Need thoughts on Health Insurance

[aczlan]

W2 for most people. You didn't need it because the doctor could either fix you up for a small cost or you died. There weren't many options.

That was also because the government instituted wage freezes during WW2 and ruled that vacation/sick time and health insurance was not considered "wages" and thus was not subject to the wage freezes.
Thus employers gave their employees retention raises in the form of healthcare and vacation time to compensate for the fact that they couldn't increase hourly wages.
Health insurance in the United States - Wikipedia, the free encyclopedia


Aaron Z

 

[Bird]

My doctor gave up her solo practice because she had to employ a full time person just to collect from the insurance companies. And they frequntly took a year or more to pay. She joined a group practice.

Yeah, I don't think there will be that many in a solo practice very much longer.

 

[jonyyuma]

Bird, My MD owns his own practice. He has 6 besides himself for the doctoring, and 25 more for the nursing, scheduling and paperwork...

 

[Bird]

Bird, My MD owns his own practice. He has 6 besides himself for the doctoring, and 25 more for the nursing, scheduling and paperwork...

Our primary doctors used to be 3 doctors, but now it's one doctor who owns the practice, one other doctor, one PA (Physicians Assistant), 4 nurses, and 7 office staff.

 

[coffeeman]

Yeah, Ron, it's a gamble no matter which way you go. I could drop the insurance we have through the city and go out on our own, as you've done, but if city retirees ever leave the city insurance, they can never get back on it. At least one insurance salesman (here on TBN) said it appears that the city is either subsidizing or getting a discount on MY part of the AARP supplement but not my wife's. As for the Part D (prescriptions), for the last 3 years, mine have cost no more than a couple of hundred a year, but until this year, my wife's cost enough (according to the insurance company) that they paid out more than the premiums we paid.

My experience tells me to stay on city or company insurance as long as possible. I jumped onto Medicare and I got to "donut hole" by May. My out of pocket for meds; 2371.87. On private side I would have paid none of this. Eight months ago I never would have thought I would be needing these Meds. Of course, there is the other costs with the Medicare that's posted here. Your right ,though, it's a crap shoot.

Cheers Coffeeman

 

[Bird]

I got to "donut hole" by May

At least with the Part D coverage we have, there is no donut hole. However, we get a monthly "Drug Summary" from United Healthcare and this month mine shows for the year to date that they have paid $10.50 and I've paid $103.12:laughing:. I haven't used a lot of prescription medicine.:laughing: For my wife, they show for the year to date that they have paid $1613.68 and she paid $292.78 for prescriptions.

 

[coffeeman]

The bottom line is that we have demanded a very high level of health care in this country (beyond what Europe has) and we are getting it through a relatively inefficient delivery system. Until that gets addressed, the cost will remain high. To some extent, I accept that because I think, as a country, we are wealthy enough to pay for more health care than other countries. High tech state of the art medical care will never be cheap and I'm OK with that as long as we do something about the efficiency and prioritization of the system.

I wonder if you believe the health care in Europe an effieient system? I would guess that a system that makes less sick people wait for care is not so efficient. Drug costs remain high here because of R&D costs. then a year later Europe gets the drugs. Of course, many countries just steal our new drugs at no cost. In addition, private insurance charges more to help subsidize Medicade etc. I don't believe a national plan will lower costs.

One thing more; lawyers! Why should a lawyer get 30-40% for a couple days in court when the injured person has to live with his problem for the rest of his life. Medical malpractice or good rear ender on highway might net lawyer more that the person who spends the rest of his life in wheel chair.

Rambling on....Coffeeman

 

[coffeeman]

At least with the Part D coverage we have, there is no donut hole. However, we get a monthly "Drug Summary" from United Healthcare and this month mine shows for the year to date that they have paid $10.50 and I've paid $103.12:laughing:. I haven't used a lot of prescription medicine.:laughing: For my wife, they show for the year to date that they have paid $1613.68 and she paid $292.78 for prescriptions.

Part D my enhanced (HMO) After total yearly drug costs reach $2840, I pay a maximum of 93% of the costs for generic drugs and discounted price for the total cost for the total cost of brandname drugs. Then the donut hole kicks in.

After yearly out-of-pocket drug costs reach $4550 I pay the greater of: $2.50 for generic and $6.30 for all other drugs, or 5% coinsurance. My company calls this catastrophic coverage.

Cheers...Coffeeman

 

[jonyyuma]

My Cialis for Ed cost $145.00 for the 30 day everyday type. Going to have to give that up, or just take it 30 min before? I am lloking at Humanis for supplement when i retire..

 

[coffeeman]

My Cialis for Ed cost $145.00 for the 30 day everyday type. Going to have to give that up, or just take it 30 min before? I am lloking at Humanis for supplement when i retire..

I have one script that retails for $1200.00 for 30 day supply. My cost for that is $650.00 while in donut hole. Somehow I get a $550 "discount" of which I don't know why. Once out of the hole I guess it will cost 5% of retail.

I asked my doctor what do people do if they can't afford cost. He indicated they either get aid or the do without.

That's a crummy deal.

Coffeeman

 

[QRTRHRS]

Thought I would bring this thread back to the top with some questions/thoughts on Medigap.

My wife turns 65 in November and my employer's insurance offers no options for us. My wife doctors alot so I am looking at a plan F through Bankers Fidelity Life Insurance Company. At 101 per month, there is no deductable period and she can go to any doctor she wishes to that will accept the plan and supposedly, most do.

Anyone hear anything bad about Bankers? At least I have a local rep. We did some searching on the net and there is no end to the list of people that have a great deal. They seem to be in a big hurry to sign us up go figure!

I still have to find a prescription plan that works too. We only got more confused using the government's site.

 

[Bird]

I'm not familiar with Bankers, but I wonder if their Plan F and the AARP (United HealthCare) Plan F that we have is the same plan. If so, that premium amount sounds like a bargain. We're paying $321.32 for both of us and I've heard a rumor it'll be $250 next year. If so, it'll be the first time in my memory that health insurance premiums went down.

 

[mjarrels]

Just spent six days in the hospital... bill came to $57,495. Insurance carrier now does not want to pay and is looking for a third party to be held responsible.

mark

 

[milkman]

Thought I would bring this thread back to the top with some questions/thoughts on Medigap.

My wife turns 65 in November and my employer's insurance offers no options for us. My wife doctors alot so I am looking at a plan F through Bankers Fidelity Life Insurance Company. At 101 per month, there is no deductable period and she can go to any doctor she wishes to that will accept the plan and supposedly, most do.

Anyone hear anything bad about Bankers? At least I have a local rep. We did some searching on the net and there is no end to the list of people that have a great deal. They seem to be in a big hurry to sign us up go figure!

I still have to find a prescription plan that works too. We only got more confused using the government's site.

I see you're from Ky so maybe this will help. I called my Soc. Sec. office in Owensboro Ky. when I became eligible for medicare and they gave me the name of a place that walked me through all the options, and there are a bunch. They knew all the policies cost and the differences in them and are not allowed to tell me which one to choose, only give me the options and I decide which is best for me. All this is a free service and each eligibility period I can go to them and they will explain all the changes and at that time I can either stay with what I have or change to something else. It does change every year, seems some ins. companies offer good deal at signing, then if you don't watch at renewal time, coverage changes. Your Soc. Sec office would probably be a good place to start.

 

[Travelover]

..... when I became eligible for medicaid ..........

I think you mean Medicare. Medicaid is for people that are indigent.

 

[milkman]

I think you mean Medicare. Medicaid is for people that are indigent.

Thanks, fixed it.

 

[QRTRHRS]

I'm not familiar with Bankers, but I wonder if their Plan F and the AARP (United HealthCare) Plan F that we have is the same plan. If so, that premium amount sounds like a bargain. We're paying $321.32 for both of us and I've heard a rumor it'll be $250 next year. If so, it'll be the first time in my memory that health insurance premiums went down.

Bird, the 101 would be in addition to 115.40/month for part A & B. We had a local agent come out to the house who explained alot of things to us. I asked her a couple of times and she said absolutely no co-pays, or yearly deductable. We would still need a drug plan.

I still have a couple of years to go and our current insurance through my work runs 153 bi-monthly with 30-40 dollar copays for the two of us. Since most visits are 40, I figure we will be putting out less overall but who knows.

My employers insurance offers no plans for retired spouses. I have a request in to find out if I can keep my wife on the dental which is seperate from the medical but a relative bargain at around 7-8 bucks bi-monthly for both of us.

What a nightmare to wade through all this info!

 

[QRTRHRS]

I see you're from Ky so maybe this will help. I called my Soc. Sec. office in Owensboro Ky. when I became eligible for medicare and they gave me the name of a place that walked me through all the options, and there are a bunch. They knew all the policies cost and the differences in them and are not allowed to tell me which one to choose, only give me the options and I decide which is best for me. All this is a free service and each eligibility period I can go to them and they will explain all the changes and at that time I can either stay with what I have or change to something else. It does change every year, seems some ins. companies offer good deal at signing, then if you don't watch at renewal time, coverage changes. Your Soc. Sec office would probably be a good place to start.

milkman, thanks for the input. As I said to Bird though, we did have a lady agent come out and she was indeed helpful even though she represented Bankers Fidelity. She was not pushy nor did she insist her way was the highway.

We did some online searches and I was not thrilled with the sales pitches. The common theme is to hurry up and sign up.

My elderly mother lives with my wife and I. She has one of the lower cost advantage plans and is always complaining about the co-pays.

 

[ronjhall]

milkman, thanks for the input. As I said to Bird though, we did have a lady agent come out and she was indeed helpful even though she represented Bankers Fidelity. She was not pushy nor did she insist her way was the highway.

We did some online searches and I was not thrilled with the sales pitches. The common theme is to hurry up and sign up.

My elderly mother lives with my wife and I. She has one of the lower cost advantage plans and is always complaining about the co-pays.

You will find that Advantage plans, regardless of who is selling them is giving the seller a commission.
Look for a Supplemental plan that has no Deductibles or Co-Pays. Hard to find because no one is getting a commission.

 

[QRTRHRS]

You will find that Advantage plans, regardless of who is selling them is giving the seller a commission.
Look for a Supplemental plan that has no Deductibles or Co-Pays. Hard to find because no one is getting a commission.

We are finding several options for the plan "F" version with no deductable and no co-pay. Hard to figure. I don't mean this to be derogatory but there is certainly no shortage of people with health issues where we live.