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Health Insurance

The TVClubHouse: General Discussion ARCHIVES: 2006 Mar. ~ 2006 May: Health Insurance users admin

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Colordeagua
Member

10-25-2003

Saturday, March 11, 2006 - 11:48 am   Edit Post Move Post Delete Post View Post Send Colordeagua a private message Print Post    
A vent! Grrrrrrrr! On another message board (not TVCH), I had a discussion with a poster about health insurance in the U.S. One poster has twice inferred that healthcare in this country is basically free. No health insurance? Go to the government. It will pay. No problem. Huh? Am I crazy in not believing that or is the poster? Peter Jennings' last special (aired after he died) was about health insurance problems in this country. What about people who are in debt to medical providers (who have collection agencies hounding former patients), credit cards (if they've charged medical bills), sell their homes, go bankrupt, have fund drives to pay medical bills?

I retired early so got private insurance with Blue Cross / Blue Shield. Private works differently than employer group (and going from group to group). When I (any applicant) applied for the private insurance, I had to disclose my health history. The carrier verifies it. (Approval takes four to six weeks.) Unlike employer group, pre-existing conditions do come into play when applying for private. Part of the application was a list of health conditions which would not be covered. If applicant has one of them -- insurance denied. I've heard more recently that if weight is not in proportion to height, insurance is likely denied because of possible future health problems (i.e., diabetes). As the cost of healthcare goes up, coverage is denied for more and more health conditions. Insurance carriers don't want to pay claims, so they state up front what will not be covered.

Am I correct in this? Does anyone know anything different?

Colordeagua
Member

10-25-2003

Saturday, March 11, 2006 - 1:09 pm   Edit Post Move Post Delete Post View Post Send Colordeagua a private message Print Post    
Guess I've pretty much found the answer to my questions -- especially about private health insurance. It's a state-by-state thing -- in MOST states, private health insurance carriers can deny coverage for any health condition.

I wanted to watch Peter Jennings' last documentary report on health insurance, but wasn't able to because my TV reception of ABC is sometimes so bad it's not watchable which was the case that night. I don't have cable or satellite.

Landi
Member

07-29-2002

Saturday, March 11, 2006 - 2:22 pm   Edit Post Move Post Delete Post View Post Send Landi a private message Print Post    
sorry color, but i really don't know any information, i was first covered by my parents, and then by my husband. i've had kaiser most of my life.

Tishala
Member

08-01-2000

Saturday, March 11, 2006 - 4:44 pm   Edit Post Move Post Delete Post View Post Send Tishala a private message Print Post    
It is possible to purchase high-risk insurance for people with chronic illnesses. It's a frequent question on the congestive heart failure boards. IIRC, many states help subsidize it..

Karuuna
Board Administrator

08-31-2000

Saturday, March 11, 2006 - 4:50 pm   Edit Post Move Post Delete Post View Post Send Karuuna a private message Print Post    
http://www.statecoverage.net/matrix/highriskpools.htm

Texannie
Member

07-16-2001

Saturday, March 11, 2006 - 4:51 pm   Edit Post Move Post Delete Post View Post Send Texannie a private message Print Post    
The main reason I went to work at Starbucks was for their insurance. We were self insured for several years and it was killing us financially! Not to mention the exclusions and if we wanted to get a waiver for the exclusions, our premiums went up even more.
I am not exactly sure of your point. If you don't have insurance there are hospitals that will treat you..some have to. I do get very frustrated paying out the nose for insurance.

Biscottiii
Member

05-29-2004

Saturday, March 11, 2006 - 5:57 pm   Edit Post Move Post Delete Post View Post Send Biscottiii a private message Print Post    
Hey, I hear you!

I'm a retired City of Seattle Employee. My insurance (Medical Only) rates have gone up from $278/mo to $553/mo in just 4 years. (Dental has gone up from $48/mo to $67/mo for really POOR coverage). And that's without any preexisting conditions, reqd weight tests or anything. Retirees pay it all, off the top and AFTER taxes. Only available until age 62 or 64, whenever Medicare kicks in to play.

I do remember several years ago, a coworker who was retiring found that his wife couldn't be covered because she weighed one pound too much. If she had any warning before the physical, maybe she could have drunk some grapefruit juice or natural dieretic, but too late-no retakes and she was denied coverage. Later though, when I retired they didn't require a physical.

This last January, when it went up another $75/mo I talked to the head of the retirement board. He said they use a "experience based" plan and "our retirees use a LOT of medical". So, no recourse there.

BUT - - I wonder if many people use MORE medical services as a result. Like, thinking....'since I'm paying so much, I'm gonna use the service and get my money's worth'. Then of course, it has the round robin effect - more use means higher premiums the following year.

One thing people need to be aware of and I try to point out to friends who are retiring - it IS tax deductible! My medical and dental had always been covered while I worked, so (stoopidly) I wasn't aware. Fortunately, my dental hygienist pointed that out and I was able to submit amended tax returns. Saved SEVERAL hundred dollars.

I know, I should feel grateful to even have insurance.
Still, I expected to be broke after retiring early (31 yrs) but the medical & dental insurance is a bank buster! Bisc

Colordeagua
Member

10-25-2003

Saturday, March 11, 2006 - 9:15 pm   Edit Post Move Post Delete Post View Post Send Colordeagua a private message Print Post    
Yep, Biscottiii, I've become more aware of deductions -- medical in particular. As I was making my app. 39 roundtrips to the hospital for radiation treatments, I started thinking, "Mileage deductible?" Yes, it is.

I was having an on-line discussion with couple of posters (not TVCH) about health insurance. That's what prodded my questions. One said health insurance and healthcare bills not a problem. If you can't pay, government will take care of you. Huh? Not if you have assets to lose.

Another said it's illegal for a carrier to deny anyone private health insurance due to previous or existing health conditions -- or sometimes simply weight. That's state law, not federal. In Illinois, where I am, it is legal.

Costacat
Member

07-15-2000

Sunday, March 12, 2006 - 9:10 pm   Edit Post Move Post Delete Post View Post Send Costacat a private message Print Post    
High risk folks can get insurance, but it can be VERY expensive and some pre-existing conditions may be excluded (in California, anyways). And they can deny you, in California. I don't know what the alternatives are if you are denied.

And that's BS about not having to pay. If you are uninsured and you have to go to the hospital, you WILL BE responsible for the bills. There have been many, many articles and stories about people going bankrupt because they could not afford the bills from some medical emergency or illness.

There are far too many people who are uninsured (or underinsured) in this country. Whomever you were talking to is seriously misinformed. The United States does not have a socialist medical program, as does Canada or the UK. Here, we are responsible for our bills, whether we are insured or not. Insurance covers most, if not all, of the costs. But if you cannot get insured, or cannot afford it, you can't always assume someone will bail you out.

Karuuna
Board Administrator

08-31-2000

Monday, March 13, 2006 - 8:09 am   Edit Post Move Post Delete Post View Post Send Karuuna a private message Print Post    
In Colorado, private companies can turn you down. However, you can apply under Cover Colorado and not be turned down, and preexisting conditions are covered. Since the state subsidizes some of the cost, it is more affordable.

Medicaid is also available for certain low income groups, and Medicare is available for the elderly. Neither program is all inclusive and both must meet income and asset tests.

Tishala
Member

08-01-2000

Monday, March 13, 2006 - 1:13 pm   Edit Post Move Post Delete Post View Post Send Tishala a private message Print Post    
California's high-risk health insurance [MRMIP] is also guaranteed. But you can only have it for 36 months and it has an upper limit on the lifetime benefit of $750K. The only way someone can be turned down is if too many people are enrolled in the program. link

Herckleperckle
Member

11-20-2003

Tuesday, April 04, 2006 - 9:42 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
I want to make one thing very clear about private insurance that some people never seem to understand: Your employer makes decisions about your coverage, not the insurance companies.

Except for a list of standard non-covered items (standard from insurer to insurer), your EMPLOYER determines what is or is not covered, what deductibles you pay, what your copays are and if there are caps on benefits (benefit maximums).

Not to make the employers the bullies, though. They have budgets, too. That is why it has become more and more common nowadays for employees to pay a greater share of the costs almost yearly. And that is why employers try to educate their employees about flex benefits (set aside tax-free money to pay for your benefits) to help reduce your costs.

About dental benefits: Dentists notoriously will not play in the same game docs are in. Dental schools keep admitting numbers low to protect their own interests. And most will NOT accept what the insurer will pay ( as payment in full for many, many dental services. So in comparison with medical benefits, dental coverage is very disappointing. Course, you can use flex dollars to defray costs.

Texannie
Member

07-16-2001

Wednesday, April 05, 2006 - 3:31 am   Edit Post Move Post Delete Post View Post Send Texannie a private message Print Post    
Heck, don't you mean group insurance? When I was privately insured, I paid for everything, decided all my coverage and had private insurance because my husband's company doesn't have it.
I have found that the dental coverage is great, but the ortho is where it truly sucks!

Herckleperckle
Member

11-20-2003

Wednesday, April 05, 2006 - 5:42 pm   Edit Post Move Post Delete Post View Post Send Herckleperckle a private message Print Post    
Yes, Texannie, I mean group insurance. Sorry. I was using the term private to distinguish between state or federally-provided benefits.

Non-group is usually referred to as 'Individual' Health insurance. Typically much more expensive with lower levels of affordable coverage (benefits).

Tabbyking
Member

03-11-2002

Friday, April 07, 2006 - 5:11 pm   Edit Post Move Post Delete Post View Post Send Tabbyking a private message Print Post    
when my husband's job ended, so did what they paid for our kaiser coverage. we were paying maybe 150/month and they paid the rest. now we pay almost 600/mo for the 4 of us. since there is no kaiser facility within 150 miles of our new home, we will be dropping kaiser at the end of may--which is a little scary because we have had the same doctors for 20 years and they know us inside and out (literally!).
we are so fortunate my dh is retired usaf. we can use tri-care west (providing we find a provider who takes new patients, of course). when dh looked about 6 months ago, there was only one guy about 60 miles from our new house and he wasn't taking new patients. now we got a new list and there are about 100 docs listed on it, a lot of them within 40 miles. dh is supposed to do the leg-work this next week and start calling to see who would take us. i hope he finds someone. that $600/month will be much-needed with 2 kids in college.
i can't believe what insurance costs. and we make 'too much' for medi-cal. too little to pay medical bills and too much to qualify for help.
but what really irks me is the cost of things. my husband got 4 gauze sponges (read this as 4x4 cotton pads) when he cut his finger and it was 28 bucks for them. you can get a whole package for about 5 bucks at walgreen's. my sister needed an anti-diarrheal med when our father passed away and she was so stressed. they charged her 45 dollars for one dose of imodium in the e.r. when i worked e.r. it used to piss me off that one tylenol pill or liquid dose would cost 30 or 40 dollars. aaargh, don't get me started...