Q?

[♦ nivek ♦]

Found a few bills from back in late 80's. Was paying the doctor's office 20 buxx us for a visit, got fifteen to thirty minutes of his time then, paid cash.

 

Was uninsured, but still a young bull and somewhat healthy.

 

Now, the folks from the prefered provider outfit send a whatchacallitz with billing info, and seems the same Doc's office is billing for 130 buxx uS for a *tight* fifteen minutes, no more, hopefully less.

 

Specialists such as kidney and podiatry go up towards 150-450 buxx uS each time.

 

Heart specialist last year with an all day work up was in area of 3500 uS, of which we got tagged with 40% of..

 

Why I ask, is that in discussions elsewhere on Boards, there seems to be one hellova lotta folks who do not have adequate insurance, or worse, none at all.

If I did not have decent insurance through Kel's work, I'd be a d-e-d sonovabitch..

 

Be no way that medications and physicians visits, trips to the various experts could be paid for.

 

Don't know of any job that has kept up payscale-wise with the huge raises in healthcare costs..

 

kL

[Amethyst]

My glasses + eye exam at a regular eye clinic cost me almost $500 last year, and the insurance only paid about $70. That is insurance I'm paying out of my pocket for every 3 months. I cannot afford much more than the $300 or so every 3 months. $500 is just slightly less than my monthly rent.

 

At the time I was making about $14 an hour, at a job where they almost hired me permanently but there were layoffs, and they hired someone from another dept. to do my job. I had to train the lady in. She was close to retirement age. I had *almost* gotten hired permanently there. As it was, I got a fancy letter of recommendation that got me my current contract job.

 

I mean, when it costs you almost a MONTH's worth of rent to go to the bloody eye doctor, it's no wonder most people go to the cheapest place in the mall that they can find and get the absolutely least expensive pair of glasses they can find. Unfortunately, I have an expensive prescription.

 

And I have a darn good paying contract job at a good company, too. But I am trying to save my money for retirement because I don't have a 401k, and saving for that means not being able to spend tons of money on health insurance or other stuff. There are downsides to contracting.

[pandora]

Yeah, I think inflation has been understated and misrepresented, especially in healthcare.

 

I don't want to get into why healthcare costs have risen, but I do agree that I don't think companies are increasing their salaries with the actual increase in cost of living. It sucks.

[No Heaven for Kevin]

We just went over our new insurance plan today, my ass is still a little sore. Seems like corporate decided to drop our most popular HMO for a PPO that costs our people a considerable amount more. And this is after promising all year that they were going to bring costs down.

 

It seems to me they are pushing everyone into these very high deductible, high premium CDHP plans, and jacking up the premiums whenever their premium to payment ratio goes over 60% (in other words, they consider a 40% profit to be fair, and will accept no risk). It's got to where the problem is feeding on itself, more and more people cannot afford insurance and the hospitals are having to increase costs because they are treating more people without insurance, which then drives up the insurance cost.

 

BTW, 'No Nevaeh for Nivek' (Sorry, couldn't resist)

[Guest RichStPete]

Well I was laid off from my job (off-shored my postion to India, What a shock!) Im currently paying the dreaded COBRA $368.00 a month. Just joined United Health care for $200.00 a month with a $1500.00 deductible... I don't go to the doctor that often but "vishnu" forbid I end up in the hospital at least I'll be covered.

[All Gods Fail]

What is this 'doctor' of which you speak?

 

Seriously, since getting laid off and surviving by freelancing, the doctor and I are no longer on speaking terms. I need to have a treatment for a blood condition but I can't afford it. Whaddya gonna do?

 

Also, I have a prescription I need to get monthly, but luckily they came out w/a generic just after my Cobra ran out, and it's only $50 a month.

 

Medically, it sucks to be me right now. I'm doing ok, but I live in dread of anything major happening. If it does, I'm screwed.

[nirrti]

Did anyone watch the news special on ABC about health insurance, the one that was Peter Jennings's last assignment? Alot of the things they reported about six million uninsured Americans, I already knew about. But the thing that hurt me the most was how hospitals have responded. It's federal law for emergency rooms to treat all people regardless of ability to pay and healthcare providers are circumventing it by closing existing ERs or not including them in the first place when building new hospitals.

 

So the result is ERs where people have to wait at least six hours to be treated or are turned away due to the ER being filled to capacity. I don't have medical insurance, myself and as a contractor at a temp agency "between assignments", getting it is out of the question. I do have state mental healthcare insurance given to me because I needed to be hospitalized and was deemed dangerous to myself after attempting suicide. It pays for my psychiatric care and if it wasn't for that, I'd be in danger of suicide again because I can't afford the $400 in medications I need to function.

 

Because of changes in what medications the program would cover, they stopped covering one of my meds. I went through horrible withdrawal because it was something I should've quit taking gradually. I had to stop suddenly because I couldn't afford the $250 per month for it. The bad part was my doctor wasn't consulted before making the decision to cut that particular medication and they only picked it because it was the most expensive, didn't come in generic nor did they consider that I might've needed that one the most.

[godlessgrrl]

We supposedly have halfway decent coverage from the spouse's plan, but we're finding out it really isn't any better than the emergency-only coverage I was getting before.

 

Spouse works for Home Depot. I went in for an office visit for a bronchial cough awhile ago and the doc's office charged about $150, half of which is covered by the plan. So I owe $75. Meds are a nightmare. They cover (or not) depending on what tier the drug is in - 1, 2, 3, or so-new-it-doesn't-have-a-tier-yet. Of course there's not much listed in tier 1. So if I want my psych meds I have to pay about $75/mo. out of pocket. After the spouse's hospital stay they had him on a tier 3 and a no-tier-yet drug - the tier 3 was $175/mo. without the plan, $150 with it. The no-tier-yet drug was $200.

 

Mental health care is not covered whatsoever. No in-patient hospital stuff, no psych-related tests of any kind, no therapy, no outpatient, no drug treatment, nothing. Nada. Zip. Zilch.

 

Spouse makes about $10/hour. About $100 a month goes for the health don't-care plan. I make anywhere from $15 to $25 an hour depending on the contract I'm doing, but with taxes (roughly 30% of what I make for both state & federal taxes), his child support ($200 a month for a kid the mom won't let him see), rent ($650), car payment ($300), car insurance ($150), and the forthcoming student loan payments ($400/mo.), our salaries get eaten up pretty quickly.

 

We do well enough - we're not living in total poverty and we can, fortunately, afford groceries - but there really isn't much wiggle room at all. Even doing okay I've gotten to a point where I only take my psych meds every other day sometimes, because sometimes it's an issue of what do we pay for this month, med bills or electricity?

 

What bothers me most is living in the wealthiest nation in the world and having to make decisions like that. There's no excuse for that.

 

A few years ago when I really was living close to poverty level I was on the state health care plan. It was pretty good, until the monthly premium even on that plan went up to about $50/month and I couldn't afford it at the time. That, plus the state ran out of money for it and had to cut everybody who didn't have kids. Last I checked they're not taking any new applicants at all, kids or not (though supposedly your kids can get covered via a different state plan, as can pregnant mothers).

 

I tend to think that insurance companies and pharmaceutical companies are a big part of the problem. Both are more concerned with their bottom line than anything else. It was particularly frustrating a few years ago when I tried to get onto a particular private plan and had to argue with the insurance co., because they'd decided that I was too sick to cover. I had 3 chronic conditions, 2 of which were minor and easily treated with home remedies, the 3rd needed meds; but they were focusing on things in my medical history like the fact that I had X condition 10 years ago and Y condition 5 years ago and because that increased my risk that I'd get X or Y conditions again then I was too sick to cover.

 

It's probably a lot of things, though, really.

[Ms. K]

We are very, very fortunate that Brinker International offers very, very good insurance coverage.

 

When my daughter and I went to the eye doctor in September, the total cost was almost $800, we paid $70 in copays.

 

We're with Kaiser Permanente for medical insurance, our doctor's visit copay is $20, and prescriptions are either a $10 or $15 copay, depending on what you get, and whether or not there's a generic available, and IF Kaiser covers it. I take Claritin rather than Allegra 180, because the Allegra 180 prescription is not covered at all by Kaiser (even though they can fill it, go figure), and costs $237 for a 100 pill prescription. I can get 100 pills of Claritin generic at the Kaiser pharmacy for $7 (I think that's what I paid, I know it's between $5 and $7).

 

My Prozac prescription, for 100 pills, a three month supply, is $10. My three month supply of birth control pills is $10. My asthma meds are $15 and $10, respectively, one is not generic, and the other one is.

 

I am the only person in this house who is on regular medication.

 

My daughter's immunizations are covered completely by the plan, so she's going to get updated while she's on Winter Break. Whether she likes it or not, she doesn't need to go without immunizations, IMHO (no flames from non-immunizing parents, I don't want to hear it, I can agree to disagree with you, but my kid's getting her shots).

 

Dental insurance is also good. We've got dental through MetLife, and our regular six month checkups and cleanings are at no cost to us, and fillings and other treatments are 80 percent covered by MetLife (if I have my numbers right, but it's late, and I'm not looking up the paperwork right now, and I'm pretty sure it's 80 percent them, 20 percent us, until we hit our deductible, then it's even less). I paid $54 when I got a filling this fall, and $36 of that was for the sedation (I will NOT have work done without gas, thanks, I'm a white knuckle patient when I have to get a cleaning and regular exam, fillings are NOT going to happen minus the sedation. Plus, I have to take half a Xanax before I have work done, or the gas is only half effective for me...SEVERE anxiety disorder).

 

We are very fortunate. We have not been nearly so fortunate with other companies Mr. K has worked for in the past. He has no plans of leaving Chili's unless he can find something with better salary and comparable or better benefits.

[pandora]

 

 

So the result is ERs where people have to wait at least six hours to be treated or are turned away due to the ER being filled to capacity. I don't have medical insurance, myself and as a contractor at a temp agency "between assignments", getting it is out of the question. I do have state mental healthcare insurance given to me because I needed to be hospitalized and was deemed dangerous to myself after attempting suicide. It pays for my psychiatric care and if it wasn't for that, I'd be in danger of suicide again because I can't afford the $400 in medications I need to function.

 

 

Wow... your state has a program like that? If our state did, I would not be two years behind in pharmacy school and $60K more in debt... (professional years are WAAY more expensive than a bachelor's degree... my scholarships ran out too... for four of my 8 years in school). Now I am really bitter. I don't mean to be a brat, just a reaction... Where do you live?

 

Anyway, yeah... Indy has a few new hospitals without emergency rooms. They tell people to call 911 if it is a true emergency.

[nirrti]

 

 

So the result is ERs where people have to wait at least six hours to be treated or are turned away due to the ER being filled to capacity. I don't have medical insurance, myself and as a contractor at a temp agency "between assignments", getting it is out of the question. I do have state mental healthcare insurance given to me because I needed to be hospitalized and was deemed dangerous to myself after attempting suicide. It pays for my psychiatric care and if it wasn't for that, I'd be in danger of suicide again because I can't afford the $400 in medications I need to function.

 

 

Wow... your state has a program like that? If our state did, I would not be two years behind in pharmacy school and $60K more in debt... (professional years are WAAY more expensive than a bachelor's degree... my scholarships ran out too... for four of my 8 years in school). Now I am really bitter. I don't mean to be a brat, just a reaction... Where do you live?

 

Anyway, yeah... Indy has a few new hospitals without emergency rooms. They tell people to call 911 if it is a true emergency.

 

We have an emergency mental health insurance that TennCare, the Tennessee gov. health insurance for poor residents, provides for people who need to be hospitalized in a mental hospital right away because they're either a danger to others or a danger to themselves. I think this was set up, initially to get help for mentally ill jail inmates who are incarcerated after being unable to control their behavior. If I wasn't suicidal and jobless, there's no way I wouldn't have been eligible for any insurance unless I had kids, even though I didn't have any income. Plus a stay at a state psych ward, if you can believe it, is $750 per day...for sub par treatment.

(And why is it that those who do the responsible thing and don't have kids they couldn't take care of get penalized because they're childless? Isn't their health any less important? )

 

Tenn"Don't"Care just made severe cuts on their roll, I think 400,000 people, because they didn't have enough funding. And we're talking about people with serious illnesses who can't afford medical care otherwise. Worse, the remaining patients had a five meds per month limit imposed so if someone is taking 10 medications they desparately need, they're stuck with paying possibly thousands of dollars out of pocket for a month's supply of the other five. Oh, and did I mention only two can be name-brand and only one of each kind is covered? I was on two anti-depressants and had to give up the Effexor since I was only allowed one. But we don't have a problem with funding a war overseas that costs billions of dollars and thousands of lives, do we?

[No Heaven for Kevin]

 

 

So the result is ERs where people have to wait at least six hours to be treated or are turned away due to the ER being filled to capacity. I don't have medical insurance, myself and as a contractor at a temp agency "between assignments", getting it is out of the question. I do have state mental healthcare insurance given to me because I needed to be hospitalized and was deemed dangerous to myself after attempting suicide. It pays for my psychiatric care and if it wasn't for that, I'd be in danger of suicide again because I can't afford the $400 in medications I need to function.

 

 

Wow... your state has a program like that? If our state did, I would not be two years behind in pharmacy school and $60K more in debt... (professional years are WAAY more expensive than a bachelor's degree... my scholarships ran out too... for four of my 8 years in school). Now I am really bitter. I don't mean to be a brat, just a reaction... Where do you live?

 

Anyway, yeah... Indy has a few new hospitals without emergency rooms. They tell people to call 911 if it is a true emergency.

 

We have an emergency mental health insurance that TennCare, the Tennessee gov. health insurance for poor residents, provides for people who need to be hospitalized in a mental hospital right away because they're either a danger to others or a danger to themselves. I think this was set up, initially to get help for mentally ill jail inmates who are incarcerated after being unable to control their behavior. If I wasn't suicidal and jobless, there's no way I wouldn't have been eligible for any insurance unless I had kids, even though I didn't have any income. Plus a stay at a state psych ward, if you can believe it, is $750 per day...for sub par treatment.

(And why is it that those who do the responsible thing and don't have kids they couldn't take care of get penalized because they're childless? Isn't their health any less important? )

 

Tenn"Don't"Care just made severe cuts on their roll, I think 400,000 people, because they didn't have enough funding. And we're talking about people with serious illnesses who can't afford medical care otherwise. Worse, the remaining patients had a five meds per month limit imposed so if someone is taking 10 medications they desparately need, they're stuck with paying possibly thousands of dollars out of pocket for a month's supply of the other five. Oh, and did I mention only two can be name-brand and only one of each kind is covered? I was on two anti-depressants and had to give up the Effexor since I was only allowed one. But we don't have a problem with funding a war overseas that costs billions of dollars and thousands of lives, do we?

 

I was born and raised in TN, haven't lived there in a few years. I can't believe they are still beating the dead TNCare Horse.

[Lizard]

I have BlueCross/BlueShield of Texas, HMO. Its not bad. I've yet to come across a med that is not covered, though the cost has gone up. Its like $20 and $35, depending on the med.

 

Office copay is $20..or is it $25? Hmm..don't remember, its been a while since I went.

 

Women have two PCP's..one general and one gyno. Reminds me, I'm late for THAT exam and mammogram too, which is also covered.

 

Labs are covered 100% as are hospital stays. Appendicitis completely covered.

 

Someone said 6 hours in a waiting room? That's short compared to hospitals around here!

 

The above mentioned appendicitis incident? Well, got to ER around 6pm..surgery was finally starting around 4am. They "prioritize" supposedly. Some guy with a cut ear (his girlfriend hit him with a whisky bottle) got in first. He was drunk..and not bleeding, but then again, neither was I.

 

Of course, once they finally decided it was appendicitis and the damn thing was about to rupture..they moved a little faster.

 

Waiting time in the county hospital ER can be measured in DAYS as opposed to HOURS. Seriously. My son once spent nearly 24 hours waiting to be seen with a severe lung infection. He could barely breathe, and they wouldn't even triage! He finally walked out.

 

Of course, if you go in by ambulance, the wait isn't quite as long.

 

Doc's office is ok on wait times. She takes appts, but also takes walkins, which is great if something comes up suddenly. Of course, appts have priority, as should be. (except for emergencies, such as needed asthma treatment)