Major Budget Buster - HEALTHCARE

[tinker&belle]

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!

Sometimes labs have to go somewhere specific (I have to use a certain clinic to get my blood work done so it goes to the right lab.) Just off the top of my head that might be worth looking into.

I know when I worked for a large university they made one plan the most attractive financially because they wanted the largest pool of people in that one...maybe that is what your employer is doing?

 

[neatokimmo]

Whats the deductible on the HD plan? And what does it contribute after you've hit the deductible? What does the PPO contribute after it's deductible is met?

On my HD plan, one physical is covered. Blood work is not. A well baby visit can include shots for "free".

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!

 

[Pastamom]

Hi

DH lost his job last October and we went on COBRA for $437 a month - which was close to what we had been paying when he was working - maybe a little less. Over the summer I was able to go full time where I work - so my pay "doubled" - I had been half-time previously and I got to get on our benefits program...I got my first new paycheck in September - expecting a nice bump in salary even with the benefits being taken out. Imagine my surprise when I found out I was making less than $200 more a paycheck...$500 per check was being taken out for health insurance...

Luckily DH got a job and we have now switched back to his insurance at about $250 per paycheck, but they're changing plans at the first of the year....we're keeping our fingers crossed

BTW - I wouldn't recommend changing insurance 4 times in 6 months to anyone....(although for about $1500 we felt we had to...)

 

[momof2gr8kids]

Who's Prime Minister flew to the USA for treatment????

A lot of Canadians go the USA to get medical treatment if it's not available in Canada, and the gov't pays for it.

I had a friend who went down a few years ago with her daughter to a special clinic for treatment for her eating disorder. She had been through treatment centres in Ontario, without success. The doctor was able to obtain prior approval and have her sent to the US. She said it was amazing the stories of parents who sold their homes, etc. so they could send their kids to get help as they had to pay out of their own pockets.

So, yeah, still thankful for my healthcare in Canada. Couldn't imagine dealing with the stress of a loved one being sick, while at the same time dealing with the medical bills.

 

[Bibbidi]

Just a general comment to those trying to keep their medical costs in check. I've found that simple things like flu, strep, UTI, etc. you can use things like the CVS Minute Clinic in lieu of your family doctor. I went about a week ago and the appointment fee was $69. My family doctor fee is well over $120. It's also very convenient since they don't require an appointment.

My health insurance requires me to hit a deductible before they will pay 80%. Doing the minute clinic has allowed me to stay under my deductible amount so far this year.

I went this route--(used Walgreens instead)--for a strep test. The nurse was super nice, but because the rapid came back negative, and they don't culture for adults, they sent me off with a penicilin prescription (which according to my past history, I knew wouldn't work). Anyway, I ended up at my doctor 3 days later--for $120 more and a prescription for a much stronger antibiotic for another $30. So all told, I spent about $250 on two strep visits & meds, instead of $150 (appt & med) by just going to my doctor instead.

 

[karice2]

I think that I am pretty lucky. This year, I left a company where I paid about $300 for insurance with I think $20 copays to a company that has pretty cheap insurance with less copays and with FSA so pretax dollars go for my copays. That is an awesome benefit to me. There are some ways that healthcare can be made cheaper.

I think the issue with all of the healthcare is that there is no incentive to remain healthy. Recurring health issues are a bigger drain on the system than catastrophic events. Things like Diabetes, heart conditions and high blood pressure are in most cases are preventable to some extent. If there were incentives for individuals to do more preventative maintenance and seek assistance early for some conditions then there would be less of a drain on the health care system. I bet if someone offered a 25% discount for every year that blood pressure remained normal or someone lowered their cholesterol we would be much more proactive about our health. Maybe that is what needs to happen. I know some companies have negotiated that with their health care plans. Incentives for employees who participate in wellness programs and the like. That could be an option for some. At least worth mentioning to HR.

I know that copays are a drag but we all talk about ways to save for Disney, I personally think that one's health is worth saving for every day.

 

[fakereadhed]

This is what happens when govt tries to control businesses without having an understanding of how businesses really work. Why did they not know they would have to raise prices to stay in business?

Again, we're confusing insurance with healthcare. Providing subsidies for free physicals or health maintenance would be healthcare. Instead they are mandating insurance coverage, provided by a third party who is trying to make a profit.

 

[Tink-aholic]

I went this route--(used Walgreens instead)--for a strep test. The nurse was super nice, but because the rapid came back negative, and they don't culture for adults, they sent me off with a penicilin prescription (which according to my past history, I knew wouldn't work). Anyway, I ended up at my doctor 3 days later--for $120 more and a prescription for a much stronger antibiotic for another $30. So all told, I spent about $250 on two strep visits & meds, instead of $150 (appt & med) by just going to my doctor instead.

This concerns me. If your test came back negative for strep, they shouldn't have given you any antibiotics at all. There is a protocol for prescribing antibiotics, and this certainly sounds like you didn't meet it.

It is abuse of antibiotics like this (and improper usage like people who stop taking them when they feel better to save for another illness) that worries me far more than the cost of healthcare. This is how resistant strains of bacteria are born.

It can take over a decade for a new drug to get on the market from the research and development stage. As of now, there are NO new antibiotics in any stage of development by any of the drug companies. Drug companies won't spend millions of dollars investing in a drug that is not treating a long-term, chronic condition (because they can't make enough money if people only take them short-term). So, they just aren't developing them.

Unfortunately, this widespread abuse of antibiotics will affect all of us. I predict that within a decade, we won't have any useful antibiotics left. That means that people (many of them children) will get rheumatic fever after strep throat and will have to fight off all infections on their own without any antibiotic help.

So please don't ask for antibiotics unless the doctor is certain you have a bacterial infection. If you do, take them all as prescribed.

 

[Tink3815]

Totally agree with you. I worked 2 jobs for many years just to make ends meet. There are jobs out there, just maybe not the one you want. My issue is with the illegal's getting state sponsered health ins.

 

[jemgumby]

It wasn't the Prime Minister. Even so, if someone wants to go to the U.S to have something done that is their personal choice. Yes, there can be waits to have things done but if it's an emergency it will get priority which is fine. I think her point was that people here in Canada should appreciate what a good thing they have. EVERYONE is able to go to a doctor/hospital without having to worry about whether they can afford it, there's no stress about trying to cover the cost of insurance/co-pays or huge medical bills.
Momof2gr8kids- I don't think we have a premium here in N.S but $250 a year isn't bad at all.

You definitely should be grateful of how your country is taking care of you and I am glad you are! It is sad that I live in one of the richest countries in the world and as you can see health care is something we have to worry about.....I do blame greedy doctors and insurance companies. I know they have to make money and profit as that is just common sense but there is a difference between making a living and making a killing!

 

[jemgumby]

A lot of Canadians go the USA to get medical treatment if it's not available in Canada, and the gov't pays for it.

I had a friend who went down a few years ago with her daughter to a special clinic for treatment for her eating disorder. She had been through treatment centres in Ontario, without success. The doctor was able to obtain prior approval and have her sent to the US. She said it was amazing the stories of parents who sold their homes, etc. so they could send their kids to get help as they had to pay out of their own pockets.

So, yeah, still thankful for my healthcare in Canada. Couldn't imagine dealing with the stress of a loved one being sick, while at the same time dealing with the medical bills.

I am so jealous but very happy for you Canadians!

 

[Kay1]

This is what happens when govt tries to control businesses without having an understanding of how businesses really work. Why did they not know they would have to raise prices to stay in business?

Again, we're confusing insurance with healthcare. Providing subsidies for free physicals or health maintenance would be healthcare. Instead they are mandating insurance coverage, provided by a third party who is trying to make a profit.

This has nothing to do with the government. My husband's organization goes through health care insurance negotiations every single year, and we pay more and receive less, every single year. Btw, I would consider free mammograms preventative care.

 

[jemgumby]

This has nothing to do with the government. My husband's organization goes through health care insurance negotiations every single year, and we pay more and receive less, every single year. Btw, I would consider free mammograms preventative care.

 

[mrsklamc]

By the time they pay student loans, malpractice insurance, and the cost of running a practice, most doctors aren't making a killing anymore. And why shouldn't they make more than the average career after all the work they put in to get there? I can't speak to insurance companies, I haven't looked at their balance sheets lately.

If it gets too bad here, some doctors will simply choose to go practice in the Bahamas and the wealthy will still have the medical advantage. Hop a short flight and you're there! Plus, I'm not sure what Canada will do when it can no longer send urgent cases here.

 

[jemgumby]

By the time they pay student loans, malpractice insurance, and the cost of running a practice, most doctors aren't making a killing anymore. And why shouldn't they make more than the average career after all the work they put in to get there? I can't speak to insurance companies, I haven't looked at their balance sheets lately.

If it gets too bad here, some doctors will simply choose to go practice in the Bahamas and the wealthy will still have the medical advantage. Hop a short flight and you're there! Plus, I'm not sure what Canada will do when it can no longer send urgent cases here.

Well that is interesting because doctors in Canada, France and England all make very GOOD livings above the average but not so much that it is immoral and unethical. In Sicko there were doctors in those countries who were interviewed and were disgusted by the greed of American doctors.

Have you ever had to pay for an operation out of pocket? I have.....my appendix ruptured and I had to have an emergency appendectomy. We were in between insurance companies and my new insurance was due to kick in a couple of weeks. Between the surgeon's fees, anesthesiolgoist's fees and the basic hospital stay......RIDICULOUS!!!! I want my surgeon to be compensated for what he did for me but my goodness $7,000......I want to pay my hospital bill but when looking over my bill they charged me $30 for a 16 oz bottle of water.......

Seriously it is ridiculous and I am glad that the healthcare industry is now going to be regulated and finally have to answer to someone for their unethical and immoral practices......it is not right for any other profession/service to do this and certainly not right for doctors, hospitals, etc.

During Hurricane Katrina there were some gas stations that got closed down because they massively jacked up their gas prices......hhhhmmmm because they were trying to take advantage of a bad situation and be greedy......so my appendix bursts and the same thing happened to me but the hospitals, surgeons, etc. got away with it.....NOT ANYMORE AND I AM VERY HAPPY ABOUT THAT!

 

[mrsklamc]

Well that is interesting because doctors in Canada, France and England all make very GOOD livings above the average but not so much that it is immoral and unethical. In Sicko there were doctors in those countries who were interviewed and were disgusted by the greed of American doctors.

Doctors in those countries don't have the astronomical fees for malpractice insurance that we do. Though I'm not sure what expertise being a doctor in another country would give you on what the balance sheet of a doctor practicing here looks like.

 

[mrsklamc]

Seriously it is ridiculous and I am glad that the healthcare industry is now going to be regulated and finally have to answer to someone for their unethical and immoral practices..

Where did you get the idea that that was going to happen?

 

[jemgumby]

Doctors in those countries don't have the astronomical fees for malpractice insurance that we do. Though I'm not sure what expertise being a doctor in another country would give you on what the balance sheet of a doctor practicing here looks like.

So the point is our healthcare system is not working and there needs to be change......which is what is trying to take place but people keep fighting it....

Believe it or not doctors can make mistakes and due to their mistakes people often time die or their condition worsens......so doctors should not be accountable for their mistakes just as in any other profession? Alot of doctors have a God complex and due to their pride alot of people suffer......

Get real, I used to type doctor reports and the average doctor I typed for saw about 30-40 patients a day, that is an 8 hour day......

right so your telling me those patients who are paying $$$$ for this wonderful service aren't getting scammed......so there are 8 hours in a day and if a doctor sees 30 patients then how much time does the doctor spend with the patient....let's do the math.......PATHETIC! Oh and I am sure that has nothing to do with greed right? I am sure it is at the patient's best interest to schedule that many patients in a day right? Seriously. I even got to type my own doctor''s reports because my doctor happened to be one of the doctor's I typed for....On my report she dictated that I had a GYN exam when I had not......She even dictated her usual report as if she had done a PAP smear on me! Yeah I sure got great care.........It MAKES ME SICK!

 

[mrsklamc]

Believe it or not doctors can make mistakes and due to their mistakes people often time die or their condition worsens......so doctors should not be accountable for their mistakes just as in any other profession?

I didn't say that at all. I'm saying, those doctors weren't taking into account the fact that expenses for a doctor here are quite different than they are here. Malpractice laws are MUCH different in other countries. Doctors have a higher liability here- and a doctor has no influence over what the hospital charges you for things like bottled water.

I have not had to have a surgery with no insurance. With insurance, my out of pocket expenses for cancer over the last year have been about $6,000. When I compare paying that to be alive and healthy over how fast I could spend $6,000 at Disney, I can't really complain.

I don't disagree with you that there should be change- I think most people would agree that changes should be made. The disagreement is what changes should be made.

 

[mrsklamc]

So the point is our healthcare system is not working and there needs to be change......which is what is trying to take place but people keep fighting it....

Believe it or not doctors can make mistakes and due to their mistakes people often time die or their condition worsens......so doctors should not be accountable for their mistakes just as in any other profession? Alot of doctors have a God complex and due to their pride alot of people suffer......

Get real, I used to type doctor reports and the average doctor I typed for saw about 30-40 patients a day, that is an 8 hour day......

right so your telling me those patients who are paying $$$$ for this wonderful service aren't getting scammed......so there are 8 hours in a day and if a doctor sees 30 patients then how much time does the doctor spend with the patient....let's do the math.......PATHETIC! Oh and I am sure that has nothing to do with greed right? I am sure it is at the patient's best interest to schedule that many patients in a day right?!

It's not like all that money goes straight to the doctor.
The fees from seeing that many patients in a day don't go as far as you would think. From that, they have to pay the nurses, the doctor, the malpractice insurance company, the janitor, the receptionist, the billing office people, and yes, even the person who does the transcriptions. Plus keep the lights going and pay for the office supplies and equipment...I'm sure lots of things I'm not even thinking of. And lots of the bills for people who can't afford to pay DO get written off.