health care thread

[madvlad]

So just starting this cause we jacked the trailer thread and bad with this, so carry on with the convo here

[bulldog]

Cool. I'll delete post over there and move it here:

Bump for the trailer

Complain for the insurance

We spend $9300 this past year on medical bills. We have a company supplied top level BCBS plan with "high" deductible. Our familys deductible is $5700 (interesting number Barn) but something new to us this year (as well as our new deductible, up from $5000 the year before) is "co-insurance". I have never really payed much attention to insurance plans or benefits outside of what we have had and stupily thought that "co" insurance was something that helps your primary insurance out. NOPE!

We now have to pay our deductible AND 20% of everything over it because of the co-insurance.

Its fucking fantastic! Matter of fact, it give me a complete raging hardon (that I have my Dr. look at regularly) because of how things have changed in the past 3 years.

I wonder how many people race their motorcycles without insurance?

Also, the $9300 that we paid is just what WE paid. The company covers the monthly premium, that also rose this year, of $650. Thats another $7800!

EJ, I have been leading a healthcare project for 10 years now and know a lot about the industry. Your issue is the "Top level BCBC High Deductible plan" you chose (assume they give you options). That plan is based for people who rarely need insurance so their rates are lower, but your deductible is higher. You should be able to go for the opposite, a low deductible plan, but you will most likely pay more a month. Insurance is basically like gambling and you may never need it and the next year you may need it bad so that is why there are so many plans to choose from. Most people just see the lower cost per month and get fooled into thinking they will save with this plan; which they will if they never need to use it.....yeah sounds dumb, but a high deductible makes them not pay till that is done. They are meant to cover huge expensive medical issues.

Co-insurance means your plan will only pay a certain percentage and then you have to pay the rest; common is 80% they pay and you get to pick up the 20% left over. It is rare to find a plan that still pays 100%; they exist, but are expensive. One option is if your wife also has medical insurance through her work. You can both get insurance and then one will pay most of what the other does not pay. This is called dual insurance and one will become your primary insurance and the other will be your secondary. It really comes down to how much you think you will need to use your insurance in a year.

As for your other question, you can always opt out of your companies insurance, but most pay a huge part of it for you, so the chances of getting a lower rate is going to be rare; and if you do it probably means you will get less coverage. Insurance companies are not dumb, so if you see a great rate on one I bet their is a reason (in the fine print).

If it makes you feel better I constantly see people with no insurance get in one accident and they get bills in the hundreds of thousands; ruins their entire financial life. To me not having health insurance is a way bigger risk because you never know what happens.

You have my number so hit me up if i can help you understand this better

I've said it before and will say it again, if a person races sportbikes they better get on the phone with their insurance company and see if that is covered because most have a clause that excludes them from paying a road sport injury. Insurances have workers just to find these things so the chances are high they will find it....even if they already paid out they can retract that money and send you the bill; up to a year later!

[~Barn~]

I have health care. If you've ever been sick, hurt yourself, had a pregnancy, had a disease managed with medicine, needed dental work, needed glasses, needed somebody to talk to before you hang yourself, needed stitches, etc., you can probably appreciate how critical it is.

I believe that if you are born with or develop a "pre-existing condition", you should not be precluded from having affordable health care.

I believe that if you are a child covered by your parent's healthcare, you should be able to retain that care while you are pursuing your education, even into your college years.

I hope everybody in the United States has healthcare soon, even if it costs me a few extra bucks to help defray the costs for people who don't earn as much.

I believe that inconvenience and misunderstanding is sometimes a necessary symptom for the type of colossal change that can only happen every few generations. Healthy Americans only serve for a healthy America.

That is all.

[bulldog]

I believe that if you are a child covered by your parent's healthcare, you should be able to retain that care while you are pursuing your education, even into your college years.

Most commercial plans do offer this, you just have to enroll the kid as a "student". I have seen people stay on their parents insurance the entire time in college. Depends on insurance company though

[~Barn~]

After reading EJs post, I have to share my personal situation also. I've had lots of jobs and lots of different insurance plans. Some have been good, others great, and others I probably just didn't understand well enough at the time to have an opinion on...

That said, I believe my current coverage is the best I've ever had. I won't go too deep into the weeds explaining my coverage's and costs, but suffices to say that it's a great value. I have no maximum lifetime benefit cap and year-over-year my out of pocket maximum expense is $2000person/$4000 family, which is extremely reasonable if something catastrophic were to happen to any of us. As somebody who has had a somewhat major procedure done that included 4 "overnights" in recovery, make no mistake that the costs you incur can quickly rise into the 10's if not 100's of thousands of dollars. And this was just the hospital working on my L-arm, a single limb. Imagine the costs of having to have your entire body treated!

While it's absolutely certain that the healthcare system has faults that need to be addressed, it's also absolutely certain that anybody living in this country with a life (and a lifestyle) worth preserving, MUST have insurance. Here is a glimpse of what my employer (and I) pay towards my healthcare plan each paycheck. I get 24 pay cycles a year and these costs are inclusive of coverage for me and my entire family - 7 individuals total. And IMO, it would be a good deal at double the price!

[bulldog]

I just did a comparison from Aetna, Cigna, and BCBS and Aetna paid the least and had the most non-covered services of them all. Not sure why they do not cover what others will, but they seem to be very picky. I like UHC, but my company just changed and I had to decide which of three to go with.....Cigna actually paid the closest to UHC of those...again plans my company offers as all can be different. Annoyed I do not have UHC anymore; United Health Care.

A insurance plan cannot be determined by how much you pay as so much more matters. Most insurances have over 100 plans for a consumer/employer to choose from so that should show how confusing this can be.


P.S. Be aware if the mother of these children (well except the one you are natural father too) has insurance too, then coordination of benefits will come into play and most likely her insurance would be primary. Just something to be aware of; not sure if she covers them too or if adoption ever came into play for the other kids. These are situations we hate in healthcare because they are very hard to figure out and can result of claims being paid and then money taken back when proper COB is found out....see it everyday. I do not think it is fair, but insurance companies do not care.....hence why they are "for profit" companies.

[madvlad]

I hadn't signed for insurance last year cause it was truly untouchable, just thankful nothing bad happened to me lol... They were quoting me anywhere from $460/month for a policy that didn't even cover my needs and around $640 for one that did, can't afford that. Thankfully my new job offers pretty good coverage for about $120/month and covers my pre-existing condition drugs that I need as well for special visits and what not. I also signed up for a long term disability just in case and also a $500k life insurance policy, both for an extra $60.

[tecknojoe]

My costs for Anthem doubled this year, and so did my deductible. they also now only cover flight for life when medically necessary (when the fuck else would I use it)

then they just leaked my personal information and social security number, unencrypted. FUCK ANTHEM

Seriously going to consider leaving my company this year to get away from Anthem

Also, anyone considering the track, MAKE SURE you're covered.
http://www.cosportbikeclub.org/forum...use&highlight=

[bulldog]

I hadn't signed for insurance last year cause it was truly untouchable, just thankful nothing bad happened to me lol... They were quoting me anywhere from $460/month for a policy that didn't even cover my needs and around $640 for one that did, can't afford that. Thankfully my new job offers pretty good coverage for about $120/month and covers my pre-existing condition drugs that I need as well for special visits and what not. I also signed up for a long term disability just in case and also a $500k life insurance policy, both for an extra $60.

I offered to help you and you never came by. Anyways glad to hear you got that sorted out and happy you are now covered....now go check if the track is covered

[#1Townie]

Fuck healthcare! I'm a rock star. Lol. Cheaper to pay the "tax" than to have something I never use.

[Kim-n-Dean]

My costs for Anthem doubled this year, and so did my deductible. they also now only cover flight for life when medically necessary (when the fuck else would I use it)

then they just leaked my personal information and social security number, unencrypted. FUCK ANTHEM

Seriously going to consider leaving my company this year to get away from Anthem

Also, anyone considering the track, MAKE SURE you're covered.

It's been a while, but Anthem was the worst insurance I've ever had!!

Being self employed, I've been on Kim's work policy (Transamerica) for about fifteen years and every year the coverage goes down a little and the rates go up a little. Thanks to that jack ass in the White House, the rates have really jumped and the coverage really sucks, now. You would think that working for a HUGE insurance company, you would have excellent coverage, regardless of how bad NoBama wants to screw things up.

Well, gotta get back to work, someone on welfare is depending on me!!!!!!!

[Clovis]

Brandon,

So you're only paying $134.10 per month for health insurance on a family of 7? If I have that right.. damn! Go you!

We HAD affordable health care coverage until Obamacare.

Up until 12/31/2011 we had two health plans offered at work. One that covered 100% and one that covered 80/20% (not sure what the deductable was). We had always had the 100% coverage plan and for my wife and I, the cost was around $250/mo in payroll deductions.

In 2012 the 100% plan went away and the 80/20 plan is the ONLY option offered. It was more expensive than the previous 100% plan to boot.

Fast forward to 2015 and for a family of 3 (me + wife + baby) it's just under $600/mo in payroll deductions for medical/dental/vision. Add in the HSA and $710 per month comes out for health insurance and health costs.

So everyone now should just count on spending $10,000 or more per year on insurance costs.

$6000 in premiums + $4000 in deductables.

Oh, and my employer kicks in a lot.

So to recap Obamacare:

Before Obamacare: Very affordable insurance, we never had to think about it. Same day doctor appointments? No problem! $10 co-pay

After Obamacare: Very unaffordable insurance costs, we think about it all the time. We have to seriously think about going to the doctor's office now because we're paying 100% until we've paid out $4000 for the year. Need to see your doctor? Hopefully it's nothing too serious and you can wait a few weeks.

My wife wants to get an IUD because the hormonal birth control affects her mood.

They're booked a month out. Just for her initial consult it was 45 days between making the appointment and having it. And another 45 day wait to actually get the implant.

Before Obamacare, this would have been a same day one and done.

So Obamacare means: Pay vastly more for health insurance, higher co-pays, welcome to having deductables for everyone, long wait times, ect... basically everything the republicans warned would happen with this monstrosity and the left said they were just being racist.

For some of us, 2017 can't come soon enough...

After reading EJs post, I have to share my personal situation also. I've had lots of jobs and lots of different insurance plans. Some have been good, others great, and others I probably just didn't understand well enough at the time to have an opinion on...

That said, I believe my current coverage is the best I've ever had. I won't go too deep into the weeds explaining my coverage's and costs, but suffices to say that it's a great value. I have no maximum lifetime benefit cap and year-over-year my out of pocket maximum expense is $2000person/$4000 family, which is extremely reasonable if something catastrophic were to happen to any of us. As somebody who has had a somewhat major procedure done that included 4 "overnights" in recovery, make no mistake that the costs you incur can quickly rise into the 10's if not 100's of thousands of dollars. And this was just the hospital working on my L-arm, a single limb. Imagine the costs of having to have your entire body treated!

While it's absolutely certain that the healthcare system has faults that need to be addressed, it's also absolutely certain that anybody living in this country with a life (and a lifestyle) worth preserving, MUST have insurance. Here is a glimpse of what my employer (and I) pay towards my healthcare plan each paycheck. I get 24 pay cycles a year and these costs are inclusive of coverage for me and my entire family - 7 individuals total. And IMO, it would be a good deal at double the price!

[Kim-n-Dean]

My wife wants to get an IUD because the hormonal birth control affects her mood.

Get a vasectomy. I did about fifteen years ago. Best thing I ever did!! Why put the female through the hormones (oral birth control), surgery (tubes tied) or implants (IUDs) that can cause damage when they move around?!?

Boy, have I heard some lame ass excuses on why a man won't get a vasectomy!!! Too many to list... Pussies!!

For some of us, 2017 can't come soon enough...

AMEN!!!!

[bulldog]

I just don't get how it is the insurance's fault that there is a 45 day wait...that is on the doctor because insurance does not control doctors appointments. Now if you are talking about a authorization for 45 days I understand, but the wording "booked out" seems to me the doctor office you called is at fault

And the major blame for healthcare going up is because so many people do not have insurance so the people paying are getting hit for their fees so the taxpayers can buy them coverage. You think the doctors/hospital that treat these people with no insurance somehow still get paid;nope it gets passed on to others. The problem with our country; everyone wants things for free without working for them and the people that do work hard for it have to pay for the slackers!

You want to blame anyone, go after the single mother with 7 kids all from different dads that is on Welfare and Medicaid that is still having kids and collecting more money. Or the people on disability that claim they cannot work when they are just scamming the system

[#1Townie]

I just don't get how it is the insurance's fault that there is a 45 day wait...that is on the doctor because insurance does not control doctors appointments. Now if you are talking about a authorization for 45 days I understand, but the wording "booked out" seems to me the doctor office you called is at fault

And the major blame for healthcare going up is because so many people do not have insurance so the people paying are getting hit for their fees so the taxpayers can buy them coverage. You think the doctors/hospital that treat these people with no insurance somehow still get paid;nope it gets passed on to others. The [problem with our country; everyone wants things for free without working for them and the people that do work hard for it have to pay for the slackers!

You want to blame anyone, go after the single mother with 7 kids all from different dads that is on Welfare and Medicaid that is still having kids and collecting more money

Doctors offices and ERS are all slammed these days because now everyone is going because their toe hurts. Or they have the sniffles.

To be honest I agree our healthcare has had issues for far too long but what we got with this new situation is just a pile of shit that really created more problems than solutions.

I think people should have the choice to buy something. I have not gone to the doctors office in..... Ummmm... I think ten years!!

Will I need it? Maybe. Maybe not.

[~Barn~]

I just did a comparison from Aetna, Cigna, and BCBS and Aetna paid the least and had the most non-covered services of them all. Not sure why they do not cover what others will, but they seem to be very picky. <Snip...>

Interestingly, that hasn't been my experience for the couple of years I've had Aetna. Obviously there are many dozens, if not hundreds of flavors of "Aetna" simply based by geographic regions, so I can't speak to their general practices, but specific to the Colorado HMO 20 plan that I have, it's pretty comprehensive as far as I can tell.

With the exception of vision and dental coverage (natch'), and things like cosmetic and acupuncture procedures, there is coverage for most everything I can realistically think of. Obviously everything being performed IN-NETWORK is crucial, but it's all pretty much there. Pre/postnatal care, in/outpatient surgeries, preventative care and immunizations, lab diagnostics and imaging (CATs, MRIs, etc.), mental health, durable goods, hospice and rehabilitation services, substance abuse, prescriptions, emergency and urgent care, specialists, so-on, so-forth.

And my HMO is also a $0-deductible plan too, so I only have copays which I end up paying with an FSA anyway. As long as I register my PCP, I can visit specialists without any referral. So yeah.... YMMV, but I really do like Aetna.

Truthfully, the only downside is that because my company offers like 20some different plans to choose from (Aetna, BCBS, Kaiser), it becomes a bit of a chore reviewing everything during open enrollment to make sure I'm picking the best one for me.

Brandon,

So you're only paying $134.10 per month for health insurance on a family of 7? If I have that right.. damn! Go you! <Snip...>

For just the healthcare piece, yes. When I bundle in the vision and dental coverage, it's actually $151.44 monthly. Long story short, I appreciate the coverage I have and god bless my company for covering such a huge percent of the total cost. I believe it's around 95%.

[bulldog]

Doctors offices and ERS are all slammed these days because now everyone is going because their toe hurts. Or they have the sniffles.

To be honest I agree our healthcare has had issues for far too long but what we got with this new situation is just a pile of shit that really created more problems than solutions.

I think people should have the choice to buy something. I have not gone to the doctors office in..... Ummmm... I think ten years!!

Will I need it? Maybe. Maybe not.

Only difference there is people with no insurance would go to hospitals that were under the category of "indigent"; meaning they cannot refuse a patient as it is against the law. They would go there and clog up ER's to report their cold....and guess what...the ER had to see them. They needed a $500K surgery.....yup cannot refuse it and gets hit on the taxpayers.....and most of these were issues brought on by drug/alcohol abuse and even obesity....something they did to themselves


Now the moral decision should be "do taxpayers have to pay for the people who do not have insurance". If we did not have indigent hospitals and could deny people then maybe they would step up and get the insurance they need; sorry but a lot can afford it but choose things they would rather buy...like cars, drugs, alcohol, motorcycles, etc. I do feel there are people that do need help, but when I see a single mother with 7 kids and one on the way it really makes me wonder why we have to pay for her bad decisions. Hey you can afford 7 kids, then awesome, but if not then why keep having kids and asking for handouts.

Interestingly, that hasn't been my experience for the couple of years I've had Aetna. Obviously there are many dozens, if not hundreds of flavors of "Aetna" simply based by geographic regions, so I can't speak to their general practices, but specific to the Colorado HMO 20 plan that I have, it's pretty comprehensive as far as I can tell.

With the exception of vision and dental coverage (natch'), and things like cosmetic and acupuncture procedures, there is coverage for most everything I can realistically think of. Obviously everything being performed IN-NETWORK is crucial, but it's all pretty much there. Pre/postnatal care, in/outpatient surgeries, preventative care and immunizations, lab diagnostics and imaging (CATs, MRIs, etc.), mental health, durable goods, hospice and rehabilitation services, substance abuse, prescriptions, emergency and urgent care, specialists, so-on, so-forth.

And my HMO is also a $0-deductible plan too, so I only have copays which I end up paying with an FSA anyway. As long as I register my PCP, I can visit specialists without any referral. So yeah.... YMMV, but I really do like Aetna.

Truthfully, the only downside is that because my company offers like 20some different plans to choose from (Aetna, BCBS, Kaiser), it becomes a bit of a chore reviewing everything during open enrollment to make sure I'm picking the best one for me.



For just the healthcare piece, yes. When I bundle in the vision and dental coverage, it's actually $151.44 monthly. Long story short, I appreciate the coverage I have and god bless my company for covering such a huge percent of the total cost. I believe it's around 95%.

With a $0 deductible I will say that is a great plan! You very rarely find those anymore We need more companies like that nowadays! Paying with a FSA is even better.

I think it was chiropractor and deep tissue massages I get Aetna would not cover. I know that is a stretch, but to me not everything needs to be fixed with a pill so I go for these "natural" options. I can say it has helped me more than pills ever did; they only masked the pain.

[#1Townie]

Bro who do you think pays for that insurance?!?!?!

http://rt.com/usa/195948-budget-review-obamacare-costs/

[bulldog]

Bro who do you think pays for that insurance?!?!?!

http://rt.com/usa/195948-budget-review-obamacare-costs/

Prior to Obama care it was passed on to the doctor and hospital...who then passed it on to us. You ever seen a doctor bill and say "wow, they charged $120 to give me a shot". That is because the doctors are passing on costs.

Obamacare really comes down to a moral decision of should we help everyone in this country be medically covered! Obama feels we should, and others feel we should not. I am in the middle and say tougher restrictions to qualify for help as that is the problems; abuse and scamming.

[#1Townie]

Prior to Obama care it was passed on to the doctor and hospital...who then passed it on to us. You ever seen a doctor bill and say "wow, they charged $120 to give me a shot". That is because the doctors are passing on costs.

Obamacare really comes down to a moral decision of should we help everyone in this country be medically covered! Obama feels we should, and others feel we should not. I am in the middle and say tougher restrictions to qualify for help as that is the problems; abuse and scamming.

And that has all of a sudden changed? So a MRI isn't 3k anymore?

[birchyboy]

We had Aetna last year and they were very good overall. The company I work for is big enough that it has some clout from a customer service standpoint. This year, we were allowed to choose from 3 carriers, all with the same plan design and cost. It came down to who we wanted to administer the plan. We elected to have UnitedHealthcare because they had been extremely good to us when we have had them. My wife has some medical issues, so we went with a 350/700 deductible plan.

[~Barn~]

Nate, Chiropractic is even covered by my plan, but it's limited to 20 visits per calendar year. My guess is that it would be viewed at the "Specialist" rate of a $35/copay per visit, but I'm not 100% sure. The $25 "regular" copay would be even better.

[bulldog]

Nate, Chiropractic is even covered by my plan, but it's limited to 20 visits per calendar year. My guess is that it would be viewed at the "Specialist" rate of a $35/copay per visit, but I'm not 100% sure. The $25 "regular" copay would be even better.

Nice...maybe it was the deep tissue massage then. Something was not covered and I was annoyed; did this like 3 months ago. Sorry I did not mean to say Aetna is not good, but it all comes down to checking what you will use them for; that is what I did and all the current things covered under UHC were not covered under Aetna, but Cigna covered them. Probably comes down to personal preference at that point.

Either way you have a great plan man! Ten years ago I also had no deductible but every year it has increased and I am at a $350 one now. Your company seems to actually care about their employees and that is rare.

And that has all of a sudden changed? So a MRI isn't 3k anymore?

A MIR is a totally different ballgame though because that machine does cost a lot to use; giant magnet that is expensive to run. What I meant is you go in for a shot and they bill insurance $120 when we all know that is a bit crazy; diabetics give themselves shots daily and is not that hard. So I just meant that was all passed on through the years till we got to this point. How do they say it "shit rolls downhill" so you better believe doctors/hospitals are going to recoup money any way they can.

[Ezzzzy1]

Lots of good information. Some of it pisses me off though... Its horse shit that plans can vary as much as they do. Company A seems to cup their employees balls and company B seems to pass the bulk of the cost, as well picking a shitty plan, off to their employees.

What the fluck ever. I enjoyed paying almost $10k last year.

For profit health care can suck it.