Jan Alaska

Still plodding along with reasonable health so I'll be sticking with my $80 / month $500 deductible Medi share group (Christian Healthcare Ministries).

BCBS of Michigan seemed to think $870 / month with $6,500 deductible was reasonable .... I think not !

civilservant

My employer offers Traditional/HSA/FSA and is a healthcare provider.

Traditional costs me $52 every 2 weeks plus another $50 for being a smoker. CoPays are $30/$60/$400 (PCP/Specialist/ER) and then 20% co-insurance beyond that. That's for employee only. I personally can't be bothered to mess arounf with HSA/FSA so just keep the traditional.

Elect to cover your family and it skyrockets really quickly.

My wife has an FSA that the employer puts $1000 in a year, then she has to meet her $2k deductible before the plan pays 80%. She pays about the same as me every month. She works in a book distribution plant.

Rete

I've yet to see anyone here mention that in many cases, the doctor will accept whatever the insurance pays as payment in full. I know that I have never gotten an invoice to pay the 20% and I'm 70 years old and have had a variety of healthcare plans over my lifetime.

Giantaxe

In many states they can't do "balance billing", meaning a doctor can't bill you for the difference between what the insurance company's negotiated rate and what they actually billed (and the difference can be large). But they most certainly can charge you whatever your copayment is or, for example, the whole negotiated rate if you've yet to meet your deductible etc.

Rete

I have always paid my co-pay at the end of the visit. That is a given. Yes, they can ask for you to pay the acceptable insurance rate for the service. My daughter with the $10K deductible has to do this and reclaims it from the HSA.

However, that is NOT what I'm talking about. I'm talking about those who have met their deductible or those without a deductible (yes, there are some of us out there believe it or not) who are not billed for the difference between the 80% paid by the insurance company and the 20% left unpaid. My doctors, either here in MS and those in NYS, have always accepted the insurance payment as payment in full. That is something that I have always asked about when I have had to go to a new doctor. If they don't accept the insurance payment as payment in full, then I'm not your patient. Unlike say Canada, there is no shortage of doctors in most metropolitan areas and one can shop around if you have a PPO and if you have an HMO, those doctors have signed on knowing they were only getting so much per visit and/or procedure and normally do not bill for that 20% unpaid.

Rete

I have always paid my co-pay at the end of the visit. That is a given. Yes, they can ask for you to pay the acceptable insurance rate for the service. My daughter with the $10K deductible has to do this and reclaims it from the HSA.

However, that is NOT what I'm talking about. I'm talking about those who have met their deductible or those without a deductible (yes, there are some of us out there believe it or not) who are not billed for the difference between the 80% paid by the insurance company and the 20% left unpaid. My doctors, either here in MS and those in NYS, have always accepted the insurance payment as payment in full. That is something that I have always asked about when I have had to go to a new doctor. If they don't accept the insurance payment as payment in full, then I'm not your patient. Unlike say Canada, there is no shortage of doctors in most metropolitan areas and one can shop around if you have a PPO and if you have an HMO, those doctors have signed on knowing they were only getting so much per visit and/or procedure and normally do not bill for that 20% unpaid.

Giantaxe

That is exactly what I'm saying. It's known as "balance billing" and is actually illegal in some states. Plus, it's in many of the contracts that doctors sign with insurance companies that they won't do balance billing.

https://www.beckershospitalreview.co...e-billing.html

civilservant

I am not sure of the legalities of out of state, but here in GA as CFO of a Healthcare Facility I can assure you you're getting billed whatever is labelled as your portion on the Explanation of Benefits form we receive. So if there's a $100 MR (Member Responsible) on your claim, you're getting sent a bill.

We do not balance bill, however, since it's usually a previously contracted adjustment.

Bob

Well that's amazing!

Our eldest is having tummy troubles and when she had her tummy scoped, our 10% portion for the 20 min procedure was $2K from the doctor, plus all the rest of the folks and the hospital.

mrken30

• Vision insurance becoming voluntary and paid for by the caregiver
• New EPO Medical Plan option for caregivers in the metro area
• Short-term disability coverage increasing from 60 percent to 65 percent of your pay
• Enhancements to our retirement programs aimed at helping caregivers save earlier for retirement

Pay $60 per pay period to cover family. $3k deductible, $6k moop. $1400 put into HSA account each year. We pay $88 for a doctor visit until we meet the deductible, this rate is negotiated by the insurance company.

BEVS

Gawd So complicated &, to me, somewhat screwy.

RICH

I believe that is by design. We are expected to pay what they want, and consider it a benefit because there is a tax break. Obviously different folks get different results, financially and healthcare wise.
I wonder what the super rich do.

tom169

Have their own doctor on call to prescribe them things... Think Michael Jackson.

Rete

And I have been horrified over the years of your description of your healthcare woes with the Mrs. and the girls. I often wonder what crappy type of healthcare your wife has and/or what kind of doctors you have in MA.

scrubbedexpat091

https://www.usnews.com/news/best-sta...gs/health-care

https://www.americashealthrankings.o...state-rankings

https://interactives.commonwealthfun...ate-scorecard/


MA seems to be one of the best states.