How good is your Health Insurance ?

First two disclaimers: First this refers to an insurance carrier policy not under Obama care but under Medicare, and second it is a personal experience with only one major company. Maybe there are good companies out there ???

Acting as an agent for a senior citizen over 90 years old I ran into this:

And then there is the issue of the Health Insurance companies - whose 'errors' can cause you so much pain and suffering that you may wish they had killed you while in the hospital [hyperbole]. The grief they can cause with errors is sickening - A perfect circle you go the hospital [medical clinic, whatever provider], and they make you well [if they don't make any mistakes[ [See: Medical Errors: STILL the Third Leading Cause of Death here on ATS:
www.abovetopsecret.com...]
And then the insurance company screws-up [possibly deliberately] and they claim you owe a small fortune for whatever reason they can think up to
deny the payment to the provider - They make you well only to make you sick again.

See why Health Care in the USA is the most expensive in the world and is rated near the bottom of quality of care among industrialized nations ?

Now back to the main story:

I use the word 'error' loosely as I have a solid suspicion tha they deliberately make these 'errors' to avoid the responsibility for what you signed up for - In a nutshell they are unethical, if not crooked.

Some of you might have had good experiences with your company - but if you are signing up now for health insurance be sure to Google a check on 'complaints against 'xyz' insurance and see what pops-up. You may want to think twice about signing up with an insurance carrier that may have hundreds if not thousands of complaints against it.

When they make a 'mistake' like saying a certain hospital is 'out of network', and you have their own book of providers saying it was 'in network' and they then refuse to update their patient responsibility column, and in fact claim you are responsible, when clearly you are not, and claim you owe a small fortune - You know you are swimming in a cesspool of rats - and whatever you saved by using that insurance company that had a policy that seemed too good to true - was in fact just that - too good to be true - If nothing else you will lose all you may have saved in lawyer fees.

In my case I would like to file a criminal complaint agaist them for fraud - failure to pay for and on a contracted service - But I will have to ask a lawyer how to do it - And if they do it they will want money.

I know in one sense Obama was right - healty care in America is unsustainable - But did he really fix it - Or is it worse now than ever ?



“There is no illness that is not exacerbated by stress.”
― Allan Lokos, Patience: The Art of Peaceful Living



“America's health care system is neither healthy, caring, nor a system.”
― Walter Cronkite





“As to diseases, make a habit of two things — to help, or at least, to do no harm.” ― Hippocrates

Ours has been fine.

Healthcare in the US is a fraudulent system. It is rife with over charges and mistakes.
It is a big business. It does not exist for the sole intent of making you healthy.
It exists to make money for its shareholders.

Medical insurance is a scam, rife with billing errors, mistakes and overcharges.

-last visit to the emergency room for a dog bite, $650 out of pocket after insurance. Total bill that insurance paid was $3500+. The wound was examined, cleaned and 5 stitches were used. Two scrips for pain meds. In and out in 45 minutes.

$3500/45 min.=$77.77 a minute. Seems reasonable...NOT!

a reply to: AlienView

I live in Britain, we have free health care, well we pay through taxes but I can walk into any hospital at any time, get treatment regardless of the condition and not have to worry the cost. If I need an ambulance to get me there that's free as well

Yeah that's pretty good insurance

Cody

originally posted by: cody599
I live in Britain, we have free health care,

Yes, ditto.

My son had a complex medical condition which cost nothing over the five-year life of the problem, including numerous hospital visits.

The US healthcare system is renown as being fantastically costly, but has similar, or worse clinical outcomes when compared to other developed nations like the UK, Germany and France. The US has amazing healthcare, if you can afford it, but not so good if you cannot. It's no secret that the US prison system is the way that mental health is dealt with!

it's been just as good as it has been throughout most of my life, nonexistent. which is okay be me really, since it didn't do much good those times when it was existent, and the healthcare really didn't do much better really...

but, ya know, we have the best healthcare in the world!! millions upon millions of taxpayer dollars have gone into it, reasearching diseases, finding cures, finding better ways to treat diseases...
it's just too bad that so many of the taxpayers who actually helped build this great healthcare system can get much benefit out of it without ending up in bankruptcy court!

a reply to: paraphi

I could never repay the NHS for my treatment alone (bike crash)

It's a luxury we afford ourselves, the US would do well to follow us (pun intended) IMHO

Cody

a reply to: paraphi

I CANNOT even imagine!!! Let me tell you..we have Blue Cross/Blue Shield Health ins. This includes dental but not vision. We pay around 500 USD/month. Now if we go to the doctor we have to pay a copay of anywhere from 5.00 - 40.00 USD. That's for each appt. My husband had to have a periodontal scraping (tooth cleaning) a few months ago. That ended up costing us 654.00..and WE HAVE INSURANCE!!! The thing that royally SUCKS is we don't know what will be covered and what won't. YES we have a manual but that thing is useless..even the receptionist will tell you that we never know the out of pocket. expense...we pay and then have to pay again and again. 600 bucks is a big hit to our budget Especially when it comes out of now where..and we think that we are covered! It's horrible and scary..it's like I don't even want to go doctor for fear of huge bill...even though we are 'covered' with the BC/BS..

If we could get the Mafia and the politicians out of our healthcare system, the hospitals would almost pay you to come...

I don't have health insurance.

I got the fine on my taxes though.

Changing my tax status to give as little to Federal gov as possible, then will refuse to pay next year.

a reply to: AlienView

I was an account rep at bcbs. I fixed problems all the time. I had a spanish speaking member looking at a $35,000 ER claim that wasn't paid because he didn't call to authorize the visit in time (they give you 48 hours after the visit)

I asked the claims rep if we would have paid the claim if he had called, and she said "yes". I asked her to pay the claim based on that, and she did

I also had a physical therapy claim where I called the claims rep and she told me the guy was being investigated for fraud and they would not make any exceptions until the case was over. there can be more to the story

your example of a book is not strong. printed material goes out of date the day after it is printed. it is the members responsibility to know and manage their benefits

there is an appeal process and you can also go look up the formal filings in the state where they are headquartered.

good luck

Mines great.

I can go to the doctors whenever i like.

It covers all health conditions even if predisposed.

Can get any approved drug or operation and even covers some trials.


Its called being a British citizen!

a reply to: crazyewok

It should be.

Americans subsidize the rest of the world's health care.

Why you think it costs so much in US for the same company's product?

originally posted by: GodEmperor
a reply to: crazyewok

It should be.

Americans subsidize the rest of the world's health care.

Why you think it costs so much in US for the same company's product?

Because your all suckers who act like sheep while the big health care providers fleece you.

And no healthcare is not all done by the USA.

Some of the biggest pharma company's are UK or EU based and most of modern medicine is based of of British and French discovery.

Yes the USA had made HUGE contributions but lets not pretend the world would be in the dark ages without US pharma.

I repeat. Ours has been fine. I have had major medical procedures. I have had to go to various hospitals. I have had to see different specialists.

While we have had bills for this, they have not been beyond our ability to pay and they have had the lion's share covered without question by the insurance.

And, of course, we are not taxed everywhere on everything to pay for this.

a reply to: ketsuko

Unfortunately many of your fellow Americans are not so lucky.


ACA is a joke and a single payer method wont work on a fedral level in the states due to its size.

But something needs to done about the variability of care.

a reply to: ketsuko


US public healthcare spending is higher than nearly any other nation in the world. Only Netherlands and Norway spending more per capita. The difference lies in these nations having universal healthcare system without deductibles or anything else like that.

www.commonwealthfund.org...



Personally I am satisfied with my health care. I pay 7,5% of my salary towards getting everything covered, no matter what. The only additional cost is 5 euros for appointment. Paid only the first time and covers any additional appointment in three months. So far, I have never problems with waiting too much. Whenever I need to see a doctor the appointment comes in a few days. I personally do prefer system like that. Even if something extreme happened, banktruptcy via healthcare is impossible in here.

originally posted by: crazyewok
a reply to: ketsuko

Unfortunately many of your fellow Americans are not so lucky.


ACA is a joke and a single payer method wont work on a fedral level in the states due to its size.

But something needs to done about the variability of care.

On that we can agree.

Every fall, we now worry about whether or not we will continue to win the lottery and have our insurance picked up, and of course, every year now the cost of that insurance sky rockets after the ACA. Quality hasn't changed though.

And it was the ACA that upped the cost too. Right after it passed, the nasty price increases began. Prior to that, we could more or less count on burning through our deductible by September/Octobor every year. Now we can forget it.

a reply to: ketsuko

Personally I think the federal government should withdraw from all healthcare and leave it to the states under the provision the states each have to ensure a a adequate standard of healthcare. Doesn’t matter what method each state chooses can be through charity, single payer or a Hong Kong subsided 100% private method ect

I just don’t see how the Federal government can provide for 350 million.

Reason MOST (emphasis on most as we both know many are in trouble) European country’s provide healthcare is because each country regulates its own healthcare there no big federal government governing it and as most EU country’s are no bigger than US states its less area n population to deal with. Unfortunately if the EU has it way that will change and it will screw it up like everything else.
I have been to enough states to recognise that cost and health issues are going to vary from state to state.

a reply to: Neopan100

We pay around 500 USD/month.

Thats pretty cheap. I pay pretty much $10 an hour for insurance. Thats easy 400 a week. That does help subsidize retirees health care though.

We are self funded and it works pretty good