Health Insurance Poll

Geronimo · Sep 29, 2004

Yeah i get most of my stuff thru the Native hospital since I am native. Course I have not gone to the doctor in years. I dont like them on general either.

airgunr · Sep 29, 2004

oriecat said:
We are working on our annual group insurance renewal here at work, and I am curious to find out what sort of benefits other assorted people have, and y'all are a good group of other assorted people therefore here I am...

Imagine it's January and you come down with something bad and need to see the doc to have it looked at. How much would you pay out of pocket for the office visit? Would you just pay a copay? Would you pay a percentage of the bill (co-insurance)? What percentage? Would you pay the whole thing because you hadn't met your deductible yet for the year? If so, what is your deductible?

If you're comfortable sharing this, then I would appreciate it! Or you can PM me if you want!

Our deductable is $5,000 and our rate is about $6K a year for my wife and I. We own a small business and can't get group insurance. We pay everything up to the $5K then it's 80-20. It sucks but were both around 50 and can't get decent insurance. BTW, it's basically major medical and that's all.

terri · Sep 29, 2004

Sadly, Orie, I DO understand it...you can't be in medical management for over a dozen years without getting caught up in this stuff. :wink:

It sounds like you're onto something good, though. Offering the choices still means a lot. It's different for everyone. I'm basically healthy as a weed, so it makes no sense for me to have anything but a cheap HMO. People who DO have problems and need to see various specialists end up miserable - because they still want the cheapness of an HMO, sign on, then get caught up in the quagmire of referrals, preauthorizations, delay of claims, etc. They'd do better to have freedom of movement within a plan and pay the small deductible for that freedom.

grrr....there ought to be a lecture on how these plans are structured and what personally fits you best. People make the wrong choice all the time and get jerked around needlessly. :angry1: Insurance companies are turning the complexities of risk management back onto consumers with the barest information, and it isn't right. :soapbox:

Not Neve · Sep 29, 2004

I can't believe I didn't even comment on prescriptions. I work at a hospital and can get meds discounted through the pharmacy. It's $20 for name brand, $10 for general, unless their cost is less, then I just pay the cost. There is a trade off, though.... only if you don't mind 1/2 the hospital (who you work with) knowing what meds you take. So far, I haven't minded. Don't even care who knows if/when I'm taking the pill. But someday I could be taking medications that I don't want them knowing I take.

Oh, and we actually had 3 plans to choice from this year. Next year we'll only have 2 to choice from but they were giving us warning that the 3rd one was being phased out.

One of the plans that was introduced this year, they give you $500 to spend how you want. You can spend it on anything, very wide range, anyway. But the incentive to not use it is that it would rollover the next year if unused. So, in addition to next years $500 you would still have whatever you didn't spend this year. Interesting plan but way too risky, in my opinion.

Not to keep harping on it, but in my case with my thyroid, I would've spent most of it on just the thyroid scan.

There is a catostrophic cap on it, so that if you ended up hospitalized or with a major illness you didn't necessarily go bankrupt but you'd spend several thousand.

mentos_007 · Sep 30, 2004

hahah there is too much to talk about health in Poland... We have to pay "taxes for health" that mean that every month government take some cash from our pocket for medicine. But when you go to the doctor... you can:
1. Stay in the queue for 4 months (for a simple intervention
2. Go to the private doctor but then you have to pay for in (again)
3. Offer a bribe to the doctor and you'll have an intervention quite fast (it depends how much you gave)

So my advice is: don't be sick!

skieur · Nov 28, 2012

Big Mike said:
Well, I'm Canadian...I don't pay out of pocket when I go to the doctor but when I see a dentist for example...I think I have to pay up front and my health plan will reimburse me the appropriate amount...something like 80%. I know that some plans have a card that you can use...then the dentist will only charge you the 20% and that's it...they charge the plan company directly.

Same with drugs, most places I have worked had a drug card so I only had to pay the 10% or 20%. My current plan does not have a card and I have to pay and get reinbursed...suposedly this saves me (and the company) some money but I would rather have the card.

I know the dental coverage has all sorts of limits. $2000 per year for minor stuff...another limit for major work...cosmetic stuff etc.

There are other coverages with limits; Chiropractor, massage therapist, etc.

I think I have coverage for eye glasses but it's only $200 every 24 months.

Hope that helps. I can break out the book if you have any specific questions.

As a Canadian, I have similar coverage. I am astounded at many Americans who do not seem to understand the advantages of a national health care system. Two months in the hospital, a MRI, cancer surgery, chemo, and almost $100 per day in anti-nausia drugs for 6 months, as well as time off work, would have cost an absolute fortune in the US.

skieur