| Author |
Across the Fence:  Medical insurance--who needs it? A "small" rant..  |
|
FebruaryViolet
True Blue Farmgirl
4810 Posts
Jonni
Elsmere
Kentucky
USA
4810 Posts |
 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/ |
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
Posted - Jun 16 2010 : 06:42:10 AM
|
Jonni- You might want to look into seeing if you can get State Insurance for Vi, usually the kids are easy to get covered and it's either free or EXTREMELY low cost- Like less than $100 a month. If we didn't have insurance where we work that is what we would do for Nora because I feel the same way you do. Sometimes I think doctors just think of ways they can phrase things on the bills so the insurance doesn't pay.
I would contest that fee with the insurer. Ask them how you were supposed to get the examination with out an office visit. Forgive me if this is a bit crude but I would much prefer my pap smear to be done IN the office as opposed to any other place. If they are paying for preventative care they need to pay for you to have it done in an office. That is just ridiculous.
Alee
Farmgirl Sister #8
www.awarmheart.com
www.farmgirlalee.blogspot.com
www.allergyjourneys.blogspot.com
Put your pin on the farmgirl map! www.farmgirlmap.blogspot.com |
 |
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
Posted - Jun 16 2010 : 06:44:12 AM
|
PS having a major problem aside- you could put that $4800 that you pay in insurance premiums into a savings account and slowly build up the additional $6000 and then you would have enough to handle just about any situation including and if you only did your yearly exams and little stuff for Vi, I bet you would still have $$ left over at the end of the year.
Alee
Farmgirl Sister #8
www.awarmheart.com
www.farmgirlalee.blogspot.com
www.allergyjourneys.blogspot.com
Put your pin on the farmgirl map! www.farmgirlmap.blogspot.com |
|
|
|
FebruaryViolet
True Blue Farmgirl
4810 Posts
Jonni
Elsmere
Kentucky
USA
4810 Posts |
Posted - Jun 16 2010 : 06:48:26 AM
|
Alee, we have something in Kentucky called the "KCHIP" program, that was designed for working families to have affordable coverage on their children. For Violet, it would be $25.00 a month, BUT, since she is already covered on my "fabulous" plan, we'd have to drop her coverage, leaving her uninsured for 6 months, then enroll her in the KCHIP program. I'm just a little bit squeamish about leaving her uninsured if something catastrophic DOES happen. But then, I'm so very frustrated by this whole experience, I might just bite the bullet.
I called the insurer and the doctor...my doc's office was rather unhelpful--she said, "if he's there for a longer period of time in discussion, we will often charge more." I told her he was there for 15 minutes, I received no "diagnosis" and no prescription for any new issue. It's unfair to charge someone an extra fee to come in to speak with a doc they see once a year. The pap was done in office, but the lab is outside. I feel like it's ALL a scam. Why go to the doctor at all if, when he says, "do you have any issues?" you can't afford to talk about your issues? It's like they should have a time clock running the second you set foot in the exam room--that way, if you're "over" your 15 minutes, you know it's $20 a minute for everything else you want to talk about. I would NEVER have thought that our discussion about my first visit a year after the birth of my child would have cost me extra money...it makes you feel like they really do NOT care about you at all, just money.
Musings from our family in the Bluegrass http://sweetvioletmae.blogspot.com/ |
|
|
|
ceejay48
Farmgirl Legend/Schoolmarm/Sharpshooter
13618 Posts
CeeJay (CJ)
Dolores
Colorado
USA
13618 Posts |
Posted - Jun 16 2010 : 08:09:49 AM
|
We don't have insurance either because it is TOO expensive and covers TOO LITTLE!!! But neither of us have it available to us from an employer. I learned a LOT about insurance when going through the "pay the bills" process in 2008 after my hubby's emergency gallbladder surgery and then, again, last fall when he had to have knee arthroscopy. A LOT about the excessive billing . .
We were able to quality for self-pay programs in both cases and, at least around here, there are significant discounts for self-pay patients and we are also able to set up payment plans with hosp. and doctors.
Insurance has it's place but it seems more and more that it is only helpful in the case of a catastrophe . . . and how the heck do you anticipate that? You can't . . so, for us, it's a step of faith and a lot of taking care of ourselves . . and prayer.
We don't have small children any longer . . . but we are getting closer and closer the the scenario of the ills and ailments of senior citizens.
It's a tough situation and tough decisions to be made . . . I hope you can get some resolution and something better for you.
CJ
..from the barefoot farmgirl in SW Colorado...sister chick #665
From my Heart - www.fromacelticheart.blogspot.com
From my Hands - www.cjscreations-ceejay.blogspot.com
From my Hubby - www.aspenforge.blogspot.com |
|
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
Posted - Jun 16 2010 : 09:07:17 AM
|
Jonni- I think it's a personal decision but unless something horrible happens, it couldn't too much more expensive than what you deductible plus premiums are! That's horrifying! I went through pregnancy and labor with Nora without insurane. That was horrible. It was $13,00 and we are still paying for it. Other than that during Nora's first 3 years we have had the normal well baby checks (Let's assume $150 each), immunizations that we do at public health for a donation or minimal charge and no office fee (usually a full round is less that $10 plus a general health check), we have had 2 emergency room visits- one for a minor injury (nurse maid's elbow when she slipped off the bed) and a horrible allergic reaction. Of course we have had the various colds and such, but all this was spread out over 3 years and even the ER visits were never more than $700 each.
I remember when you posted that your work was going to stop paying for your insurance. I think it's horrible when companies do that to their workers. It really lowers the effective wage. *hugs* I hope whatever you decide that you guys get a break soon.
Alee
Farmgirl Sister #8
www.awarmheart.com
www.farmgirlalee.blogspot.com
www.allergyjourneys.blogspot.com
Put your pin on the farmgirl map! www.farmgirlmap.blogspot.com |
|
|
|
Mikki
True Blue Farmgirl
1510 Posts
Mikki
Austin
Indiana
USA
1510 Posts |
Posted - Jun 16 2010 : 10:14:59 AM
|
I don't have insurance either. I can't get insurance for myself because I have had to many health problems and the only place that would insure me wanted 700 dollars a month. Now I have to have scans every three months because of spots on my lungs to make sure they aren't growing or spreading, rather than having a biopsy. I have to go to the dr often for her to continue to give me my blood pressure meds because she likes to monitor me, and it's costing a fortune. Some tests I have just declined because I can't afford them. It's a shame.
~~Blessings, Mikki Jo
"Courage is being scared to death... but saddling up anyway" ***John Wayne
http://main.acsevents.org/goto/iloveyoumom
http://burningmeadowsprings.blogspot.com/
|
|
|
|
kristin sherrill
True Blue Farmgirl
11303 Posts
kristin
chickamauga
ga
USA
11303 Posts |
Posted - Jun 16 2010 : 4:23:17 PM
|
This is why I don't go to a doctor unless I have to. I did go the other day for my finger. They took x-rays. I have no idea what that will cost. But I didn't have to pay a co-pay then. I can't afford to go to my gyno because our insc. doesn't pay anything anymore. Or for mamograms either. And for just my hubby and I our insc is $143. a week. I can't afford to go. My hubby has to have insc with all his medical problems. And it keeps going up too.
I can understand your frustration, Jonni. It's all in the way they code the insc carriers. And if there is a diagnosis too. You have to have a diagnosis for the insc to pay anything anymore. I had gone to a doctor a few years ago and I could hear the nurses trying to come up with a diagnosis for me. If you talk to the billing dept. sometimes they will work with you. It's worth a try.
Kris
Happiness is simple. |
|
|
|
knittingmom
True Blue Farmgirl
665 Posts
AnneMarie
Edmonton
Alberta
Canada
665 Posts |
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" |
|
|
|
Marybeth
True Blue Farmgirl
6418 Posts
Mary Beth
Stanwood
Wa 98292
USA
6418 Posts |
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
http://www.smallcityscenes.blogspot.com
www.day4plus.blogspot.com
"Life may not be the party we hoped for...but while we are here we might as well dance!" |
|
|
|
LouisvilleMom
True Blue Farmgirl
246 Posts
Kathryn
Louisville
KY
USA
246 Posts |
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/ |
|
|
|
FebruaryViolet
True Blue Farmgirl
4810 Posts
Jonni
Elsmere
Kentucky
USA
4810 Posts |
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/ |
|
|
|
MagnoliaWhisper
True Blue Farmgirl
2817 Posts
Heather
Haysville
Kansas
USA
2817 Posts |
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 |
|
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
|
|
MagnoliaWhisper
True Blue Farmgirl
2817 Posts
Heather
Haysville
Kansas
USA
2817 Posts |
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 |
|
|
|
MagnoliaWhisper
True Blue Farmgirl
2817 Posts
Heather
Haysville
Kansas
USA
2817 Posts |
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 |
|
|
|
knitnpickinatune
True Blue Farmgirl
1140 Posts
Sherrie
Gardena
California
USA
1140 Posts |
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.
http://www.mandolinbabe.info
http://www.mandolinbabe.net
@MandolinChick on Twitter
mando pickin & fiddle sawin' Farmgirl #702 |
|
|
|
sue5901
True Blue Farmgirl
122 Posts
Sue
Wellingborough
United Kingdom
122 Posts |
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! |
|
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
|
|
LouisvilleMom
True Blue Farmgirl
246 Posts
Kathryn
Louisville
KY
USA
246 Posts |
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/ |
|
|
|
jclambert
True Blue Farmgirl
149 Posts
Judy
Stringtown
Oklahoma
USA
149 Posts |
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" |
|
|
|
MagnoliaWhisper
True Blue Farmgirl
2817 Posts
Heather
Haysville
Kansas
USA
2817 Posts |
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 |
|
|
|
Alee
True Blue Farmgirl
22937 Posts
Alee
Worland
Wy
USA
22937 Posts |
|
|
MagnoliaWhisper
True Blue Farmgirl
2817 Posts
Heather
Haysville
Kansas
USA
2817 Posts |
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 |
|
|
|
OneCraftyBugger
True Blue Farmgirl
626 Posts
R
USA
626 Posts |
|
|
Bear5
True Blue Farmgirl
13055 Posts
Louisiana/Texas
USA
13055 Posts |
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 |
|
|
|
Across the Fence: Medical insurance--who needs it? A "small" rant.. |
|
Medical insurance--who needs it? A "small" rant..
