Insurance

[Daren Todd]

Has anyone else noticed some wonky changes in there insurance after the first of the year?

Had to go to the docs today for a back issue. Apparently it wasn't my back, but my hip popped out of joint Anyway, noticed on my new insurance card it didn't list any co-pays. So when I got to the docs, I asked if they could look up my insurance. It used to be 25$, 50$, 100$ for a copay. Insurance coverage was excellent since it's only me on the policy so we could afford the difference for the premium plan. My wifes work pays for her insurance. Max out of pocket was around 4k if I happened to be accident prone and end up with a hospital stay. My average for going to the doc's is between 2 and 4 times a year at 25$ a pop before. Today cost me $90

Insurance switched this year to a 480$ deductible for office visits, and then 20 percent till I hit 5k max out of pocket So now I'll be around 380$ for my average office visits. Which still isn't too bad. But...... my coworker who had the same plan and happens to have 3 kids on the insurance plus his wife, is gonna be eaten alive. The 480$ deductible for office visits is per individual

 

[RCW]

Ya' see, it's the implementation of our President's Health Care Plan, otherwise known as Obamacare.

EVERYTHING costs more now especially for employers, but employees too. More people have to be covered by law. More scrutiny is given to affordability of premiums. Tax credits are given to some for premiums. More services must be covered.

Only way to accomplish that is to spread it thinner.

I have some other names for it!!

It's not gonna get better.....trust me on that one.......

 

[Diydave]

if you like your doctor, you can keep your doctor...

 

[skeets]

Yeah well the FEDs decided that they were no longer going to carry my ins, and I had to find a new one off the list,,, coast 2 times as much and everything is higher,,,, I aint gona say no more or I WILL get banned,,

 

[Grouse Feathers]

Not to worry when everyone who has the subsidized coverage starts going to the doctor for a headache or a scratch, you will have to wait 6 months for an appointment for your dislocated hip. Ask our friends from the GWN how socialized medicine is working out. By the way where will you guys from up north go for health care when our system is as good as yours.

 

[OldeEnglish]

Ouch Darren! It's going to get to the point where it's not worth paying for the insurance every week. The whole system is mess... I'm fortunate my wife has an excellent policy, and her company pays our deductible. I feel sorry for you folks that have taken all of the burden of paying to insure the "entitled," the working class always gets stuck with the crap end of the stick.

Hopefully they will get the raise they have been asking for. That way their income will bring them into a working man's or woman's world when they make too much money to qualify for benefits. Then they will find out what it's like to have to pay full price for everything, the real world.

 

[Humblebub]

Daren, that is really interesting. Many of us in Canada do not understand the new US system. I have been in Canada for 40 years and watched our system go from excellent to marginal and now working back to pretty good. Our system has saved my life twice and 6 weeks ago saved my wife's life. My observation is if you are really sick here you do not wait and have reasonable quality care. If you go to emerg because chicken nuggets hurts your tummy you are in for a long wait.

 

[Daren Todd]

Humblebub, They (work) had told us in November that we had to go online and approve our deductions for our insurance. But there's this little option on there that if you wish to keep it the same with no changes, you just clicked on a button that said no changes and then submit it. We didn't realize that they had done away with the insurance plan we were on and it automatically signed us up for the next best plan. It was mine and my coworkers fault for not looking at the insurance plans in depth.

Our insurance is privatized. With different options based on who our employers choose to go with.

As far as waiting to see the doc, we choose our own doctor, or some insurances use a walk in clinic to supply care for the patient. On mine, I don't need a referral to see a specialist. If I decide I need to see a dermatologist, ect... I can just go. We just make an appointment. Yesterday, I had to see someone besides my normal doc, but if I wanted a second opinion besides what that person said, I could have had him flag my doctor down for a consult.

As far as an emergency, we can go to a walk in clinic (usually cheaper) or to the ermegncy room at the hospital. It depends on what the complaint is, and you use your own judgement. If you have a sinus infection, sprained ankle, broken finger, ect... and can't get a work in appointment to see your doc, then the walk in is the better choice and your seen in the order on the sign in sheet.

At the emergency room, your seen based on the priority of the illness or injury. Few years back, I had to take my wife to the ER, for an allergic reaction to some medicine she was taking. She got a fast track and bumped to the head of the line. They took her back for treatment while I was still checking her in. Now if she just had a tummy ache, we would have waited for hours.

Now I couldn't explain how Obama care works.

 

[D2Cat]

If this keeps up, soon we will need insurance to cover what isn't covered by insurance.

Kind of like medicare. Gov't provides some basic Dr. and hospital coverage, but more complete coverage requires another plan (an Advantage or Medigap plan).

There are some truths in life. They work whether you believe them or not. Gov't policy makers don't seem to believe them!

1. When your out go exceeds your income, your up keep become your down fall. (ought to be taught in grade school, but you can't learn it at University either)

2. When you take from the "Haves" to give to the "Havenots", soon the "Haves" will work less.

There's a few more........

 

[Humblebub]

Darin, thanks. It has been 40 years since I left NYS so that helps. In many ways the access part is similar - though we are required to have referral to specialist and there are not enough of them - unless you are ultra sick and jump to the front. Same here with docs, walk in clinics etc. The big difference, of course, is payment. Most provinces you pay through income taxes and I have never seen a medical bill. West Coast province pays separately and I am told it is $134 per month for a couple.

Meds are another story. Private insurance looks after the cost or you pay. After 65 most provinces have a Medicare type program where prescriptions are maxed at a certain cost. Here on the East Coast I pay a maximum of around $16 per script if the med is on the approved list.

No system is perfect but the Canadian system has some benefits. The one part that I support is that regardless of station in life you have access to good care. Here some well heeled individuals who prefer not to wait will go to various for pay diagnostic clinics and some will go to Boston to the Mayo. That is a rarity as few can afford the $5000 USD minimum and those that do usually come home with the same advice / outcome.

 

[Daren Todd]

Humblebub, I have really good insurance through work. But other people insurance here varies drastically.

My prescription drug coverage varied. Before the company was bought out, I was paying 50$ for a prescription acid reducer for an ulcer. There was only a name brand drug available that my doc wanted me on. After it healed I was able to get generic prilosec for around 19$ per month. And was happy to pay it. The scary part was the full price for the name brand drug was cheaper then the full price for the generic prilosec. The pharmacy listed the full price on the reciept.

After the buy out, I was locked into using one pharmacy, which the closest one was 60 miles away Had to use there mail order for maintenance drugs I could use a local pharmacy for a prescription that was needed immediately like an antibiotic. It took me 24 hours worth of phone calls to get my prescriptions straightened out. In the mean time I was supposed to be either paying 10$ per month or 20$ for a 90 day supply. The billing was horrid and was getting charged 40$ per month for the two prescriptions. And I was never able to get a refund for what I was supposed to be paying

This same company tried getting the nursing home that my wife works at to switch and use them instead. She stopped the guy 30 seconds into his sales pitch in there morning meeting and asked what company he represented. As soon as he said the name my lovely wife proceeded to tell him what she thought of there service and billing. And that there was no way in hell that she was gonna deal with them for 150 people. Then threw him out of the building

I'm still locked into using them, but they have a pharmacy in town now which is much easier to deal with. One prescription costs me $20 for a 90 day supply, and the other is 3.85$ per month. The cheaper one, they aren't running through my insurance. If they ran it through my insurance it would be 10$ per month Go figure, on some meds you pay a higher price using your insurance

 

[D2Cat]

Now Daren, you say, "This same company tried getting the nursing home that my wife works at to switch and use them instead. She stopped the guy 30 seconds into his sales pitch in there morning meeting and asked what company he represented. As soon as he said the name my lovely wife proceeded to tell him what she thought of there service and billing. And that there was no way in hell that she was gonna deal with them for 150 people. Then threw him out of the building."

Are you sure this is the same woman that has that baby doll shepherd pup?

 

[Daren Todd]

Yup she's sweet when she wants to be. But she can make a badger look tame also


Sent from my iPhone using Tapatalk

 

[Diydave]

Humblebub, I have really good insurance through work. But other people insurance here varies drastically.

My prescription drug coverage varied. Before the company was bought out, I was paying 50$ for a prescription acid reducer for an ulcer. There was only a name brand drug available that my doc wanted me on. After it healed I was able to get generic prilosec for around 19$ per month. And was happy to pay it. The scary part was the full price for the name brand drug was cheaper then the full price for the generic prilosec. The pharmacy listed the full price on the reciept.

After the buy out, I was locked into using one pharmacy, which the closest one was 60 miles away Had to use there mail order for maintenance drugs I could use a local pharmacy for a prescription that was needed immediately like an antibiotic. It took me 24 hours worth of phone calls to get my prescriptions straightened out. In the mean time I was supposed to be either paying 10$ per month or 20$ for a 90 day supply. The billing was horrid and was getting charged 40$ per month for the two prescriptions. And I was never able to get a refund for what I was supposed to be paying

This same company tried getting the nursing home that my wife works at to switch and use them instead. She stopped the guy 30 seconds into his sales pitch in there morning meeting and asked what company he represented. As soon as he said the name my lovely wife proceeded to tell him what she thought of there service and billing. And that there was no way in hell that she was gonna deal with them for 150 people. Then threw him out of the building

I'm still locked into using them, but they have a pharmacy in town now which is much easier to deal with. One prescription costs me $20 for a 90 day supply, and the other is 3.85$ per month. The cheaper one, they aren't running through my insurance. If they ran it through my insurance it would be 10$ per month Go figure, on some meds you pay a higher price using your insurance

Darren, I have found it easier and cheaper to use North Drugs, in the great white north, on some newer, more expensive drugs, like half the price of the US stuff. One comes from the Island of Venuatu, near Austrailia. Once the meds go off patent, though, they stop stocking them...

 

[Daren Todd]

My coworker is really getting run through the coals on these new insurance plans. To the point, where he's fixing to cancel the insurance and take the penalty on the taxes. He found out last week, the medication his kid takes is not on the "approved" list of medications. They either have to switch the kids medication to something that they know does not work, and try that first. Or burn through a $3000 deductible before insurance picks up the cost. The meds cost 250$ per month. So no chance of hitting the deductible. On top of that, he pays $6000 a year for insurance for his family.