So mad - our health insurance copays are doubling next year!

[Piecey]

From what I can tell, our insurance didn't change at all.

It did get $7/check more expensive.

I was actually surprised there were no changes.

 

[shells4]

Not the copays for dr visits but for all the visits we do weekly (OT, PT, and speech). The copays are doubling from $20 to $40 per visit. This is going to cost us $60 per week! Has anyone else had their copays go up for 2012?

thanks, Jen.

Yes, copays are going up and our Premiums doubled! I would be happier with a higher copay if our premiums remained the same.

 

[jeepgirl30]

My premium went up $80 per month. We weren't sure what was going to happen as highmark is our insurance but most of our doctors are UPMC.

 

[minnie1928]

I wish we would get rid of all insurance for health care both employer and or government paid... The entire thing is a big racket. In the 1960's you paid $5.00 for a Dr Visit ($38 in today's dollars) without insurance! The insurance industry helped to drive the cost of healthcare sky high. Now we have to insure against getting even the most common sickness.

It's not the insurance industry, it's how much the times have changed since the 60's. Malpractice insurance is CRAZY high for those that practice, they have to pass that cost on to their patients. There are more drugs available than there were in the 60's and those drugs came at a high cost in research & development. Those costs need to be recovered. The cost of tests in general are higher because of the costs associated with purchasing the technology that is used to perform the tests.

If we as a nation want to lower healthcare costs, then we need to start taking better care of ourselves. Much of our nation is overweight or suffering from conditions that are treatable/avoidable without medical intervention. If we started taking better care of ourselves, we wouldn't need the numerous prescriptions/doctors/tests and the high costs associated with them.

Remember, the healthcare industry doesn't make money on healthy people. It's a better profit plan if they can keep the patient alive and dependent upon their services.

 

[Acklander]

It's not the insurance industry, it's how much the times have changed since the 60's. Malpractice insurance is CRAZY high for those that practice, they have to pass that cost on to their patients. There are more drugs available than there were in the 60's and those drugs came at a high cost in research & development. Those costs need to be recovered. The cost of tests in general are higher because of the costs associated with purchasing the technology that is used to perform the tests.

services.

Exactly

The medical industry has grown by leaps and bounds since the 60's. Even for basics. Example - the first time I was pregnant was in 1980. Until the last month, I would go to the dr once a month where he would weigh me, listen for heart beat, and check my blood pressure. With my last pregnancy, in 1999, I had 3 different ultrasounds, blood screenings, glucose test among other things. Advances have been made with great results, but it costs more.
When I was a child, I broke my leg, got an X-ray, had a cast that everyone signed, had cast removed. When my broke my foot as an adult, I had minor surgery to aid in the setting and months of PT following the cast removal.


I read that Vt voted on a single payer system for the state, which, on paper, should reduce the costs for everyone since it's taking the profit out of the insurance and using a much higher percentage of the $$$ for actual patient care. If that's how it ends up, I wonder if more states will follow suit.

 

[PrincessSuzanne]

Luckily, our premium is going to drop, by $5, but that is a $60 savings per year.

I am really glad that we now have the insurance we have, because I just switched from what we had through my employer to Tricare Reserve Select and it is saving me $1800 in premiums alone. We went from a $4000/person deductible to $50/person and the out of pocket is minimal, which is nice because I have run into some trouble with my foot/ankle. My family doctor over charged me on my portion at a recent office visit, which would have been a nightmare to get back from them, Tricare sent me a check for the portion I over-paid, that was a nice surprise.

My prescriptions have really dropped in price, also.

If any of you have a spouse that is in the Reserves or Nationl Guard, this is an option for all of you. A family plan is $182/ mo for 2012, an individual plan is $54/mo.

 

[sparklynails23]

When my broke my foot as an adult, I had minor surgery to aid in the setting and months of PT following the cast removal.


I read that Vt voted on a single payer system for the state, which, on paper, should reduce the costs for everyone since it's taking the profit out of the insurance and using a much higher percentage of the $$$ for actual patient care. If that's how it ends up, I wonder if more states will follow suit.

I don't understand what kind of miracles PT and OT provide a patient. Can't you exercise twice a week at home and see the doctor once a week or once every two weeks? That's the way it used to work.

A single payer health system, like in France and Canada, seems the only way to go. Companies and individuals can't afford healthcare, anymore. Let's cut out insurance, completely.

 

[patsal]

My copays went up in September, since I teach my contract is effective September to August. All of my copays doubled, except ER and Immediacare which both tripled the copay. My vision care benefit also doubled the copay and lowered the amount covered for lenses, frames, etc.

 

[tar heel]

This is not something new for the vast majority of us. Most of the increases we've experienced had nothing to do with Obamacare.

My husband's company insurance used to have low co-pays, no deductibles, etc. Over the past five or so years, that has changed drastically. Now, there are many drugs with $100 co-pays and doctor visits are 20% of the charge. On paper, I seem to have better insurance -- I do still have an office visit co-pay, but I had a sleep study last year and my share of the studies and prescribed equipment was close to $4,000.

 

[tar heel]

The comment about having to work until you qualified for Medicare just struck me as out-of-touch because it's the norm not an exception for most Americans. I'm in my mid-50s and that describes most of my friends. It described my mother 20 years ago. My DH's company stopped covering retirees, not just their families, a few years back -- they can be part of the group if they pay the premium.

 

[Happy Mom2]

I would be more surprised if someone's insurance didn't go up. I'm sure doubling your co-pay is going to a hit to budget. We went to a high deductible plan 3 years ago. We pay 100% of everything until we reach our deductible of $3500 each year. After we meet our deductible 100% of everything except name brand drugs is paid. Name brand drugs get paid at 80%.

 

[Acklander]

I don't understand what kind of miracles PT and OT provide a patient. Can't you exercise twice a week at home and see the doctor once a week or once every two weeks? That's the way it used to work.

completely.

LOL that was my exact statement to the Dr. Keep In mind, I'm one of those people that fell between the cracks - I was considered uninsurable AND am self employed, so was unable to get health insurance and pay cash for all my medical expenses. There I was, in the ER, negotiating with the dr. Which procedures were absolutely necessary, which ones were nice to have, and which ones were for "just in case".

 

[Marionnette]

I don't understand what kind of miracles PT and OT provide a patient. Can't you exercise twice a week at home and see the doctor once a week or once every two weeks? That's the way it used to work.

I can't speak for everyone but only from my own experience. My PT not only involved daily exercises that I did both at PT and at home, but also some serious stretching and manipulations of the shoulder joint that the therapist performed. I could not do those on my own and I would not have trusted a non-professional to do it.

It was also the physical therapist who ran interference with my insurance company and prescribed a device when my shoulder froze up midway thru therapy. If I had only been doing the exercises at home, I might have resigned myself to being limited in my range of motion.

 

[BubMunkeyBles]

Luckily, our premium is going to drop, by $5, but that is a $60 savings per year.

I am really glad that we now have the insurance we have, because I just switched from what we had through my employer to Tricare Reserve Select and it is saving me $1800 in premiums alone. We went from a $4000/person deductible to $50/person and the out of pocket is minimal, which is nice because I have run into some trouble with my foot/ankle. My family doctor over charged me on my portion at a recent office visit, which would have been a nightmare to get back from them, Tricare sent me a check for the portion I over-paid, that was a nice surprise.

My prescriptions have really dropped in price, also.

If any of you have a spouse that is in the Reserves or Nationl Guard, this is an option for all of you. A family plan is $182/ mo for 2012, an individual plan is $54/mo.

My DH is active duty. My family opts to be on Tricare Standard (PPO style that we pay for) verse Tricare Prime. My insurance is 100X cheaper than most peoples. No monthly premiums, $300 year family deductible, $1000 catastrophic cap which is when Tricare covers everything else in full. I paid less than $1000 (never met the cap) the year I had DD and had cancer, chemo, multiple tests and surgeries. Pretty crazy. I'm definitely thankful. We'd be bankrupt without it I'm sure.

I don't understand what kind of miracles PT and OT provide a patient. Can't you exercise twice a week at home and see the doctor once a week or once every two weeks? That's the way it used to work.

A single payer health system, like in France and Canada, seems the only way to go. Companies and individuals can't afford healthcare, anymore. Let's cut out insurance, completely.

Even PT once a week is still expensive under some insurances. Also depending on the injury more may be needed. I went 3x a week for a year after I had a post op infection that ate half my ankle away.

 

[PrincessSuzanne]

I don't understand what kind of miracles PT and OT provide a patient. Can't you exercise twice a week at home and see the doctor once a week or once every two weeks? That's the way it used to work.

Well, that really depends on what condition they are receiving the PT and OT for. Some people require inpatient PT/OT, some require outpatient treatment, and others may require PT/OT thru home health. Some people only require one visit to be given instruction on home treatment, but sometimes there is equipment involved that isn't available in someones home.

Some people require ultrasound therapy as part of treatment, I don't know of many people that have an ultrasound machine at home.

After I had wrist surgery, I had to have paraffin therapy and that was before you could buy those warmers in stores, I had to be supervised and assisted to make sure I didn't cause more issues for myself.

 

[PrincessSuzanne]

As part of my job in the hospital, we work closely with Case Management on patient care and the Supervisor says we are all probably better off if we didn't have insurance. We see alot of uninsured patients and they don't have the restricitions on them that those with insurance do, because of the things that insurance will allow and won't allow.

She also said that under the new Medicare, if the hospital gets a bad rating from the patient, the hospital won't get paid and we have alot of regulars with Medicare.

I work in a fairly small hospital, so we do alot of things other larger hospital may not do, buy meds for the patients (usually a one time thing), pay for a cab ride home if they have no transportation, they have even been know to pay a patients insurance premium if they think it will benefit them. I provide some services to self pay patients that may be elig for benefits in the community that may be able to pay for their visit, as well as assist thr truly disabled with obtaining SSI/Social Security Disability.

 

[akcire]

The comment about having to work until you qualified for Medicare just struck me as out-of-touch because it's the norm not an exception for most Americans. I'm in my mid-50s and that describes most of my friends. It described my mother 20 years ago. My DH's company stopped covering retirees, not just their families, a few years back -- they can be part of the group if they pay the premium.

My mom is 66 and has a part-time retail job. She only works for the insurance (not her paltry wages) so she can choose which doctors to see, since many of the best specialists in our area do not take medicare. She has had multiple bouts of cancer over the past decade, so continuity of care is important to her.

The funniest part is that her insurance through her employer costs her slightly less than she would pay for medicare premiums. So while her wage from her employer is ridiculous, the medical benefits are priceless.

We joke that she will be working for insurance until the day her employer calls me and I have do drive her over to the funeral home.

My husband and I are uninsurabale without a group policy, one of us will always have to work for a large company to provide insurance for our family.

 

[ccgirl]

As part of my job in the hospital, we work closely with Case Management on patient care and the Supervisor says we are all probably better off if we didn't have insurance. We see alot of uninsured patients and they don't have the restricitions on them that those with insurance do, because of the things that insurance will allow and won't allow.

She also said that under the new Medicare, if the hospital gets a bad rating from the patient, the hospital won't get paid and we have alot of regulars with Medicare.

I work in a fairly small hospital, so we do alot of things other larger hospital may not do, buy meds for the patients (usually a one time thing), pay for a cab ride home if they have no transportation, they have even been know to pay a patients insurance premium if they think it will benefit them. I provide some services to self pay patients that may be elig for benefits in the community that may be able to pay for their visit, as well as assist thr truly disabled with obtaining SSI/Social Security Disability.

One of the reasons I am glad to live in MA. We still have uninsured but not as many in other states since it is a requirement. The insurance is asking for medical necessity to cover things. A lot of MD's get referral fees when they refer you to a specialist. Unfortunately, sometimes greed sets in and they refer you when it is not truly medically necessary.

I agree with needing a good rating too. Patients have a choice with healthcare and a lot don't realize that. My closest hospital does not have a very good reputation. I never go there. Cab rides home have been pretty common in every hospital I have worked in.

 

[RockAndRollBallerina]

A single payer health system, like in France and Canada, seems the only way to go. Companies and individuals can't afford healthcare, anymore. Let's cut out insurance, completely.

This. Germany has a system in place as well. My husband has a bunch of friends who live over there. 7-8% out of each paycheck is taken out to cover each persons care head to toe. So you could work what is their version of a minimum wage job and be covered for brain surgery.

Even the Bahamas has a system in place, my husband and I talked with a local while we were there a couple weeks ago on a cruise.

Now here in the states however, you start qualifying for Medicare at 65, or have to have little to no money to qualify for Medicaid. Our healthcare system is pretty low ranking compared to other countries.

 

[nilseks]

I haven't read all of the responses but I just have to say...

For the past 4 years, the premium's for DH's company have gone up so much, it almost negates any paltry raise that he gets. Last year, the co-pays skyrocketed as well. It now costs $102.50 just to walk into urgent care. I have to pray my kids only get sick when our GP is in the office.

I keep telling myself it could be worse though...at least DH is employed.