$15,780 for a dislocated hip ??

[wdfifteen]

Originally Posted by JanusCole

Honestly, any American who pays much more than $2000 per year for top shelf medical care is a chump who deserves to be taken advantage of.

I guess I'm a chump. I buy health insurance for my employees - 10 families. Renewal time is an annual rite that i dread more than April 15th. Every year ALL of the health insurance plans available in my state are compared. The same company isn't the cheapest every year. Some of my employees cost me less than a $1000 a year (30 year old male). A 50 year old female - no way. I agree I'm being robbed, but my staff and I put a lot of work in every year to get the best deals and some of our people still cost more than $2000/yr.

[Wrecked944]

wdfifteen, I don't know you but I'd gladly help. I had no problem finding many excellent and affordable private health plans when I was looking. MANY. It took all of about ten minutes. And like I said, I'm 44 years old and I have the mother of all pre-existing conditions. So if I can do it, I am certain *anyone* can. By all rights, my health insurance should cost more than anybody else's because of my heart. And yet even with congestive heart failure, I could have paid *less* - but I wanted free access to the cardiac clinic. I already listed the website of one excellent and inexpensive insurance company. So I am obviously not crazy. They really do exist. And all of my neighbors and colleagues have outstanding inexpensive private health insurance. I simply don't understand why so many people are paying so much *and* getting hit with medical bills - unless they somehow enjoy getting fisted. I get totally cheap and outstanding coverage and it was easy as clicking my mouse. I'm sure you are working very hard for your employees. So I have to assume you are simply looking in the wrong places. I'll gladly go back to my notes to see what websites I used and such if it would help.

[shbop]

Originally Posted by JanusCole

Hey Todd, I am still getting no joy from your email address. I also tried a PM but I have been away so long that I couldn't figure out how to make it work. So I am posting here and hopefully the trolls will leave me alone. Anyway, here is a link to my health insurance company...

"http://www.fchp.org"

My plan is as follows:

Cost: $164/month or $1986 per year
Pre-existing conditions? NO, nada, never - not even my Congestive Heart Failure
Full Coverage Day One: YES!
Co-Pay: $60 for a cardiologist visit
Cancellation? No, never, not for any reason ever. I will never lose my coverage. Period.
Telephone Customer Service? OUTSTANDING
Quality of medical care? OUTSTANDING++

Honestly, any American who pays much more than $2000 per year for top shelf medical care is a chump who deserves to be taken advantage of. And I like you too much to let you be a chump. If Fallon doesn't work for you then I am sure we can find a similar deal where you live. I know because I had no trouble finding a wide range of excellent and affordable private health plans to choose from. I went with Fallon only because of the cardiac clinic. So it is simply impossible that we both live in the same country and yet I pay a fraction of what you pay. Especially since I am sicker now than you will probably ever be in your whole life! Pick up the damned phone and switch companies! It is ludicrous that my heart should cost so much less than your hip! YOU ARE BEING ROBBED!

No offence there Janus, but you're either getting your medical care from a Cub Scout or your stated price per month is your share of your unions medical coverage. To have a reasonable plan in the USA, you'll pay $18k/yr. for a small family plan. That gives you most Dr.'s of your choice. The only way to do it cheaper is to be illegal, then of course, it's free; for the illegals. $2000/ yr. won't buy squat for medical insurance.

[Wrecked944]

shbop, I take no offense because I assume you've already called the number I gave for Fallon insurance company and verified that I am mistaken, right? Otherwise, it would have been extremely rude to post that comment without checking first. Look, I'm not going to argue with people on the internet - especially people who don't bother checking their facts even when I provide the damned phone number. This is why I left PP in the first place. Trolls. And yes, unless your small family has 9 people in it (all over the age of 40 and with incurable fatal illnesses like mine), then paying $18k for health insurance represents an EPIC FAIL.





TODD CALL ME! EMAIL ME! SAVE ME! I'VE HAD ENOUGH OF THE PELICAN TROLL PARADE!

[Noah930]

I don't see how you guys can try to compare insurance costs across state lines.

[Wrecked944]

Originally Posted by Noah930

I don't see how you guys can try to compare insurance costs across state lines.

Not me! Before the trolls chimed in I was only hoping to tell Todd about my positive personal experience with *provider based* health insurance (i.e. eliminating the insurance company d-bags entirely by going direct to a clinic). It was only after a troll claimed that the underlying premise of super-cheap health insurance was impossible impossible impossible did we end up in a pissing game about rates. That said, it would be hard for me if I had a small family at my age to explain to my wife how I had managed to pay $18k a year and had therefore essentially given a free gift to the insurance company over time equivalent to a new Carrera GT or a child's college education or a vacation home or a decent start on a retirement plan or a diamond ring the size of a walnut. And why again? Um...

Anyway regardless, Noah, you are a doctor, right? I use a clinic in my area called Fallon. I am not competent to rate them from a professional medical perspective. But from the perspective of a patient, I am very enthusiastic about the experience I am having. The seamless coordination between all of my doctors (even my eye doctor) is a new thing for me and I really like it. May I ask if the "provider based" business model is popular with physicians? I am having trouble finding a downside.

[Gogar]

Janus,

are you paying $164 a month right now? I'm just asking because those screenshots you posted are over three years old.


Do you have an individual plan or a plan through an employer?

Do you have a rural MA address or metro?

I looked at MA plans through that commonwealth connector and used a Boston Metro zip, and the lowest zero deductible plan I could get for a 44-year-old from Fallon was $374 a month, at any deductible level.



People questioning your facts or trying to talk to you is not trolling.

[Dottore]

I used to weigh in on these threads, based on my experience with the health care systems in Canada and Germany and Switzerland.

I sense that the tenor of the discussion has at least shifted in the US over the past couple of years. People are starting to realize—methinks—the the current US system is irretrievably fecked, and much less civilized than almost any European counterpart.

That, at any rate, is a start.

I don't expect much from my government. But education and healthcare are just basic.

[Noah930]

Janus my comment was not directed towards you, as you've surmised.

Doctors are people. Some people just want to do their job, and allow the business side to be run by others. Other people like to be captains of their own ship, and dictate their own workplace rules. Would you rather have a steady salary but have your work schedule/responsibilities/duties/etc somewhat dictated by management? Or would by rather see the patients you want to see, financially sink or swim based upon how hard/efficiently you work, and run your office yourself? I think that's part of the balance the physicians try to achieve when picking practice models.

from the perspective of a patient, I am very enthusiastic about the experience I am having

Unless you're getting some horrible care and don't even know it, isn't that one of the most important factors in selecting your healthcare providers?

[Wrecked944]

Originally Posted by Noah930

Unless you're getting some horrible care and don't even know it, isn't that one of the most important factors in selecting your healthcare providers?

Yes, exactly, I was only hoping that doctors were as enthusiastic as I am. The business model is new to me and I am hopeful it is popular with doctors.

Cogar, I suppose I did promise to explain how I did it, right? Okay, here goes...

First off, when searching for a provider based plan, location is everything. Fallon is local to me and so I will get the best price. I'm actually surprised Boston is even included in the coverage area. Using my zip code, here is a screen print using the Commonwealth Connector website...



The numbers you see on the web are averages So those numbers don't include any discounts (as noted in one of the screen shots I posted earlier). I actually started out just two or three years ago around the low $130's per month because I maxed out my co-pays and deductibles. For example, my office visit co-pays start at $60 - not $30. And all of my out-of-network deductibles were maxed to the annual limits. The biggest single savings I got however is that I went without a drug benefit. The older numbers I posted mentioned the no-rx option but the new ones don't seem to. Anyway, all of my drugs are generics and so I pay $4 each. That is actually less than the copay - So I'd literally be paying for coverage that I *couldn't use*. Dropping the drug plan was my single biggest savings. Jeez, I hope they still allow new customers to drop the rx plan - otherwise people like me would literally be paying for nothing.

Anyway Cogar, your underlying point is still well taken. Since signing up, my premiums have gone up something like what? 25%? The Bastids! It definitely pisses me off but I don't blame my provider based insurance. As for your specific questions, I pay directly to Fallon with no employer or other party involved. There is no subsidy of any kind. I live in Worcester, MA which is a *city* in Massachusetts. I know almost zero about how insurance works - like I said, I can't figure out how/why other people pay so much. All I know for certain is that given my age and especially my medical condition, NOBODY should ever have to pay more than me. My premiums should be the highest in the whole country. And yet...

Anyway, I googled the thing and hopefully the following screen print will help.

[Dueller]

Janus...is this part of the MA state plan that everyone against health care reform seems to demonize? How do MA residents react to their state subsidized plans? What is the public attitude towards the MA plan/taxes/premiums etc?

I really don't know...just curious....not trying to make this a PARF thread.

[Noah930]

Originally Posted by JanusCole

Since signing up, my premiums have gone up something like what? 25%? The Bastids!

Side note/rant: I go to one industrial clinic, where I see workman's comp patients. WC law says that if a patient doesn't speak English, an interpreter (not just a nurse or office worker who's bilingual, but a state-certified interpreter) must be provided and the cost is borne by the insurance provider.

So at this clinic, the interpreter helped translate on one particular patient 5 times or so. The interpreter is an independent contractor, so he bills for his own services separately. Well, the insurance company denied his bills, gave a bunch of canned answers why they denied payment (i.e. interpreter did not seek prior authorization), and even wrote something to the effect: "in these difficult economic times" they did not think it was proper that they should have to pay for interpreting services. So they didn't pay.

Maybe next time they raise your premiums, you should write back that "in these difficult economic times" you shouldn't have to pay more, either.

The golden rule: He who has the gold, makes the rules. In general in the world of medicine, "he" is the insurance industry.