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Thread: Parts of health-care law to take effect

  1. #21
    Senior Member road kill's Avatar
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    When my wife passed and my kids moved away I was paying $550 a month....for just me!!
    With a $2,500 deductible.
    (insane)
    $30 copay on office visits.
    Annual cost befor I got to insurance?
    $9,100 +!

    Annual check up---$500
    (blood work etc.)
    Monthly Chiro visit--$30 cash ($360 annual)

    Where is the other $9,000?????


    I get VA benefits, so if I get cancer or a heart attack or something major, that's where I'll go.


    Healthcare in America is excellent.
    Health Insurance is NUTZ!!!

    Let's GIVE more of it away, so those who can and do pay can pay MORE!!!



    RK
    Stan b & Elvis

  2. #22
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by badbullgator View Post
    What I don’t think a lot of people relies is that insurance is who sets the price for healthcare…..not the evil rich doctors. .
    Insurance companies do not set the the fees providers receive for their services. They do establish "reasonable and customary" limits for charges in a given area. These R&C limits are determined by the going rate for a procedure in that area. This prevents providers from gouging patients by charging more than they should. They also establish PPO networks which providers may join in order to increase patient load. For this increased patient load, they must discount their fees to a predetermined amount. The providers do not have to join these PPO's but do so to increase activity. They would not join these if they were going to lose money by doing so.

    Over my career in this business, I have witnessed many instances where providers charged substantially more for treatment when the patient had insurance than they do for those who do not. One specialty (which will remain nameless) in particular is famous for this practice. On the other hand I have seen hospitals offer deep discounted "package deals" for those who are willing to pay cash for a procedure.

    Many years ago when my company was paying claims for several insurance companies, we were instructed to audit any hospital bill over a certain dollar amount before full reimbursement was to be made. We would pay 50% of the bill with the balance pending the results of the audit or the hospital could get 80% of the billed amount with no audit. They almost always settled for the 80% because they got paid quicker but they also knew that discrepancies would be found which would not be allowed.

    Reputable insurance companies are not the evil money grubbing organizations they are made up to be. If it were such a cash cow, there would be more of them competing for your business. Unfortunately there are companies out there that offer programs that have inside limitations, play games with claims,etc and are just attracting folks with cheap premiums. These programs are usually direct marketed by telemarketers or salaried employees without a professional insurance agent.

    Oh, as far as the "evil rich doctors" are concerned, I have several that are clients. Many of those over 50 are considering getting out of the game due to Obamacare. Don't need the hassle.

    Big print giveth, small print taketh away regards,
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  3. #23
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    It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.

    Quote Originally Posted by M&K's Retrievers View Post
    One specialty (which will remain nameless) in particular is famous for this practice.
    I'm guessing chiropractors...

  4. #24
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    Quote Originally Posted by ducknwork View Post
    It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.



    I'm guessing chiropractors...
    Me and Sgt Schultz know nothing....
    M&K's HR UH Tucker of Texoma JH
    M&K's SHR Prime Black Angus
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    Mike Whitworth

  5. #25
    Senior Member M&K's Retrievers's Avatar
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    It's difficult for me to evaluate what other people are paying for coverage because age, sex, location, plan design, the insurance company and previous medical history figure in to the equation. I can tell you that my wife and I in Dallas pay $532 a month for a $3500 deductible. I'm 62 and she is 59. We are increasing to $577 11/1 and will go up again next March when she hits 60 (I'm guessing $700ish). We will probably increase our deductible to $5M at that time. I'd go bitch to my worthless agent but it wouldn't do any good 'cause it's me.
    M&K's HR UH Tucker of Texoma JH
    M&K's SHR Prime Black Angus
    M&K's Miss Jessie Girl JH
    Sir Jacob of Lakeview-Jake
    Freeway JYD

    Mike Whitworth

  6. #26
    Senior Member ErinsEdge's Avatar
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    Quote Originally Posted by ducknwork View Post
    Will that cause everyone's rates to go up because the insurance company will obviously be paying out more money now?

    I can't wait to see what my rates are going to be when we have open enrollment in November. They have gone up considerably in the last few years.

    2005-Not married, paying for insurance only for myself, approx. $20/week.
    2006-Got married, paying assoc. +1, approx. $30/week.
    2007-Had a baby, paying family rate (max rate), approx $45/week. (this is the last increase that was MY fault.)
    2010-Still paying family rate (2 kids later) but now the rate has jumped to approx. $75/week. That's $120/month MORE than I was paying 3 years ago. In the famous words of Joe Biteme, 'This is a big f-----g deal!'
    2011-Scared to find out what it will be. I am sure it will increase and have an impact on my non-necessity spending, which will also have a negative effect on the economy, as I won't be the only one who can't afford what I used to be able to afford.
    $300 a month for a family is unbelivably cheap-I wouldn't complain. Chances are your work is picking a lot of it up? I keep taking a higher duductible to stay near $500 a month. I am now at $3500 deductible. 5 years ago I was at $500 deductible. Every year it has gone up $60-$120 a month.
    Nancy P



    "We give dogs time we can spare, space we can spare and love we can spare. And in return, dogs give us their all. It's the best deal man has ever made." M.Facklam

  7. #27
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by ducknwork View Post
    It's very interesting to hear information from those obviously in 'the know'. I am sure there are a few people who will continue to discount what you say on this, regardless of your obvious knowledge and experience in the field.



    .
    Dave will have another take on this as he should. Providers and insurance companies are not enemies. They are both forced to work within state and federal regulations that make it difficult to make a profit. Some of these regs are good while many suck by making all involved jump through hoops.
    M&K's HR UH Tucker of Texoma JH
    M&K's SHR Prime Black Angus
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    Mike Whitworth

  8. #28
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    Quote Originally Posted by Eric Johnson View Post
    Children will be allowed to remain on parent's plans until age 26....only if they were already on the parent's plan. If they were un-insured and now seek to join the parent's plan, they can be refused apparently.

    Also....

    http://www.washingtonexaminer.com/op...#ixzz10N84ui58

    http://tinyurl.com/36a53dm

    Examiner Editorial: Obamacare is even worse than critics thought
    September 22, 2010

    Six months ago, President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi rammed Obamacare down the throats of an unwilling American public. Half a year removed from the unprecedented legislative chicanery and backroom dealing that characterized the bill's passage, we know much more about the bill than we did then. A few of the revelations:

    -more-

    Our single biggest hope is that one section will be declared unconstitutional because then the whole 2000+ page bill will be tossed. The idiots in Congress were rushing so much to pass it that they reportedly forgot to add a severability clause.

    Eric
    This isn't true at all. I haven't been on my parents insurance for over a year and she recently got a letter stating that i would be eligible to go back on her insurance starting on 1/1/2011. They are required to allow you back on to your parents insurance. Your parent still has to pay so its not like you are getting something for nothing...

  9. #29
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    Quote Originally Posted by ErinsEdge View Post
    $300 a month for a family is unbelivably cheap-I wouldn't complain. Chances are your work is picking a lot of it up? I keep taking a higher duductible to stay near $500 a month. I am now at $3500 deductible. 5 years ago I was at $500 deductible. Every year it has gone up $60-$120 a month.
    I forgot to mention that work pays 50%. So the total cost is around $600. Thank goodness for work place insurance!

    My point was that the prices have already increased significantly and I am not looking forward to seeing what happens this November during open enrollment.

  10. #30
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    Quote Originally Posted by ducknwork View Post
    How do you figure? The insurance company is providing a service that we purchase. Not really any different than buying a product at WalMart.

    It's gambling. Sometimes we win, most of the time they win. We are betting that we'll get sick and need a doc, they are betting that we won't.
    The primary purpose of Insurance is to distribute risk over a large percentage of the population, NOT to make profit. When Profit became the single objective of Health Insurance Companies, our costs began to go through the roof and our healthcare rankings began a freefal that continues to this day. Profit in insurance is not needed. maximizing Profit for insurance to the healthcare equation adds 30% more cost, and deprives millions of coverage when they need it.

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