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Medical Insurance


carinab

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I hate that my hubby's employer has switched us yet again to another insurance carrier.

I hate that this is the same cheap@ss carrier that tried to screw us over mercilessly when my daughter was born ("We're sorry but your cobra policy doesn't cover the child once it hits the end of the birth canal - we can add the child to the policy for $$$$$").

I hate that this carrier has the perception of being "pretty good" but in reality they are difficult SOB's to work with. How is it that you pay for a "service" when it's anything but?

I hate that when we called this carrier to verify my chiropracter was "in network" and that visits would be covered, we were told "Yes" on both counts with a $20.00 copay. We gave them our group number, id number, everything so they should have been able to give us proper information.

I hate that they gave us the wrong information.

I hate that it took nearly two months for us to receive our coverage documentation from the hubby's employer only to find out that it's a $20.00 copay AFTER a $750.00 deductable has been met. I hate I've already made four visits.

I hate that I have to pay $65.00 a visit until I accrue $750.00 worth of expenses when the negotiated fee the chiropractor gets from the insurance carrier is only $25.00 (which means that they pay a whole $5.00 above the copay amount).

I hate that the insurance rules limit how many visits to the chiropractor I can make in a year. This of course ensures that they will never pay more than $50.00 per year based on their negotiated rate.

:angry::angry::angry::angry::angry::angry::angry::angry::angry:

Now I understand that they'll cover the big stuff should an random incident or illness drop me in the hospital for an extended period...albeit only 20 physical therapy visits a year are covered (let's hope I never need to learn to walk or talk again because of an illness). But do they have to nickel and dime you to death on the day to day stuff?

I have a physical on Friday. Guess I better read the fine print about what tests are covered and which aren't.

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I hate 'em with you! We just had to change carriers due to my wife's layoff. I hated them anyway because they gave us fits over chiropractors too. Now, the new company is giving me trouble over medications. Went to pick up a refill for some stuff I take for acid reflux and the insurance company won't approve it until they confer with my Dr. WTF is that all about? They'll probably come back and tell me to just take Rolaids and don't worry about esophagus erosion because it's not as bad as it sounds. <_< I get reamed out on allergy meds too. Ever since Claritin hit the OTC list, the insurance companies think that's all you need. Yeah, too bad it doesn't work real well for me. :angry:

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+++++++++1. Wait till you have to pay full price for your own coverage and are over 50!

I am the most conservative person there is politically, but health insurance may be one of those problems only government can solve. God I hate saying that.

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B)-->

QUOTE(Paul B @ Aug 17 2006, 07:04 AM) <{POST_SNAPBACK}>

+++++++++1. Wait till you have to pay full price for your own coverage and are over 50!

I am the most conservative person there is politically, but health insurance may be one of those problems only government can solve. God I hate saying that.

If you think it is expensive now, just wait to see how expensive it will be when it is "free". That's not to say that a lot of insurance companies arent crooks and that something should be done about how the health industry operates. I just don't think that governemnt take over is a good idea.

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Yeah, ask someone from Canada about the "quality of care" that is available under socialized medicine. I too have a bone to pick with the bean counter mentality of medical insurance carriers, but do realize that it can only get worse if it goes gubmint'!

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Isn't it in Great Britan that people over a certain age, 65 I think, are told that they are too old for a by-pass?

No thank you to socialized government healthcare.

Unless of course we can get the same plan as the Senate and the House.

Jim

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In Britain the National Health Service is in chaos. Patients are waiting over 6 months to begin cancer treatment and heart bypass can take up to 3 months. USA has the best health care in the world, it also has some of the worst insurance companies, though also some very good ones.

I'm with Kaiser at the moment and it's great. The problem is locking a bunch of people into a single provider. Choice brings competition and that drives UP service and drives DOWN cost. Everyone should be free to pick their provider of choice not be dictated to by your employer.

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B)--><div class='quotetop'>QUOTE(Paul B @ Aug 17 2006, 09:04 AM) <{POST_SNAPBACK}></div><div class='quotemain'><!--quotec-->

+++++++++1. Wait till you have to pay full price for your own coverage and are over 50!

Jeesh! We already pay over 50% of the cost for the coverage....Another thing to look forward to... :(

If you get it though an employer group plan, you're probably paying a standard per-employee, employee+spouse or family rate.

If you try to buy as an individual, you can expect your rate to be based on your age and medical condition, and are much more likley to have an exclusion for any pre-existing conditions. Care to guess what rates a 50 year old cardiac bypass survivor would pay?

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Not offering any solutions here and in fact hoping that I am not violating the rules of this particular topic.

There are several bills in the congress that address competiveness. One in particular woiuld allow small companies to join groups that cross state lines AND to count their total employee census as a single unit as opposed to the current methods of each small group being unique.

In other words, My company with its 30 or so employees could join with 400 others in an association and suddenly we'd be 12,000 strong! This would mean we'd be buying at a level that would make the industry sit up and take notice. Right now, each small group has a ridiculous loading of overhead.

If this is disallowed, I understand, trust me on this, I could retire on my companies health insuarnce premiums very nicely!

Jim

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B)--><div class='quotetop'>QUOTE(Paul B @ Aug 17 2006, 09:04 AM) <{POST_SNAPBACK}></div><div class='quotemain'><!--quotec-->

+++++++++1. Wait till you have to pay full price for your own coverage and are over 50!

Jeesh! We already pay over 50% of the cost for the coverage....Another thing to look forward to... :(

I hate that I pay $1100 per month for my medical coverage. :angry:

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I wish my monthly premium were only $1100.

I still think we will have to have some sort of government "interference" if the medical insurance industry in this country is to step up with affordable coverage for everyone.

If you've ever analyzed the profit and loss of the the big carriers you would be amazed at the shell game.

They all say they are only making something like 10% profit, (which they do almost like clockwork every year) but that is of their gross premium. Actually they are really big dollar fixed cost money machines with huge salaries for the top management. Think about it, if you write a Billion dollars in premium, the actuaries can predict almost to the dollar how much they will pay in losses. Why should their profit percentage be based on the billion dollars and not on what is left of the premium after losses are paid. That percentage would make the oil industry look like pikers.

Property Casualty business can be evaluated differently because often the numbers are not as big and more things like hurricanes can effect the business.

I know there is no free lunch, but in the states where there is a mandatory market with affordable coverage the big medical companies are still making a ton of money. Why don't they do it everywhere ---------because they don't have to.

Sorry if this hijacked the thread a little. It is still hate not rebuttal!!!

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The problem with healthcare IS the insurance companies. Get rid of them and the system will improve. Free markets do not function well with third party payers, get rid of them and the market will function better.

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