<p>Steve…Nah… i’m good. I don’t need a broker. </p>
<p>You have pushed me to change my plan…so… I think…thanks for that. We will see how much my new plan has price increases.</p>
<p>I think you need to read stories like moonchild’s. There are a lot of people with coverage that have problems …and there are people that really struggle to get any insurance coverage at all.</p>
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<p>(Y)</p>
<p>Agree with you completely here!!</p>
<p>weatherga-if you expect perfection from anything you won’t find it. Yes, coding issues happen, especially for procedures that can be coded either preventative or diagnostic. Yes, as a consumer you do have to have a little knowledge of your plan. One phone call took care of that issue. How often do you really need to make those calls? Is is really THAT hard or are you exaggerating a bit?</p>
<p>dstark–you need to approach your plans like companies do, shop them annually for the best rates. If you stick with the same plan year after year after year, that is where you get hit the most with increases, especially now with all the changes happening.</p>
<p>poetgrl–the problem with your lawsuit is it isn’t the insurance companies that determine coverage, it is whomever bought the plan-your company if you work for someone else or you if you bought your own plan. Who really is at fault then?</p>
<p>Many posters on this thread have had trouble with finding, using, paying for health insurance and there is just one poster who is belittling those concerns or experiences. People! What are you complaining about? It’s not that hard, that bad, that unfair, that unbalanced. It’s just that you haven’t done your homework. If you tried a little harder you wouldn’t be having these problems.</p>
<p>SteveMA, I do have to make these kinds of calls quite a lot. Another family member has a chronic health condition and their care frequently causes insurance issues. Then there’s the annual exercise of deciding which version of coverage to choose, and how much money to put into our flexplan account. (Well actually, for my family, that’s easy. We put the max and always run out).</p>
<p>All of this probably just sounds like “choice” to you, or so simple and trivial it’s not a problem. I feel like someone trying to explain that electric lighting really is better, to a person who’s only ever had candles. Gosh, wick trimming just takes moments. You can have loads of consumer choice when shopping for candles, while electrical service is (horrors!) a government regulated monopolistic utility.</p>
<p>I presume you’ve not lived outside the US, and are just not able to imagine how much less stressful life can be.</p>
<p>wellspring–again, it is NOT hard. Do a google serach for health insurance carriers in your state, open their websites. There will be a link to individual plans. You enter your zip code, the ages and genders of those needing coverage and click next. They will show you side by side comparisons of various plans, what the deductibles are, what the premiums will be, what is included in the plan, etc. If you don’t want to go through the work of checking each company, do a google search for health insurance brokers in your area, pick up the phone and call them. They will as you the same questions as above and get you quotes. What is so hard about that??</p>
<p>Canada’s insurance model is not much like US Medicare. Canada controls supplies, Medicare doesn’t. Provinces in Canada give lump sums (“global budgets”) to hospitals, which severely constrains the quantity of services hospitals can offer, and which directly leads to the wait times that have been published. (And I consider reports on wait times commissioned by the Canadian government to be reasonably authoritative summaries of true waiting times.) They even determine whether a hospital should get an MRI machine, and if so, which one. That’s a throttle on health care costs in a huge way. </p>
<p>Medicare is fundamentally a fee-for-service model – the Medicare administrators (and there are multiple private companies around the US that are the local administrators for Medicare) do not determine supply of medical services. They don’t restrict what MRI equipment a hospital purchases, or set a limit on the hospital’s overall annual budget. </p>
<p>Comparing Medicare to the Canadian system is really like comparing apples and oranges.</p>
<p><strong>thrive</strong></p>
<p>stevema–I’m glad you for that you appear to live in insurance utopia. Unfortunately, most of the rest of just don’t. Even those of us with employer sponsored plans.</p>
<p>A single phone call to fix a mess–wow, why didn’t I think of that? You obviously either never have a medical claim or you do not deal with the average Anthem phone clerk. Sorry if this is any of you, but they are morons. </p>
<p>One example–I have tons–At one of my mammograms, they determined I needed additional films. Then, due to those films decided they needed to move on to an ultrasound. This took me a YEAR to get them to pay. They told me the ultrasound was not diagnostic–I had just “chosen” to get it. </p>
<p>Another time, they were a YEAR behind on paying for my D’s specialty home health drug. I ended up having to send a certified letter to the CEO of BCBS. $7,000 per month, all of which had been pre-approved. $84,000 hanging out in financial “limbo-land” doesn’t help my sleep pattern.</p>
<p>Coding issues “happen”. Yes, according to Anthem most everything is a “coding” issue. Then the dr. office says it was coded properly. I have never gotten Anthem to fix the code–NEVER. It has to be resubmitted from the dr.'s office.</p>
<p>I definitely believe the above poster who said it’s a second job to stay on top of claims. For anyone with health conditions, it’s not a second job–it’s da*n near equivalent to another job! As they mentioned, that’s not including submitting all the documenation that’s required to substantial FSA charges.</p>
<p>"(And I consider reports on wait times commissioned by the Canadian government to be reasonably authoritative summaries of true waiting times.)"</p>
<p>Remember: the vast majority of hip and knee replacements in the U.S. were funded by the socialized, single-payor system. Provide the same number of dollars per capita in Canada and all wait times virtually disappear. Not that we ever experience them in BC. (Do you have any idea what the wait time is in the U.S. for non-single-payor paid hip and knee replacements? I’ll bet it is at least four months - I know it would be at least that in the highest ranking insurance company in Washington State.</p>
<p>Steve…you have to listen…I wasn’t able to change my plan until recently…</p>
<p>Because of the new healthcare plan…I am able to change…</p>
<p>I did try to change right before the new healthcare plan was passed and Anthem said…</p>
<p>“You have a pre-condition. The answer is NO”.</p>
<p>Now during the last year there have been two opportunities to switch. I turned down the first opportunity. Anthem said they may increase my
rates high enough that my switched new plan may end up costing me more than my existing plan.</p>
<p>After a year of 30% increases with new increases promised…up to 26%…I think I am going to switch.
Anthem has warned me to think about the switch carefully. I am sure they are warning others…I am not special. ;)</p>
<p>The cost of healthcare insurance concerns me…but what really, really, really concerns me is the rate of increases. Because I am a finance guy and the compounding of rate increases can become problematic. ;)</p>
<p>I am giving out way too much detail about myself. There are so many people I know that have issues.</p>
<p>And Ucbalumnus is correct in his/her posts. I am not commenting on what he writes…or what she writes because…I have already said that stuff myself. 
so ucbalumnus thanks for your posts…and again thanks for all the posters…sharing their experiences.</p>
<p>I have extremely good, extremely inexpensive (to me) extremely subsidized heatlh insurance through an employer. Which is good because I have a kid who can rack up $60,000 in hospital bills in no time at all. We usually hit the maximum out of pocket in the first week of January.</p>
<p>But all that time he’s in the hospital I am surrounded by people whose kids are just as sick, just as in need as mine but who don’t have the same coverage. Who are going to lose all their savings or who will never be able to pay their bills, who are probably not offered the same treatment options as my well insured kid. </p>
<p>You can call all over town, you can take all the brokers you want out to lunch and you’re never going to get health insurance like my child’s unless you are lucky enough to get hired by a company that provides it. </p>
<p>And that’s not right.</p>
<p>sryrstress–actually I have spent the better part of last year jumping through hoops for a medical issue. In the end, it was taken care of, but a lot of work on my part and it helped that I knew what our policy covered. I never said it was perfect, however, I would STILL be waiting for this medical issue to be taken care of in Canada vs being able to call my dr one day and having the appointment the next and the procedure done that same day–not life threatening either.</p>
<p>Sryrstress – While I hope you don’t have any more “coding” problems, if you do, and can’t get them quickly resolved, consider filing a formal complaint with your state insurance commissioner. We had a problem, the insurer was recalcitrant, I filed a complaint, the state issued the insurer a copy of the complaint and a demand that they respond to the state within 30 days, and within a week I’d been contacted by some escalation department at UHC, and the problem went away.</p>
<p>Wellspring …thanks for your posts. I wish you the best…</p>
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<p>And you know this how?</p>
<p><a href=“https://uc2011.chooser2.pbgh.org/Pages/Costs.aspx[/url]”>https://uc2011.chooser2.pbgh.org/Pages/Costs.aspx</a></p>
<p>Here is a handy chart for plan costs for Bay Area CA. These are employee costs with the total cost (~80%) paid by UC for someone with salary 100-150K. Clearly Anthem is the most expensive of the options, and Kaiser one of the lowest. Kaiser consistently ranks among the highest in customer satisfaction (unless you were a kidney transplant patient several years ago). Choices are available, and Kaiser P is an excellent alternative to the high cost options.</p>
<p>Momsquad…i can’t read your link.</p>
<p>Some of the sellers of insurance are not the most honest individuals, IMO, and the insu companies themselves are scum. As a provider, my billing office fights with them day in and day out. There is no such thing as a “simple phone call” to straighten something out. She sits on hold for 45 min, gets transferred or cut off. Gets told its “in process” and then another denial comes several weeks later and she starts anew. In some cases, even with preauthorization, they deny at the back end and it takes sometimes 2 years (yes, you read that right) of constant appeals, documentation, etc to get a claim appropriately processed. They just hope we will give up. It is so frustrating.</p>
<p>I just got a whopping $67 and change in the mail for some class action lawsuit that was settled against UHC. They are the worst of the worst at the moment (this honor changes- different companies rise to the top of the “worst to deal with” list). I am about to go apply my whopping windfall towards a much needed massage.</p>