[diamondgirl45]

I have seen some reports on CNN about the high costs of health care in the states compared to here in Canada. My husband has Blue Shield down there and he says that we don't need to worry. We have the top coverage, but because of all I have heard of people having astronomical bills I am concerned. Any advice??

[Coldjensens]

You have to review the policy very carefully. It is insanely complicated and very confusing. In our experience, HMOs tend to cost a whole lot less than a PPO or just plain "Insurance" However it will vary from family to family, depending on your issues. Right now, it seems like we are paying through the nose for everything and the insurance covers nothing. My son had five stitches last week and our portion cost us over $300. On the other hand, years ago our infant daughter had major heart surgery and the total bill was $380,000. We had to push the insurance company a little bit, but in the end, we paid nothing - not one penny. Some programs are better at covering ongoing issues (thyroid problems for example) others are better at covering the big once in a lifetime emergency. You pay more for more choices in doctors and hospitals. You pay a lot for unlimited choices. If the Dr./Hospital that you like is on your plan, then you can choose the no choices plan and save money. However if you have an unusual disease, it may cost more.


We have Blue cross, but blue cross has a half dozen or more different programs. how you come out depends on which program you are in and what medical needs you have in any given year.


Sorry, no one can tell you how good your insurance coverage is unless then know your specific needs and plan/program. Your company administrator or the insurance company liaison may be able to help a lot if your plan is not a new one. However sometimes not even these people can figure it out. There are simply too many variables to compare anything. We have some years that our medical expenses are almost zero. we have other years when it is $20,000 or more. It really depends on what happens. It is the type of illness or injury that matters more than the cost of the procedure. Also, your employer very likely has a cafeteria plan where you can put pre-tax dollars in an account to pay medical bills. You pay the costs that are not covered by insurance and then get reimbursed from the account. However, you have to guess how much to put int he account and if you do not use it in a given year, you lose it. This account can also be used for day care expenses if you both work full time.

[diamondgirl45]

Wow! There is so much to know. Luckily we are all healthy right now. And in Alberta everything is covered...period. So anything else is scary. I have heard of the cafeteria plan too. I will ask my husband to inquire more about his plan. Thanks for the advise.

[Coldjensens]

You will
discover that the medical care here is generally excellent. Lots of choices, most of them good. I do not know what it is like in Canada, but it is better here than anywhere else that I have been int he USA. It may not be the best in the country here, but it is certainly batter than a lot of places.

Check out the hospitals before you need them. We learned the hard way. Henry Ford Wyandotte is very close to us, but, unless it is a dire emergency, the next time we need a hospital, we are going to drive the hour to Ann Arbor. The care was very good once we got their attention, but waiting five hours after rushing like crazy people to get there seemed pretty stupid. Their triage was terrible and very disorganized. Plus they do nothing to keep things separate. Here were were my wife terrified thinking that she might die and some screaming crazy guy tackles three orderlies into our tent area and had to be piled on and then subdued with drugs screaming profanities all the while. Maybe that can happen anywhere, but I have been to hospitals where the separate the family types from the really awful stuff (i.e. gunshot wounds, stabbings crazy screaming people in one area, and sick kids or mommies in another area).

[hellomama]

I am in texas, and rates here suck for someone who doesn't have health problems. For someone who is mainly using healthcare system for preventative care, health insurance is too expensive. I may as well not have health insurance (if it wasn't for the over the top prices in the ER) and pay for what I need as I go, rather than paying $200-$400 out of pocket/month for a premium that doesn't cover anything. Deductibles here are WAY too high, they need to be lowered. Also, any type of plan that I have seen that is more affordable per month doesn't cover preventative care (doctors visits, gynecology, etc.)
What I have also seen, is that if you want to have a baby, you have to pay $100 more on average a month just to do so, and even then, most insurance providers I have dealt with, treat it like a pre-exsisting condition.

People get turned down for health insurance, simply for being the ones who NEED it (i.e. health problems). If you ask me, thats discrimination, and is not right.

I grew up in Canada, and let me tell you, i'm not complaining by any means, I will go back when I get the chance. Long waits for surgery etc. can be fixed, if Canadians make their voices heard.

[sikes0000]

Originally Posted by Coldjensens

You have to review the policy very carefully. It is insanely complicated and very confusing. In our experience, HMOs tend to cost a whole lot less than a PPO or just plain "Insurance" However it will vary from family to family, depending on your issues. Right now, it seems like we are paying through the nose for everything and the insurance covers nothing. My son had five stitches last week and our portion cost us over $300. On the other hand, years ago our infant daughter had major heart surgery and the total bill was $380,000. We had to push the insurance company a little bit, but in the end, we paid nothing - not one penny. Some programs are better at covering ongoing issues (thyroid problems for example) others are better at covering the big once in a lifetime emergency. You pay more for more choices in doctors and hospitals. You pay a lot for unlimited choices. If the Dr./Hospital that you like is on your plan, then you can choose the no choices plan and save money. However if you have an unusual disease, it may cost more.


We have Blue cross, but blue cross has a half dozen or more different programs. how you come out depends on which program you are in and what medical needs you have in any given year.


Sorry, no one can tell you how good your insurance coverage is unless then know your specific needs and plan/program. Your company administrator or the insurance company liaison may be able to help a lot if your plan is not a new one. However sometimes not even these people can figure it out. There are simply too many variables to compare anything. We have some years that our medical expenses are almost zero. we have other years when it is $20,000 or more. It really depends on what happens. It is the type of illness or injury that matters more than the cost of the procedure. Also, your employer very likely has a cafeteria plan where you can put pre-tax dollars in an account to pay medical bills. You pay the costs that are not covered by insurance and then get reimbursed from the account. However, you have to guess how much to put int he account and if you do not use it in a given year, you lose it. This account can also be used for day care expenses if you both work full time.

I totally agree. It all depends on your situation etc. Everyone is different. When my son was born (c-section) the bill was 14k but I didn't pay one dime. On the other hand I go to urgent care (supposedly covered by my insurance) because I need an antibiotic and it costs me 150 bucks. You just can't win.

All - all I have had pretty good coverage over the years. HMO, PPO whatever it has been. Except for one place that I had to pay 300 bucks a month for that covered squat. currently I pay 120 a month (medical, vision, dentist) but well worth the money considering how much my family likes to go to the doctor. Its all pretax anyways.

The really good plans even have no out of pocket at all. Have not been that lucky yet with my employers.

I have heard that Canada has some of the best health care if you can afford the wait.

[DRD]

Originally Posted by diamondgirl45

I have seen some reports on CNN about the high costs of health care in the states compared to here in Canada. My husband has Blue Shield down there and he says that we don't need to worry. We have the top coverage, but because of all I have heard of people having astronomical bills I am concerned. Any advice??

The main thing to keep in mind in the US is to keep coverage at all times and don't get sick if your insurance lapses.

Four years ago I had heart stents put in while I was on Tenncare, the state run insurance that didn't work out.

I was quickly shuttled off of that plan when they made their first round of cuts to the program leaving me without insurance and unable to get any at any cost.

The USA is the only country I know that makes criminals out of sick people with poor health as these delinquent accounts are reported to collection agencies and your credit is ruined.

So, now I have to relocate to a border town, re-establish a job in Canada(I'm Canadian living in US since 1992) and go back on that insurance.

I've had doctors drop me because I couldn't afford the three hundred dollars for the visit and lab work required.

[detshen]

Originally Posted by hellomama

I am in texas, and rates here suck for someone who doesn't have health problems. For someone who is mainly using healthcare system for preventative care, health insurance is too expensive. I may as well not have health insurance (if it wasn't for the over the top prices in the ER) and pay for what I need as I go, rather than paying $200-$400 out of pocket/month for a premium that doesn't cover anything. Deductibles here are WAY too high, they need to be lowered. Also, any type of plan that I have seen that is more affordable per month doesn't cover preventative care (doctors visits, gynecology, etc.)
What I have also seen, is that if you want to have a baby, you have to pay $100 more on average a month just to do so, and even then, most insurance providers I have dealt with, treat it like a pre-exsisting condition.

People get turned down for health insurance, simply for being the ones who NEED it (i.e. health problems). If you ask me, thats discrimination, and is not right.

I grew up in Canada, and let me tell you, i'm not complaining by any means, I will go back when I get the chance. Long waits for surgery etc. can be fixed, if Canadians make their voices heard.

Michigan has a law that Blue Cross can't deny coverage due to medical conditions, it's one of the few states that have this law and I am so grateful for it. When I lived in California, I was denied any health coverage due to a prior condition my doctor said was cured and a non issue. It was such a horrible feeling to have no choice but to go without insurance when I was willing to pay for it. I ended up having to give up being self employed in a career I loved so I could get coverage through a company I disliked. That is just wrong, the insurance industry in the US has way too much power.