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.
$10,000 is high for a CT. Definitely get the itemized bill. There is a growing trend of providers claiming they provided a clinical service (consult, exam, etc) and billing for it, when they actually only spent a minute in the room with you. This is mostly a problem with surgical procedures. Traditionally, ER physicians are hospital employees, and not independent contractors, so this is unlikely to happen for ER visits, but once other specialties are involved it may be a problem. For example, make sure you are only paying for one radiologist to read you CT, and not for a second opinion you never requested.
Exactly. That's basically what a high deductible plan is. You get the contracted rates assigned to the insurance company, and your monthly premiums are a lot lower than they would be with a traditional PPO.
Exactly. That's basically what a high deductible plan is. You get the contracted rates assigned to the insurance company, and your monthly premiums are a lot lower than they would be with a traditional PPO.
It is all a gamble in deciding on a plan. Usually with the higher deductible you will also have higher co-pays. Some plans/companies even offer that if you pick the higher deductible plan they will set up an Flexible Spending Account with a certain amount of money that you can supplement if you choose.
It is all a gamble in deciding on a plan. Usually with the higher deductible you will also have higher co-pays. Some plans/companies even offer that if you pick the higher deductible plan they will set up an Flexible Spending Account with a certain amount of money that you can supplement if you choose.
Right -- with a high deductible health plan (HDHP), you usually pay the total claim (100% of the contracted amount) until you reach your deductible, and then you pay a small amount (10% of the contracted amount) until you reach your OOP max. vs. a traditional co-pay ($20/$40/etc.). That is why your monthly premium would be lower. However, pretty much everything that has a claim will count toward your deductible with an HDHP -- including prescriptions. Prescriptions do not count toward your deductible with a PPO.
You almost always come out ahead with an HDHP -- whether you're in really good health (very few Dr's visits) or fairly poor health (a lot of Dr's visits and/or prescriptions). If you are disciplined enough, and have the money to fund your HSA properly, you'll be fine. If not, then you're better off with a PPO. And if you have an employer sponsored plan, and the employer supplements by depositing money into an HSA for you, then there is almost no way an HDHP won't cost you less money over the course of the year (factoring in the difference in your monthly premium).
As for HSAs/FSAs/HRAs -- If the deductible amount is high enough, then the plan will qualify for an accompanying HSA (Health Savings Account), which is different than an FSA (Flexible Savings Account) and an HRA (Health Reimbursement Account). An HSA is like any other savings account. It is in your name and (if you have employer-sponsored insurance) it travels with you even if you leave the company. The funds can also carry over from year to year, and there are more items eligible for payment from an HSA vs. an FSA. An HRA is employer funded and acts like a hybrid HSA/FSA. You can pay for more with it, and I think it can carry over year to year, but it doesn't travel with you.
I could go on, but I see some of you falling asleep. What? Health insurance isn't exciting?
This is the phenomenon I was referring to above. It generally shouldn't be a problem with ER visits if you are treated 100% by ER providers, but once you start receiving services from other departments, in this case radiology, you're exposed to lots of fee-for-services games and up charging.
This is the phenomenon I was referring to above. It generally shouldn't be a problem with ER visits if you are treated 100% by ER providers, but once you start receiving services from other departments, in this case radiology, you're exposed to lots of fee-for-services games and up charging.
Many ER doctors are not hospital employees, but are working for a company contracted by the hospital.
I saw the doctors face at the very end for about 5-7 minutes. "He came to say, nope everything looks good you just might have contacted something viral...". Most of the time was just waiting...
Anyways, yes mine in a BCBS plan with employer funded HRA and I had accumulated about 5K in funds over the years. But my deductible is 2500 and after that they cover 70%. This CT might wipe out my accumulated HRA.
Oh well I get the itemized bill & go from there. Thanks
I saw the doctors face at the very end for about 5-7 minutes. "He came to say, nope everything looks good you just might have contacted something viral...". Most of the time was just waiting...
Anyways, yes mine in a BCBS plan with employer funded HRA and I had accumulated about 5K in funds over the years. But my deductible is 2500 and after that they cover 70%. This CT might wipe out my accumulated HRA.
Oh well I get the itemized bill & go from there. Thanks
Keep an eye out for the claim information from BCBS. There is a clause that generally requires pre-authorization for CTs, MRIs, etc. because of this exact problem. There is a tendency for Drs to send patients for unnecessary scans before they try to figure out what's wrong in a less expensive way. In case of emergency, I believe the pre-auth is waived, but just keep an eye out.
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.
