Your Perspective on Health Insurance?

Baron

Baron

ET Founder
Paying health insurance premiums just annoys the hell out of me. I think it's because I take care of myself from a diet and exercise standpoint.

My wife and I went without health insurance for a couple of years because the premiums were getting up there in the $800 per month range for just me and her, which just seems absurd.

My wife started getting spooked out about the whole thing though because when she told her friends we didn't have any health insurance, they instantly started feeding her with the "what if" scenarios that could happen. She recently started a new career as a loan officer and opted to get us health insurance through the company she works for, but yet again, they are deducting $400 from her check every two weeks for the privilege of having health insurance.

So recently she goes to her OB-GYN for a checkup. Now before in years past when we had no insurance, her checkup was about $170, which we paid out of pocket. So she went in for a checkup the other day with her almighty insurance card in hand, and all tests came back fine. A week later we get a bill in the mail from the insurance company for about $170, which represented our 20% of the bill. So I look at the bill and lo and behold the exact same services we got before insurance for $170 were billed at $850+ by the OB-GYN to the insurance company. So now we get to pay $170 in addition to the $800 per month in insurance premiums we've been paying.

So the whole thing just feels like a racket and a money pit.

Your thoughts?
 
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"I'd rather have it and not need it... then need it and not have it"

My youngest has scripts that run $50K/year. I have coverage through my wife who is a level 4 with AT&T (don't know what it means). Otherwise, unremarkable.

All cancer treatments run into six figures the first year. Heaven forbid, but you're screwed w/o ACA if you need coverage with a cancer diagnosis. Nobody will underwrite you.

Stanford5? $200K the first year and that's cheap. Immunotherapies? $500K. SpA plasmapheresis? It was $700K in 1995...

Open hear surgery? Mitral valve? $150K-$250K?

You want to be stuck in the ER and bankrupted on admission?
 
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Before I think you were paying a lot because of individual coverage and no company to underwrote it. So you were paying the full premiums.

Now I have no doubt that doctors up charge their costs to insurance companies by highballing and insurance yet to chop them down where they can and it goes back and forth with you on the middle. One time they cover the while visit and consultations. The next time I get a bill for all of it, they will deny whenever possible.

I always tell myself that I will get even with them when I am older and have to go to the hospital for something and watch the hospital rape them for everything!
 
As irritating as it is, I call and regularly question settlements with our insurance, which is through my wife's employer. I am constantly catching what now I am thinking to be less errors than intentional screwups. I say this based on the number of times and amount of time I end up spending on the claims that are incorrect.
As an example, for the last 5 years one of our sons has been away at school, and we fill out a form each year to identify where he is so any care that may come up will be covered at the in network rate. The last 3 years he has had various health issues and needed to be seen, and a few have required multiple visits and testing. In each case I have had to call to have Aetna correct the settlements to reflect in network coverage. This has been multiple calls and literally hours of wasted time for something that we supposedly filled out and advised them each year. On quite a few of the calls the representative has acknowledged the paperwork is on file and they will make the correction. Ok, then why not do it correctly in the first place?
Also, reiterating the "rather have it and not need it..." statement, my wife currently is dealing with a lung issue that without the insurance one of the drugs she is using would run just over $10,000 a month with coupons, and she is currently getting at no cost with insurance. Beyond the obvious reason we are hoping that this drug as well as others she is currently using for her issue work, is that her next option is to go out of state to a research hospital group that specializes in her problem, and I can't even imagine the insurance headache that will accompany the trip.
I'm a firm believer that insurance drives a large part of healthcare costs, as well as various other middlemen, but for the time being we at least can't live without.
 
It's a racket for sure, but as previously stated it's not something you want to be caught without. I did not have any serious heath issues for my entire life until three years ago when the old ticker started acting up. Four trips to the ER in six months, all with overnight stays on the cardiac ward, eventually a three day stay while administering and observing how I would react to a very powerful arrhythmia drug, all that would have put a serious dent in my finances, not to mention all the on-going treatment for the rest of my life. I, like you and most others pay thousands for years and years, most all of it for nothing. Then the day comes when you need it.
 
El OchoCinco said:
...I always tell myself that I will get even with them when I am older and have to go to the hospital for something and watch the hospital rape them for everything!
More...

That's exactly what happen to me...the hospital charged my private health insurance a whopping $1.2 million including coverage for the medevac travel expenses back to Canada and they had to pay for the flight nurses along with paying for a medical translator for my brother to understand what was happening to me. He had power of attorney over me until we landed in Canada in which then those rights were passed to my mother. She was hysterical, uable to travel to Europe and in no condition to make any decisions when I initially became critically ill.

Also, I have private disability insurance...that disability insurance supplemented much of my loss income while I was hospitalized and later going thru rehab...then for another 1 1/2 years after rehab until I was back at trading.

Crazy thing is that I got disability insurance only a few years before my critical illness (term the disability insurance company uses). It was the best advice I ever gotten from the government healthcare plan for self-employed persons because the government universal healthcare only covers the basic medical needs and emergency needs within the country...not abroad.

That was a big concern for me because I have homes in different countries.

Private Health Insurance and Disability Insurance...gotta have them both because sometimes shit happens when you least expect it to. Without them both, the financial burden can be enormous on your family members if you have no coverage and then shit happens.

Also, get insurance while you're healthy...may be impossible to get it after a serious illness / injury...many insurance companies will then just blacklist you and tell you that you're not eligible for insurance.

wrbtrader
 
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Well, just killed another hour during the trading day trying to clear up an insurance issue. We received a notice of a denied claim from my wife's previous insurance from her employer 8 years ago. After worrying that it might be identity theft it looks like a claim for my son who is away at school was submitted to the wrong insurance provider with our current policy number, a different insurer. So not exclusively on the insurer, but I had to jump through hoops to get the information out of the old insurance company, and they still wouldn't give me the name of the provider as my son is 23.
A lot of bad words flying at the moment, and now time to relax and get back to work.
 
Baron said:
So recently she goes to her OB-GYN for a checkup. Now before in years past when we had no insurance, her checkup was about $170, which we paid out of pocket. So she went in for a checkup the other day with her almighty insurance card in hand, and all tests came back fine. A week later we get a bill in the mail from the insurance company for about $170, which represented our 20% of the bill. So I look at the bill and lo and behold the exact same services we got before insurance for $170 were billed at $850+ by the OB-GYN to the insurance company. So now we get to pay $170 in addition to the $800 per month in insurance premiums we've been paying.

So the whole thing just feels like a racket and a money pit.

Your thoughts?
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?¡? seen like this insurance isn´t worth one bit !
It works differently depending on countries, I´ve lived mostly without private health insurance but contracted one in Spain because, besides needing it to get a residence permit faster, it works the opposite as in your case. Public and private health care are completely separated here, and if you go to the private practice without a private insurance accepted there, you are most of the time charged much more. Premiums are cheap as well, for 60/70eur euros a months I get for instance free consultations otherwise charged 120e and free blood tests otherwise charged around 200 (other private clinics offer somehow better deals to uninsured patients, but if one want to deal with private healthcare here, private insurance seems the way to go). Still a major issue with private insurances is they don´t cover old issues and don´t cover you at all if they don´t like those old issues.
In France it is quite different, private practice are always at least partially covered by public insurance, one is just charged extra by the private practice, afaik it is usually the same amount to a private person or their insurer. I see buying insurance in those conditions akin as buying puts, which I prefer selling, if having any relationship with them. Lived in Asia for many years as well and mostly lived without insurance there, also saw it as buying puts, was quoted insane prices in China/HK, over 30k a year I thimk for a family of 4, still with restrictions on all previosu ailments
I read in the US private patients get regularly charged more than insured patients, so surprised to read your story. I would feel quite a bit upset as well.

PS , as you are also on TRT, after trying the only TRT clinic in Madrid, where it appeared the doc would happily prescribe me test but wouldn´t care about my health one bit (came up with extremely dodgy blood test results that would justify a TRT in spain but with some numbers that were plainly faked), I went to see as a private patient an endo working for the major insurer, who started prescribing me 350mg test C every 2 weeks, the low end of what I want but acceptable. than talked to the insurer which besides covering all future health issues, accepted to cover the endo consultations and blood tests if not whatever therapy needed for problems resulting from TRT. But on my second visit to the endo she decided to lower the dose to 250mg every 2 weeks, although my test levels were far from too high imo. Huge bummer, I´m not following the dose she prescribed but pissed anyway, would rather pick up the test from the drugstore here.
 
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Baron said:
Paying health insurance premiums just annoys the hell out of me. I think it's because I take care of myself from a diet and exercise standpoint.

My wife and I went without health insurance for a couple of years because the premiums were getting up there in the $800 per month range for just me and her, which just seems absurd.

So the whole thing just feels like a racket and a money pit.

Your thoughts?
More...

I am paying 850 dollars per month with a 6500 dollar deductible (single). Essentially it is a VERY expensive catastrophic health plan. Before the "Affordable Care act" I was able to get the same coverage for roughly half what I pay now.

To put this in perspective this payment is MORE than the median house payment in my county. If I actually USE the insurance it is the equivalent of buying a brand new Nissan Versa car every year.

The "ACA" did nothing to address out of control healthcare costs and the clear violations of anti-trust and price fixing laws.
 
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