Help, I don't understand medical insurance
#47
Re: Help, I don't understand medical insurance
We recently, for the second time in 4 years I think, received a check back from a health organization with a note to say that as part of a review they note that they overcharged me for something last year. I suspect that no-one, not even the organizations involved in the process, fully grasps how it all works. On several occasions while dealing with the front desk of some health place the struggle for the receptionist to figure out what they should be charging me under my insurance takes longer than the treatment.
Health insurance is one of the reasons nature built the human being with the ability to cross its fingers.
Health insurance is one of the reasons nature built the human being with the ability to cross its fingers.
#50
Re: Help, I don't understand medical insurance
I don't think anyone thinks that Obamacare in its current form, as legislated, will last. Depending on who follows Obama, a number of changes are possible; IMO some sort of change is certain.
Last edited by Pulaski; May 1st 2013 at 1:59 pm.
#51
Re: Help, I don't understand medical insurance
This is why I like my HMO, although they might be more restrictive on who you can see - the referrals (so far) have always been covered by my insurance and I've never had to worry about that in-network/out of network issue. My insurance seems to cover whomever my PCP refers me to.
I also don't like the % thing on PPOs you can never get a straight answer as to how much that is. At least with my OOP maximum I know that's all I'll be paying out if I have, but even then there can be some hidden surprises - and I have to say after 24 years I still don't get it, and I administer our plan at work!
I also don't like the % thing on PPOs you can never get a straight answer as to how much that is. At least with my OOP maximum I know that's all I'll be paying out if I have, but even then there can be some hidden surprises - and I have to say after 24 years I still don't get it, and I administer our plan at work!
#52
Account Closed
Joined: Mar 2004
Posts: 2
Re: Help, I don't understand medical insurance
There was an item on the Radio about increasing premiums in Colorado, this was Progressive Radio. The highest increase I remember was 40 odd %.
#53
Account Closed
Joined: Mar 2004
Posts: 2
Re: Help, I don't understand medical insurance
When I visited Hospital last week, I was tagged. Seems simple enough to tag your Insurance info and a do not treat me if you are not in my network instruction.
#55
Re: Help, I don't understand medical insurance
re what lansbury said, one the example policy they referred to on the PPO said this...." out of pocket max is the maximum you would pay in any one year for deductable and copayment for network covered services. Once you reach this maximum the plan pays 100% for most services."
Am I reading it right that that is the opposite of Lansbury's experience....say 10% copay up to the MAX of annual max-deductable?
Am I reading it right that that is the opposite of Lansbury's experience....say 10% copay up to the MAX of annual max-deductable?
#56
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Joined: Feb 2010
Location: Temecula, CA
Posts: 4,759
Re: Help, I don't understand medical insurance
Hah! The new plan lists the same service twice - one at "no cost"; the other at $50 copay.
And that was wrong too (including my mistake). I was quoted anything from $2500 upwards to $30 copay. After the 3rd time of calling them it turns out the $2500 applied to general anaesthetic; the $30 for a standard day procedure. But the plan says $250. The new plan says $50 in one section and free in another section. Just one example of how you can't get a cost up front for a routine procedure.
And that was wrong too (including my mistake). I was quoted anything from $2500 upwards to $30 copay. After the 3rd time of calling them it turns out the $2500 applied to general anaesthetic; the $30 for a standard day procedure. But the plan says $250. The new plan says $50 in one section and free in another section. Just one example of how you can't get a cost up front for a routine procedure.
#57
Lost in BE Cyberspace
Joined: Jan 2008
Posts: 41,518
Re: Help, I don't understand medical insurance
Not me, I think UK prescription charges are great value - OK often you pay £7.65 (or whatever) for 50p worth of medication, but balance that against £7.65 for £500 worth of stuff and it is a no brainer. Also if I really need that 50p worth of stuff to turn me back into a functioning human being 7 quid is a bargain.
#58
Re: Help, I don't understand medical insurance
All prescriptions are also free for pregnant women and for the following 12 months after the birth...free for people with a chronic illness.
#60
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Help, I don't understand medical insurance
60 votes to get a change through the Senate so it will be tough...The basic tenets of Obamacare are here to stay imo: no discrimination on those with pre-existing conditions, no dropping people because they get sick, insuring young adult children etc.