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  1. #1
    KivaDiva Guest

    Default Health Insurance Rant

    So I had a baby in February. I pay about $300 per month for a ppo health insurance. Now I have a $3000 bill for a c-section (3 day stay for me) and a 4 day stay for the baby. Why do I have health insurance. Just had to vent. I know some have it worse (and others better). Just frustrating when I know someone who was on Medacaid (or whatever the state aid program was) that paid nothing 2 weeks after me.



  2. #2
    Join Date
    Oct. 22, 2003
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    1,884

    Default

    Not to be a bitch, but you should have looked at your plan. If all you have for that stay is a $3,000 bill then your insurance probably kicked in a lot, and you're probably just getting hit with a deductable.

    As for the person on Medicaid who had a baby, they shouldn't have freaking had the baby. IMO anyone who qualifies for public assistance shouldn't be reproducing on the dole. >
    "The nice thing about memories is the good ones are stronger and linger longer than the bad and we sure have some incredibly good memories." - EverythingButWings



  3. #3
    Join Date
    Aug. 2, 2004
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    Whidbey Is, Wash.
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    9,958

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    Quote Originally Posted by littleum View Post
    As for the person on Medicaid who had a baby, they shouldn't have freaking had the baby. IMO anyone who qualifies for public assistance shouldn't be reproducing on the dole. >
    THIS a million times over.

    To stay on track: OP, check your bill. Pretty sure insurance covered some of this, but yes, hospital stays are spendy.
    COTH's official mini-donk enabler

    "I am all for reaching out, but in some situations it needs to be done with a rolled up news paper." Alagirl



  4. #4
    Join Date
    Dec. 1, 1999
    Location
    flyover country
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    Default My niece is a teacher and her insurance STINKS!

    She has Blue Cross and used to have Humana. She pays several hundred every month for this crappy ins, and when her then 7? 8? year old daughter fell off her scooter and broke out her new front teeth, insurance paid 0. She switched from that to the equally worthless BCBS and they routinely deny coverage, [her kids seem to be a bit accident prone] or at least need a lot of medical care. Obviously she cannot look for her own as it is negotiated but I told her to go to a union meeting and raise hell about rotten ins.
    I hate to say anything about ins as mine is excellent.
    Another killer of threads



  5. #5
    Join Date
    Jan. 14, 2003
    Location
    Massachusetts
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    6,230

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    Quote Originally Posted by TheJenners View Post
    To stay on track: OP, check your bill. Pretty sure insurance covered some of this, but yes, hospital stays are spendy.
    The infuriating thing is for those of us "lucky" enough to have employer sponsored health plans -you often don't know how your benefits have been cut, even as the contribution has been raised every year.

    I think for specific claims like giving birth, it would be easy enough to research and come up with an estimate ahead of time but it often is not easy because you often start getting bills from individual Dr's and tests. So, you might know your deductible but if you also have a 20% co-pay,there is no way you are going to know ahead of time what that 20% is.

    My last insurance cost me a deductible plus 20% of all charges. I went to the emergency room for a wrist injury and got a huge number of bills-ER Dr, Radiologist, bloodwork etc. Each service bills you separately.



  6. #6
    Join Date
    Nov. 18, 2010
    Location
    california
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    4,674

    Default

    The health insurance industry is a very profitable industry. They spend a considerable amount of money lobbying for the right to deny claims. Our insurance at my work went through the roof this year-huge changes that people are still trying to understand- so I canceled and rely on my husband's insurance. I am lucky that I had a choice.

    I think the health insurance industry needs to be held accountable, like every other business. This industry is entrusted with people's lives and yet they have a business goal to deny as much as possible (which is not wrong it is just how they profit). Glad we have some insurance reform, but it is still a "business".



  7. #7
    Join Date
    Sep. 7, 2009
    Location
    Lexington, KY
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    20,079

    Default

    In the last six years, our insurance has gone from $20 doctors copays and $250 deductible, to $40 copays, $1,000 deductible and 80/20 with max out of pocket of $10,000 per person.

    I claim excess medical expenses on my taxes every year. My daughter, who aged out of our insurance, but is in college, has a very serious past medical history. Her insurance is worse. I guess I should be thankful she has insurance.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant



  8. #8
    Join Date
    Feb. 20, 2010
    Location
    All 'round Canadia
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    5,926

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    Quote Originally Posted by Larksmom View Post
    She has Blue Cross and used to have Humana. She pays several hundred every month for this crappy ins, and when her then 7? 8? year old daughter fell off her scooter and broke out her new front teeth, insurance paid 0. She switched from that to the equally worthless BCBS and they routinely deny coverage, [her kids seem to be a bit accident prone] or at least need a lot of medical care. Obviously she cannot look for her own as it is negotiated but I told her to go to a union meeting and raise hell about rotten ins.
    I hate to say anything about ins as mine is excellent.
    Isn't it normal that there's no dental coverage? In my limited US experience most plans don't seem to include any kind of dental work, beyond possibly an ER doc lancing an abscess.



  9. #9
    Join Date
    Oct. 22, 2003
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    1,884

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    Quote Originally Posted by sketcher View Post
    So, you might know your deductible but if you also have a 20% co-pay,there is no way you are going to know ahead of time what that 20% is.
    You can ask for quotes and shop around the medical care to get an idea. ER visits are a bit different (emergencies are emergencies!) but I went some long spans without coverage of any sort and I did a lot of calling around.

    Most medical practices (ime) are able/willing to give you estimates. And they don't act funny about it either- they give you an estimate just like a plumber or a roofing guy would. When you get ref'd for an MRI or what-not if you have a place in mind you can ask for that- I got ref'd for an MRI and requested a specific place because I knew I'd have to pay a % and their price was better. I've also requested specific labs. The doctor's office doesn't really care. They just assume a patient isn't going to know anything about it so they send it off to Lab X. If you want Lab Y or Lab Z, that's normally fine as well. Some places offer a 10-20% discount if you're a self pay or willing to file the insurance yourself.

    Sorry if you knew they already, it's just been my experience that a lot of folks don't know they can shop around their medical care to save some bucks.
    "The nice thing about memories is the good ones are stronger and linger longer than the bad and we sure have some incredibly good memories." - EverythingButWings



  10. #10
    Join Date
    Dec. 1, 1999
    Location
    flyover country
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    2,196

    Default This wasn't even dental

    She knocked out the two front teeth-broke off at the gum line. It was major surgery, and I don't think she is done yet. She has to stop growing before they can put in real teeth as replacements.
    Another killer of threads



  11. #11
    Join Date
    Nov. 13, 2006
    Posts
    1,418

    Default

    My daughter is almost 2, when I had her the hospital bill for a vaginal birth with no complications not including the cost of the epidural was $11,000.That was before her insurance covered some of the costs. I can't imagine what a c-section would have been. Just to give you an idea.



  12. #12
    Join Date
    Jan. 14, 2003
    Location
    Massachusetts
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    6,230

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    Quote Originally Posted by stolen virtue View Post
    The health insurance industry is a very profitable industry. They spend a considerable amount of money lobbying for the right to deny claims. ...

    This industry is entrusted with people's lives and yet they have a business goal to deny as much as possible (which is not wrong it is just how they profit). Glad we have some insurance reform, but it is still a "business".
    Exactly. IMHO, the insurance industry should not be a for profit business. As a non-profit, there would be no pressure to keep stock prices rising or to keep increasing the profits. They could still make money, employ people and provide coverage without the extra demands from Wall St.



  13. #13
    Join Date
    Feb. 16, 2008
    Posts
    959

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    Please..this subject is such a thorn in my side, although not so much the insurance as the providers....we have BCBS, so we have co-pays for dr visits (which have increased substantially over the past few years), deductibles, and 80/20...I go for blood tests once a month (sometimes every week depending on my results), which involve simply a finger prick and showing the results to a nurse practitioner who either tells me keep taking the same meds, or increase or decrease the amount....most recently they wanted me to pay the $40 co-pay, just for the blood test...I argued with them that is ridiculous for the whole 5 minutes of what you are doing..yeah got the explanation of benefits and after the insurance, my amount owed is $4, not $40!!! I am so tired of them trying to overcharge for everything!



  14. #14
    Join Date
    Dec. 6, 2000
    Location
    SE Mass
    Posts
    4,249

    Default

    Nationalized Health Insurance folks.



  15. #15
    Join Date
    Sep. 7, 2009
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    Lexington, KY
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    Quote Originally Posted by IFG View Post
    Nationalized Health Insurance folks.
    Yes. Absolutely. Positively. Yes!
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant



  16. #16
    Join Date
    Mar. 12, 2006
    Posts
    4,343

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    It probably would have been $20,000 without insurance. At $300 a month, that is $3600 a year you paid to save $17,000. It's not a bad deal.

    Insurance is pretty good bang for the buck when you see the care it gets you. My SO had a $100k plus brain surgery.Top surgeon. Cost him $2500. He did not have to wait for an MRI, did not have to wait for a surgeon. He had the tumor removed before they even caused a headache. He stayed in an ICU with a private nurse.

    We bitch and moan in the US, but its not a bad deal when you really need it.



  17. #17
    Join Date
    Jan. 14, 2003
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    Massachusetts
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    Quote Originally Posted by heatherny2 View Post
    I argued with them that is ridiculous for the whole 5 minutes of what you are doing..yeah got the explanation of benefits and after the insurance, my amount owed is $4, not $40!!! I am so tired of them trying to overcharge for everything!
    Yep. Quest labs keeps sending us bills for charges over and above what the insurance will cover, according to our insurance, there is no co pay or partial insurance for the lab work and Quest has no right to bill us but they do anyway.

    My Dr'soffice told us to call Quest and ask them if we need to address this with the insurance commissioner and that gets them off our backs until new bills are incurred, then the whole process starts all over again.

    They must have quite a number of people who just pay the bills without question. I'll bet they also sell the ones who ignore them and don't pay to collection agencies - so even then they are getting some payment for bills they have no right to be sending.



  18. #18
    Join Date
    Feb. 16, 2008
    Posts
    959

    Default

    ha ha let me tell you about Quest! I went just this past week for a blood draw there for my thyroid issue and when I was checking in, they asked for my credit card to do a "pre-authorization" of $40, so that whatever the insurance didn't cover they could charge to my card...I said a big HELL NO. I am not giving you my authorization to charge whatever you want whenever you want...are you crazy??!!



  19. #19
    Join Date
    Jul. 24, 2008
    Posts
    3,408

    Default

    As a Canadian, I am glad to say that while our system is not perfect (often long wait times and doctor shortages) I am really, really glad our system is set up the way it is.



  20. #20
    Join Date
    Jul. 31, 2007
    Posts
    15,562

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    Quote Originally Posted by magnolia73 View Post
    It probably would have been $20,000 without insurance. At $300 a month, that is $3600 a year you paid to save $17,000. It's not a bad deal.

    Insurance is pretty good bang for the buck when you see the care it gets you. My SO had a $100k plus brain surgery.Top surgeon. Cost him $2500. He did not have to wait for an MRI, did not have to wait for a surgeon. He had the tumor removed before they even caused a headache. He stayed in an ICU with a private nurse.

    We bitch and moan in the US, but its not a bad deal when you really need it.
    OK, now you can flame me.

    OP, you got off cheap. $20K is the average cost for in-hospital birth. And by the way? The $3K was the tip of the iceberg as far as the cost of having kids. Heck, choosing to have kids *is* a financial decision. Think about all the childless folks in your insurance pool who subsidized your decision.

    This is how insurance works. There are people making sure they make a buck between you paying in and the cost of your health care delivered. But the rest is about pooling risk.

    If you want to get mad at people who smoke, eat too much and the rest, do Evil Knievel stuff for fun, then you logically have to assert that the people having kids are taking their share, too.

    The part that does make me mad is the "Squeaky Wheel Gets the Grease" part of billing. You must be prepared to put in lots of time (and therefore money) if you want to contest a bill. I suspect insurance co.s and other providers make a fair share of profit by making it hard to collection on what is owed or to contest unfair charges.
    The armchair saddler
    Politically Pro-Cat



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