<p>“My daughter works in the health insurance industry and she doesnt know how much her premiums are or the company’s share of the premiums.”</p>
<p>My H has know idea about any of it. I doubt he even knows how much is taken out of his pay for our premium (I do) and he definitely has no idea what our deductible is. I only know because I looked it up. We have never paid a penny towards our deductible, ever, as we have only ever use preferred providers.</p>
<p>“Even among insured people, half have almost no health care expenses. If you’re among that happy 50%, thank your lucky stars and hope your good fortune continues. And know that one hospitalization boosts you right into the expensive 10%.”</p>
<p>I think if people started doing routine checkups these numbers would change. There are many out there like me who never bother visiting a doctor for years at a time. I am not sure what the exact percentage might be.</p>
<p>Right now, you need to spend $8500 or more in a year to boost yourself into the top 10% of spenders. A routine checkup isn’t going to get you there.</p>
<p>There is a vast difference between “almost no health care expenses” and trying to be in the top 10%.</p>
<p>The statistics can change if people start behaving differently because preventive care is mandated by law.</p>
<p>^ I think Texas is implying that the routine physical will turn up something which will boost you into the big spender category. Imo, it’s a good thing if a physical turns up something which can be treated before it turns into something more complicated, but maybe that’s just me.</p>
<p>On phone, so too hard to search, but repeating from way back that Oregon health project showed that an increase in access to Medicaid increased spending by something like $3k per year, with no improvement of physical health. But this is a rehash</p>
<p>So, texaspg, you’re suggesting that if more people get routine screening/preventative care, then that would tend to level out health care spending. That remains to be seen, but I doubt it. </p>
<p>We’d like for that to be true. We’d like for screening to catch expensive conditions before they get expensive. But unfortunately we can’t screen for most expensive conditions. Some expensive conditions are chronic, like diabetes, with high expenditures year after year, and some expensive conditions are unpredictable, like accidents and infectious diseases. </p>
<p>Healthy people don’t cost much, and some sick people cost a lot. I don’t look for that to change.</p>
<p>That is interesting. I would like to see that study, bay.</p>
<p>The Oregon study is mentioned. </p>
<p>[What</a> is Medicaid?s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence ? Issue Brief | The Henry J. Kaiser Family Foundation](<a href=“http://kff.org/report-section/what-is-medicaids-impact-on-access-to-care-health-outcomes-and-quality-of-care-setting-the-record-straight-on-the-evidence-issue-brief/]What”>What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence – Issue Brief | KFF)</p>
<p>The Harvard study…</p>
<p>[Harvard</a> School of Public Health » HSPH News » Expanding Medicaid to low-income adults leads to improved health, fewer deaths](<a href=“http://www.hsph.harvard.edu/news/press-releases/medicaid-expansion-lower-mortality/]Harvard”>Expanding Medicaid to low-income adults leads to improved health, fewer deaths | News | Harvard T.H. Chan School of Public Health)</p>
<p>Let me explain.</p>
<p>Almost no expenses to me means less than 50-100$ unless there is a different number out there. I am guessing this will probably move up to 250-500$ when people start using the preventive care provisions of ACA and here is why I think so. </p>
<p>Currently most plans have some costs to visiting a doctor and filling prescriptions and doing lab tests. So people like me who don’t visit, don’t incur any cost to the system.</p>
<p>Now I decide to use the preventive care and baseline benefits. Lets say I am a woman and need birth control measures, what is the minimum cost to the system? What is the cost of visiting a doctor to get it covered?</p>
<p>I am a man aged 50 (55?) and visit a doctor for colonoscopy- what is the basic coverage cost? I might show up because I have no cost whatsoever. </p>
<p>How about a routine blood screen? </p>
<p>I was told by a colleague that our company is issuing us a debit card to use when we visit a doctor to cover the preventive care provision which means that is the expected upfront cost they are expecting to confirm to the law. He mentioned $1000 on the card but he has a whole family covered and so I am not sure I will get that amount. However, I would be surprised if they are not expecting me to spend at least 300-400$.</p>
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<p>The numbers I was using said that the bottom 50% used less than $900 per person per year. Someone who starts costing $500/year instead of $0/year is still in the noise.</p>
<p>“I was told by a colleague that our company is issuing us a debit card to use when we visit a doctor to cover the preventive care provision which means that is the expected upfront cost they are expecting to confirm to the law.”</p>
<p>I don’t understand this. When you go for you annual checkup there is no cost to you, your insurance will pay 100% of the cost. Do you mean the debit card will pay for lab tests the doctor may order?</p>
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</p>
<p>[MMS:</a> Error](<a href=“http://www.nejm.org/doi/full/10.1056/NEJMsa1212321]MMS:”>http://www.nejm.org/doi/full/10.1056/NEJMsa1212321)</p>
<p>…but we already had this discussion and several on this thread dismissed the study and like Kaiser’s spin on it better.</p>
<p>"I don’t understand this. When you go for you annual checkup there is no cost to you, your insurance will pay 100% of the cost. Do you mean the debit card will pay for lab tests the doctor may order? "</p>
<p>The debit card will cover the “no cost” part of it including the check up. </p>
<p>“The numbers I was using said that the bottom 50% used less than $900 per person per year.”</p>
<p>Did not realize the cap is at 900. That is quite high. I wonder what percentage comes in at zero+</p>
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<p>Do you have any proof of that? Because, frankly, I think that’s a bunch of bull.</p>
<p>“The debit card will cover the “no cost” part of it including the check up.”</p>
<p>Ok. Sounds like a weird way to do it, but your company must have their reasons. Do they self insure?</p>
<p>I believe so but we have coverage through pretty much every major player out there (Aetna, Cigna, Unitedhealthcare, Kaiser to name a few).</p>
<p>Think of people being on multiple plans - PPO, HMO, upfront deductible until a certain amount before you start sharing - the list goes on. </p>
<p>How do you break out routine/preventive billing from the standard plan? In the past I would pay 20/40 $ when I went to someone but I should no longer be doing that right?</p>
<p>See where all the random thoughts take us? I am confused by recent posts. TPG needs to learn what that debt card is for. Is the employer offering a lump sum against your costs? See what you can learn. TPG, if you are not changing your plan, not in the midst of all this checking, I can understand why some if it seems confusing. Routine lab work as part of an annual, eg, is meant to be covered. If your doc throws in something else, it may or may not be. Again, we have to look into these things. </p>
<p>I happen to be on hold with BCBS now and am asking some of these questions. Some misc details will depend on your policy</p>
<p>The phrase “pent up demand” refers to a bump in how people previously not insured use their new coverage; it’s projected for 2014 and not expected to be a big deal after that. That’s from Kaiser, I believe.</p>
<p>“eg, is meant to be covered” </p>
<p>I believe this is what they are addressing since today I go to the doctor, I make a copay, get some tests done, make the deductible or pay a percentage and so on. Tomorrow, I pay nothing but also tomorrow, there are certain areas of my care that need to be absolutely free while the follow ups may not be.</p>
<p>I am still waiting on the debit card with the instructions on its usage!</p>
<p>“How do you break out routine/preventive billing from the standard plan? In the past I would pay 20/40 $ when I went to someone but I should no longer be doing that right?”</p>
<p>If it’s a preventative check-up it would be indicated by the code checked on the bill submitted to the insurer. </p>
<p>Right, the $20/$40 was your co-pay. </p>
<p>I still don’t understand what the reason your company is choosing to do it that way. Each of those companies should know what the negotiated price is for a check up and be able to pay the provider.</p>
<p>Texaspg, my insurance company (Blue Shield) implemented the free preventive care aspect of ACA right away, even on my old policy. I have no co-pay, but I do have a high deductible HSA plan. (Deductibles have ranged between $3500-$5000 over the years, will be $4500 under ACA so not much different). The way it works is I don’t pay anything up front to see the doctor or use the lab – I just provide my insurance card. The provider bills Blue Shield. If it is coded as preventive, Blue Shield pays 100%. If not, Blue Shield determines the allowable rate for the service and I pay that – and that is applied to my deductible. (I’ve got a debit card tied to my HSA and typically use that)</p>