Let's talk about Medical Insurance.

[PRICEPLUS]

Medical costs are rising every day. Hospital stays can destroy the finances of those with inadequate or no medical insurance. I have several questions.

1) Do you have medical insurance? What type if you have it? What you do if you have no coverage? If you have it through an employer what does it cost you?

2)Should the government provide a safety net for those with no or inadequate coverage? How would a program like this be paid for?

3) How many here are paying privately for coverage? What does it cost?

When I started out I only had Blue Cross/Blue Shield for Hospitalization. Back in the 80's it cost me a couple of hundred a month. I paid for doctor visits and medications. Thankfully I was relatively healthy. Now I pay about 700 a month for insurance which include eyeglass and dental as well as prescriptions. The DW and I have it through her union. I consider us lucky.

How do you save money on medical treatment? How do you know which plan is good? Are all HMO's bad are are some very good? Given the costs involved I thought it would make for an enlightening discussion.

[meaghanchan]

Re: Let's talk about Medical Insurance.

I have no medical insurance right now. I'm a 'permalancer', so it's not offered through my job. I haven't had health insurance for the past year and a half, since I graduated from college. I'm currently applying, though, for a plan through the Freelancer's Union (http://www.workingtoday.org).

It's very reasonably priced- about $200 a month for a single person, for very basic coverage. It's just a lot of paperwork that I haven't totally gotten around to.

[Bluezy]

Re: Let's talk about Medical Insurance.

I received my certificate for health insurance today! My plan is with Golden Rule/United HealthCare's HSA 100 Plan. My premiums for baby CJ and I are $244.43 per month:

a) $216.43 for actual premium

b) $3.00 per month FACT membership dues

c) Govt mandated $25.00 per month contribution to the HSA

All contributions to the HSA are tax deductible when paid by the insured and not the insured's employer. Interest is paid (4.00% APR) and is tax free for qualified medical expenses. Our deductible is $3650.00, so $3650.00 is allowed in the HSA per calendar year....and quite a help towards any future medical emergencies that could send one into bankruptcy. Also with an HSA, all balances in the account are carried over. You lose nothing!

Because the deductible is so high, Golden Rule/ United HealthCare has contracts out with physician in their FACT network. When a member of this plan needs medical attention, the physicians and hospitals within the FACT contract give the insured a VERY affordable rate for services. A doctor visit can cost a mere $15-20!

[CRFSaver]

Re: Let's talk about Medical Insurance.

I have it through my company. It uses the Blue Cross (California has two blues) network. I pay about $25 every two weeks for coverage for myself, 3 dollars for dental and 1.50 for vision. Thats about how much it was at my last job as well. If you are unemployed for a while or waiting to get on insurance you can by a catastrophie insurance through an insurance agent ( I got it through my car insurance agent). It was like 60 bucks a month for a maximum 6 months and something like a $1000 deductable. Nice thing about it is its just temporary so you dont need a medical exam. Sometimes they will let you extend it as well.

[PrincessPerky]

Re: Let's talk about Medical Insurance.

We have one thru DHs work, the premium and carrier just switched,

Meaning A, we will have to pay out of pocket for the apointment on Thursday (we never get new numbers in January) but we will be reimbursed. And B we are paying more. . We had none before we got married (no risk of pregnancy) we would (and did) skip all minor medical issues (you can fight a cold without antibiotics, ear infections too, man that hurt!) we pay about 400 a pay (think) for medical, all 5, and dental for the two of us. no eye.

2. should the government provide a safety net? well as a libertarian NO! but as a humanitarian..... umm prolly not no, maybe low cost immunizations (helps keep everyone safe that way) and some minor stuff (ear infections, kid help ect), but I don't want to be paying for expiramental procedures or anything, there are drug companies who will sponser the stuff to get the tax break and the research, prolly not enough, but then there is NEVER enough.

[flash]

Re: Let's talk about Medical Insurance.

I've posted my opinions on the part D plans elsewhere. MD and I both had excellent insurance as VPs in a fortune 500 company. But when it came down to up-to-date cancer treatments and hospital care after my assault, we had to fight tooth and nail to get MDs radiation covered, as it was "new", had only been around two years, and other doctors were still using outdated treatments. $20K out of pocket. For my assault, again, cheaper alternatives with less success were available, and out of pocket was $120K to get up to date treatment.

Since we "retired", we pay our own insurance premiums, about $400 each without prescription coverage. We did not sign up for these plans in case of "catastrophic" illness, though, we'd been through that with the best insurance. We did sign up to keep current on our insurance, for regular checkups and to stay out of the "pre-existing condition" hole should anything recur.

As a medical researcher turned manager, I think medical insurance across the board is a problem.

[lrjohnson]

Re: Let's talk about Medical Insurance.

As I've said elsewhere, my job involves Medi-Cal (California's Medicaid). I would recommend everyone do what they can to get insurance, even if it's very high deductible. I've seen too many instances where people are immensely financially damaged due to illness/injury. They may have too many resources for public assistance, says $3000 in an IRA, but are looking at a $75,000 medical bill. Sometimes these people had insurance available at work but they considered it too expensive. I myself had over $2000 in medical bills even when I had insurance years ago, in 93/94-sliced my knee open and it got infected. I can't imagine what that "minor" injury would have cost without insurance.

I have employer-sponsored insurance and am very grateful. It's a PPO, fair coverage, fair price, I think my payment is about 40 a month. When I worked retail I was exceedingly lucky to have employer sponsored insurance at Ross Dress for Less-it was HMO, and it was great. I have periodically had some major health issues, so I rely on insurance, though thankfully I haven't needed too many medical services lately.

[barbara L]

Re: Let's talk about Medical Insurance.

I recently had to remove my children from my employer's insurance because I could no longer afford the cost. They were approved for Kaiser's child program at only $45 per month for all 3.

My insurance is through my employer. They pay the first $556 per month of insurance, which means right now for me I don't have any insurance costs other than co-pay's that are very minimal if I go to one of the doctors in the network hospital.

My son sliced his hand open and I had to take him out of the network (closest hospital) and it cost $1400 for the hospital and $700 for the doctor. I had to pay $250 of it (copay).

I am thankful that I have insurance. There are so many that don't. I do believe we need some kind of insurance fix. What ??? I don't know.

[PrincessPerky]

Re: Let's talk about Medical Insurance.

I have a question, if you were a rich dude, wanting to start offering insurance, and of course humanitarian enoiugh to want to help with affordable premiums...just what would you charge to be able to cover the costs of 20K, or 120K treatments and such? I mean that is a lot of other premiums to cover one bill, and lots of people have medical bills. after all I have insurance because it SAVES me money, I suppose the risk of major medical issue is there, but as it is I save by paying less in premiums than I would for delivery and well baby checkups (and well kid, and other kid, and oh yeah I have to go buy a pregnancy test!)

What I am saying is, medical care is expensive, insurance or no insurance, stupid malpractice suits raise it, as do unneccessary procedures. But plain and simply it costs money to train someone to do all that stuff (sorry DH may have seen 3 kids delivered, but he is not qualified to deliver, I want my well trained nursing staff) And it costs alot for new equipment, new testing. the nurse doesn't draw your blood for free, the tech doesn't seperate it for testing free, the expert doesn't stare in that mini scope for free. There is sooo much that goes into a 'simple' routine, I am not supprised it is expensive.

[Ima saver]

Re: Let's talk about Medical Insurance.

We had insurance that we paid for, for many years thru Blue Cross. We figured that we paid out over $90,000 and never had one claim because it was a $5000 deductible and we never needed it , thank goodness. We dropped it and a year later my husband had a neck disc problem. We were able to get him insurance for $125 a month, but it is a $10,000 deductible which we have not used yet. I hope we just stay healthy. I have no insurance on me at all. In 4 years I will be eligible for medicare. I am lucky, I have never been to the hospital.

[abowers]

Re: Let's talk about Medical Insurance.

I have Aetna through my work, and I pay $45 per pay period/$90 per month. This is just for myself. I have a PCP, need referrals for a specialist, and pay a $15 copay for doctor visits and prescriptions. But, I'm relatively healthy, and have not yet needed to use my insurance yet, since starting my job in August. Dental is $5/pay period; $10 per month. Vision is included.

[cercis]

Re: Let's talk about Medical Insurance.

Princess - Malpractice claims have been proven to have no affect on the price of healthcare. Malpractice insurance rates ARE rising, but not in proportion to claims (the study has been posted here).

And if doctors really wanted to do something about malpractice claims, there are proven things they can do easily. 1) develop a good bedside manner - patients are less likely to sue when they are treated as partners in their medical care, for example, midwives are rarely, if ever, sued, even when there is a mortality, 2) make complaints and grievances public. If a person knows a doctor has grievances against them, then they go into the exam with their eyes wide open and are more likely to question things that seem off, for example, I was told to watch the local hospitals because they sometimes double medicate so everytime they brought me a pill I asked what it was for and by doing that didn't take the stool softener twice in an hour. I also have a medication allergy, so I double-checked everytime they brought something to make sure it wasn't that medication.

The simple fact is, doctors and hospitals injure many, many people each year. Sometimes to the point where those people can no longer work and have medical expenses into the 6-7 figures each year for the rest of their lives. Sometimes it's because the patient didn't ask the right question to prevent an accident (still not the patient's fault) and too many times it's because a doctor has had soooo many complaints and is still allowed to practice.

[flash]

Re: Let's talk about Medical Insurance.

I have a question, if you were a rich dude, wanting to start offering insurance, and of course humanitarian enoiugh to want to help with affordable premiums...just what would you charge to be able to cover the costs of 20K, or 120K treatments and such? I mean that is a lot of other premiums to cover one bill, and lots of people have medical bills. after all I have insurance because it SAVES me money, I suppose the risk of major medical issue is there, but as it is I save by paying less in premiums than I would for delivery and well baby checkups (and well kid, and other kid, and oh yeah I have to go buy a pregnancy test!) .

Well, let's see, I've been employed with benefits since age 16, and until I was 39, had NO prescription costs or medical/doctor/hospital costs, and only annual physicals, which were actually required for the job and covered under a separate contract. My last insurance, PPO, my company paid $500 a month and I paid $200 a month. Same for my husband, only his medical need came at age 38.

So, let's see, $1400 a month for 23 years, and yes, that was with mostly the same insurance carrier. And the insurance company WOULD cover $50K plus followup for life for the radiation that would not work, as long as it was within their PPO, just not the $20K that was the only treatment proven to work for his cancer, but was offered by the university.

I think we more than paid our way. Insurance is just that, to insure that you have adequate treatment if you need it. When your PPO tells you that you have a 1% chance of survival, and none without this treatment, but they are only set up to cover a different treatment that they know won't work in your case, I think we had a right to expect SOME coverage. If insurance doesn't cover life and death, the checkups and prescriptions seem pretty meaningless.

Neither of our treatment costs were considered out of line. Medicare would have covered both completely. A non-PPO insurance, such as we have now, would have covered 100% of the costs, and our premiums are LESS, although we don't have prescriptions. Medicare premiums are less. Our bills were STANDARD costs in a plan that we had paid into without using a dime for YEARS.

So, what is your answer to your question?

[PrincessPerky]

Re: Let's talk about Medical Insurance.

Me? I don't gamble, I always lose, and I could never turn down the help of someone in need if I had the loot, so I would be a bankrupt dude, and no one I insured would even have the loot for shots.

And circis, your here link didn't work.

btw I have heard when arguing with insurance if medicare would have covered it then they often change their mind did you try that? and congrats on beating the odds.

and I very well know that not all insurances are created equal, I have 3 kids all different insuances, all same care needed, yet my debt is for my second. lousy insurance.

[flash]

Re: Let's talk about Medical Insurance.

You sound like me. I have actually covered hospital bills for friends.

Medicare, well, it's actually one of the best insurance plans out there. Combine with a Medigap plan, everything except prescriptions is covered. Despite the lower "acceptable" rates, almost every doctor/lab/etc. accepts it, and the patient has the freedom to choose everything. I've actually been told by doctors that it is so much easier to get approvals, and payments, with Medicare!

Me, well, as you can see it is a sore subject. MD's oncologist wrote to the insurer, as did I. I actually asked them what they felt MD's life was worth, laid out the circumstances, and asked what his absence would be worth to our unborn child....and for the next stages of his treatment, EVERYTHING was covered, even a private room his surgeon requested, with an extra bed for me. It does pay to petition, but you do have to know how the system works.