| T O P I C R E V I E W |
| FebruaryViolet |
Posted - Jun 16 2010 : 06:23:37 AM
We have a craptastic insurance plan that I pay $400 a month for, plus a $6,000 deductible to satisfy...preventative care is supposed to 100% covered. Which is why the only time I go to the Doc is for my annual gynecological visit (b/c they hold birth control hostage unless you actually MAKE an appointment) or take Violet for her vaccinations/well visits. We don't go otherwise--we can't afford it!
So, I was roped into making my annual appointment, and I received my "coverage summary" from my insurer yesterday. They covered the "preventative examination" but not the "office visit" which was $85.00. When I asked the insurer "what" the office visit was, she asked me if I had "talked with my doctor about any medical issues..."??????
So, let me get this straight: I can go to the doctor, but when he asks me if there's anything I want to discuss about my health, I should just keep my mouth shut because it's going to cost extra? Seriously? He was in the room all of 15 minutes, he told me that I didn't have any issues, and then he was gone. My opinion is that if I see a doctor once a year, there MIGHT be things that come up during that time that I'd like to discuss with him...but I assume that's the wrong idea. Doctors aren't supposed to care about you or your health. Just money, apparently.
I'm sorry, but unless I get hit by a car or fall off a 3 story building, there is absolutely no reason to have insurance.
Musings from our family in the Bluegrass http://sweetvioletmae.blogspot.com/ |
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| Betty J. |
Posted - Jun 21 2010 : 07:25:02 AM
Sue, I've been wondering about the UK medical care, as well as all the other European care that is given. I would gladly pay more taxes to have the care you folks have. I don't know why Americans are so allergic to taxes when the benefits are so great.
Betty in Pasco |
| graciegreeneyes |
Posted - Jun 21 2010 : 07:16:31 AM
It's nice to have your perspective on your insurance Sue - we don't tend to hear that here.
I'm thankful that my insurance is what it is - not as good as it used to be but really very good - I would probably have to choose no insurance if things changed much.
Amy Grace
Farmgirl #224
"use it up, wear it out, make it do, or do without"
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| goneriding |
Posted - Jun 21 2010 : 07:02:54 AM
I have insurance thru my job but otherwise, we'd be non-insured. I've gone for years without insurance and did just fine. Even when a horse walloped me or whatever, just went to the ER and then paid up. It was cheaper that way.
I knew of a family who took a 'chance' and put all their 'premiums' away in a sock or savings account. Then one day, the dad had to have heart surgery. The surgeon (or someone) asked him who was gonna pay for the surgery and the man said he was. The surgeon was confused, couldn't take it in that there wasn't insurance. But the family had saved it back and was able to pay the whole thing, just from saving the premiums plus the discount for paying cash, which was about 30%.
I feel for you, it really seems that the docs are trying to squeeze every penny out, which I guess if I were in their shoes, I'd be worried too.
An idea which works for us country bumpkins in my neck of the woods...there is a PA who only charges $50 for lock, stock and barrel. He's not a doctor but seems to be able to do all the regular office type things...pap smears, draw blood and some testing, that sort of thing. Emergencies still need to go to the hospital but he's there for sprains and cuts. Maybe you could find someone like that locally??
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| sue5901 |
Posted - Jun 20 2010 : 11:29:51 PM
Louisvillemum - I'm sorry for your friend as she seems to have been trhough a really rough time lately but if this actually happened how it reads in your post your friends FIL needs to go back to their GP and start legal procedings against them. If someone needs an essential operation in the UK - and the loss of the use of an arm would be an essential operation - it is not only unheard of for them not to get the surgery but their local health authority would be acting illegally.
Until my daughter became a firefighter 6 months ago she worked booking appointments for the NHS and all essestial operations had to be booked within the timescale dictated by the Dr and non urgent had to be booked with 18 weeks - by law!!!
If she couldn't get the patient into a local hospital in that time she had to search all the hospitals in the UK to find a date including all the private ones and if that failed then they started looking abroad - the NHS would pay for it all.
I am having a minor non-urgent operation done soon year where the NHS are paying for me to go to a private hospital because the NHS ones could only book me in whilst I was away on holiday so they had to find me somewhere that could do it within the timescales without it clashing with my pre-booked social arrangements. The days of us having to wait years for surgery are long gone back in the 70's. If the Dr considers it can wait then we may have to wait longer than we would personally like - and that is why some people choose to use private Drs but we never have to wait longer than we need based on clinical medical assessments.
As i said in my post there are problems with our healthcare system but getting essential medical care when it is needed is not one of them - absolutely not!
Dance like nobody's watching! |
| MagnoliaWhisper |
Posted - Jun 19 2010 : 11:55:57 AM
true Kathryn I had to do that years ago about my insulin!
See, insulin only lasts (is good for) 30 days after bring opened. At the time it only came in a certain size vial. I was on two different insulins, one for fast acing (after meals) and one long lasting (to regulate the blood sugar 12 hours at a time). any way, the fast acting one I could use a whole vial in less then 30 days and that was fine. The long lasting one, I didn't need the entire amount that came in the vial with in 30 days. The amount I was on, if I was to use the whole vial would last about 2 months. (60 days). So the insurance only wanted to provide me with one vial every two months. I called them, and told them that I needed one vial a month, and they said no that I was only using the amount of units that I could use one vial every two months. I said, but the papers that come with the insulin say it's only good for 30 days. They said, that didn't mean anything, that the insulin company just puts things like that in their paper work to make you buy more.
I said, well, I didn't care why they put it there, but I thought I had the right to go by what they suggested and get a new vial every 30 days!
I also asked the person on the phone her name, and if she was a pharmacists or a dr, and if she could swear that expired insulin would regulate my blood sugar. And if she was sure she wanted to be liable for me going into DKA, and possibly dieing. And that if I did die from expired insulin being inadequate in regulating my blood sugar was she ready for my family to sue her.
After several phone calls like that, the insurance finally agreed, I could have unexpired insulin each month. YEAH, we live in America for goodness sakes not some third world country. It's sad, I was having to beg like some kind of less then human thing, to just have what should be a right to have-unexpired medication! Makes me angry just remembering it. Because, a lot of women in my church have my same insurance, have diabetes, that is way out of control (even some are going blind from it, my husband's grandmother has lost her leg from it!) and I wonder, are they just doing what the insurance says and using expired medication, and could this be one of the reasons? UHG utterly rediculous!
http://www.heathersprairie.blogspot.com |
| magnoliakathy |
Posted - Jun 19 2010 : 08:07:13 AM
Yep insurance is a rip off, you have to get mean and persistant on the phone to get what you want. Always ask for a supervisor the 2nd time and every time after that when you call. My hubby is allergic to wasp stings, we made a trip to the ER in Oct. 2008, it took until March 2009 to get them to pay for a $650.00 antivenom shot. They kept tell me it was a car accident and they could not pay for an antivenom shot for a car accident. I kept track of every name I talked to, every date I called and even the time. Fianlly, after six months, lots of phone callls, and two copies of the ER aperwork, they paid $575. Most insurance companys will not pay anything until the third call, if you don't keep calling, they keep denying. You paid your premimus, call every week, get loud and don't give in. Always works for me.
When you free your mind your heart can fly. Farmgirl # 714, |
| Candy C. |
Posted - Jun 18 2010 : 5:41:51 PM
I know how all of you feel!! I am self-employed and some days I feel like I am working solely to pay for my health insurance which I haven't even used yet but the premium went up!!  
Candy C.
Farmgirl Sister #977
Go confidently in the direction of your dreams. |
| Bear5 |
Posted - Jun 18 2010 : 5:09:38 PM
Jonni:
I thought you were descripting my medical insurance and my last doctor visit. I have no respect for medical insurance or my doctor. So sad. I say people need to stand up and not take this crap anymore. The doctor never does help me. I fainted once in his office and he ran away from me. I asked why. He said he didn't want me to throw-up on him. What a sissy! I go for the exact reason Jonni goes to the doctor. It is all a reap off to me. I'm glad to see someone is speaking out about such crap! Thanks, Jonni.
Sorry for my rant.
LOL
Marly
"It's only when we truly know and understand that we have a limited time on earth- and that we have no way of knowing when our time is up- that we will begin to live each day to the fullest, as if it was the only one we had." Elisabeth Kurler-Ross |
| OneCraftyBugger |
Posted - Jun 18 2010 : 12:48:39 PM
Its ALL so insane!
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| MagnoliaWhisper |
Posted - Jun 18 2010 : 12:38:21 PM
Thanks Alee, I literally don't know what I would do otherwise. I think, I would be forced to go to the ER, and try to get them to admit me or something. But, sad thing is they probably wouldn't do a thing till I was already in DKA! It's crazy really.
http://www.heathersprairie.blogspot.com |
| Alee |
Posted - Jun 18 2010 : 11:41:33 AM
Heather- That is so frustrating! *hugs* I am so glad you have a doctor in the family that can help you!
Alee
Farmgirl Sister #8
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| MagnoliaWhisper |
Posted - Jun 18 2010 : 08:54:22 AM
Kathryn, you can tell your friend, it could of been the same for her FIL even with insurance!
I have insurance, I also have type 1 diabetes! It was in remission for several years, and just came back a few months ago. I called to get a rx, because I need medication right away, as I have been in DKA before. DKA, is diabetic keytone acidoses. 75% of people die from it. Once you go into it once, it's easier and easier to go into it more times. Basically your body completely shuts down and begins to die. It's from having too high blood sugar (only type ones get it though not type twos). any way, I called to ask for a rx. They said there was no way she could prescribe me medication with out seeing me. And she can't see me for 4 months! I told them of me being diabetic, DKA, etc, and it all don't matter! Why can't I just get a rx, till the 4 months are up and I can get in? Policies. I could die in 4 months, literally. But, thank god my mother is a dr. She doesn't live in my same state though. I live in NYC and she is in Kansas. But, at least she was able to send me insulin and syringes (against the law to sell them over the counter in NYC, legal in the other states!). If it wasn't for that, I literally could be dead in 4 months, and insurance wouldn't care apparently. I called the dr they provide for the insurance clinics, and this was the wait I was told, no matter how emergency it is!
Hmm, so insurance or gov medical care. Well, I have friends in Australia with diabetes, and I never heard them have to wait 4 months to get medication at the chemist (their pharmacy). Same with my friends in Canada, and Sweden. Makes me sick, I'm paying for insurance, and if it was up to them, I'd die!
http://www.heathersprairie.blogspot.com |
| jclambert |
Posted - Jun 18 2010 : 06:06:08 AM
Jonni, I feel so bad for you and others in your situation. My husband and I couldn't afford private insurance if we had to pay out of pocket. Thankfully, I am a member of the Choctaw Nation and use their health care facility. It is absolutely free no matter what I need and the care is great. My husband uses the Veterans Admin. and it costs a very small amount in co-pay.
Some friends of mine had to drop their insurance because they are self-employed and their premiums went to around $800 a month. What a crazy system.
Judy
"Speak your mind and ride a fast horse" |
| LouisvilleMom |
Posted - Jun 17 2010 : 7:38:15 PM
My best friend in English (Manchester) and she is really torn on the issue of government provided healthcare. Her FIL needed surgery or he was going to lose the use of his arm. They could not schedule him for a year and that would have been too late. They had to pay thousands to go to a private doctor to have the procedure done. Now that being said her son almost died a few weeks ago and her dh is currently out of work so it was a blessing that they didn't have to worry about money when her son needed to be intubated and stay in the PICU.
I don't think there are any easy answers. My personal opinion is that we need to pay for the little things and that insurance should be used for catastrophic things, terminal illnesses and debilitating illnesses/syndromes. Insurance and pharmaceutical companies are stealing from everyone.
SAHM mom to four great boys.
http://ksfarnsworth.blogspot.com/ |
| Alee |
Posted - Jun 17 2010 : 5:43:53 PM
Heather- exactly right! Other than my pregnancy living without insurance wasn't really too bad. And it would have been fine if I had been disciplined enough to put away a health savings account! :D
Alee
Farmgirl Sister #8
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| sue5901 |
Posted - Jun 17 2010 : 2:16:38 PM
My Mum was taken seriously ill around the time the big debate was going on in the US about medical care and I remember sitting in the hospital thinking I couldn't imagine having all the worry of my Mum's health plus the worry of money or even just making a claim at the same time. And I simply don't know how you guys manage to make some of the tough choices you mention above.
There are problems with our health care system but knowing that when you need it, all the best medical care will be provided, as much as is needed for as long as is needed, totally free, is something I simply can't imagine living without.
Sue
Dance like nobody's watching! |
| knitnpickinatune |
Posted - Jun 17 2010 : 1:35:24 PM
I pay $214 a month for my coverage,and yet when I went for a check-up last Dec.,which didn't include a urine sample because I was in my cycle,I still had to pay $140 something for tests, The dr was hardly in there- the staff took blood,my temp,looked in my ears.blood pressure reading,EKG,(why I don't know) I couldn't believe it-dr was in long enough to ask if I wanted a flu shot,if I had a tetnus booster,(I did at his office & they didn't record it) and that was with a $30 office visit fee. I'm wondering what the $214 a month is really for...interestingly enough,Insurance Co's in California are being investigated as to why they keep raising the rates annually on healthy people like myself. Honestly,the monthly fee keeps me from an annual. I get a check up every 3 years. Later this year I'll see a OBGYN for a pap but not till either the biz is doing a lot better or it's really busy at the college and I have a fat paycheck.
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| MagnoliaWhisper |
Posted - Jun 17 2010 : 12:41:32 PM
oh btw, Alee, I think your idea of the state children's insurance is good too. I can tell you, because our insurance is so crazy and barely pays for anything, I've had to talk to drs about cash transactions for a lot of things for my daughter. All the drs I have went to (I always seek out the best since I'm paying out of pocket any way) have offered, with out me even bringing it up a discount, because I am paying cash instead of insurance. And usually a pretty good discount at that. I was shocked how cheap I have gotten things.
So I think if she used the 400 a month she is paying for insurance and put it in a account for a emergency, and waited the 6 months she would probably be just as safe too.
Another thing to think about is, they have to give you medical care in a emergency regaurdless, so you don't have to worry about not getting care. And then youc an usually work something out afterwards, in the unusual event something were to happen in that 6 months. I think insurance companies have people scared you can't live with out them, and there is no way. But, I've done a lot with cash and with out the insurance, and most offices/hospitals are more then happy to negotiate, and work things out.
http://www.heathersprairie.blogspot.com |
| MagnoliaWhisper |
Posted - Jun 17 2010 : 12:36:53 PM
Yeah that's what I was thinking Alee. If my mom wasn't a dr it is who I would be having to go to. My stupid insurance won't pay for birth control. Hmm, nine months of a high risk pregnancy, with literally dr visits 5 days a week because of my medical problems, and pregnancy, or birth control, which is cheaper? hmmm? so stupid!
http://www.heathersprairie.blogspot.com |
| Alee |
Posted - Jun 17 2010 : 12:30:29 PM
Heather- I was just thinking the same thing! When I was in college I went to planned parenthood. If you made a decent wage they do ask you to pay a nominal fee, but they do a womanly exam with no silliness about paying for an office visit and they can give you birth control also at a very reasonable cost.
Alee
Farmgirl Sister #8
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| MagnoliaWhisper |
Posted - Jun 17 2010 : 11:44:18 AM
Violet, do you have a planned parenthood? It seems to me that my sister in law was getting a birth control shot from there for 15 dollars every 3 months. Maybe they would help you better.
And to miss Canada, here, here. Isn't it said that we can't have health care as a basic human right here, but we are so "free"?
http://www.heathersprairie.blogspot.com |
| FebruaryViolet |
Posted - Jun 17 2010 : 11:15:36 AM
The frustrating part of this to me, is WHY I even had to GO to the doctor in the first place! After Violet was born, I went back on bc pills...they gave me a prescription until my annual examination time came round. They WOULD NOT give me another prescription until I came in for my annual appointment. Not to be too open with you gals, but, I've been on birth control since I was 15 years old because of my weird cycle--I think I know by now that it works for me...I've NEVER had an irregular pap smear, and some docs don't ask you to come back for an annual if you've had a clear pap for 3 years in a row.
This was frustrating enough, that they basically hold your "rights" hostage until you bend to their will and make an appointment, but that in going to the doctor who delivered my baby, the doctor who I am supposed to be able to discuss "medical" issues with, well, because he's a DOCTOR, I can't even talk to because it costs $20.00 per minute to do so...I might have been better served calling telephone psychic!!!!
Musings from our family in the Bluegrass http://sweetvioletmae.blogspot.com/ |
| LouisvilleMom |
Posted - Jun 17 2010 : 11:12:38 AM
We have insurance because we have 4 kids and one is special needs. We pay over $10k out of pocket for premiums and deductibles and then they only pay 80%. It is ridiculous. The worst part is that dh worst for a healthcare company.
SAHM mom to four great boys.
http://ksfarnsworth.blogspot.com/ |
| Marybeth |
Posted - Jun 17 2010 : 10:50:56 AM
Several Doctors out this way have gone out of practice or opt to only take uninsured patients because according to them it is the insurance companies that dictate to the doctors what they should charge and even which hospital to send patients. The rate is significantly lower when paying cash.
Fortunately we have seldom had to go to a dr. Even when my children were little---I was Dr. Mom. MB
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| knittingmom |
Posted - Jun 16 2010 : 4:41:08 PM
I am so sorry to hear what you gals go through with your HMOs. I hope things change for you and your countrymen(and women). Basic medical coverage is a human right and citizens should not have to fork out huge insurance premiums (that's my Canadian view anyway)
I think it's ridiculous that your insurer refused to pay the $85.00, you're going to a MEDICAL DOCTOR, what else did they expect you to discuss but a medical issue isn't that what the doctor was trained for? What were you supposed to talk about instead the weather? gardening? how nice he was dressed?
I just don't understand the system in the States and how this became ok.
"There is no foot so small that it cannot leave an imprint on this world" |
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