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Thread: Health Insurance and National Health Care

  1. #151
    lisalouver Guest
    Quote Originally Posted by AFoolandHisMonkey View Post
    No, not that I know of. My boyfriend's friend who also died young of pneumonia definitely wasn't one. My understanding (about the first guy) is that it was viral pneumonia... antibiotics aren't going to do much then.

    Semi-related: I have a friend who almost died of sepsis. She was perfectly healthy, suddenly felt sick, went to the ER on her dr's advice, and within just a few hours she was at death's door. Antibiotics saved her life. And the drs *still* don't know how she got it. Freaky.
    No, if it was viral, antibiotics will not help it, but it is also much more rare to get a viral pneumonia. Was he immuno-compromised? There has to be more to the story.

  2. #152
    darlingdawn Guest
    You can actually get a vaccination for pneumonia now and they last 5 years I believe. You can probably get this along with the flu shot for about 20 bucks at a health clinic.

  3. #153
    AFoolandHisMonkey Guest
    Quote Originally Posted by lisalouver View Post
    No, if it was viral, antibiotics will not help it, but it is also much more rare to get a viral pneumonia. Was he immuno-compromised? There has to be more to the story.
    I don't know. I'll be honest: That was my first thought. But if he was, I would think he'd have insurance. He seemed perfectly healthy and like someone who took care of himself.

    Again, my bf's friend was in excellent health and not an alcoholic... from what I heard, he got pneumonia, went to the ER, it cleared up, then it came back, and that's when he died. Puzzling.

    Not saying this is the case here, but this is rather frightening:

    http://www.infectioncontroltoday.com...ia-deaths.html

  4. #154
    Frank 'N' Howie Guest
    I had my gall bladder removed a year ago and I had no insurance. I had several mind-blowing attacks and I begged for death. Anyhow the surgeon would not even talk to me and the folks in the office were rather smug. Luckily, before the economy started sucking, we had money in the bank. It was so funny, they definately speak in cash terms. Other than having to pay an ambulance bill a little at a time everyone started being soooooo nice. Assholes....

  5. #155
    Noreen Guest
    That is a sad story, FoolandhisMonkey (LOL, what a name, I don't know how to shorten it without it sounding insulting). I wish you a long, happy life in your new house. Maybe set up a little memorial to the former owner in your house or yard? I think I would, to create a Blessing for All who enter

  6. #156
    AFoolandHisMonkey Guest
    Quote Originally Posted by Noreen View Post
    That is a sad story, FoolandhisMonkey (LOL, what a name, I don't know how to shorten it without it sounding insulting). I wish you a long, happy life in your new house. Maybe set up a little memorial to the former owner in your house or yard? I think I would, to create a Blessing for All who enter
    That is a lovely idea!

  7. #157
    DitaFatale Guest

    Health Insurance

    Hopefully this is in the right forum, I wasn't sure if this belonged in Everything Else, if it does, sorry, please move it. Ok so I found out my healthcare insurance at work has limits on prescriptions. They'll only pay for a limited amount a year. I think my limit is 500. Basically it sucks. Plus I have to wait a year for dental work to be approved. I might as well not have any at all.And the way my job is going I won't even be there a year from now. Is there a good and reasonable health insurance program anyone knows of that they use, not through their work? I can't afford to go to my pain management dr, without it.There has to be something you can get independently. Times like this I wish I lived in Europe or Canada. They really know how to do healthcare.
    Suggestions anyone?
    Thanks!

  8. #158
    RocketQueen Guest
    I have heard that Costco has health insurance now. What don't they have.

  9. #159
    cachluv Guest
    http://www.findadeath.com/forum/show...ghlight=pfizer

    PLUS now Walmart has a $4 prescription plan, I believe. I don't know that some prescriptions are covered there in that plan but the link I posted above tells how each pharmaceutical company has a discount plan.

    Good luck! Don't take no for an answer, there is something out here for you!!

  10. #160
    WendyK Guest
    I have a State Funded Insurance it is based on your income. You do have some copays..But for the most part I'd like to call it State Aid. I have to drive miles to go to a dentist that takes it.I took my kids to the dentist yesterday my middle daughter needs a root canal my choices, drive an hour and a half or pay a grand out of pocket to have it fixed...and to top things off even though the dentist knows what is wrong we will have to take her at least twice so this new dentist can do his own evaluation on her tooth! ( Darn Candy) We had private insurance for the longest time ( Mr. WK is self employed) And the stuff was higher then our house payment every moneth and basically covered NADA. We had no other choice but to apply for the Family Care in the GREAT State of Illinois... you might want to check and see if something is simular in your area! Good Luck!

  11. #161
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    I got blessed (if you could say that) with BC/BS.
    I don't have eye or dental, but it really does a good job covering all that I have done because of my MS.
    I agree with Wendy..check into state aid. It's better than nothing and they cover alot of things some other insurance companies don't.
    Good luck, my dear!
    "Go to Heaven for the climate - Hell for the company" - Mark Twain

  12. #162
    DitaFatale Guest
    Quote Originally Posted by WendyK View Post
    I have a State Funded Insurance it is based on your income. You do have some copays..But for the most part I'd like to call it State Aid. I have to drive miles to go to a dentist that takes it.I took my kids to the dentist yesterday my middle daughter needs a root canal my choices, drive an hour and a half or pay a grand out of pocket to have it fixed...and to top things off even though the dentist knows what is wrong we will have to take her at least twice so this new dentist can do his own evaluation on her tooth! ( Darn Candy) We had private insurance for the longest time ( Mr. WK is self employed) And the stuff was higher then our house payment every moneth and basically covered NADA. We had no other choice but to apply for the Family Care in the GREAT State of Illinois... you might want to check and see if something is simular in your area! Good Luck!
    The problem is I can't get pain meds in the state I live. They're too strict. The pain Dr I had here retired. All the other drs won't give me what helps. I'm forced to go a state over where they're not as strict.I had a really bad injury to my lower back.So I can't apply for state help when I don't go to the state I live in.Or can you?
    It's funny when you have one dr tell you there's nothing wrong with you, that you're body was used to being in pain for so long it's in your head(ass), one dr at a clinic told me he can't give me narcodics, and he said in so many words to go buy them on the street (WTF)to the dr I'm seeing now actually told me I have severe muscle and tissue damage, and is giving me new medication along with my pain meds and I'm feeling better than I have in years.
    It's so funny how Dr's have diffrent opinions. You just have to find the right one.
    Thanks for all the suggestions so far!

  13. #163
    WendyK Guest
    Quote Originally Posted by DitaFatale View Post
    The problem is I can't get pain meds in the state I live. They're too strict. The pain Dr I had here retired. All the other drs won't give me what helps. I'm forced to go a state over where they're not as strict.I had a really bad injury to my lower back.So I can't apply for state help when I don't go to the state I live in.Or can you?
    It's funny when you have one dr tell you there's nothing wrong with you, that you're body was used to being in pain for so long it's in your head(ass), one dr at a clinic told me he can't give me narcodics, and he said in so many words to go buy them on the street (WTF)to the dr I'm seeing now actually told me I have severe muscle and tissue damage, and is giving me new medication along with my pain meds and I'm feeling better than I have in years.
    It's so funny how Dr's have diffrent opinions. You just have to find the right one.
    Thanks for all the suggestions so far!
    What state do you live in? No, you have to apply in the State that you live in. If anything they sell meds online from Mexico.It is just crazy what some actual sick people have to go through to get the proper treatment.I call it Bull Shit! And then you have had MD's to tell you to buy it on the street? SAFE...NOT! I am not saying buying online from Mexico is safer...but it is an actual company, Dr.'s in the US are just to worried about giving you meds these days, I guess because of addiction. But hell my kids pediatrician does not even like to perscribe antibiotics! It is crazy! I am so sorry about your situation!

  14. #164
    DitaFatale Guest
    I tried to Pm you WendyK, but I'd rather not say pubiclly where I live. I apperciate the help But so far all the dr's in the state I live won't give me my pain meds. Dishonest people ruin it for the rest of us. Maybe I'll ask my pain dr I have now to recommend a dr he knows in my state that does the state program, and if he refers me, then that dr will know I'm a legit patient.
    I don't know. There has to be something

  15. #165
    WendyK Guest
    Quote Originally Posted by DitaFatale View Post
    I tried to Pm you WendyK, but I'd rather not say pubiclly where I live. I apperciate the help But so far all the dr's in the state I live won't give me my pain meds. Dishonest people ruin it for the rest of us. Maybe I'll ask my pain dr I have now to recommend a dr he knows in my state that does the state program, and if he refers me, then that dr will know I'm a legit patient.
    I don't know. There has to be something

    Add me as a friend..They may be why you can't PM me?? Yes, everytime we need something done we need a referral. It sucks but you do what ya gotta do! When we were without any type of insurance my daughter got swimmers ear ( which I already knew what she had) Ya think the doc could just call a script in for her? NO...Wanted to see her , it cost me 90 bucks for less then 5 minutes of his time to confirm what I already said! I was pissed! Then the script was 70 bucks! What a joke! Yes, it is the abusers that ruin it for everyone else!

  16. #166
    tarsier Guest
    Quote Originally Posted by DitaFatale View Post
    I wish I lived in Europe or Canada. They really know how to do healthcare.
    Thanks!
    Sure they do Doctor shortages and strikes; well done!
    I consider insurance the root of all evil.
    My organization offers crap on health but the life insurance is awesome.

  17. #167
    Hag1 Guest
    I do not have health insurance; i am self-employed. I have checked every plan available and it's just so expensive I can't afford it. So far, it has been cheaper to just pay as I go. I go the dentist regularly and pay that too. That, together with wallmart prescriptions, well is cheaper. My plan if I have a catastrophic illiness---bankruptcy. It's sad that we have to be this way.
    As for pain meds, well no doctor here will prescribe them anymore because they are afraid they will get in trouble. Pain meds are the street drug of choice here, and dealers go across state lines to get them. That has ruined it for everybody that really needs them.

  18. #168
    WendyK Guest
    Quote Originally Posted by Hag1 View Post
    I do not have health insurance; i am self-employed. I have checked every plan available and it's just so expensive I can't afford it. So far, it has been cheaper to just pay as I go. I go the dentist regularly and pay that too. That, together with wallmart prescriptions, well is cheaper. My plan if I have a catastrophic illiness---bankruptcy. It's sad that we have to be this way.
    As for pain meds, well no doctor here will prescribe them anymore because they are afraid they will get in trouble. Pain meds are the street drug of choice here, and dealers go across state lines to get them. That has ruined it for everybody that really needs them.

    Have you looked into a major medical policy? I know it still sucks, but God forbid and thing major happens. Private insurance is a SCAM...Been there Done That!

  19. #169
    John Connor Guest
    We are damn lucky as Canadians. Of course I can't go to the 7-11 and buy a bottle of vodka. That would be so weird.

  20. #170
    octobersky Guest
    Quote Originally Posted by keeunjames View Post
    We are damn lucky as Canadians. Of course I can't go to the 7-11 and buy a bottle of vodka. That would be so weird.
    I can't either and I live in the USA. Virginia is a strange state

  21. #171
    WendyK Guest
    Everyone with GREAT Medical Insurance! You are all blessed! Most of us in the USA file Bankrupcy over Medical Bills..

  22. #172
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    I work at a hospital so by God I'd better have insurance. We PAY for it though, although it could be worse. I consider myself lucky to have it. The pharmaceutical and medical industries are fucked up beyond all recognition. It is BIG business and even BIGGER money. I don't know if it's been mentioned before, but some pharm companies will assist you with prescription costs or give you your meds free for a certain amount of time, ask your pharmacist about which ones will do this.
    The most dangerous woman of all is the one who refuses to rely on your sword to save her because she carries her own.

    - R.H. Sin

  23. #173
    octobersky Guest
    Quote Originally Posted by WendyK View Post
    Everyone with GREAT Medical Insurance! You are all blessed! Most of us in the USA file Bankrupcy over Medical Bills..
    I have good insurance. But I am on Cobra because I would never ever get a plan on my own because of all of my pre-existing conditions.
    I pay 1/3 of my income just for the premium. Another third (at least) goes towards co-pays, medicines and hospital bills.
    So even with good insurance Cobra is an ass kicker.

  24. #174
    Dollyplum Guest
    Quote Originally Posted by DitaFatale View Post
    Times like this I wish I lived in Europe or Canada. They really know how to do healthcare.
    We do have the NHS thankfully and medical care is free to all. We dont need to worry about running up huge bills either . But the waiting lists and facilities are dreadful in places. We pay for our prescriptions is £7.10 per item ($10.22). But if you unemployed or under 16 or in full time education the scripts are free. But no where as expensive as buying the item yourself could be (or sounds on here). I have bought some items over the counter as its cheaper than prescription sometimes.

    There has been cases here where expensive drugs could extend someones life and the NHS have refused to fund? I am grateful but I really think this country should invest more money into the hospitals and education and less on other areas. I wont go into this as I dont want to get political.(sp?)

    On the other hand I can see how something as corporate and cut throat as private insurance can be good for a nations health. It must be harder not working or minimum wage in the USA than the UK?

    Dont think either side has is sorted out.

    Good Luck sorting it out. x

    PS Why can you not buy a bottle of Vodka in Canada? Whats that all about?
    Last edited by Dollyplum; 02-19-2009 at 09:19 AM.

  25. #175
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    Quote Originally Posted by Dollyplum View Post
    We do have the NHS thankfully and medical care is free to all. We dont need to worry about running up huge bills either . But the waiting lists and facilities are dreadful in places. We pay for our prescriptions is £7.10 per item ($10.22). But if you unemployed or under 16 or in full time education the scripts are free. But no where as expensive as buying the item yourself could be (or sounds on here). I have bought some items over the counter as its cheaper than prescription sometimes.

    There has been cases here where expensive drugs could extend someones life and the NHS have refused to fund? I am grateful but I really think this country should invest more money into the hospitals and education and less on other areas. I wont go into this as I dont want to get political.(sp?)

    On the other hand I can see how something as corporate and cut throat as private insurance can be good for a nations health. It must be harder not working or minimum wage in the USA than the UK?

    Dont think either side has is sorted out.

    Good Luck sorting it out. x

    PS Why can you not buy a bottle of Vodka in Canada? Whats that all about?

    Hey Dolly: Everything you just said applies here. Personally I don't think we have that great a deal. Nothing is free, since we all pay for it through higher taxes. But perhaps it's worth it.

    As for the booze...IU think what KJ was talking about is the fact that you can't buy it in corner stores here. In order to buy liquor in Canada you have to go to a special provincially-run liquor store. Same goes for beer: If I want a six-pack, I can't just go to the corner store. I have to go the oh-so-creatively-named "The Beer Store", which is owned and operated by the province.

  26. #176
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    Just remember that there is no regulation on what docs or hospitals can bill, if they were more reasonable on their rates, insurance wouldn't be so high.

    I work for a plan management group where we go out and negotiate rates with hospitals and doctors for insurance plans that are self funded. It's amazing what health care professionals get away with. Not all of them are that way, but health care is big business, just like everything else.
    "I'm not great at the advice, can I interest you in a sarcastic comment?"



  27. #177
    Dollyplum Guest
    Province? I assume that this is what we would call a county in the UK or a state in the USA?

    Its the same in the UK but we pay it through a duty tax included in the price. Always amused me to think the government where skimming off the top! But I can walk to the local shop and buy my drinks.

    So with it being owned by province and being from a "beer store" does that mean you get cheap booze?! If so, no wonder your full! How much is a bottle of voddie? :-)

  28. #178
    Guest Guest
    Quote Originally Posted by duster View Post
    As for the booze...IU think what KJ was talking about is the fact that you can't buy it in corner stores here. In order to buy liquor in Canada you have to go to a special provincially-run liquor store. Same goes for beer: If I want a six-pack, I can't just go to the corner store. I have to go the oh-so-creatively-named "The Beer Store", which is owned and operated by the province.
    That's how it is here in PA for liquor or wine. You have go to a State Store. You can't even order wine over the internet and have it delivered here. They feel they will be deprived of their precious tax (no, it's not because they fear kids are gonna order wine and have it shipped like they say, it's cause they fear loss of revenue).

    Beer we can get at a "Beer Distributer" that are privately owned, however the state regulates their hours.

  29. #179
    Dollyplum Guest
    Thats crazy. They really have a thing about controlling alcohol over the pond. You should be more like us Binging Boozed up Brits! hiccup x

  30. #180
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    Quote Originally Posted by octobersky View Post
    I have good insurance. But I am on Cobra because I would never ever get a plan on my own because of all of my pre-existing conditions.
    I pay 1/3 of my income just for the premium. Another third (at least) goes towards co-pays, medicines and hospital bills.
    So even with good insurance Cobra is an ass kicker.
    Cobra is ridiculously, prohibitively expensive. INSANE.

    Insurance companies are effed up, too. Don't get me started, ugh.
    The most dangerous woman of all is the one who refuses to rely on your sword to save her because she carries her own.

    - R.H. Sin

  31. #181
    MrsF Guest
    I'm not sure if they have it in your area, but Optima is the most reasonable I have found. Hubby is self-employed and we get damn near raped with BC/BS.

  32. #182
    mel306 Guest
    Quote Originally Posted by Nessa View Post
    Cobra is ridiculously, prohibitively expensive. INSANE.

    Insurance companies are effed up, too. Don't get me started, ugh.
    Cobra is 102% of what the company would have paid for you. Usually bigger companies have top of the line insurance and that is why it is so expensive.

    Here in NY we have a website called HealthyNY. It lists where an individual can buy affordable insurance including the medicaid level. You do not have to be on medicaid to be get their insurance here.

    It is worth checking your state web page for a link for health insurance.

    And also high deductible insurance is usually the way to go if you are in good shape. You will pay for each doctor visit but there will be some limits in case of catastrophic accidents or illnesses.

  33. #183
    WendyK Guest
    Quote Originally Posted by octobersky View Post
    I have good insurance. But I am on Cobra because I would never ever get a plan on my own because of all of my pre-existing conditions.
    I pay 1/3 of my income just for the premium. Another third (at least) goes towards co-pays, medicines and hospital bills.
    So even with good insurance Cobra is an ass kicker.

    We have been on Cobra before too! We were paying $800 a month for it to cover the kids! Well, one of my kids got sick ended up in the hospital and, then the bills start pouring in...NOT COVERED.We call them up to find out what the hell was going on? Turns out someone fucked up and we had been paying for DENTAL insurance NOT MEDICAL! For gods sake at the time I had 5 year old, 1 year old and a newborn!!! WHY WOULD WE GET DENTAL INSURANCE FOR THEM??? Especially at that cost!

  34. #184
    Shano Guest
    Quote Originally Posted by Hag1 View Post
    I do not have health insurance; i am self-employed. I have checked every plan available and it's just so expensive I can't afford it. So far, it has been cheaper to just pay as I go. I go the dentist regularly and pay that too. That, together with wallmart prescriptions, well is cheaper. My plan if I have a catastrophic illiness---bankruptcy. It's sad that we have to be this way.
    As for pain meds, well no doctor here will prescribe them anymore because they are afraid they will get in trouble. Pain meds are the street drug of choice here, and dealers go across state lines to get them. That has ruined it for everybody that really needs them.

    My hubby and I are self employed and this is what we do for us and the kids. We pay as we go. This is after being on different 5 Health plans (scams). We were paying more for half ass coverage than we were for our house! We go to the doctor/dentist for check ups and when we are sick, but if anything ever happens and one of us gets very ill, well then we start selling stuff or file for bankruptcy. I know it does sound harsh but we can't pay over $1,000 a month for Health coverage. And that is not even including the Eye Care plan or Dental.

    Cobra is the WORST. We were on it when my hubby was laid off in 2000. It didn't cover shit. Thank god I had already had my son and wasn't pregnant at the time with our daughter. We would have gone bankrupt for sure then.

  35. #185
    Hag1 Guest
    At the very minimum, with basic crap insurance that doesn't pay anything, I would have paid out over $48,000 for premiums over the period I haven't had health insurance. I have paid out approx $5000 in doctor, dentist fees, prescriptions during that time. I know that I have so far been lucky that I don't have any major illnesses. If I had the insurance, and had, say, a major surgery like open heart, the tab would have been at least 1/2 million dollars here. Insured, my part would have been $100,000, plus the $5000 deductible---which I couldn't have paid anyway. I know that I am taking a huge gamble not having it, but I, and many others, don't have a choice.

  36. #186
    MbalmR Guest
    It's a crying shame to note that, because I don't have health insurance either, it will be much cheaper for my husband to bury me that it would for him to try to keep me alive after a major medical event.

    I'm not sure about all states, but in Wisconsin, you don't qualify for state medical benefits if you don't have children.

    Medical assistance is a Federally funded program, and in order to qualify, you have to dispose of all your assets and then wait 3 years to receive benefits.

    It's bad news all the way around.

    On a brighter note, there is a website out there called BidRX.com which will help you find your medications at the lowest possible price, assuming that your meds are part of their program. However, you still need a prescription. In your case, Dita, I don't know if this site will help you at all, but it can't hurt to look into it.

  37. #187
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    Quote Originally Posted by xoxojessicaxoxo View Post
    Just remember that there is no regulation on what docs or hospitals can bill, if they were more reasonable on their rates, insurance wouldn't be so high.

    I work for a plan management group where we go out and negotiate rates with hospitals and doctors for insurance plans that are self funded. It's amazing what health care professionals get away with. Not all of them are that way, but health care is big business, just like everything else.
    Oh, please......

    I pay $345/month in health insurance. Last year I went to the dermatologist and racked up a $150 office visit...which, since my deductible was not met was paid for by me.

    Can you explain to me who made out like a bandit in THIS scenario???

    'Cuz if my math is correct, I paid over $4,000 into a system that I took nothing out of. And that's not considering my employer's contribution.

  38. #188
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    Quote Originally Posted by cdaver mangler View Post
    Oh, please......

    I pay $345/month in health insurance. Last year I went to the dermatologist and racked up a $150 office visit...which, since my deductible was not met was paid for by me.

    Can you explain to me who made out like a bandit in THIS scenario???

    'Cuz if my math is correct, I paid over $4,000 into a system that I took nothing out of. And that's not considering my employer's contribution.
    nope i can't tell ya. the part of it that i'm involved with is not with an insurance company. the monthly premiums that our members pay all get deposited into one account since they are self funded. $345/month is a shit load to pay for insurance btw.

    the members of our self funded plans are mostly school districts and they pay between $50-$150/ per month depending on their situation and dependents etc. not to mention that if one of our members goes to a dermatologist, with the rates we negotiate, the dermatologist is usually reimbursed (depending on the code) no more than 15-20% of billed charges. the last dermatologist that billed for a regular office visit was $225, and the insurance paid $50, member paid their copay and that was the end of it. of course this member had already met their $500 deductible.

    but to speak to your particular situation, depending who your insurance company is, your $345/per month is probably helping pay the hospitals when your co-worker goes to the er for the sniffles, or for another co-worker who has cancer. in comparison to other insurance companies like bcbs for example whose contract with hospitals will reimburse as much as 90% of billed charges.

    so. that probably doesn't make a whole lot of sense but, i'm up to my neck is this shit everyday, but trust me i understand everyone's frustrations with insurance companies and health care as a whole. i get it.
    "I'm not great at the advice, can I interest you in a sarcastic comment?"



  39. 02-20-2009, 07:23 AM

  40. #189
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    Quote Originally Posted by cdaver mangler View Post
    Oh, please......

    I pay $345/month in health insurance. Last year I went to the dermatologist and racked up a $150 office visit...which, since my deductible was not met was paid for by me.

    Can you explain to me who made out like a bandit in THIS scenario???

    'Cuz if my math is correct, I paid over $4,000 into a system that I took nothing out of. And that's not considering my employer's contribution.

    I can sympathize. That would be frustrating but remember, health insurance plans are like handguns: Better to have one and not need it, than need it and not have it.
    You premiums are buying you peace of mind.

  41. #190
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    Quote Originally Posted by duster View Post
    I can sympathize. That would be frustrating but remember, health insurance plans are like handguns: Better to have one and not need it, than need it and not have it.
    You premiums are buying you peace of mind.
    I understand that d00t3r, I'd just as soon have the 4Gs to spend on myself, tho.

  42. #191
    I♥TinyTim Guest
    Quote Originally Posted by xoxojessicaxoxo View Post
    Just remember that there is no regulation on what docs or hospitals can bill, if they were more reasonable on their rates, insurance wouldn't be so high.
    If insurance folks would actually pay up when it came time, the docs wouldn't feel like they have to raise rates.

    I can't count the # of times that the doctor I worked for would submit a claim for a pt. only to have it denied, and their excuse was, "Oh, our fee schedule changed and we no longer cover ____." Well, thanks for letting us know... Sheesh!

    Quote Originally Posted by Nessa View Post
    Cobra is ridiculously, prohibitively expensive. INSANE.

    Insurance companies are effed up, too. Don't get me started, ugh.
    Cobra IS expensive. Speaking of insurance companies... Sorry, I have to... dental insurance is a joke. Most dental insurance comapnies will not pay for preventative care (FL2 Tx). They would rather see you get a cavity, and pay for cheap silver/murcury/amalgam fillings (which is toxic, btw), than to pay for a Fluoride treatment (which is cheaper) so you won't get cavities in the first place!
    Here's another scenario: People would always come in the office and want "only what insurance will cover," and I'm sorry, but if Sally has an abscess forming and doesn't feel it now, and asks us to skip the x-rays because her insurance won't cover it this visit, guess what? She'll have to have them done anyway in two weeks, when her jaw is swollen to kingdom come, and she can't open or close her mouth. Then, because she didn't have the x-rays done BEFORE, when she was due, she will now require a root canal and crown because of the abscess. If she would have done the x-rays, we would have caught the abscess in time, and all that would probably be needed was a script for antibiotics. All because her DENTAL INSURANCE didn't cover x-rays but once per year, when it's imperative to have them done every 6 months (at every hygiene visit).

    It pisses me off that some dentists out there are giving ALL dentists a bad name, and the good ones are labeled right along with them as being money-hungry and wanting to do "unneeded" treatment, when in fact, it's the other way around. They're TRYING to provide proper treatment but the insurance companies don't want to cover much of anything - and getting them to pay up after services are rendered is, in itself, like pulling teeth (pun intended).

    The insurance companies are the bad guys; not the doctors (most of the time.) People aren't getting proper treatment because

    1. they can't afford it, and...
    2. They aren't educated about the above scenario.

    The doctors can explain things until they're blue in the face (and my hygienist, and the dentist and I would all try to explain all this when a pt declined x-rays), but until a patient has this happen to them, THEN they change their tune, and they say what a joke dental insurance is. Otherwise? They just shrug it off and say, "I don't feel any pain." Well, if you felt any pain, it would be too late!

    *rant over*
    Last edited by I♥TinyTim; 02-20-2009 at 07:52 PM.

  43. #192
    Patience54 Guest
    The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 47 million without health coverage and millions more inadequately covered.

    This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

    Click here www.pnhp.org

    We can make a difference and help pass laws for "medicare for all." There are links on the above web site for contacting your congressman and senator.

  44. #193
    Join Date
    Oct 2007
    Location
    Lubbock/San Angelo Texas
    Posts
    3,304
    Quote Originally Posted by ihearttinytim View Post
    If insurance folks would actually pay up when it came time, the docs wouldn't feel like they have to raise rates.

    I can't count the # of times that the doctor I worked for would submit a claim for a pt. only to have it denied, and their excuse was, "Oh, our fee schedule changed and we no longer cover ____." Well, thanks for letting us know... Sheesh!


    BTW... Schedule 5 drugs are the real money-makers.
    i completely agree.

    also consumers should be aware of the fact that they can appeal any and every decision made by the insurance, and by law they have to at least consider it. if there is a real complaint like the one you listed above, there is a state department of insurance you can take your complaint to as well. ex: tdi or texas department of insurance. they audit insurance companies on a regular basis.
    "I'm not great at the advice, can I interest you in a sarcastic comment?"



  45. #194
    Chunga Guest
    I wish I had an answer for you. Every year, work changes insurance companies. I am now working 4 days a week. Losing $848 before tax a month. I pay $53.75 a week for health insurance. $50 co-pay. Can't afford to see councilor for this depression. She wants to see me every week for the first month or so. Sorry. Can't. Contacted an EAP for 3 free sessions. I have to drive to Cleveland just to use it and the session is a half hour. I have a lump on my back. Probably nothing, but, $50 co-pay, $1000 deductible. It'll probably cost me well over $800 out of pocket or more just to get this thing looked at and cut out in his office. So I am putting that off to. Hoping that the work hours will pick back up to 5 days a week and I will do it then. Have to get it done before summer cause it looks gross. American "health insurance" sucks.




    Last edited by Chunga; 02-20-2009 at 07:51 PM.

  46. #195
    Join Date
    Oct 2007
    Location
    Lubbock/San Angelo Texas
    Posts
    3,304
    i found out last week that there are new codes they can bill for over the phone consults as well, fyi.
    "I'm not great at the advice, can I interest you in a sarcastic comment?"



  47. #196
    DitaFatale Guest
    Thanks for all the great suggestions guys. It's hard out there for everyone. I may need insurance now more than ever.

  48. #197
    Pamebabby Guest
    I recently lost mine, and am not eligible until June. It's bullshit, because the reason that was given to us for my losing mine was because we make too much for a household of 2. I won't be eligible until I hit 55, and now I just go to the Dr. if I absolutely have to, get samples, etc. I can't follow up with my regular Dr. without insurance, or see a specialist. If I am dying, it's to the emergency room-they HAVE to treat you. I'll worry about the bills later. This countrie's health plan, or lack of one, sucks putty balls. I had no trouble getting SSD, with my cancer history, but insurance is a different story, somehow.

  49. #198
    Join Date
    Apr 2008
    Posts
    4,049
    Quote Originally Posted by MIZIZVOGUE View Post
    My husband and I do. However, last year, our 22 year old son that works full-time at LOWE'S, came home from work emergently, with severe abdominal pain. He did not have health insurance, didn't sign up for it at work because he didn't think he needed it. My husband and I took him to our local ER. He told them he worked full-time but didn't have insurance. They MUST treat you anyway. They took him back, started an IV, gave him pain medication, did an X-ray and did a CT scan. Diagnosis? He had a right kidney stone! They released him after a few hours, gave him oral pain medication and told him that he would most likely pass the stone within 24 hours. He did. His hospital bill alone was $3,468. The doctor that read his x-ray and CT scan charged $299. The ER doc's bill was $120. Moral of this story: GET HEALTH INSURANCE!!
    I do, but our insurance changed in 2008 and now our deductibles are much higher than they used to be. This past January I went to the ER (coughing up blood) and was bracing for the bills I knew would be coming. So far, the ER physicians group has charged me $200 (of about $350), and the whole ER visit (I'm guessing including tests, x-rays) is also $200 (of $1650, so that's not bad), then another physician (don't even know who he is because I never saw him) charged $12 for who knows what. The last time I went to the ER several years ago for what I thought was a fractured wrist (fell off a horse), I didn't pay a thing.

    I feel bad for your son--that is A LOT of money.
    [SIGPIC][/SIGPIC]

  50. #199
    endsleigh03 Guest
    Quote Originally Posted by Pamebabby View Post
    I recently lost mine, and am not eligible until June. It's bullshit, because the reason that was given to us for my losing mine was because we make too much for a household of 2. I won't be eligible until I hit 55, and now I just go to the Dr. if I absolutely have to, get samples, etc. I can't follow up with my regular Dr. without insurance, or see a specialist. If I am dying, it's to the emergency room-they HAVE to treat you. I'll worry about the bills later. This countrie's health plan, or lack of one, sucks putty balls. I had no trouble getting SSD, with my cancer history, but insurance is a different story, somehow.
    Wonder how this plays out in the long run. People without insurance are going to avoid earlier health maintenance and when you can only go to the ER when you are sick that runs into so much money.
    I never got bills on other plans that my daughter has been on, now there are always bills, and that is with her Dad paying a hefty chunk for this BCBS.
    Something affordable with reasonable coverage would be great. Health care is out of control, as are insurance costs.

  51. #200
    TallulahDahling Guest
    I've been extremely blessed--my hubby's company has FAB insurance. Enabled me to get the tops in treatment when I was diagnosed with breast cancer in 2007.
    I'm so sorry for those of you who are without. Explains why a lot of people, including hubby, continue to work in jobs they despise just for the insurance.

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