Health Insurance Stuff......

[Dave Stewart]

The problem with the health insurance industry is money grubbing HMO's that not only control the hospitals...and now many of the doctors that used to be in private practice but can't afford to do so anymore because of frivilous mal practice law suits driving the cost of their malpractice insurance thru the roof....and guess who's hand is in the health insurance business?,,,yep HMO's.

Actually I can't complain right now...my health insurance is from the military retirement....37.50 a month covers me and the wife with basically major medical plan from Blue Cross....wife just had outpatient surgury..bill total was over 12,000...we paid our co pay...25.00. Just waiting on the government to go bankrupt like the USSR did so I can not only lose my retirement but health care too.

[GeoFisher]

The problem with the health insurance industry is money grubbing HMO's that not only control the hospitals...and now many of the doctors that used to be in private practice but can't afford to do so anymore because of frivilous mal practice law suits driving the cost of their malpractice insurance thru the roof....and guess who's hand is in the health insurance business?,,,yep HMO's.

Actually I can't complain right now...my health insurance is from the military retirement....37.50 a month covers me and the wife with basically major medical plan from Blue Cross....wife just had outpatient surgury..bill total was over 12,000...we paid our co pay...25.00. Just waiting on the government to go bankrupt like the USSR did so I can not only lose my retirement but health care too.

Well.......HMO's are NOT the problem either.......they try to create LARGE groups to lower the cost, and actually they did a pretty **** good job of it.

Next......You, and ALL soldiers and ex-soldiers get a "by" from me with regards to health care......I RESPECT your and EVERY ONE who serves, and they DESERVE the benefits earned due to service to our country.

Finally............with regards to that 12,000 dollar bill for outpatient surgury.....Someone paid for it.......and in this case it was probably Tricare and the Taxpayer.....your 37 dollar premium and 25 dollar copay paid for maybe the needle to knock her out....

Later,

Geo

[GeoFisher]

ALSO, as a side note.........I work for a LARGE Health Insurance Company.

AND health insurance companies don't make lots of money..........in fact our profit margins are about 3-4 percent.

Imagine ANY other business making 3% as a profit.........HOLY CRAP.......but EVERYONE thinks the insurance companies are what are SCREWING UP Health CARE.

My friends.......they are NOT.......

* Doctors charging 300 bucks for a 50 dollar service fee.......BECAUSE MEDICARE will PAY IT.

* Doctors charging 5 THOUSAND DOLLARS for an MRI......because MEDICARE WILL PAY IT.

* Doctors charging 100 bucks for a 15 minute office visit to read my LAB. THEY charge that 100 bucks because their overhead is 10 THOUSAND dollars a month....what causes that overhead........how about the 150 THOUSAND DOLLARS an OB/GYN needs to pay for malpractice insurance.

GUYS...........the problem is NOT the INSURANCE COMPANIES........FAR from IT.

One thing missed in my post above about my HSA Debit card is the "on demand" claims payment. When I go to the doctor, and have a service........I swipe my debit card, and it is PAID THERE.........period. NO FORMS, NO claims adjudication, bla, bla, bla.......DONE. Talk about eliminate red tape a paperwork.....and REDUCING COST.

Later,

Geo

[Dave Stewart]

Well.......HMO's are NOT the problem either.......they try to create LARGE groups to lower the cost, and actually they did a pretty **** good job of it.

Next......You, and ALL soldiers and ex-soldiers get a "by" from me with regards to health care......I RESPECT your and EVERY ONE who serves, and they DESERVE the benefits earned due to service to our country.

Finally............with regards to that 12,000 dollar bill for outpatient surgury.....Someone paid for it.......and in this case it was probably Tricare and the Taxpayer.....your 37 dollar premium and 25 dollar copay paid for maybe the needle to knock her out....

Later,

Geo

Don't think I said anything about not knowing who paid the 12,000 bill...I know the tax payers (of which I am one) paid for it. Yes, I earned these benefits...just so folks could come on this site and bitch about anything the government does...good or bad.

[JD7.62]

ALSO, as a side note.........I work for a LARGE Health Insurance Company.

AND health insurance companies don't make lots of money..........in fact our profit margins are about 3-4 percent.

Imagine ANY other business making 3% as a profit.........HOLY CRAP.......but EVERYONE thinks the insurance companies are what are SCREWING UP Health CARE.

My friends.......they are NOT.......

* Doctors charging 300 bucks for a 50 dollar service fee.......BECAUSE MEDICARE will PAY IT.

* Doctors charging 5 THOUSAND DOLLARS for an MRI......because MEDICARE WILL PAY IT.

* Doctors charging 100 bucks for a 15 minute office visit to read my LAB. THEY charge that 100 bucks because their overhead is 10 THOUSAND dollars a month....what causes that overhead........how about the 150 THOUSAND DOLLARS an OB/GYN needs to pay for malpractice insurance.

GUYS...........the problem is NOT the INSURANCE COMPANIES........FAR from IT.

One thing missed in my post above about my HSA Debit card is the "on demand" claims payment. When I go to the doctor, and have a service........I swipe my debit card, and it is PAID THERE.........period. NO FORMS, NO claims adjudication, bla, bla, bla.......DONE. Talk about eliminate red tape a paperwork.....and REDUCING COST.

Later,

Geo

Very good points. I use to review certain HCPC codes billed by providers such as unlisted codes. Its amazing to see what they charge for the most inexpensive things. For example, during flu season we will often see an unlisted supply code for about $25 with a description of something along the lines of "flu vac kit". Well after further investigation guess what is in that kit? Alchohol wipe and a band aid!! What is up with that?!

Also you are correct with the profit marigins, like oil companies we make very little compared to other industries yet for some reason because oil companies and the big health insurance companies are successful and make money and employ hundreds of thousands of people, they are evil...

[know1]

Some people and some groups get FSA, MSA and HSA mixed up.....They all are limited.....but I believe HSA's and MSA's are the plans that allow you to roll money over. If you have a FSA and a HSA, you have limits as to what you can use the FSA dollars for.......but HSA.......I believe you can use for pretty much any qualifying medical expense.

hell, I've use HSA dollars to purchase over the counter stuff.......JUST KEEP your Receipt. Tylenol, cough syrup, Nyquil, whatever......AND that is a pretty good savings of about 25-30% if you consider I didn't pay tax on the dollars USED to purchase the products.

AND at the end of the year, I can look at my HSA spending, download all the DATA into excel or whatever and get an EXACT breakdown of what EVERY FREAKIN DOLLAR was spent on.......

It is NICE controlling my OWN destiny with regards to my health care dollars.

Later,

GEo

Ours was an HSA. We already have the FSA.

You can roll over the money, but my question is what if you end up somewhere else that doesn't have an HSA after 10 or so years and that place offers a different kind of insurance and now you can't use your HSA savings. Is it possible to withdraw it at some point and use it for other things if it's not needed.

And I do think that the major part of the problem is the existence of, and reliance on the health insurance industry. Even if they aren't making a profit, they've eliminated competition and we are not only paying for our healthcare now, but we're ALSO paying the salaries and infrastructure of the health insurance industry.

Think about it, nobody is just growing money on trees here to pay for health insurance. Ultimately, the consumers are the ones footing the WHOLE BILL - either directly through insurance premiums or indirectly through higher costs of goods, lower salaries, etc. - so why do we need to also pay for another entity to pay our bills for us?

[Mean Morone]

I'm glad someone brought up tort reform. It's the lawyers that are driving up costs not only in the medical industry but in many aspects of every day living. BHO shot down any thought of tort reform right away. If you take a look at the members of the house and senate you will see one lawyer after another. They are everywhere. Tort reform would make a world of difference, but it will never happen as long as the lawyers are making our laws. Like I've said before, they need to fear us, not the other way around.

[medicalsure]

Hi GeoFisher, thats bad tho..let me suggest you health insurance comparison. Affordable and cheap health insurance everyone's looking for. You can save up to 40% off your next health insurance premiums. And major discounts on all leading brands. This site is good tho.

[RoadToad]

I work for the same company Geo does, and have basically the same insurance plan. HDHP with a $3000 deductible, after that I pay 10% to a max out-of-pocket of $6000. But my situation is a little different. I have a couple of medical conditions so I take enough medication that I meet my deductible every year. Now up until last year, once your deductible was met, everything was paid 100% after that, so I only contributed enough to meet the deductible every year. Then when I got married, I went from a $1500 deductible to the current $3000 and while it was not a problem to contribute enough to meet the deductible by the end of the year, between my wife and me, we were going to meet it within a couple months, so I had to really ramp up the contributions - dumped >$500 a paycheck in there for a couple months. OK fine, deductible met, no problem, EXCEPT, now I have to work on next year's increased deductible of $4800, and I'm running up against the max contributions allowed in a year, which is $6150 in 2011, unchanged from 2010. And actually, you CAN contribute more, but you end up paying 6% excise tax on any of it that's not paid out by April of the following year, and most important, it's not tax deductible, so I don't see the point in doing that.

All that said, I feel pretty good about my insurance, and count myself lucky to have it. The ONE thing that kind of sticks in my craw about next year's changes (and BTW our plan year is from July1 - June 30, so it's about to change) is that the max out-of-pocket is going up to $7800, which is a lot more that you're allowed to contribute to an HSA in a year. I don't expect to hit that (knock on wood), but that still kinda bugs me.

[RoadToad]

Also, I can't remember the answer to this question, but can you ONLY use the money for medical/prescription costs? Where this comes into play is if you switch jobs and go somewhere that the HSA isn't offerred. Now you have a bunch of money that you can't touch - or don't need to touch because your new employer's insurance is paying it.

You can withdraw the money at any time, but if it's not used for medical or prescription costs, you have to pay taxes on it. That's for an HSA. An FSA is generally a "use it or lose it" deal. And like Geo mentioned, if you have an FSA and an HSA, there are restrictions on what you can use the FSA for. I have one because I wear glasses and my wife wears contacts.

[Tom523]

Know1, if you think there is no competition now--just wait until the government is the only one providing health insurance!!

I saw a commercial today about the $400 hammer, the $600 toilet seat, and other things the government has paid for and wondering why we think the government can do it better AND CHEAPER than private industry. Good question.

Grumpy

The stories about the hammer and toilet seat amount to peanuts compared to what really gets wasted in government. I work for the government and I've seen close to a million dollars wasted in one afternoon. I reported it to fraud waste and abuse hotline and they said it was an acceptable mistake. It's like Sh** Happen!

[elnutsmalljaws]

Speaking from a patient that has had more hospital bills than probably everybody on the Off Topic board COMBINED, Insurance companies are not the problem THE HOSPITALS, DOCTORS AND THEIR POLICIES ARE THE PROBLEM. I could go into so many billing issues, double billing, multiple doctors doing the same thing at the same time all billing their individual fees, hospitals charging wrong due to coding errors and so forth to the tune of $123,000 in hospital and doctor bills that I owe since 2004 and there has NEVER been one single day that I have not been covered by the BEST plan offered by Kentucky State Government.

For example, I am patient of Blue Surgery Group at UK Hospital. MANY times I have been told to come to UK by my Blue Surgeon on staff to be admitted. I show up to the ER, because that is Hospital policy, I am then sent to the ER seen by an ER doctor and then a 2nd ER doctor as they are full aware that I was told told to come there to be admitted by Blue Surgery after triage, but I am still billed by both ER doctors that do nothing except tell me that Blue Surgery will be down to see me and admit me.

I was in Celina TN this past December and was air lifted out on December 3rd for emergency surger due to an infected abcess in my abdomiinal wall where they drained almost 4 liters of infected fluid. The doctor at the hospital in Celina and the doctor at UK hospital both said it was critical that I get immediate surgery because if it ruptured I could have died. The insurance company agreed that it was critical but because I was flown across state line, what is that about 8 miles from the hospital in Celina to the KY state line which is just past Holly Creek, and it was not pre-approved that I am stuck with the $28,000 helicopter ride. If I was flown to Vanderbilt instead, where nobody knows my case or how the plumbing inside me has been re-routed, versus to where a surgeon knows my plumbing inside and out, they would have paid the full bill.

I was even billed for two surgeons in one of my surgeries where one surgeon did nothing but OBSERVE the procedure, but he still billed my insurance. I did not ask for this surgeon to OBSERVE. My surgeon, who is the best in the state, certainly did not need anyone to OBSERVE him perform his duties. But because this cheesepuff decided to sit in and observe one of my surgeries he felt it was his duty to bill almost $4,000 to my insurance company for his services - AND MY INSURANCE COMPANY PAID IT.

These are just a few of the gross problems with the medical billing and other stuff that has put us $123,000 in debt to medical bills even though I am "supposed" to have a $5,000 MAX out of pocket annually, 2003-2011 is 8 years times $5K is $40,000 if we never paid a nickle to date. Long way between $40,000 and $123,000. There are a lot of people getting rich