<p>Great stuff Theresa. I think for most of us the way insurance works is a mystery. I have found out a great deal in the last few months and most of the time, my reaction is “you’re kidding me!”</p>
<p>DS tried the bartering with the dentist. He has NO dental coverage. He even HAD the EOBs for the same services with the WRITE OFF that the dental group took when he WAS covered on our plan. He told them that he wanted some kind of discount because folks without insurance should not be paying more than those with. They would not budge.</p>
<p>I have no dental coverage - no prescription coverage either. My dentist gives me a courtesy write off to put me on par with those who have insurance. </p>
<p>With regard to young people with pre-existing conditions, some will have to specifically target jobs with group policies as the protection offered is much greater for those in a group and there is federal limit on how long a pre-existing condition can be used to deny coverage. Relying on the individual policy market is expensive and risky because there is nothing to stop the carrier from refusing you, dropping you or raising the premium to the point of no return.</p>
<p>Would anyone be willing to recommend an insurance company and plan they bought for their recently graduated unemployed son/daughter? Cobra is a possibility but would be very expensive for us.</p>
<p>If you live in CA, CT, NH, CO NV or GA…check the TONIK plans offered through Anthem/BC/BS. They are individual plans that really are designed for healthy young adults who don’t have group coverage. We looked into this for our son but he has prescriptions and this plan only offers $500 a year prescription coverage. BUT the TONIK plans offer office visits, dental, prescription(yes only $500 a year…but for a healthy young adult who is not taking any kind of maintenance med…that isn’t bad)…and a number of deductibles. The one we selected that didn’t work for DS was about $150 a month with a $1500 deductible. I believe it paid 100% coverage after the deductible. There is a copay for office visits and in CT is was $30. Don’t know what it is after that. The child MUST live in one of the states. In other words, kid can’t live in NC and get coverage in GA because parents live there.</p>
<p>This plan was recommended to me by two agents. Very likely it is what we will get for DD when she moves home in June and is no longer on our plan. She is healthy…now.</p>
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<p>I once read an article in the Boston Globe which explained that uninsured patients pay way more than those who are insured (especially through a group health plan) because doctors, dentists and hospitals try to recoup the money they think they are losing when treating insured folks. For a diagnostic surgery whose cost might be $1800, the HMO pays out only about half, the patient pays the co-pay (ours is $15). But an uninsured patient pays the whole $1800. I suspect the actual cost of the surgery is less than $1800; but the price is inflated to make up for the fact that an insured patient brought in only half of that amount.</p>
<p>S2 is still on our family health plan until he is 26. We hope that by then, he will have a job and be self-supporting!</p>
<p>My son was recently treated in the ER of a hospital and neglected to present either of his insurance cards. When the bill came the charges read:</p>
<p>Billed Balance: $2496.00
Adj - Self-Pay - No Insurance: $1896.00
Patient Responsibility: $600.00</p>
<p>He ended up forwarding his insurance information and expect that eventually he will only pay the $150 deductible, but I was surprised at the huge discount offered to someone with no insurance. Made me understand why insurance drives up the cost of healthcare.</p>
<p>Archiemom, not really correct. The hospitals generally participate with many insurance plans, and they won’t get the full amount either. I get notices from my ins co if one of the hospitals in the area no longer accepts the insurance, so I know to go to another for elective things (even er can be elective depending on the problem.)</p>
<p>As to no ins vs. high deductible, it is not accidents that are really the issue. If God Forbid, someone gets an illness (like leukemia as mentioned above), they will really have a problem getting care. Much of that treatment is not considered emergency service, and will not be available without a cash deposit! A big deposit.</p>
<p>If you are injured and found unconscious in Central Park, they will take you to a city hospital (likely Metropolitan), and you will get care, hospitalization etc. However, lets say you need reconstructive surgery, wouldn’t you want insurance for that? </p>
<p>No ins. is penny wise and perhaps pound foolish. Once you are sick or injured, you then have the dreaded preexisting condition for new coverage.</p>
<p>Archie,
In hospitals that have been studied in New Jersey and California, the uninsured are billed far more than insured. It is a myth that most uninsured will get discounted or free care for hospital services. Some hospitals offer charity care for people who meet qualifications such as 100% above poverty level, etc. Typically an uninsured person is a citizen who is employed full-time and has some assets (equity in a home, car, some money in a checking account). This person cannot receive non-emergency care from a hospital unless they produce a check-book or a credit card. If the hospital does not receive full payment rapidly, they will sell your account to a debt collection agency. (That is why you should be very careful about putting any medical bills on a credit card; if the hospital sells your debt to debt collection, your credit rating will be ruined and your interest rates will skyrocket) .</p>
<p>Hospitals make the argument that they charged uninsured more because they collect less. Perhaps that is true. But hospitals are not the only ones that charge uninsured more. Imaging centers, laboratories, doctors, drugstores all charge uninsured people more. Discounts are rare. But these medical providers are not losing money on uninsured. If you do not have the money for the medical care, you don’t get it. It’s that simple. </p>
<p>These providers are charging uninsured more to make up for the lowered fees charged to Medicare and privately insured patients.</p>
<p>Medical billing is mysterious and confusing, and the interaction of insurance, in-network versus out of network only makes it worse. But there are plenty of other areas where different people are charged different prices for the same services.</p>
<p>Movie theaters charge lower prices for children and seniors. They sit in the same seats that adults do and get the same services. Why do they pay less?</p>
<p>Many public transit systems have lower senior fares. Again, seniors sit in the same seats and get the same service.</p>
<p>So medical services are not unique in having discriminatory pricing.</p>
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No.</p>
<p>
Airlines for one.</p>
<p>We are in California and went with a Kaiser plan that is $130 per month with a $1500 deductable. Our son is working as an engineer in a position that normally offered health insurance but with the down-turn in the economy they told him up-front they could not give it to him right now. At least he has a job. We bought this policy primarily for a catastrophic illness or injury. We did not want him to come out of an ER or hospital stay with $100,000 in debt. Plus, if something huge really did happen to him, we figured we would end up in debt as we would not let him go without treatment. We have seen the kind of treatment that non-insured patients get, and it is far from the best!</p>
<p>Nitpick:</p>
<p>If you try to get a lower price from a medical provider, that is BARGAINING (or haggling), not BARTERING.</p>
<p>Bartering would be offering the doctor non-monetary goods, like a watch or a car, in exchange for services. If you’re paying money, it’s not barter.</p>
<p>“Who tolerates such in the world outside of medical service?”</p>
<p>Colleges, too.</p>
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Would these by any chance be the same parents who say that financial aid will take care of putting their kids through college, or that their kid is so smart, he or she will get a “full ride” to an Ivy league school?</p>
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<p>Insurance of any type is a hedge, derivative, flipside-of-coin, the opposite, against the primary product. There is NO substitute for insurance save, self-insuring-the-risk, which in itself is a type of insurance. </p>
<p>The counter examples of airlines, hotels, colleges, and even food are not examples of products that have alternative pricings that mimic the pricing of insurance. The aforemention products are perishable. The producer has a product that fails to have “value” after a certain time and the producer will do what is necessary to sell that product at a profit before that product expiires and before the consumer moves on towards an alternative product, which may not be exactly what he may want, but close enough. Insurance does not have these features.</p>
<p>If your kid gets hit by a bus, he has to DEMAND to see an in-network ER doctor and not let anyone touch him because the insurance companies will use that as an excuse to deny his claim. Ridiculous.</p>
<p>Just remember that insurance companies are *******s and you should collect every single piece of paper they send you, read it thoroughly, and let them know exactly what you think if you disagree.</p>
<p>"These providers are charging uninsured more to make up for the lowered fees charged to Medicare and privately insured patients. "</p>
<p>I’d put that a LITTLE differently. Providers charge what they consider a fair, “market” rate, and insurers tend to demand a discounted rate in exchange for “volume”.</p>
<p>With my high deductible policy with BCBS north carolina, the $2500 deductible applies to hospital stays. Regular doctor visits are $25 copay, specialist is $30 copay, ER is $50 copay, generic perscriptions are $10, just like the low deductible plan.</p>
<p>We are paying S’s monthly insurance premiums on his high deductable insurance (he is an independent contractor) and so far he hasn’t needed it. Only routine care, like the annual dental checkup. I consider us lucky and would never ever consider not paying for it. Some day soon, he will be able to afford it himself.</p>
<p>Anyone heard of a good plan in Ohio? Seems like Aetna and UnitedHealthOne have a variety of products here but it is rather confusing.</p>