I hate my health insurance

[LD1]

I find it hard to point the finger at the doctors office
hough. Cause they have do deal with dozens of carriers and hundreds of different policy variations. I understand that it would be impossible for them to know the ins and outs of every patients policy. And they have to have some sort of standard way they bill, and can't possibly do it differently for everyone.

And if I understand things correctly, they only bill the insurance company as a courtesy and are not obligated to do so.

I am starting to think that I would just be better off going in and saying I don't have insurance ( and get the cheaper rate), and when its all said and done, forward my expenses on to the insurance for reimbursement. No question I would still be out the $3k. But I met my 30% coinsurance would be less.

 

[Mickey_Fx]

Boy, have times changed. When we had our kids, insurance didn't cover pregnancy as it is not an illness. Like any business, insurance companies are run differently, some better than others. If you look at the data, on the whole medical insurance Co's. profit margin is ~5%.

Differences in rates based on whether you have insurance or not. You can write that off to Drs and Hospitals trying to recover that lost revenue to those they serve and either can't or don't pay. You can add in people wanting more things covered but not wanting to pay the price and all that service must be provided perfectly or it's going to end up in the courts. Much of our problems could be taken care of by tort reform. I had the opportunity to observe open heart surgery while standing at the head of the patient. At one point I said something about the qty of people and equipment being used. A Dr replied that in (forgot which country he mentioned) they had the same success rate for the same procedure as here in the states and their OR was almost devoid of people and equipment but there, they didn't have any concerns over ending up in court. There, the medical profession doesn't have to practice defensive medicine.

We've no complaints about our medical insurance. The biggest concern in recent yrs is, if you are on auto-pay for your premiums, their billing system can't send you a bill.

Wife went through colon cancer a couple yrs ago. I doubt our out of pocket expense came to $800. $500 for the hospital stay and numerous $20 co-pays. Wife had her annual CAT scan last week and our cost was $50. No, we don't have any complaints. Our Insurance, Kaiser Permenete. They run their own clinics and hospitals. As we're on Medicare, our premiums, $138/mo for each of us.

 

[Bird]

I find it hard to point the finger at the doctors office
hough. Cause they have do deal with dozens of carriers and hundreds of different policy variations.

Yep, some of us are old enough to remember when our insurance was $100 deductible and then 80/20. And doctors didn't bill insurance companies. We paid the doctor, hospital, clinic, lab or whatever, got a receipt and mailed it in with a one page claim form.

 

[MoKelly]

I am starting to think that I would just be better off going in and saying I don't have insurance ( and get the cheaper rate), and when its all said and done, forward my expenses on to the insurance for reimbursement. No question I would still be out the $3k. But I met my 30% coinsurance would be less.

Not that you really should try this --- but --- I woul dbe interested in what happens. I would be afraid the doctor's office wouldn't even want you to stay.

MoKelly

 

[JBourquin]

My wife used to work in the medical billing department at Bassett Health Care. She told me the Amish patients got something like a 30% discount because they always pay cash. Don't really know how that fits in here but this thread just reminded me of it..

 

[aczlan]

The fact that our insurance covers all office prenatal stuff is a bit deceiving, since I have now found out in the "Real-world", only the first appointment is billed as such. And obviously, my preference would be to get as much as possible billed as prenatal:mur:

Sounds like your wife's doctor needs to bill prenatal appointments as prenatal appointments... We had our 2nd last fall and the prenatal appointments were all billed as prenatal so they were covered by BCBS.

Aaron Z

 

[Dr_Zinj]

I'm insured under TRICARE. Only had to risk my life for 22 years to get it.

 

[JBourquin]

I'm insured under TRICARE. Only had to risk my life for 22 years to get it.

That's another funny one. When I got out of the military I lost Tri-Care. It is offered to Reserve/Guard guys as Tri-Care Reserve but since I had accepted a DOD position I wasn't eligible and had to get it through my employer. Still haven't figured that one out.

 

[LD1]

Mokelly: I don't think the doctor would lick us out. Because one of my calls questioning things and talking about how bs insurance was, she even mentioned the kind of discounts they give people with no insurance. Discounts on par with the discounts I get for being "in network"

Aaron: I questioned this billing globally. They said it was the ONLY way they bill. No other options. And that its standard practice across the board.

 

[aczlan]

Aaron: I questioned this billing globally. They said it was the ONLY way they bill. No other options. And that its standard practice across the board.

Odd, I know every time we went in for a prenatal, it was covered 100% by our HDHP... Perhaps paying cash, then submitting it yourself is the way to go...

Aaron Z