Medical Insurance in the US
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@scottalanmiller said:
@marcinozga said:
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
I don't know why it happens, do insurance companies refuse to pay so doctors refuse to do the service? Do doctors just not like doing it? No idea. But something makes US doctors commonly refuse this surgery (commonly enough that I know like four first hand examples). No matter what the reason is, the result is still a lack of coverage. The insurance companies have many routes to avoid paying for things even if the law says that they have to.
Yep. Just because you have insurance, that DOES NOT guarantee actual service. I know at least 1 person very well who was going for an MD before OC, and decided that an RN would make him more money after it passed. Scale that up from one person's very close friends to an entire nation, guess how service is being effected!
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@Minion-Queen said:
This is only me using the insurance. If husband or son ever need to use it well the costs go up from there.
Also assuming nothing serious happens, which is kind of the definition of insurance.
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@scottalanmiller said:
@Dashrender said:
Well in that case you're fringe case - and while I agree that there should be provisions for that in the law - The situation is not screwing you into a 40K a year plan. You can probably get an insurance plan in crete for significantly less if you so desire while you are there, and the next place, etc.
Thankfully no. The situation is simply screwing me into paying out of pocket (which is essentially zero) and having to pay the tax penalty for being uninsurable.
If there wasn't a penalty to mock us for being uninsurable it wouldn't be so bad. But it is literally a form of mocking us for having not been given an option. It's downright mean.
No reason to have insurance on Crete. We CAN get it here, but that would be silly. Insurance outside of the US is SO low.
You're not uninsurable though - you've already said you could get a US only plan and you could get an international traveler's plan - so you're not uninsurable, not even uninsurable in the USA - you Choose to not have insurance in the US because the cost outweights the benefits in your mind for the dozen or less weeks a year you spend in the US. Definitely not the same as uninsurable.
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@BRRABill said:
Family of 4, was $1876.34 a month. That's a NO DEDUCTIBLE plan.
That's not horrible, but it is really high considering it would provide zero coverage for us. It doesn't even remotely offset the tax penalty. And Texas offerings are not as good as many states. We put in a lot of time on this, I don't think we found anything even that good, and that's not good enough to consider at all.
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@marcinozga said:
@MattSpeller said:
@scottalanmiller @BRRABill @coliver @marcinozga @Dashrender
Y'all need to get yourselves some socialism.
runs far and fast from thread
I grew up in socialist country
Who knows, perhaps Bernie Sanders will become the next president.I feel the Burn haha - we're cheering for him here in Canada. It'll be a frosty day in hell before he gets elected though.
If he moved north he could probably run our Conservative party and kick our PM's butt in the next elections.
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@Dashrender said:
You're not uninsurable though - you've already said you could get a US only plan and you could get an international traveler's plan - so you're not uninsurable, not even uninsurable in the USA - you Choose to not have insurance in the US because the cost outweights the benefits in your mind for the dozen or less weeks a year you spend in the US. Definitely not the same as uninsurable.
Sorry, I'm uninsurable under Obamacare. I can buy insurance that does not qualify for Obamacare that would cover me.
I choose not to be covered in the US because I am NOT covered by US insurance. I'm allowed to pay for it, but it doesn't provide healthcare coverage. If that's what you call insurance I think we found where the confusion is. I define insurance by it providing insurance against bills. You seem to be defining it as the ability to take my money.
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@scottalanmiller said:
That's not horrible, but it is really high considering it would provide zero coverage for us. It doesn't even remotely offset the tax penalty. And Texas offerings are not as good as many states. We put in a lot of time on this, I don't think we found anything even that good, and that's not good enough to consider at all.
Actually I put in an Austin, TX, ZIP code and it was significantly cheaper.
$1394 a month was the highest plan they offered. But on that plan you have a $30 co-pay for doctor visits.
This is through the web, though. But the prices are similar to others I have seen.
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@Dashrender said:
Definitely not the same as uninsurable.
So we can choose to define this one of two ways then....
- My way is calling it uninsured because 90% of the time they wont' provide coverage. So essentially I am not covered.
- Saying that I am covered but that I have to pay $5K per week or something to be covered.
One of the other. Both are insane and ridiculous.
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@BRRABill said:
@Minion-Queen said:
This is only me using the insurance. If husband or son ever need to use it well the costs go up from there.
Also assuming nothing serious happens, which is kind of the definition of insurance.
that's true. However my deductibles for visits, surgery etc. is still crazy. It's just not worth having.
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@BRRABill said:
$1394 a month was the highest plan they offered. But on that plan you have a $30 co-pay for doctor visits.
What service did you use?
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@Minion-Queen said:
that's true. However my deductibles for visits, surgery etc. is still crazy. It's just not worth having.
If my company wasn't paying for the cost, I'd definitely consider.
Well, I wouldn't, because I know my family has conditions that require medical care.
But, I at least would get the argument.
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@scottalanmiller said:
What service did you use?
I just went to
https://www.ehealthinsurance.com
Could be a total scam. But I have priced out plans near me before, and these are about spot on for my area.
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@Minion-Queen said:
@BRRABill said:
@Minion-Queen said:
This is only me using the insurance. If husband or son ever need to use it well the costs go up from there.
Also assuming nothing serious happens, which is kind of the definition of insurance.
that's true. However my deductibles for visits, surgery etc. is still crazy. It's just not worth having.
How is your deductible so high? Max out of pocket is $6850 for individual per year, including deductible. Your insurance is screwing you and most likely breaking the law.
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If you look here:
http://www.aetna.com/individuals-families/document-library/rates/2016/TX_Rates_2016.pdf
That's direct from the horse's mouth. About the same cost as the website I gave for the BEST plan.
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@marcinozga said:
How is your deductible so high? Max out of pocket is $6850 for individual per year, including deductible. Your insurance is screwing you and most likely breaking the law.
Pretty much all health insurance breaks the law. The problem is that it is very hard to prove and nearly impossible to prosecute and way beyond the means of normal people. They know this and they regularly leverage it. I know of hospitals that use HIPAA violations to try to extort family members for money. Who sues them? No one, they are a nearly untouchable entity with deep pockets and they control your personal data, the ability to bill you anytime for anything and all kinds of government protections. Health care in the US operates like organized crime and has nearly total impunity.
If you know anyone successfully suing health care, let me know. Because I never see it work.
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@marcinozga said:
How is your deductible so high? Max out of pocket is $6850 for individual per year, including deductible. Your insurance is screwing you and most likely breaking the law.
A lot of plans have super high deductibles.
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Yeah insurance companies do that. Now as of next year my Deductible will be less. But the coverage is even worse (I keep checking to see what my options are), copays are out of this world and no point. My meds will no longer be covered but of course if I have the insurance I pay more than I do without. Now to be clear this is coverage that will allow me to keep my awesome Dr.
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@BRRABill said:
If you look here:
http://www.aetna.com/individuals-families/document-library/rates/2016/TX_Rates_2016.pdf
That's direct from the horse's mouth. About the same cost as the website I gave for the BEST plan.
Not as bad as when we were looking in October.
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@scottalanmiller said:
Not as bad as when we were looking in October.
Again, I'm not saying it is cheap, not even remotely.
But it's not 40K with terrible coverage and caps.
And all tax deductible, of course.
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@BRRABill said:
@scottalanmiller said:
Not as bad as when we were looking in October.
Again, I'm not saying it is cheap, not even remotely.
But it's not 40K with terrible coverage and caps.
And all tax deductible, of course.
Yes, when we were paying $40K/year, Aetna (which who would trust an insurance provider that mispronounces their own name) wouldn't even talk to us.
