[Jeff Hail]

Shop, shop, shop!

Doctors in California have gotten very keen to the insurance industry. A few remain stagnant when it comes to what carriers they accept and how they bill. At the end of the day they will get paid no matter what the insurance provider pays, customer will get billed for the difference. At the same time you dont want your insurance provider dictating what level of health care you deserve but they feel they should pay.

I think its more like 80% percent dont accept ACA plans. Number seems to be growing.

Also something in the past few years is happening Doctors no longer classify themselves as GP's and go to Specialty Practice for billing purposes which allows them to bill at higher specialist rates. I personally have no issues with this as in network allowances for GP rates as so low it makes no sense to accept that insurance carrier any longer.

I have family and friends that are practioners. I have two Doctors that are great. None accept insurance any longer because #1 it takes too long to get paid and #2 costs too much to employ people to get paid. By the time they do see payment its 90 days down the road. These Doctors are super busy and will spend 2-3 hours with a patient versus 40 minutes trying to cure the world.

It is also not uncommon for a practice to have $750,000 to $1 million in receivables on the books while still paying off medical loans , tuition, rent, lease, practice, employee's, billing sub-contractors, malpratice insurance etc.

Doctors are not doing anything for a $150 or $200 visit anymore. If anyone thinks they are wise up.

Get good insurance with a good carrier if you can. The best you can afford. If you can get into a group plan to dilute the cost pool try to. Evaluate premium cost, deductibles, current age and health considerations. Look at health insurance for the big cost items, open heart surgery, bypass, valve replacement, joint replacement, cancers, pre-existing concerns. Have kids and /or spouse versus being single all need to be factored. Drink or smoke all matter on what you will pay. Small stuff like office visits or cheap meds consider paying cash for them. Most medical practices will discount a self -pay bill and not have to go about collecting for it.

If you have lab work let them bill your carrier so you can get the agreed contractual rates and discounts are applied to when the out of pocket comes to you.

Most importantly if you are not healthy and have sins to pay and atone for get healthy, get on a program or talk to someone to get you in the right direction. Lots of free stuff for nutrional guidance, physical activity and lifestyle adjustments is available.

Friend of mine griped at having to pay $7k a year in premiums with a $1000 deductible and no co-pays. Until he had a full chest crack quintuple bypass, aortic valve replacement, pace maker, 4 stents, saphenous vein harvested for coronary bypass surgery all in the same day. Bill was $450k for a weeks work. $1,500 ambulance ride he paid for which was credited towards his deductible.

Looking at the cost versus the scope of repair and replacement he received a bargain.
A lot of people think it or nothing will ever happen to them. With age it will, its inevitable.

Also think about long term care insurance. Cost is about $3000-4000 a year. If you are disabled or unable to care for yourself its a bargain. Post surgical care recovery outside the hospital setting needed that is not covered under out patient services or home medical coverage. Most long term care has limits of around $2500- $2800 a week for a good policy. The term is usually unlimited. Current caregiver rates are about $15 an hour for semi-skilled persons live in 24 hours per day, cost is around $360 a day. Premiums are also deductible as medical expenses on taxes. Do the math, if you are getting older really consider long term insurance is a steal.