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