Grrrr.....the cost of health care. (1 Viewer)

Bleu Raeder

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Long story short - my doctor wants me to have a PET scan just to confirm there is not a problem where they think they may see a problem from a CT scan done a few weeks ago.

The only place in town (Lourde's) called from their billing department right after the scan was scheduled. They said that "....after the pre-auth and with your deductible and out-of-pocket the bill will be $1100.00. How would you like to pay that?"

I, to say the least, was shocked.

I politely told them to cancel the appointment and I'll meet with my doctor again to see how compelling this test requirement is.

Holy crap on a stick!
 

coldseat

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How else will they pay for that fancy new imaging center?

But yeah, medical insurance is only useful if you have to go to a doctors appointment or if you have a catastrophic injury/illness that requires a hospital stay. Since for most plans now a days, you have to pay your full premium and full deductible (which increase just about every year and only get larger and larger), it's useless for ER visits, Imaging and anything else not covered by a co-pay until you pay the deductible.

I know I have a $4,000 individual/$8000 family deductible and my yearly premium is $ 9600. My company pays $4000 of that, but total, it's still $13,600 - $17,600 before my insurance starts covering my medical bills in earnest. Everything before that is window dressing mostly.
 

efil4stnias

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Long story short - my doctor wants me to have a PET scan just to confirm there is not a problem where they think they may see a problem from a CT scan done a few weeks ago.

The only place in town (Lourde's) called from their billing department right after the scan was scheduled. They said that "....after the pre-auth and with your deductible and out-of-pocket the bill will be $1100.00. How would you like to pay that?"

I, to say the least, was shocked.

I politely told them to cancel the appointment and I'll meet with my doctor again to see how compelling this test requirement is.

Holy crap on a stick!

yeah i paid $1800 for a CAT scan a year ago for my daughter - my deductible was like $2500 BEFORE Ins co pays ANYTHING resemgbling copay.

Did you ask what "cash" price was?
 

Saint_Ward

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Long story short - my doctor wants me to have a PET scan just to confirm there is not a problem where they think they may see a problem from a CT scan done a few weeks ago.

The only place in town (Lourde's) called from their billing department right after the scan was scheduled. They said that "....after the pre-auth and with your deductible and out-of-pocket the bill will be $1100.00. How would you like to pay that?"

I, to say the least, was shocked.

I politely told them to cancel the appointment and I'll meet with my doctor again to see how compelling this test requirement is.

Holy crap on a stick!
1. Do you have an HDHP plan with an HSA? The Out of pockets can be jarring, but at the end of the year, in many cases, it's still cheaper than a PPO with "co-pays".

2. Is this a hospital or an imaging center? If not an imaging center, you should look outside of town.

3. PET scans are expensive though. But if you're trying to screen for a potential cancer situation, it's often the best way. MRI might be an option though. If it's slow growing, PET might not even bet that great of an alternative. So, it's fair to push your doc.

CATs, PETs and MRIs - Getting to know your scans
 
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Bleu Raeder

Bleu Raeder

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1. Do you have an HDHP plan with an HSA? The Out of pockets can be jarring, but at the end of the year, in many cases, it's still cheaper than a PPO with "co-pays".

2. Is this a hospital or an imaging center? If not an imaging center, you should look outside of town.

3. PET scans are expensive though. But if you're trying to screen for a potential cancer situation, it's often the best way. MRI might be an option though. If it's slow growing, PET might not even bet that great of an alternative. So, it's fair to push your doc.

CATs, PETs and MRIs - Getting to know your scans
1. I can contribute to an HSA but have never needed to before.

2. It is a hospital system and I, along with the insurance company, have checked outside resources. None that are close (within driving distance) are any better.

3. Thanks
 

bclemms

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Health insurance is a giant scam.

Average cost of a PET scan is about $4500. You can get the exact same scan in Mexico for about $750.

With my insurance they'll pay 50% of approved scans. In order to get a PET scan I have to see my primary doctor, pay $25 co-pay for the visit. Then he has to give me a referral to a specialist. Specialist co-pay is $50. Then the specialist has to set up the PET scan and I would pay 50% of scan cost. So that's now 3 days of missed work, my total out of pocket would be $2325.

For the same amount of money I can take a nice 5 day vacation in Puerta Vallarta and get the pet scan. They will let you know same day the results then you can have the scans transferred back to home and you can get a second opinion when they look at the scan.

My insurance costs me $550 a month. At the end of the year insurance cost me far more than it's worth. There are a few cases where insurance would be helpful. Something like a cancer diagnosis or catastrophic care it would be worthwhile. The odds of a catastrophic injury happening outside of work or in a car accident are quite low. If it's in a car, my car insurance would cover it. If it's at home my home owners would cover it, if it's at work then workers comp would cover it. So basically the odds after factoring that it becomes tiny.

If I got a major medical diagnoses then the odds of me getting the best care or near the best care is so low given the insurance companies track records. I'd also likely be out of pocket or fighting them in court that I'd spend more than I could afford anyway. So if I got a major diagnoses I would likely look out of the country anyway. Better treatment for far less money. It's shameful.

Health insurance isn't to cover our *****, it's to cover the *** of big medical, we just foot the bill.
 

Grandadmiral

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My deductible is $3,000 a year. As a Type I diabetic on an insulin pump, I get to that goal pretty quickly, considering insulin and pump supplies are almost $1,000 a month. Once I meet my deductible, all bets are off. Insurance covers 100% and I make sure they do.

Thank goodness for my HSA.
 

MaraJadeSkySaint

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I have just been trying to wrap my head around our own insurance plan. My husband and I got married last year, and my premium more than quadrupled when I added him as a spouse. For one person! That is not even the family plan.

We pay $360/month with a $6,000 deductible. Our plan is a HDHP with an HSA, and my company contributes $3,000 to the HSA each year. For major medical the cost after deductible is 100% covered, so it's not an unreasonable plan. But sometimes what is and isn't covered just hurts. For reasonably healthy people, we're rarely if ever going to reach the deductible each year. So we're paying premiums primarily in case of an unexpected major medical emergency.

My husband was just diagnosed with Type 2 diabetes, and you would think great, at least we'll have that covered. But they don't even cover the lancets he has to buy every month. How can you not cover something like that for a diabetic? It doesn't even count toward the deductible. I just don't understand.

My parents struggled and we never had insurance growing up. Somehow they always made it work. It's tempting, but with a baby on the way we don't want to take that chance. And of course the premiums will jump another $150/month. Just one of those things, I suppose.
 

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Bill Clinton just railed on the ACA:

Bill Clinton Rips ObamaCare: 'It

“You’ve got this crazy system where all the sudden 25 million more people have healthcare and then the people are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half,” Clinton said.

“It’s the craziest thing in the world,” he said…

He hinted at what has been a rough summer for ObamaCare, with double-digit premium hikes in many states and the high-profile departures of many insurers – a scenario that Republicans are grabbing hold of on the campaign trail.

“We gotta figure out what to do now on healthcare,” he said, adding that the current system only “works fine” if people are receiving the ObamaCare subsidies or are enrolled in Medicare or Medicaid.

“The people who are getting killed in this deal are small business people and individuals who make just a little bit too much to get any of these subsidies,” he said, arguing that the law does not give any new bargaining power for people struggling to pay their healthcare costs.
 

Saint_Ward

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I have just been trying to wrap my head around our own insurance plan. My husband and I got married last year, and my premium more than quadrupled when I added him as a spouse. For one person! That is not even the family plan.

We pay $360/month with a $6,000 deductible. Our plan is a HDHP with an HSA, and my company contributes $3,000 to the HSA each year. For major medical the cost after deductible is 100% covered, so it's not an unreasonable plan. But sometimes what is and isn't covered just hurts. For reasonably healthy people, we're rarely if ever going to reach the deductible each year. So we're paying premiums primarily in case of an unexpected major medical emergency.

My husband was just diagnosed with Type 2 diabetes, and you would think great, at least we'll have that covered. But they don't even cover the lancets he has to buy every month. How can you not cover something like that for a diabetic? It doesn't even count toward the deductible. I just don't understand.

My parents were poor and we never had insurance growing up. Somehow they always made it work. It's tempting, but with a baby on the way we don't want to take that chance. And of course the premiums will jump another $150/month. Just one of those things, I suppose.
That monthly rate for your HDHP is insane, but if it's going straight to 100% covered after deductible, that might be why, or is part of that $360 also your HSA contribution? Most others are 80/20 until OOP max. The HSA amount contributed by the company is pretty high though. 3000/year is just under half of how much you can put away per year tax free as a married couple.

I'm not up on the medical supplies, but when we needed a back brace, I was shocked how expensive it was (like $800). The medical companies have found a way to milk Diabetics now. My grandmother just took an insulin shot every day. She never checked her blood sugar, until she was in her 80's or 90's.
 

Saint_Ward

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Bill Clinton just railed on the ACA:

Bill Clinton Rips ObamaCare: 'It
Well, the big issue is that Rubio found a way to not help the insurance companies get compensated for the early year losses (I am going off memory, so that may be faulty). He passed some legislation or help up a payment. So, insurance companies started to pull out, because only the sick were joining, so now you have lack of competition and not enough healthy people to balance out their profits. That, coupled with many states not expanding Medicaid, has caused a group of people to fall between the cracks.

You're going to see growing support for a public option, where people can at least buy into Medicare or Medicaid. (probably medicare).
 
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Bleu Raeder

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I rescheduled and have now had the test. I'm probably sicker from writing the check than anything which will be found on the test.
 

Grandadmiral

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The medical companies have found a way to milk Diabetics now. My grandmother just took an insulin shot every day. She never checked her blood sugar, until she was in her 80's or 90's.
We I was diagnosed more than 30 years ago, it cost an arm and a leg for a meter. Nowadays, they give meters away for free, buy you're paying out of your *** for strips ($100 for 50). As I posted here and the other thread, insulin prices are just criminal.
 

dtc

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My insurance costs me $550 a month. At the end of the year insurance cost me far more than it's worth. There are a few cases where insurance would be helpful. Something like a cancer diagnosis or catastrophic care it would be worthwhile. The odds of a catastrophic injury happening outside of work or in a car accident are quite low. If it's in a car, my car insurance would cover it. If it's at home my home owners would cover it, if it's at work then workers comp would cover it. So basically the odds after factoring that it becomes tiny. .
Your car insurance isn't going to likely carry enough limit to cover a major accident.

Your homeowners insurance isn't health insurance and also isn't likely to cover you at all if you fall off your roof.

If you were to fall off your roof and break your back you can expect a life of poverty and medicaid unless you have health insurance.

If you think worker's comp in Mississippi is going to cover you with first class care if you get really hurt at work, I'd beg to differ.

I agree insurance is a scam and that the costs of medical care are obscene, but I hope nobody reads your post and decides that they're better off without insurance because as a person who might have spouted the same stuff you just did a few years ago, I learned what really happens when even the mildest cancer diagnosis meets your family.
 

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