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I had insurance through work, with BCBS. Was free to me so I signed up. I am also on my wifes plan at work, which is also BCBS. In 2012, we had to start paying 35 bucks a week. To some that's not much, to others it was a weeks worth of gas to work. I gladly paid it, and had no problems until early last year, when my heart raced up to 218 beats per minute. In the past, coverage through my work was primary, her work secondary, and I very seldom had to pay more than 40 bucks to go to the doctor. This heart problem ended up costing me out of pocket, over 5 grand. BCBS was basically fighting with itself to pay this bill, and determined I had to pay the 5 grand. Had I not been covered twice, I could possibly have only had to pay 2300. (The problem was my BCBS was in SC, hers in Tn, which is where her company is based out of.) I dropped mine at work in October. Now we only have a 4000 deductible, instead of a $9000.
I agree with grannynancy about this starting a long time ago. BTW, ACA went into effect in 2014 - first year to sign up (remember healthcare.gov startup issues in the news). There were some minor things before that, mostly states suing the federal government.
The company I worked for (~$18B/60k employees) started this change in ~2003 passing more costs onto the employees. BY 2008/9 all the plans were high deductible. The party line was "by seeing your costs more directly, you would be more involved in your healthcare, and make better choices". Problem is, if you are having a heart attack, choices are go to the hospital or die. Most healthcare choices are really not choices for the most part.
I also see issues with insurance companies/providers masking the real costs. I had a test done earlier this year, results great, no problems. GHS charged ~$18k, Blue choice plaid ~$6700 via some back room negotiation. I had already met my $3400 deductible, so that was the final transaction. I understand if I did not have insurance, I would be liable for the $18k. So there is no transparency in what real costs are, was it $18k or $6700?
I agree about masking costs. Insurance always negotiates a much lower cost than is charged the uninsured patient. SO they apparently will negotiate or write it off as a "loss" but it is just a tax thing not a real loss. The doctors and nurses are not making all this money.
I agree about masking costs. Insurance always negotiates a much lower cost than is charged the uninsured patient. SO they apparently will negotiate or write it off as a "loss" but it is just a tax thing not a real loss. The doctors and nurses are not making all this money.
In 2009 I had been laid off and had no job, no health insurance. I had to have a heart cath, and I was told by my doctor to apply for a hardship case with the hospital. When i went to the hospital to ask about it, they said that since I owned my home and had other assets, I did not qualify for hardship, but since I had no insurance and would be paying cash, I was entitled to a SEVENTY-FIVE PER CENT discount! That's right; my $10,000.00 procedure went to $2,500.00 just like that! I was actually better off not having insurance.
In 2009 I had been laid off and had no job, no health insurance. I had to have a heart cath, and I was told by my doctor to apply for a hardship case with the hospital. When i went to the hospital to ask about it, they said that since I owned my home and had other assets, I did not qualify for hardship, but since I had no insurance and would be paying cash, I was entitled to a SEVENTY-FIVE PER CENT discount! That's right; my $10,000.00 procedure went to $2,500.00 just like that! I was actually better off not having insurance.
That is true about them charging you Medicare rates. The hospital used to cover everything with a hardship from what I understand. After April 2015, their policy has changed. They cover emergency room visits and only a small portion for other procedures. I guess it still was a good deal for you.
It's too bad health insurance is so expensive and many times doesn't cover much. I hope they are working to fix this situation.
Healthcare providers should have to give you a total cost estimate upfront for all non-emergency procedures. The current system makes it all but impossible to evaluate the quality and cost of care, both of which are key to making an informed decision. We pay more per person for healthcare in this country than anywhere else in the world. If you have an endless supply of money, our healthcare is unmatched. The problem is most people don't have an endless supply of money.
The current system benefits insurance and pharmaceutical companies and screws pretty much everyone else. Many smaller hospitals are losing money with government reimbursement rates below the cost of providing care. Nurses, technicians, and doctors are well paid but given the level of training required and stress level of their jobs, they should be well paid. The push to drive down costs is leading to staff cuts at many hospitals. Talk to a nurse and you will hear how they are drastically understaffed in many cases.
The current system also pays more to providers that are ranked highly by patients. This results in patients being given non-essential services that do not impact actual care just to keep them happy. In the worst case, it results in patients receiving care that is actually detrimental to drive up scores.
The system is broken. Why we can't look to the rest of the world and implement the best of what is done in other industrialized countries is puzzling to me. I guess all the lobbying of congress by insurance and pharma companies works.
Little over a year ago, I was sent in for a colonoscopy. Being 41 at the time, insurance would cover it, but only after my deductible. Which was $2000..
Price of the colonoscopy? About $2500.. So, figure $2000 for the deductible, then 20% of the $500 remaining.. I would wind up paying about $2100 of the $2500 bill.
So.. I started doing some searching. Found colonoscopyassist.com.. At the time, they had just raised their rates from $950 to $1075.. But, I got the colonoscopy and all labwork done for $1075. Then filed it on my insurance, which satisfied $1075 of my deductible.
For a procedure that 9 years later, they would have to cover 100%.. A little research saved me about $1k
Actually.. A little over a year later they would have had to cover it 100%, because my brother was diagnosed with colon cancer this year at 46, which puts me into the high-risk category, which means insurance has to cover it 100%.
Back when I was self-insured and self-employed.. My doctors office constantly told me there was a cash discount.. They were.. It was part of Laurens, and I think it was right before they linked up with GHS.
In 42 years.. I have met my deductible for health insurance once. In 2001 I had to go through sinus surgery.
When I was employed I paid about $160 a month, but my health insurance plan rivaled the one I had when I worked for the federal government. I mean, it covered everything -- including adoption fees and infertility treatment costs, which is practically unheard of in employer health plans from my experience and from what I've asked people I know.
When I lost my job due to lupus disabling me, COBRA kicked in. If it weren't for the COBRA subsidies that I qualified for I wouldn't have been able to afford it. I think I was paying $151 a month. But, then, the subsidy bill came up for renewal and Congress postponed their decision until after their Christmas break and left Washington early. Unfortunately, for me, their timing was horrible because I had a full, non-subsidy payment due for December. The company administering the COBRA policy wouldn't take a half payment or work with me in any way, so I lost the COBRA. Congress did re-fund the COBRA subsidy bill the next month, but it was too late for me. If I'd known then what I know now, I'd have started saving months in advance to pay full price for December and January until Congress re-approved the bill. You live and learn, I guess.
I was without insurance from December 2008 until January 1, 2014 when the ACA went into effect.
The first ACA policy I chose in 2014 was a Gold Plan that had everything. I'd just been doing the minimum needed to keep me going for five years and I had a lot that needed to be checked up on and treated by the proper specialists. I paid $182 a month after the subsidy I qualified for. In 2015, I switched companies (first company lied) and also went down to a Silver Plan. I paid $114 a month after the subsidy. For 2016, I'm with the same company and plan, but my premium has gone down to $99 a month after the subsidy.
I have a Silver Plan (80/20) with a $1,000 deductible. My max out-of-pocket is $2,250. Office visits at my primary care are $0. Urgent care visits are treated like primary care visits. Specialist office visits cost $20. Generic drugs are $0. Non-generic/Preferred drugs are $50. I do have a couple of meds that are $10, so go figure. My plan covers two dental exams and cleanings a year and one eye exam a year and a pair of glasses/contacts either once a year or every two years.
When I was employed I paid about $160 a month, but my health insurance plan rivaled the one I had when I worked for the federal government. I mean, it covered everything -- including adoption fees and infertility treatment costs, which is practically unheard of in employer health plans from my experience and from what I've asked people I know.
When I lost my job due to lupus disabling me, COBRA kicked in. If it weren't for the COBRA subsidies that I qualified for I wouldn't have been able to afford it. I think I was paying $151 a month. But, then, the subsidy bill came up for renewal and Congress postponed their decision until after their Christmas break and left Washington early. Unfortunately, for me, their timing was horrible because I had a full, non-subsidy payment due for December. The company administering the COBRA policy wouldn't take a half payment or work with me in any way, so I lost the COBRA. Congress did re-fund the COBRA subsidy bill the next month, but it was too late for me. If I'd known then what I know now, I'd have started saving months in advance to pay full price for December and January until Congress re-approved the bill. You live and learn, I guess.
I was without insurance from December 2008 until January 1, 2014 when the ACA went into effect.
The first ACA policy I chose in 2014 was a Gold Plan that had everything. I'd just been doing the minimum needed to keep me going for five years and I had a lot that needed to be checked up on and treated by the proper specialists. I paid $182 a month after the subsidy I qualified for. In 2015, I switched companies (first company lied) and also went down to a Silver Plan. I paid $114 a month after the subsidy. For 2016, I'm with the same company and plan, but my premium has gone down to $99 a month after the subsidy.
I have a Silver Plan (80/20) with a $1,000 deductible. My max out-of-pocket is $2,250. Office visits at my primary care are $0. Urgent care visits are treated like primary care visits. Specialist office visits cost $20. Generic drugs are $0. Non-generic/Preferred drugs are $50. I do have a couple of meds that are $10, so go figure. My plan covers two dental exams and cleanings a year and one eye exam a year and a pair of glasses/contacts either once a year or every two years.
I'm happy to see some reasonable ACA plans from some of you. I used to have insurance through my employer as well as Medicare (because I had a kidney transplant,) but the Medicare ends at the beginning of November because of a limit imposed after the transplant. I am now self employed and was getting really nervous about how much everything might cost me. The total cash price on 2 of my medications is over $1000 per month alone. Though I have never been a fan of the ACA, it looks like I may not need to be as scared as I have been. I do know that I can't make any mistakes when I choose a plan, though. I hope I can find a good adviser when the time gets closer to make sure I don't screw up. In the past, around open enrollment time, it seems like "advisers" spring up in low income areas, but I've never really heard anything about legit people who do that.
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