Hey everyone, I was wondering what everyone's insurance coverage was? My work's insurance is really expensive so I can only afford the cheapest kind (which is normal cost for most companies) and I just found out it doesn't include any "lab" costs.. So any bloodwork, tests, etc won't be covered. I just got my bill from the lab for my latest Rheumy visit and 0 later... Anyone know how to get around this besides getting different insurance!?!?
Off topic a bit - same situation I have with my girl doc. I have had 2 biopies done because of "abnormal paps" and luckily they came back negative both times for cervical cancer. I had a different insurance when that happened and I didnt know they sent the tissue off to a lab and they sent it to a lab my insurance doesn't cover. So that was 0 out of pocket. Second time I was smarter and it was covered. But.. I need to go in again now and if it comes back abnormal and I have to have another biopsy then I'll have to pay the lab costs cuz of my current stupid insurance that doesn't cover labs! ugh!! I'm frustrated. I'm probably out of luck and just venting but insurance companies can be so stupid!!
This might end up being more of a venting about insurance thread...
Aw yes, the never ending medical bills for the chronically ill!!I'll just comment about two of my experiences.
I had an MRI once and found out afterwards that my insurance didn't renew their contract with this particular imaging company. While I didn't have to pay the entire amount, the copay for the out-of-network provider was a "hefty" amount. When I called the billing office at the imaging company and explained that I didn't realize they had dropped out of our network, they were kind enough to write off the excess amount and I didn't have to pay any of it.
Once when my insurance changed, my husbands doctor was no longer part of the network. His office visit was 0. We paid out-of-pocket. A year later when the doctors receptionist found out our insurance wasn't reimbursing us, they lowered the cost of the office visit to . I'm happy to only pay the , but it sure shows how much they are inflating the bill for the insurance companies.
I guess it pays to complain about the bill!
Julez~Do you have RA? (Sorry; find it hard to keep up with everyone) If so you should know that lab work is going to be a routine part of life on strong medications. Your insurance not covering your labs could get costly in the long run.
Could you increase your coverage so that it would? You should inquire about that and weigh the cost of the increased coverage against what you may spend out of pocket. RA labs on a lot of the medications range anywhere from 1 to 3 month. If you're paying for labs I imagine you'd have to pay for x-rays too right?
My health insurance is 9 a month. My employer pays 100% of that. I have a ,000 deductable that I rarely need to be concerned about. The only time it really comes into to play has been when I've had to have MRI's. All of my other cost is covered and that included a great prescription medication coverage which is worth it's weight in gold trust me. I'm not sure what your drug coverage is but that one is a HUGE one. When I was on humira weekly injections would have been over 00 a month! No way could I ever have taken that without that coverage. I paid out of pocket. Most of my meds are either , or and I take plenty of medication every month and I think that's where I see my real benifits from my insurance.
When I go to the doctor I just pay a co-pay. My RD and any other "Specialist" are and all other doctors are .
Yes I have RA, for 10 years now. I usually have lab work done about 2-4 times a year and my insurance has always covered it. Last time I had lab work done it didnt cost as much, less than I think. I guess the doc did a full blood work check this time :( I dont have to do xrays or mri's or anything like tho.
For doc visits, my current insurance isn't too bad. It covers most of normal expenses. If I were to switch over to the better insurance, it would cost 5x as much as I currently pay. And I think the main difference would be that it's a different company (Aetna vs United HealthCare) and that my labs would be covered. I think in the end, I am better off with the cheaper insurance and just paying the lab fees. Unless I get worse.
I didnt think about trying to get a discount for cash customers through the labs. I'll have to try that. My husband's work has a pretty good insurance policy. And it's cheaper. I'll have to get on that as soon as open enrollment comes up.
Ugh...I'm sorry but the more i read about insurance problems in the US the more I just can't understand why people are so against universal health care insurance. I know it's not your guys' fault but what are some anti-universal health care insurance USers thinking?Julez~I think you are doing the right thing for now, just staying with the plan you have and paying out of pocket for what you have to. Always have in the back of your mind though that RA is progressive and certain cost get higher as your problems get worse. You may never experience what I have but it's been my experience that after about the 8 or 9th year things got more costly for me. Luckily for me my insurance has covered the majority of it all. MRI's have honestly been my biggest expense and I didn't have to have those until about my 11th year. I've had three since then and the doctors have wanted to do others and I declined. For the most part they just confirm what we already know so I see little reason to have to meet a 00 deducatable unless it's absolutely nessesary.
If you have the opprotunity in the future to get on your Husbands plan I'd do that. It's sad it all has to be so complicated. I agree there's problems with the health care system.....but I have no idea what the right answers are.
I am fortunate to have really good coverage. Yes, dealing with theMY WIFES IS INSURANCE IS PRETTY GOOD IT'S BC BS 80/20 WE PAY 20.OO FOR SPEACILIST OR PCP VISITS 10.00 ON GENERIC MEDS AND 20.00 ON NAME BRAND NOW MY HUMIRA COST ME 35.00 FOR MY PART LABS ARE THE SAME WAY WE PAY 20.00 AND IF WE HAVE TO GO TO THE HOSPITAL FOR THE FAMILY IT IS 2000.00 A YEAR THAT WE HAVE TO PAY.
HOPE YOU HAVE A PAIN FREE EVENING.
"I wish it was as easy as moving money over from the defense fund to
health care, but that is not the way the Federal system works."
Mary, just because it doesn't currently work this way doesn't mean it
can't. Money is money....our government can make the decision to stop
spending money outside this country when we need some attention here.
It CAN be done.Unfortunately, that is not how the government works. Even if a bill was passed, the funds still must be appropriated. The US budget is divided by mandatory budget programs and discretionary. We have to fund the mandatory and the discretionary budget the money is divided up among all the programs.
Discretionary spending is about 1/3 of the Federal spending and the defense budget is included there. Medicare/Medicaid is in the mandatory portion of the budget.
The Department of Defense spends 3.7% of the Gross Domestic Product. In 2005 health care costs consumed about 16% of the Gross Domestic Product. Medicare/Medicaid spent about 5% of the GDP in 2005 at the federal level. Most people do not realize that each state pays for a portion of Medicaid and that is not included in most statistics of total spending.
Medicare/Medicaid usually pays only one half of the charges for health care. Where is the money going to come from? How is each state going to collect for their portion? My family already pays 28% income tax, plus 6.2% for Social Security and 1.45% for Medicare. Luckily, I live in WA state and we do not have to pay additional state income taxes.
I think that the real reform needs to be on the cost of health care. Again, I think competition would be very helpful. I would much rather have control over my own money and how it should be spent on health care.
Do I think we need to help those who cannot provide for themselves? Of course. Even with all the money the government takes we give away a substantial portion of our income. Our giving directly involves no administrative costs that reduce the amount to those who need it. Many American do this, we are an incredibly generous nation. Some of just don't like being "told" how to give our money and the "government" money is our money and it is our money.
Mary B,
I was going to chime in, and then got to your post. Unless you're in the healthcare industry, you really don't have a clue as to how much work is involved when submitting claims, etc. etc. Insurance companies do not make it easy for the providers.
Also - I hear people complain a lot about their coverage. The best way I can describe it....If you buy a shirt at Walmart and a shirt at Bloomingdales the quality will be very different. You need to research what your benefits are and decide if it is beneficial to pay more each month for better coverage, or pay less a month and "gamble" that you won't need a lot of services.
As far as doctors office's inflating the charge. We charge a patient without insurance coverage a smaller amount because it is a quick transaction. No dealing with the insurance companies is far less expensive for a provider than the hassle of submitting a claim.
Debrakay, the shirt analogy is good!Mary,
That was awesome how you broke the information down for people. I keep telling my kids not to look at the dollar figure for the jobs they may get out of college, to really dig into the insurance information as that can be more important.
Thanks Debra, I teach medical coding and reimbursement and sometimes it is confusing for my students and sometimes for me too. I am working on my thesis in Health Information and I came across this map. Lots of interesting breakdown, especially the one about uninsured by state.