I’ve learned a few things since I’ve started writing here:
- My posts are spam filter and FYWP honey traps
- There is a massive amount of relevant expertise in the comments
- My original plan to write to a schedule went out the window.
- The better plan is to riff off of questions and insights from commenters.
- There is a lot of pain that a lot of people are experiencing or have experienced with and without insurance
To address #5, let’s make this an open thread for airing of grievances and mutual support….
Ted & Hellen
I live in Boston and own my own business.
Without Mass Health, I would be unable to afford comprehensive, decent health insurance. But because of MH I can.
Yay Mass Health.
Tommy
I got a health care horror story … how about a happy story :).
My mom spent an entire month in the ICU. Ever seen the TV show House? They thought they knew what was wrong with her, they’d treat her, and she’d get worse. This went on for a long time. She is much much better now (long story).
My dad got a bill for $890,000.
Guess what he was asked pay, nothing. 30+ years working for the military (civil service I might add), it was covered.
I recall saying to him, not a liberal but a fair minded person, how amazing that was and how many other people would like to have what he had.
Linda Featheringill
I finally aged into Medicare and my medical care improved drastically immediately.
Before that, I did get minimal medical care through neighborhood clinics, FSM bless them. Sooooo much better than nothing.
WereBear
The United States’ degenerated system of health care is in large part because of the insurance bureaucracy. Diagnosis gets herded into spreadsheet cells, and then treatment becomes similarly rigid and dogmatic.
For instance, I had borderline high blood pressure and rising blood sugars, and I was overweight. Doctors told me to eat low fat, controlled calorie, and exercise. I know this works for lots of people, but it wasn’t working for me. They simply assumed I was eating whole cakes just to spite them.
So I switched doctors… and health approaches. I went low carb, Paleo, gluten-free… and lost the weight, stabilized the blood sugars and the blood pressure went into the “perfect” zone.
Because diabetes runs in my family, my pancreas over-reacts to carbs, and lowers my blood sugar way too much. Then I am starving… eat more… gain weight.
A spreadsheet approach to health won’t get us there. And not figuring out what was going on with me would have led to at least three drugs (a statin, a diabetes drug, and a BP med) I really didn’t need.
Tommy
@WereBear: Amen. I mentioned my mom above but years ago my father had some health issues as well. Guess what they did, they gave him a lot of pills. Pills he takes each month. I hate to think what the government has paid.
Look I am not perfect, but work hard on my health. What I put into my body. There was a time in my adult life where I weighted more than 100 pounds more than I do now (both my parents problems I mentioned, weight based). I an 5’4 male. That was a lot of weight to carry around.
There is NOT a second that goes by any day I don’t think about what I eat. I’d love to go buy ten donuts right now and eat them all. But I don’t. Just a somewhat off topic rant, but wish folks would think, as clearly you have, of what they eat and not take pills ….
debbie
I was uninsured for 15 years, and the dancing it took to get financial assistance for anything that came up was pretty tiring. I now have a job with insurance, and I’m spending the same kind of time and effort to make sure I’m getting the coverage I’m paying for.
Most recently, I had about $2,000.00 in x-rays and blood tests. The insurer negotiated a lower price and then billed me for the balance. About a month later, I get bills from the hospitals billing me for the discount they’re contracted to accept.
After about an hour on the phone trees for both the insurer and the hospital (with the insurer conferenced in), it came down to the hospital basically saying, “Oops, you caught me.” Right.
This certainly isn’t as horrible as having no insurance, but can’t health insurance ever stop being a hassle for anyone at any time?
Tommy
@debbie: Amazing isn’t it. I now work for myself and dealing with health care is close to a nightmare. I ponder back to the day where I had it employer based. I didn’t have the “Cadillac” plan, I had the Ferrari. I miss those days.
WereBear
We’ve created Pill-Based Medical Care, and it’s time to back off. There are better interventions… and insurance won’t pay for them!
Boudica
My concern is that employers are going to stop providing insurance for healthcare, forcing people onto exchanges, but not increasing salaries to help pay for the premiums. Companies will get richer, people will get poorer and Obamacare will be despised. Can anyone talk me down?
debbie
@Boudica:
They already have, but then, this was happening well before Obamacare loomed so frighteningly on the horizon.
Randy P
@Tommy:
There’s a reason every doctor’s practice I know pays a full-time person to deal with insurance now. Somehow this all got much worse during my adult lifetime, starting around when the HMO concept appeared.
Johnny's Mom
The last year I had health insurance, it cost about 15% of my gross/17% of my net. BEFORE the deductible. My dear little dog scratched my cornea and bruised my eyeball in the process. NOT covered. I got a toothache. NOT covered. I spent about a third of my annual income on healthcare that year, and did not receive one iota of benefit from having health insurance.I felt as if I were making donations to the stockholders’ vacation plan more than buying a safety net for myself. I realized, between the monthly payments, deductible, and the % the healthcare provider expected me to cover, if anything happens to me health-wise, I would be bankrupt anyway. So, what’s the difference?
Sister Rail Gun of Warm Humanitarianism
@WereBear:
Been there, done that, lost the better part of a decade to it.
The good: Kaiser, when they were first in the area. Very results-oriented doctors. The attitude seemed to be “if this doesn’t work within X weeks, try something else, because otherwise we’re throwing money down a drain.” That changed over time, I suspect because it was getting harder and harder to keep the good doctors in an area known for high-quality (and expensive) medicine, but for a while, I had a taste of what health care should be like.
The bad. Post-Kaiser. Hoo boy. My number one complaint at the time was overwhelming fatigue. We went through the usual list: my asthma was under control, mild sleep apnea was verified and a CPAP prescribed, and losing weight is kind of hard when you sleep more than 12 hours a day.
That medical group was on a Syndrome X kick at the time and loaded me down with a statin, which upset my GI system, and a diuretic, which dropped my blood pressure low enough to give me a migraine-level headache that lasted three stinking days. I literally crawled to the phone, called my husband, and said “I’ve fallen and I can’t get up.” They insisted it was not possible that the cause was the drugs. Multiple tests later, including an MRI, and they decided it was a migraine with an unknown trigger. I refused to take any more of the drugs and got labeled as difficult.
Syndrome X went out of fashion, fibromyalgia came in, and I got a referral to an endocrinologist. She decided it wasn’t fibro and asked why they hadn’t done tests for Vitamin D deficiency and thyroid issues. I said “I dunno, I’ve been asking for them for over a year.” She ordered them herself and sent me, and the results, back to the PCP. I was then told by them to get out in the sun more and not worry about the weird thyroid results, because birth control pills often cause them. (!)
At that point, I joined another PCP’s waiting list. Before a slot came available, I had a minor foot problem. I suspected a plantar wart, but since I had never had one before, I wanted confirmation. They diagnosed a really bad case of athlete’s foot. When I protested that the peeling was from a huge blister that had broken before I could get to them, they gave me a referral for custom orthotics. They asked about it on one of my med checks, I told them I had bought a bottle of Freeze-Away instead.
Then I got a call from the other PCP, she took one look at my blood work and prescribed Armour and megadoses of Vit D and potassium, and most of my Syndrome X symptoms disappeared. Now I’m trying to undo the side effects of being a lump for so many years.
debit
When my previous employer went under, I lost my insurance. That was in 2005. My plan, should I have had a catastrophic accident, was to just go ahead and die.
Tommy
@Johnny’s Mom: Hey I totally hear you. I am 43. Had health insurance my entire life. When I say I have almost never used it, I mean I have actually never used it. One check up two years ago. Now I get, I have to help cover the costs of others as a healthy person. I get that and I am totally in.
But I know a day is coming where in four decades on this earth the folks I’ve paid insurance too, I need them, and they will corn hole me. I don’t know what my health problem will be, but there will be one. I will talk to some rep telling me this or that and I will just say, fuck you!
Sister Rail Gun of Warm Humanitarianism
@Boudica: Trader Joe’s is going part of the way there. They are dropping their part-time employees from their health group, forcing them onto the exchanges, and giving them $500 to help cover any out of pocket after the subsidies.
HeartlandLiberal
Please explain how Obama can keep dribbling out back offs like unions and Congress inclusion being delayed inclusion in the pools, assuming I am understanding news reports.
No amount of compromise will satisfy his opponents, the GOP, their only goal is to make AHA fail. Every crumb he thinks he throws out as a compromise is seized on as a sign of weakness, and failure, and only encourages his enemies to up the ante.
His entire presidency has been characterized by this pattern.
The whole point of the pools for insurance, as I understand it, is to ensure by the mandate that as many people as possible participate, because the bigger the pool, the more financially stable and viable it is.
But then, of course, this could be solved in one fell legislative swoop by passing Medicare for all, with payroll deduction to fund it, and Medicaid to cover those not working or able to support themselves.
But then I digress thereby into a better world not owned and by the corporate oligarchy, who now have put 50% of all income into the pockets of the top 10 – 20%.
hoodie
@debbie: This. The unfortunate thing is that Obamacare may be blamed for a trend that was already happening. I’m a part owner of a small, but not tiny business and we’ve been steadily cutting back health benefits for several years now. Our situation is exacerbated because our folks are aging as a group and getting more expensive to cover.
My sense is that the long-term effect of Obamacare may be to undermine employer-based health insurance, and I’m not sure that’s a bad thing. If our experience is any guide, small businesses tend to get screwed in relation to big ones. Do you have any thoughts on that?
Boudica
@Sister Rail Gun of Warm Humanitarianism: That’s what prompted my post. TJ’s gets to keep previous premium payouts, gov’t now receives less in taxes due to Obamacare subsidies….it’s all gonna go kablooie. Unless we dramatically increase the penalty corps pay for not providing insurance.
Davis X. Machina
@HeartlandLiberal
I am so there. Send me the address of your Senate campaign headquarters so I can donate.
Keith G
Depression and stress caused by professional burnout adding to a list of things that were quite actually killing me. So I left a well-paid insured vision to follow my bliss. Now a pastry chef I am as emotionally energized as I have ever been. And I am a 55 year old man with no health insurance. Since at least 1991.
Harris County Texas is one of the best places to live if you are poor and suffering from AIDS. The subsidized care is high quality. My general health is quite good. And a new position has meant greater income just in time for the implementation of Obamacare.
This will be interesting. A lot of expensive care and medicine goes into keeping an HIV patient healthy. At present I might be at about 150 percent percent of poverty, but I am not sure since we are still negotiating new rates and incentives at a business that does not carry insurance.
I have no complaints or questions. I will keep you posted on my progress as I navigate through this terra incognita.
Forgive any typos I’m dictating as I bake
Keith G
@Keith G: I see that my dictation edited out the sentence….. since 1991 I have been HIV positive
Lolis
Ugh, I have United Healthcare through work and they screwed me big time. I went to see a specialist in April that I hadn’t seen in a couple years. I told the office I had new insurance (United) and they took all my info. Turns out I had to have a new referral to see this specialist that I didn’t have. I felt like the doctor’s office had a responsibility to tell me but they deny any responsibility. Then the doctor took four months to bill me and United would not back date a referral for me because they won’t do that. Anyway, I am on the hook for $140 for doctor visit in addition to the $40 copay I paid at the time. I was planning on switching doctors and not paying but I got a letter saying they were sending it to collections so I had to pay. I appealed to the insurance company and they refused to cover it. I totally got screwed so yeah, I’m still switching doctors. I just wish I could ditch United too.
Thlayli
I had a pharmacy refuse to fill a prescription because my insurance didn’t reimburse them enough for that particular drug.
I found another pharmacy.
WereBear
@Lolis: THIS.
The rules are stupid, and there solely to trip people so the insurance company doesn’t have to pay.
I recently ran across the MTFHR gene; if you have a mutation in this area, you are INCREDIBLY prone to various illnesses because it interferes with the clearing of toxins from the body.
Fortunately, one can take megadoses of the vitamins involved, and regain good health.
Except insurance won’t cover the treatment… but it will cover the diseases you get for not having it treated!
maye
COBRA runs out in March 2014. After that, uninsurable due to laundry list of pre-existing conditions. Counting on Obamacare to save my bacon!
Di
Four years ago I was diagnosed with cancer. It was discovered early and both my doctor and my surgeon recommended a laparoscopic procedure, which would cut down on length of hospital stay, pain and pain medication, recovery time. All good, you’d think. Enter my insurance company, who refused to pay for it, insisting that my tumor, which they repeatedly mischaracterized as Stage 3 when it was Stage 1, called for full abdominal surgery. My doctor spent the six weeks between my diagnosis and the surgery on the phone with BCBS, arguing for the laparoscopy. I didn’t even know about this until the morning of the surgery, when the anesthesiologist said something like, well, up until last night, we didn’t even know if this was going to happen today.
This is the backstory to my hysterical laughter whenever an anti-Obamacare person rails on about how now the government will come between a patient and their doctor, as if your insurance company hasn’t already grabbed up the biggest chair at that small table.
mai naem
@Lolis: I am surprised the specialist is charging only $200. Her it would be at least $300 unless its a podiatrist. They’re less.
My parents went without insurance for several years before they hit medicare and I’m certain the lack of care contributed to my fathers early death. The state had no high risk pool. The only group of people they would assist at that time were kidney transplant patients, I know this because a coworker’s husband had a kidney transplant. A kidney transplant patient can start working but who’s going to hire somebody whose anti-rejection drugs will cost several thousand dollars month for a few years.
GHayduke (formerly lojasmo)
Gladly, my $4900 in medical bills are wending their way through my wife’s insurance (which wasn’t listed on either my, or my son’s demographic information at my employer (and health care provider) and Health Partners just sent me an EOP from last November that showed the charges paid in full.
Whew.
just_kate
@Tommy: Yep, this is where I am too – been paying in for decades with no major issues. Some minor issues NOT covered: cat bite – prophylactic treatment not covered but infection treatment would be covered and one Gynecologist who took my insurance but NOT for PAP tests (WTF?). And I absolutely hate open enrollment time because I have NO IDEA what might happen.
My company now offers a ‘consumer based’ plan with super low premiums so you pay for expenses from a special bank account (with banking fees – yay!!). They say that the plan brings people into the process but frankly I don’t want to fucking shop around for medical care. By far the best system I’ve ever been in was as a military kid.
Lolis
@mai naem:
They charged me the insurance rate. Which is funny since my insurance won’t pay it.
beth
@Di: This is the backstory to my hysterical laughter whenever an anti-Obamacare person rails on about how now the government will come between a patient and their doctor, as if your insurance company hasn’t already grabbed up the biggest chair at that small table.
After my c-section, I remember the nurse telling me she could give me something for the pain if I needed it. Since I have weird reactions to many medications, I asked her what drug they would be giving me. She answered that she’d have to check to see what my insurance would pay for and if it didn’t work, they’d call the company and see if they’d pay for something stronger.
geg6
@debbie:
THIS!
I used to have a great plan through work. I paid extra for it, but it wasn’t so much that it hurt. I paid for nothing on that plan. They now have forced all of us onto the same shitty plan. $2500 deductible, co-pays for everything. If you don’t have a full physical every year, you pay an extra $100/month. If you use any tobacco products, an extra $75/month. They pay for Weight Watchers but no gyms. I just had my mandated physical and, though my sugar is great, my blood pressure is very low and my BMI is 23, I have high cholesterol (very high good cholesterol but just on the high side of borderline on bad and triglycerides). They told me that I should contact my doctor to get onto a cholesterol drug. I’m not going to do it. It’s not so high that a change of diet and more exercise shouldn’t straighten out. But I can’t afford to go to a nutritionist (which they won’t pay for either), so I’m going to have to do my own research and figure it out myself.
Snarki, child of Loki
When big employers cut deals with big insurers, you kinda wonder if they’re hiding stuff in the fine print.
Some years back, plan description says “covered 100%”, but insurer says “nope, huge copay”. WTF? “It’s in the Group Master Contract”. Okay, I’d like a copy of that contract, please. “ask your employer” Did that, the response? “ask the insurer” round and round and round. Never did get a copy, even after official registered mail request. Just delay and BS.
There must be something *really* damning in that contract, thinks I.
geg6
@Johnny’s Mom:
I feel your pain. I had dental surgery in May. Our dental insurance has a $1000/year limit. I have a flexible spending plan that I gutted. I still had to pay over $3K out of pocket (partially for the surgeon and mostly the anesthesiologist). And now I’m getting bills from lab tests that I didn’t even know about. I had hoped that my medical insurance would cover the lab tests and anesthesia, but they won’t cover it because it was for dental surgery.
CaseyL
My health insurance has, knock wood, been good to me. My horror story is a different sort: seeing the difference between having and not having insurance as illustrated on the bill for minor surgery.
In April I had out-patient surgery to remove a bone spur from my foot. The entire procedure, from entering the hospital to leaving it, took 2.5 hours. Afterward, I rec’d the EOB: the Explanation of Benefits, which is not an invoice, but an early warning of what to expect when the invoice does arrive.
My eyes about popped out of their sockets: the surgery charge was $11,000. For 2.5 hours. I wasn’t too worried, because I know how this works: the $11,000 is what the hospital charges before all the insurance company-negotiated reductions kick in.
And, indeed, the final invoice was for just under $700. Less than 10% of the hospital’s initial “ask.”
Neither the EOB nor the invoice gave a detailed breakdown, but the EOB noted I could get a detailed bill if I called and asked for one. So I did. More eye-popping: the sterile supplies (disposables, IV, surgical tools) was nearly $1,000. OK. The drug total was $300. OK. The recovery room charge was nearly $1,000 – really? Why is it so much?
… and the “Total OR Service”? That was $8,000.
This does NOT include the podiatrist doing the surgery, which was billed through her office and not through the hospital. What on earth were they doing that racked up $8,000 worth of charges in 2.5 hours? (I still need to call to get a detailed breakdown of that; it should be fascinating reading.)
The point is, without insurance I would have been on the hook for the whole $11,000. With it, my cost was just under $700.
We used to say that the insured were subsidizing the non-insured, by paying outrageous sums for things like aspirin and Kleenex.
But that was a long time ago.
Now the shoe has moved to the other foot: the uninsured are subsidizing the insured. The people who can least afford to pay are the ones being charged the most.
I’m not sure what impact Obamacare will have on that end of things. A big one, I hope.
silvery
@debit:In 2007 I had a catastrophic accident without insurance and planned to die so I wouldn’t leave mr. silvery in debt. I was kicked in the ribs by a very large horse and just waited it out to see if there was internal damage or not. I remember googling internal bleeding symptoms and thinking there were worse ways to die. Mr silvery was not a fan of my plan, but it took him a couple days to figure out I’d been hiding the seriousness of it from him. It took me about 2 years to finally go to the doctor; I had found a job with insurance that would cover pre-existing conditions.
Soonergrunt
This year is going to be really tight, finance-wise. The daughter’s new drugs (Entocort, generic name Budesonide) are going to cost a bit, and we’ve exhausted our FSA. The good news is that both my wife and I have pretty good insurance plans, and we should be able to find a way to muddle through. We still have several appointments between now and the end of the year for her, and of course I have ongoing issues–many of which are covered by VA, some are treated at VA and billed to my insurance.
We’ll have to change our benefit plans this year, and raise my wife’s FSA contribution–hers uses a MasterCard, mine requires an assload of paperwork so we only use hers.
As much heartache and heartburn as this can be, I’d like to see the federal employees insurance packages become the baseline, and I’m hoping that in states like Oklahoma, where the government has flat refused to set up an exchange, that would be what happens. I haven’t been following this closely enough because we have good insurance, but now I’m going to have to get a LOT more involved.
Soonergrunt
@Soonergrunt: I just found out that my union has a “medical bill negotiating service” among the benefits package. So I’ll be in the union office today investigating that.
ruemara
I wake up every morning and toss back 3 pills plus vitamins. At 12 hours later, I toss back another pill, plus some vitamins. 4 hours after that, it’s another 2 pills plus vitamins. My blood pressure is high. The medications… make them moderately less high. Even in my medicated sleep, I wake up with something around 110/130. I have no idea which meds are working and I have a cabinet with other meds I was prescribed that definitely do not work. With nearly $25 out of pocket for pills, I’m happy the ACA has reduced the costs for them, but I’m too broke to keep heading back and forth to my doctor for better treatment. I am so sick of being prescribed shit and the costs for the specialists she sent me to, man-why can’t insurance cover all of that? But I’m terrified of another round of emergency room treatments for fall or winter. My former boss keeps trying to make me feel better about my job by talking up the health bennies, but seriously, I can’t afford to use them. There’s a dental appointment I have to keep this week and I need to scrape up some cash to pay for the out of pocket on it, but it’s a sacrifice. This is insurance? To make things worse, I need real dental care. I have a massive gap in my jaw and the bone is eroding. The repair would have been 2k out of pocket 2 years ago. I told him he might as well ask for a million while he’s at it and left the chair. I’m in an even worse fiscal position now. Great insurance, fabulous, but I’m sick of how costly it is to use it.
just_kate
@Soonergrunt: Seems to me like almost everything with our current systems/culture is requiring more and more work – and I’m not talking about just being engaged. A lot of employed folks are having to do more and more work at work, we have to spend time on our retirement plans, our health plans, people with kids need to be more vigilant with schooling and social stuff than ever. Busy busy busy. It’s exhausting :(
gelfling545
Last weekend I was in Panera Bakery for lunch. They had a big fund raiser going on because one of their workers has cancer & doesn’t have insurance that covers chemotherapy (???). OK, nice enough. Then I got an email from them on how their CEO was going to be doing the SNAP challenge. OK, again nice. Then I got to thinking about WHY the employee has no coverage for this catastrophic illness and whether their employees make a living wage. I mean fund raisers & public consciousness raising are terrific but not if you are skimping on the basics you offer your workers. I’m still waiting for a reply to my question from the CEO (or anybody there actually).
crack
Richard,
Could you address these two things and what they mean when taken together?
1. Meaningful use 2 requirements with respect to patient’s access to their medical information.
2. The Government’s ongoing efforts to collect all data on the Internet.
kindness
@geg6: Having Kaiser my health insurance is great but dental is a separate beast. I have Delta Dental and get $1000 a year max. That covers 2 cleanings/exams which is nice but if I need a filling and FSM forbid root canals/crowns like I did last year it’s $800 out of pocket for me.
It is curious how dental is somehow separate from health.
nancy darling
@ruemara: I don’t know the specifics of your dental situation, but is it possible to have a temporary appliance made to maintain the space? You could probably get away with wearing it only at night. It is a stop gap remedy, but might get you through til you are in a better $ situation.
Elizabeth
Health care basically pays for nothing. Every bill I get has tons of fine print explaining how they sliced-and-diced the bill to pay nearly nothing. If I had nothing else to do, I could spend my life dealing with their bills, and that is what they count on–deny-and-delay nets health insurance companies huge profits.
Without ‘Obamacare’ I would be totally screwed. When my husband lost his job for a year ten years ago, I developed stress-related psoriasis. When COBRA ran out, no insurer would cover me, for a stress related condition, which shot my stress through the roof.
I have lived with knowing that I am uninsurable for over a decade, while my husband drifts in and out of contractor gigs. My job (county government–they call it ‘temporary part time’ despite wanting me to fill the position for a minimum of 2 years!) has no benefits.
I cannot overemphasize the immense peace of mind and decrease of stress that Obamacare has effected in my life. Here in CA, it is lowering premiums, increasing covered procedures, weeding out junk insurance, and providing a safety net to a huge chunk of the struggling middle class.
I have mixed feelings re the TJ’s move. Truly, healthcare should be decoupled from work. We should have Medicare/Medicaid for all. Now. But this is a step in the inevitable direction. If no one has noticed, health care as a job benefit has been vanishing for many years now. And when something labeled “insurance” is offered, it is usually just a junk vehicle that pays out almost nothing while sucking money out of employee’s pocket. We need to have health insurance decoupled from work. Soon.
MaryJane
@kindness:
Yes, especially when a dental problem is directly related to an event that is covered by medical insurance. Several years ago I was in a car accident. My health insurance paid the ER and doctors for treating the concussion and facial lacerations, but the dental insurance (through the same company) wouldn’t cover a penny of the care I needed for losing a tooth and damaging two others.
Nellie in NZ
I miss my kids and am thinking of returning to live near them in the US. Then I read this. I spend no time thinking about health care costs. I don’t deal with insurance companies and constant billing and indecipherable reasons for both costs and refusal of coverage. I make an appointment at the doctor and pay $17. I take a prescription in and pay $5 per Rx for three months worth. Then I go home and forget about it. Instead, I read a book, take a walk, work. I can stay here (I have permanent residency). Other than my husband, though, I have no family within thousands and thousands of miles. I have pleasant friends but no one that I knew ten years ago. My son had MRSA several years ago when he was a 20 year old college student. He was dumped from one hospital to another one. He ended up at a fine hospital – they saved his leg, they saved his life and I willingly paid about $10,000 for his care. He had a deductible (easily met) and supposedly had 80% coverage on the rest. But there were so many loopholes and declined coverages that the insurance covered between 40-50% of costs. The son always complained about our frugality and I was able to say that this was why we were frugal – we might grizzle about the costs that we thought insurance would cover but we had the money stored away for this kind of emergency. The nightmare of appeals and adjustments on billing from multiple doctors, services, and hospitals went on for over a year afterwards.
Villago Delenda Est
Mr. Mayhew, may I just restate, for the record, that you are awesome.
Carry on.
Villago Delenda Est
@debit:
Amazingly, that is the GOP health plan for all 99% Americans. Coincidence?
VividBlueDotty
@ruemara: I totally understand being too broke to USE your insurance. I’ve been stuck working contract jobs for several years with an 8 month stint of unemployment in between. I finally got a year long contract at a good rate, so I can “afford” to pay the $100 a WEEK it costs for “OK” medical insurance and standard dental insurance. I’m just not sure I can afford to use my insurance and I haven’t yet looked into how pre-existing conditions are defined and or treated.
That is a fairly minor grievance in the scheme of things. My mother, on the other hand, had good insurance, provided by her employer with a minimal premium contribution from her and pretty good coverage. Her battle with breast cancer showed us how bad things can be with “good” insurance. Her out of pocket costs (after battling the insurance company’s nickel and dime denials, correcting their errors, spending her vital energy dealing with insurance bureaucracy instead of getting well or enjoying her last years) was about $10,000 a year. For 10 years. How many people could afford THAT?
I pray that we get to Medicare for all (or at least opt in for all) sooner rather than later.
numfar
My 27 y/o son was injured in an offset head on collision over the labor day weekend. He was riding in the backseat when an oncoming car crossed the center line and struck the vehicle he was riding in. His hip was broken.
He’s been in the hospital ever since. He has United Healthcare and they will cover the rehab. Unfortunately, since there are multiple insurance companies involved, and settling all the claims will take a couple or three years, the rehab center will not take him because they won’t be paid for a while.
We’ve burnt thru our PTO and live 300 miles away.
Fuck all these sumbitches.
Betsy
@geg6: fiber. If you are asking for advice, which I believe you were not.
jl
Thanks very much to Richard for the posts on health insurance. I look forward to more.
James E. Powell
I am satisfied with my health insurance plan – Anthem Blue Cross HMO – that is part of my compensation.
However, I am one of those people who is staying with a totally unsatisfactory job – not just the job but the pay – in order to hold onto this health insurance benefit that I would not be able to get very easily if I switched jobs.
This may not be exactly what Mr Mayhew was looking for, but I wanted to put it out there.
Original Lee
I am very blessed to have fairly decent health insurance through my employer. It used to be an almost care-free existence, but now the insurance company is shifting huge amounts of work and expense onto my shoulders, plus the premiums are due to go up starting next month and me with no raise to speak of in years.
I just got a threatening e-mail today from the insurance company because I apparently have not submitted receipts for some things I paid for with my “wonderful” new flexi-card. Um, the charge does not go through without a cost detail. I bought antibiotics at CVS, and I paid for a visit to the doctor (to get the scrip for the antibiotics). So I have to scrounge around for my copy of the receipts and mail them in by then end of next week, or I will have to pay them back for these charges.
How crazy is that?