Major Budget Buster - HEALTHCARE

[cm8]

if DH's insurance goes up this year, and i'm sure it will, we're going to be sunk, financially. even with insurance, we can't afford to go to the doctor unless one of us is deathly ill, because copays are so high. i'm still waiting for MY "hope" and "change".

why is this thread and or comments turning political, I thought politics were not allowed? I am sure that some of you are not as slick as you are trying to be with the snide remarks.

 

[ancestry]

What are you talking about? There is no such law in the US. Why should doctors be forced to work for free? Would you work for free??

I think what the previous poster that you quoted was talking about is that most hospitals can not deny urgent life threatening medical care if the patient doesn't have the ability to pay. Individual doctors certainly can but if you walk into a hospital emergency room with a life threatening condition/injury they are required to treat you.

That doesn't mean that that hospital won't try everything they can to collect on the money they are owed for the services they provided.

 

[dreaming4disney]

Just to commiserate: we are fam of 5 with 3 of us having chronic health issues. We pay 300/mnth and have 2500 yearly deduct. we put the max(4k) into flex spndng and go through it by the summer every year. Our monthly meds cost over 300/mnth. the costs go up every year. Our out of pocket is about 7-8k a year. On one hand- we are lucky to have insurance and be able to pay for it. But on the other, our disposable income is less every year.

The prices of insurance and costs are increasing so much every year, that more and more people cannot afford it anymore and drop their coverage, which really only adds to the cost of insurance for everyone else still in the system.

The fact that this thread has reached all these pages so fast shows how much of an issue this is for so many people.

 

[OrangeCountyCommuter]

When people make a profit on your health care, health care will always take a back seat to profit. Private insurance companies are greedy.

How many of who agree with this have Blue Cross?


And how many of you realized they are NOT FOR PROFIT?

Food for thought!

 

[mrsklamc]

Shouldn't someone who went to med school with the purpose of helping people.... .....How is it that places like Salvation Army, Red Cross, and other organizations like those help people regardless of their financial situation and don't charge a dime for their services.

Who says they went to med school with the purpose of helping people? There are other reasons one might choose to be a doctor.

The Salvation Army and Red Cross receive donations.

 

[RockAndRollBallerina]

When people who already have health insurance cant afford to go to the doctor unless they are flat on their back sick due to sky high co-pays, and the rising costs of medications, then Houston we have a huge problem!

 

[mrsklamc]

When people who already have health insurance cant afford to go to the doctor unless they are flat on their back sick due to sky high co-pays, and the rising costs of medications, then Houston we have a huge problem!

No one is disputing that. The disagreement is what is causing it, and what to do about it.

 

[Belle5]

Shouldn't someone who went to med school with the purpose of helping people be helping everyone including those less fortunate who absolutely can not pay out an additional penny a month for health care? I know its the law anyways that they are required to give care to those who cant pay, but when they send a bill to these people that obviously don't have the funds anyway to pay I find it very insulting to those individuals. And health care as a business, are you kidding? How is it that places like Salvation Army, Red Cross, and other organizations like those help people regardless of their financial situation and don't charge a dime for their services. Yet for something that should be a right of all citizens regardless of their financial situation is geared towards those privileged enough to pay? Absolutely absurd.

This is the most astounding post I think I have ever read on these boards. No, there was one other a long time ago... It was when a hair stylist insisted that we should NOT be cutting our families' hair at home when people (like her) have gone to school to earn money to do this. She insisted we should be supporting them. That one might have taken the cake...

I have a son who has a year left in pre-med. His bills are going to be staggering by the time he is finished with school. He is denying himself every moment of fun and happiness now hoping for some pay-off when he is done. So, he should do this for free why? That would be a ministry. I have a niece and sister-in-law who give medical care to the needy for free on certain days of the month (to people who wouldn't even know there is a place called WDW). My son will probably join them when he is finished with school and established. They do this because they want to. No one should be forced to do so. People who sacrifice so much in order to study the way we need them to should be rewarded. If not, the brilliant and disciplined will just go into stock brokering or sales.
My girlfriend and her DH went to live in Canada for a while. She couldn't sing the praises of socialized healthcare for "free" enough. That was until...her DH had a serious sports related injury and had to wait weeks for a surgery that he would have had that day or the next in the US.

 

[JB2K]

why is this thread and or comments turning political, I thought politics were not allowed? I am sure that some of you are not as slick as you are trying to be with the snide remarks.

I don't think it's so much the posters trying to "one-up" The DIS...

...in fact, from what I'm reading here, I'm getting the impression that a lot of folks were sold a faulty bag of goods.

You can interpret that any way you like.

 

[Junebugwv]

Shouldn't someone who went to med school with the purpose of helping people be helping everyone including those less fortunate who absolutely can not pay out an additional penny a month for health care? I know its the law anyways that they are required to give care to those who cant pay, but when they send a bill to these people that obviously don't have the funds anyway to pay I find it very insulting to those individuals. And health care as a business, are you kidding? How is it that places like Salvation Army, Red Cross, and other organizations like those help people regardless of their financial situation and don't charge a dime for their services. Yet for something that should be a right of all citizens regardless of their financial situation is geared towards those privileged enough to pay? Absolutely absurd.

Most taxpayers have no problem helping those INCAPABLE of helping themselves.

 

[RockAndRollBallerina]

Most taxpayers have no problem helping those INCAPABLE of helping themselves.

What about the person who is out there working making an honest living and has very little left over after all bills are paid and cant afford health insurance?

 

[JaymeC]

There are a lot of people struggling now. My family is both lucky and unlucky right now. My husband is leaving the military. Yes, it's bad timing, but so goes life. I'm a college graduate, but it's doing no good at helping me get a job, and really may have slowed it down. I finally found a job doing office work for $13/hour, that offers no healthcare. We're lucky in that we live in a relatively cheap area (2 years of live in San Diego and 3 years of living in Japan brings cheap into perspective!) and we have no debt, but we're still in trouble as far as healthcare goes. I've been looking for work for 4 months. I won't walk away from $13/hour now. My husband will be going back to school using the GI Bill. If he were to get a job now we'd lose money after childcare, etc whereas this way he at least gets his degree and has an opportunity for better earning in the future. We'll eek by... except for healthcare. Right now our only current plan is to put the kids on the state plan and pay out of cost for a catastrophic coverage plan for dh and I. Needless to say we're not planning any trips to WDW or DL for the next few years, but we're hoping we can be back on our feet four years out and go then

 

[StephMK]

We have had higher than normal expenses this year (younger child had birth defect and had a couple surgeries this year, one that OOP would have be over 60K) and the HSA plan still worked better for us.

I never would have dreamt that would be the case, but compared to the money I was paying every month for premium, plus the MANY $20 copays that didn't go toward a deductible or OOP max (that's what KILLED us) the HSA worked well. We pay $100 for the premium and put $325 in HSA per month.

We ARE fortunate that Dh's employer does put some more money in the HSA. Even if this was all that was being contributed in a normal year with two healthy children it would more than cover typical expenses for our family-it has just been atypical the last few years.

I think if anyone has an HSA available it is worth running the numbers and seeing how much co-pays are adding up to. With our HSA once the deductible was met it even meant we were only paying 20% of prescriptions instead of having to buy them on a tiered system. Once we hit our OOP max, prescriptions are covered at 100%. So it can be good for people with LOTS of expenses too. It was certainly better for us than the PPO system was when we ran the numbers.

Thanks so much for posting that. DH's reenrollment is coming up & we may look seriously at switching. In the past, I haven't because I thought we go too often but it sounds like I need to take a close look. DH & I both take daily meds & each year the kids end up with oddball med expenses - x-rays, labs, etc. The bills have really gotten us this year so this might help. Thank you, it helps to hear from a family that has had success with it.

 

[neatokimmo]

We are a high deductible family. This years premium was $125 for the entire year because I'm a non smoker. I get 1K in the savings account from my employer. I rolled a ton from last year too, we have about $1100 left between the 2 years. The next cheapest plan was $125 a month roughly, so in the past 2 years I've saved a ton.

What I've learned is:

• barring catastrophe, we won't hit $4200 (the deductible). If something does happen (like my friend who broke her ankle and had surgery and it cost 27K) I will only pay an additional $200 OOP for the year. So run those numbers.
• my doctor charges $80 for an office visit. If I hand the clerk my medical card, $79 is billed to me later (the contracted rate from my insurance - I save a buck haha). If I say "cash" please, it is $64, 20% discount. I pay with my debit card that the company gave me.
• my doctor will call in scripts for amoxicillian when I have a sinus infection so I don't have to pay $64. I'm smart enough to know when to take it for things like that. And I think it is great customer service that they'd do that.
• that if I get an antibiotic from my doc, I ask questions about it. I had to go to urgent care one night for tonsillitis. Doc prescribed a compounded antibiotic. It was $58 with insurance, almost $200 without. It was name brand augmenten (sp) with potassium added. The amount of potassium? 1/4th of a banana. So the kind people at Walmart called, got the scrip changed to generic amox and I bought bananas. $4 plus bananas.

Its almost like a game trying to keep it all straight.

 

[tinker&belle]

Thanks so much for posting that. DH's reenrollment is coming up & we may look seriously at switching. In the past, I haven't because I thought we go too often but it sounds like I need to take a close look. DH & I both take daily meds & each year the kids end up with oddball med expenses - x-rays, labs, etc. The bills have really gotten us this year so this might help. Thank you, it helps to hear from a family that has had success with it.

No problem...I would read the HSA policy and other offered policies super carefully and find out:

If deductibles and OOP maxes are individual or a family rate (this is key and seems to vary a lot)
If pharmacy is included in deductible and OOP max
If co-pays go toward deductible or OOP max

 

[riley2008]

I know it has been brought up already in the thread, but I just wanted to second how great the High Deductible/HSA has been for our family. We pay a low premium (about $100 a month) and DH's employer puts some money in the HSA. Between the employer and us we max out what is allowed per year.

This is really nice because at DH's old job we were paying almost $600/month for health/vision, plus there was a deductible plus TONS of $ in co-pays. I really like with our HSA that all money spent goes toward our deductible then our OOP max.

It's been GREAT for us too. We don't get any employer contribution. I just contribute the difference in the high deductible plan and the middle choice of our plans. We've been lucky the last couple of years and used next to nothing. We have a great medical nest egg saved.

 

[mrsklamc]

What about the person who is out there working making an honest living and has very little left over after all bills are paid and cant afford health insurance?

This makes no sense as a response to what you quoted.As she already said, no one is opposed to helping out those who are doing the best they can to help themselves.

 

[susianew]

[*]that if I get an antibiotic from my doc, I ask questions about it. I had to go to urgent care one night for tonsillitis. Doc prescribed a compounded antibiotic. It was $58 with insurance, almost $200 without. It was name brand augmenten (sp) with potassium added. The amount of potassium? 1/4th of a banana. So the kind people at Walmart called, got the scrip changed to generic amox and I bought bananas. $4 plus bananas.
[/LIST]
Its almost like a game trying to keep it all straight.[/QUOTE]


I know it's off topic, but as a pharmacist I just can't let that one fly. Augmentin contains amoxicillin plus potassium clavulanate a beta-lactamase inhibitor that significantly extends the spectrum (and effectiveness) of the amoxicillin. The potassium is just there to stabilize the clavulanate moiety.

So bananas + amoxicillin DOES NOT EQUAL Augmentin!

Sometimes the urgent care doctors do seem to bring out the big guns early...if they're prescribing amoxicillin and seeing a lot of people coming back a week later, still sick (unable to work or working and spreading their infections to co-workers) and then they have to charge another office visit co-pay, plus you have to shell out for the expensive antibiotic anyway, so sometimes the more expensive drug does end up being more cost effective.

Susan

 

[neatokimmo]

I know it's off topic, but as a pharmacist I just can't let that one fly. Augmentin contains amoxicillin plus potassium clavulanate a beta-lactamase inhibitor that significantly extends the spectrum (and effectiveness) of the amoxicillin. The potassium is just there to stabilize the clavulanate moiety.

So bananas + amoxicillin DOES NOT EQUAL Augmentin!

Sometimes the urgent care doctors do seem to bring out the big guns early...if they're prescribing amoxicillin and seeing a lot of people coming back a week later, still sick (unable to work or working and spreading their infections to co-workers) and then they have to charge another office visit co-pay, plus you have to shell out for the expensive antibiotic anyway, so sometimes the more expensive drug does end up being more cost effective.

Susan

Thanks for the info, I was just going off what the urgent care place at our hospital and what the pharmacist said. Luckily I respond well to antibiotics because I rarely take them.

 

[StephMK]

Ok, can someone help me? I pulled out the benefits guide from 2009. I do not expect figures to be close to the same now but for comparison, I'm not sure the HSA plan is right for us.

We have BCBS and I have never understood how they figure what goes under our deductible vs. what is covered. Our outline of coverage says preventative/routine labs are covered but they never cover either DH's or my annual blood work. What constitutes preventative or routine?

We still have a PPO $500 plan = $276 a mo in 2009 $500/indiv-$1,000 family
The HDHP/HSA was $256 and the employer contributes $800.


Does that really make sense since the HDHP/HSA option is only $20 less a month? I think that's why we've never switched because I'm not sure I see the financial gain in our case.

Thanks for any help!