspirin Use - Adults 40+ taking low-dose aspirin (%)
Reproductive Health - Vaginal deliveries (%)
Reproductive Health - Cesarean deliveries (%)
Reproductive Health - Deliveries resulted in a live birth (%)
Reproductive Health - Pregnancies resulted in a delivery (%)
Reproductive Health - Women breastfeeding newborns (%)
Reproductive Health - Women that had a hysterectomy (%)
Reproductive Health - Women that had both ovaries removed (%)
Reproductive Health - Women that have ever taken birth control pills (%)
Reproductive Health - Women taking birth control pills (%)
Reproductive Health - Women that have ever used Depo-Provera or injectables (%)
Reproductive Health - Women that have ever used female hormones (%)
Sexual Behavior - People 18+ that ever had sex (vaginal, anal, or oral) (%)
Sexual Behavior - Males 18+ that ever had vaginal sex with a woman (%)
Sexual Behavior - Males 18+ that ever performed oral sex on a woman (%)
Sexual Behavior - Males 18+ that ever had anal sex with a woman (%)
Sexual Behavior - Males 18+ that ever had any sex with a man (%)
Sexual Behavior - Females 18+ that ever had vaginal sex with a man (%)
Sexual Behavior - Females 18+ that ever performed oral sex on a man (%)
Sexual Behavior - Females 18+ that ever had anal sex with a man (%)
Sexual Behavior - Females 18+ that ever had any kind of sex with a woman (%)
Sexual Behavior - Average age people first had sex
Sexual Behavior - Average number of female sex partners in lifetime (males 18+)
Sexual Behavior - Average number of female vaginal sex partners in lifetime (males 18+)
Sexual Behavior - Average age people first performed oral sex on a woman (18+)
Sexual Behavior - Average number of woman performed oral sex on in lifetime (18+)
Sexual Behavior - Average number of male sex partners in lifetime (males 18+)
Sexual Behavior - Average number of male anal sex partners in lifetime (males 18+)
Sexual Behavior - Average age people first performed oral sex on a man (18+)
Sexual Behavior - Average number of male oral sex partners in lifetime (18+)
Sexual Behavior - People using protection when performing oral sex (%)
Sexual Behavior - Average number of times people have vaginal or anal sex a year
Sexual Behavior - People having sex without condom (%)
Sexual Behavior - Average number of male sex partners in lifetime (females 18+)
Sexual Behavior - Average number of male vaginal sex partners in lifetime (females 18+)
Sexual Behavior - Average number of female sex partners in lifetime (females 18+)
Sexual Behavior - Circumcised males 18+ (%)
Sleep Disorders - Average hours sleeping at night
Sleep Disorders - People that has trouble sleeping (%)
Smoking-Cigarette Use - People smoking cigarettes (%)
Taste & Smell - People 40+ having problems with smell (%)
Taste & Smell - People 40+ having problems with taste (%)
Taste & Smell - People 40+ that ever had wisdom teeth removed (%)
Taste & Smell - People 40+ that ever had tonsils teeth removed (%)
Taste & Smell - People 40+ that ever had a loss of consciousness because of a head injury (%)
Taste & Smell - People 40+ that ever had a broken nose or other serious injury to face or skull (%)
Taste & Smell - People 40+ that ever had two or more sinus infections (%)
Weight - Average height (inches)
Weight - Average weight (pounds)
Weight - Average BMI
Weight - People that are obese (%)
Weight - People that ever were obese (%)
Weight - People trying to lose weight (%)