Cost of healthcare

  1. I'm just curious... what kind of insurance do you ladies have?

    My father is self-employed and covers his own health insurance. He's always been healthy as a horse (knock on wood, hope he always will be), but recently had a hip replacement after a totally freak accidently. Despite insurance, I can't believe the extraordinary cost... just the least of it is physical therapy, which is $300 an hour, out of pocket.

    Luckily my folks are pretty comfortable, but I can't imagine how devasting this would be to a family in less fortunate circumstances. Hell, it would put me in debt for a good several years!!

    I recently got a job with a PPO so I pay almost nothing out of pocket (so they say, but I really don't know). Man, I won't take that for granted!
  2. I am extremely fortunate in that I was already included on the HMO partially paid by Mr Puff's employer before my diabetes and complications were discovered.

    Many families who are to all appearances quite comfortably off are in fact one serious illness or injury away from some very challenging circumstances, even those lucky enough to have health plans.

    Your father is extremely fortunate that he is able to purchase the treatment he needs without difficulty, but I would have to say I don't think that most people are so lucky. Health care is a high-ticket item!

    If you suppose a health plan, for example, that pays 80% of hospitalization costs, it is not unusual at all for people to find that the 20% exceeds their assets. And of course that does not include everything, just the cost of the hospitalization and in some cases, surgery and some professional fees.
  3. We have Cigna PPO and although they take a healthy amount from DH's paycheck, our office visits are cheap as are our prescriptions.
    I can go see ANY doc for $15 and all prescriptions are $10.
  4. i have.... ummm... none? but we have a national health service in the uk which in my post code is great, all prescriptions are £6.35 or something like that and going to the doctor doesn't cost anything. neither does going to the hospital and having surgery. i think my parents actually calculated how much they'd saved not having insurance, i think they said that for the whole family it would've cost £6k a year or so, and in the past ten years i've never had anything that wouldn't have been on the nhs anyway other than a rather large number of fillings (which my dentist can never be bothered to bill me for, he does my whole family and he always says he feels sorry for us because it gets so expensive :roflmfao: ), my one brother hasn't had anything, the other one has had his appendix out which we didn't pay for, and his tonsils out which would've been free but he went to my parents' friend in finland and had it done for a few hundred euros i think. my mother broke her leg or toe or something slipping on the pavement in helsinki but she had that fixed for free too. there's no way we would EVER have spent £60k on healthcare in 10 years, probably not even £6k. when you're somewhere you can get most things done free it's really not worth it unless you live in a postcode with really awful services.

    having said that, if i had anything serious that wasn't routine i'd go private for it, if only to avoid the insane waiting lists they have for anything that isn't urgent.
  5. LOL annanas, thanks for reminding me. I should have said that I live in the US, where health care, is essentially a market-driven commodity. The UK, and most other industrialized nations have a very different system, and whether that is a good thing or a bad thing is probably a good subject for a different forum.

    As is the case with Swanky Mama, money is deducted from Mr Puff's check to pay our part of the insurance premium. In addition to that, we must make a "co-pay" for each visit to a doctor and for each prescription, etc.

    The "co-pay" sounds very reasonable, but if you have to visit a lot of doctors and buy a lot of medications on a regular basis, those can add up!

    Still, I never take for granted or forget how lucky we are to have the HMO, because I am now "uninsurable" meaning I would not be accepted by any insurance company even if I had a lot of money with which to pay the entire amount of the premium, and with no insurance at all, the costs of the doctor visits and medications would be prohibiitive.

    For example, the retail price of a very brief consulatation with a doctor can cost $300-$400, and a month's supply of some medicines can be about that.

    Health care professionals and insurance companies do not always agree on questions of treatment and care.

    For example, in my own case, doctors have been trying to get the insurance company to pay for a newer version of one of the pills I take, citing difficulties in obtaining the desired result, and my pharmacist has even joined the fray, pointing out to the insurance company that I am taking such a large number of Pill A that Pill B would actually be cheaper for them at this point!

    However, the insurance company has an agreement with the company that manufactures both Pills A and B that makes it more profitable for them for me to keep taking pill A!

    It can definitely be a challenge sometimes for both patients and health care professionals to remember that it's a business!
  6. If you "fail" treatment A and need B, your insurance should be hard pressed not to give you the B treatment. And now of course since I am so nosy I want to know why you would be uninsurable, must be a pre-existing condition of sorts...
  7. I am sorry if I was not clear. My diabetes and complications were diagnosed a year ago. So even if I had enough money to do so and wished to purchase private insurance, I would be considered "uninsurable" at least with regard to what would be, as you say, a pre-existing condition.

    And the same would be the case should Mr Puff change employers. If his new employer offered health insurance benefits, they would almost certainly agree to cover any illness or injury of mine that is NOT related to my pre-existing condition.

    But the condition was not present, or at least not known, when Mr Puff went to work for his current employer, so while for several years, we were an excellent value, paying our share of premiums and seldom making any "claims" such as doctor visits or medicines at all, for the last year, the situation has been quite different, and the cost of my treatment exceeds the part of the premiums that we pay, and might even exceed the total of what we and Mr Puff's employer pay.

    And you are quite right that in some cases, insurance companies will agree to pay for a costlier pill once all the alternatives have been tried without success, and in this also I am very fortunate, because in my case there are really only two candidates, some people have to go through several!

    While I am sure that there are some instances where it is cut and dried formulaic kind of thing, and the company will automatically OK the drug the doctor requests after so many weeks of trying each cheaper alternative, in other situations, it will be on a case-by-case basis, and the decision making process may not be as swift as both doctor and patient would like.

    And in some cases, including mine, there is no guarantee that the new "son of" pill would do any better than the old one. I am already costing them money as it is, this is not the first time that doctors have asked them to permit different pills for me, and while of course health questions are always personal to the patient, we have to remember that for the insurance company, it is not personal, it is simply a business decision, and like any other business, they must make the choice that is in their own best interests! :smile:
  8. Until the time that I was 20, I was covered under my parents' health insurance. My dad was in the army, so he had Tricare - which costs significantly less than many (if not all???) of the other US health insurance providers.

    Now that my parents have split and I am living with my mom in German, I am covered under her health insurance since I am still in school. German has a social healthcare system. So basically, anybody who pays into the system can be insured by it. Of course, you have the option of having your own private insurance...But I don't think a lot of people do. I am insured by AOK Bayern here :smile:

    With Tricare, we didn't have to pay anything - as long as we went to their approved doctors. My mom had her thyroid taken out in...2002, and it didn't cost her one penny since she had the surgery done at the National Naval Medical Center in Bethesda, MD. We went to the doctor at the Naval Academy, so that didn't cost anything either. Neither did prescriptions!

    Here in Germany, I am not exactly sure how it works. I am pretty sure that all necessary procedures are paid for by insurance. Massages and physical therapy (but most of the times not alternative physical therapy) are covered under insurance, as long as a doctor deems that it is necessary. You pay $10 per quarter (I think???) to go to the doctor, and you may have to pay a little bit for prescriptions...But I am not sure about that either, since I still have refills on my pills from the US, and I just have my dad fill the refill and send them to me :smile:
  9. My health care plan thru work is great! My tubal ligation cost me about $20.00 out-of-pocket.
  10. United Healthcare.. love them- no questions asked coverage is great especially with Diabetes and expensive medication.:flowers:
  11. Healthcare if you are self employed costs an arm and a leg. Getting insurance through work is a great portion of your yearly pay, if you figure it out that way.

    I have Blue Cross Blue Shield PPO. I have separate dental and eye care also. PPO's are typically better in my opinion...
  12. We have excellent coverage through DH's job. Which means if I stay married, I have lifetime medical coverage. Hmmm.
  13. You know, I am not sure how PPOs work, but I am certain that they are better than HMOs, which is the cheapest option, the bottom rung of the health insurance ladder, so to speak, but I am grateful to be able to cling to that bottom rung! :smile:
  14. I have blue cross blue shield Triple Choice plan. I get the option of choosing HMO, Option, or Indemnity. Plus it includes my dental and vision. It's really great insurance and I only pay 17 bucks a pay. I work for a great company. My last job made us pay most of our health insurance at a whooping 70 bucks a month and that wasn't even including dental.
  15. i'm under my parents insurance...or, rather, i was...
    just found out tonight that, as of december 22, we will have no insurance. it's via my dad's small business insurance (he's the vp of the company) and the company is struggling right now. so, it had to get cut temporarily or else the business would collapse.
    for both my parents and me, it was costing $30k/year for insurance. and that was the cheapest available...
    my mom is seriously considering moving up to canada...