Do you have private health insurance...??

[carole]

The reason i started this thread was that i was watching our local TV programme Sunday last night, and it was about health insurance in the USA.

I was astounded at what i saw,so many people cannot afford health insurance and so many are dying because of it.

They had people arriving in cars at 5.30 am in the morning from out of state to get free medical care,babies, young mothers etc etc.

They were saying it cost like $12,000 dollars a year to have insurance.

This one poor young mother of five children, needed a liver transplant, had two type of cancer.

They were also saying drugs are like twice the price of anywhere in the world.

Now i am wondering what is your experience, is this all true or is it media hype.

I was horrified and sad at the same time.

I believe Obama is going to right it all at a cost of tribillion dollars.? I ask how?

We in NZ still have a public health system, thank god, i do have private medical insurance, because i choose to, but it is only for surgical cover, and cost us for a family of four $1600 dollars a year, and believe me it is a struggle to pay, but we do, of course when we are elderly i doubt we will be able to afford it, as it will be like $600 a month then, going up every year as we age, and of course we get a discount at the moment because we have not had any surgery's cross fingers.

Anyhow would love your opinions,and to discuss this with you all.

Again it was a real eye opener to me.

[chocolatepuppy]

I have health insurance through my employer for myself and my husband. It costs me nearly a weeks pay to pay for it. With the new plan they started this year, they pay less and copays and deductibles are much higher. Still, I'm thankful I have it, it truly could make the difference between being treated or turned away.

[pomtzu]

Medical insurance is very expensive, and not everyone here is fortunate enough to have coverage paid in full or even partial by their employer - if they're lucky enough to even have a job! When I had to retire 3 years ago on disability, I was not old enough to be on Medicare, so I had to pay to continue with the coverage I had at work - to the tune of almost $500 per month. And that was just for me. I couldn't afford it, but at the same time, couldn't afford to be without it, so what choice did I have? I have since become eligible for Medicare, and pay $96 per month for that, but Medicare doesn't cover all expenses, so I had to purchase a supplemental policy to cover those expenses, and that runs me $121 per month. A lot better than the $500 I was previously paying.
I can understand why so many people have no medical insurance, and in this country of ours, it is a shame that this situation exists. But after paying the mortgage, utilities, food, and other living expenses - there's not much - if anything left.
I hope that this new administration of ours can do something to help alleviate this situation. So many people are doing without medical care because they just can't afford it.

[carole]

I don't know how it all works over there, but here even if you don't have private medical insurance, you can see a doctor, we have a community services card which allows us to get cheaper doctors fees and prescriptions, you have to qualify for this, hubby and I do, your income has to be within certain limits.

And you can still get operations and seen to at our public hospitals, of course there is a waiting list, and that is why i choose to have surgery cover incase i need urgent surgery i can have it, as waiting for the public might endanger one's life or one may be in a lot of pain until you receive surgery.

I thought medical care in the states was only not affordable for those who were on very low incomes, the poor, but at $12,000 dollars a year, we certainly could not afford to pay that, it seems outrageous and yes in a country such as the United States, it is not good enough is it?

I think at one time they were trying to privatize all medical care here too,but i am so thankful it did not happen, as it stands now one does have a choice and one can get medical care, no matter what your financial status is.

[pomtzu]

Yes - there is coverage for low income folks, but the "average Joe" usually makes too much money to qualify. I guess the one benefit here is that we don't have the wait or have to go to designated providers for care that you do with a public health care system. If we feel that we aren't getting the care or consideration deserving of a condition, we can always go to a different doctor, and we don't have to wait sometimes months or longer for a particular test or procedure. If I were to go to my doctor tomorrow and he said I had to have an MRI (or whatever), it would be scheduled and performed in a matter of a few days or less. I guess that's why we pay the big bucks!

[ramanth]

Thankfully my medical (including dental, vision, and prescriptions) are covered by my employer. They pay about $14,000 for it.

[Edwina's Secretary]

Private insurance is the major health care system in this country. Public health care is only for retirees or indigent.

Most people have their private insurance through their employer and the employer might pay a portion of the premiums. Consequently, many employees do not know the real cost of the coverage until the company is no longer paying it - loss of job, etc.

An adequate plan will cost around $900 to $1,200 a month for family coverage. And still the insured will need to pay co-pays and deductibles.

With so many layoffs now I often have the responsiblity to tell employees being laid off what they will need to pay if they want to have medical insurance.

It is very difficult. I had an employee just last week call me frantic how he will provide medical care for his family if it will cost him over $900 a month. And he will only get about $2,000 in unemployment benefits.

The stimulus plan just passed by Congress has a provision that will pay 65% of the premiums for employees involuntarily terminated for nine months.

This will be a help.

[carole]

wow really, that is fantastic, i still prefer our system, i guess it is the only one i know, with the private medical insurance, we also can have treatment rather swiftly, but a few days is really great, we would probably still have to wait about two weeks,but you can pick and choose as well, that is why i have chosen to take it out even though it is almost not affordable for us, as we get older when we need it most, is when we will probably have to stop it as we just will not be able to afford it,plain and simple.,and that worries me alot.

I am somewhat confused, as this programme showed hundreds of people lining up at all hours of the morning to get free medical care as they cannot afford private insurance, but yet you are saying there is coverage for those on low incomes, can you please explain, thanks.

Ok just read your post edwinas secretary, here public health system is available to all no matter what your financial situation is, rich or poor, you can choose as of now,there i see a bit of a grey area, i think if you can afford it, you should have to take our medical insurance, that way the waiting lists will go down,for those who cannot afford it.
Maybe we should be rewarding those who take our private medical insurance, the government should pay a percentage, but of course whether that is financially viable i don't know, but i think it would be a good idea.we also have employee schemes which means we can get it cheaper, we did not opt for that with my husbands employer because we have to basically start all over again, and any pre-exisiting conditions would not be covered, so that was not a good option for us alas.

[pomtzu]

I am somewhat confused, as this programme showed hundreds of people lining up at all hours of the morning to get free medical care as they cannot afford private insurance, but yet you are saying there is coverage for those on low incomes, can you please explain, thanks

I wish I could explain - but I don't know of any situation like this. The low income here that are on public medical care, can go to the same doctors I go to. I couldn't tell from looking at people in a doctor's waiting room, who is there with high priced insurance, and who is having it paid by the government.

[Edwina's Secretary]

Yes - . I guess the one benefit here is that we don't have the wait or have to go to designated providers for care that you do with a public health care system.

This is not necessarily true. In many HMOs if you do not like your doctor or the service you receive the only way to change (at least until the next open enrollment) is if you want to pay the whole thing on your own (and who can afford to do that??) I had an employee recently who needed to see a specialist but her HMO could not schedule her for weeks.

Most plans today are HMO or PPO - in an HMO you do not have coverage unless you do to the designated doctors/clinic/hospital. In a PPO you can go to other than the designated but your benefits will be reduced (often sharply.)

And doctors go in and out of plans. In Chicago we had a doctor we liked very much. His hospital decided not to stay in the plan we had. We either had to change doctors or switch to a lesser plan in order to continue to see him.

[pomtzu]

This is not necessarily true. In many HMOs if you do not like your doctor or the service you receive the only way to change (at least until the next open enrollment) is if you want to pay the whole thing on your own (and who can afford to do that??) I had an employee recently who needed to see a specialist but her HMO could not schedule her for weeks.

Most plans today are HMO or PPO - in an HMO you do not have coverage unless you do to the designated doctors/clinic/hospital. In a PPO you can go to other than the designated but your benefits will be reduced (often sharply.)

And doctors go in and out of plans. In Chicago we had a doctor we liked very much. His hospital decided not to stay in the plan we had. We either had to change doctors or switch to a lesser plan in order to continue to see him.

Yes - that's true. But you do have the option to go out of network.

Another thing that I find rather ludicrous, is what doctors are "allowed" to charge. I'm now on Medicare and supplemental insurance, and I questioned a recent bill for a routine follow-up visit with my primary care doc. I was charged $122 for a simple office visit, yet a sign in the reception area stated that rates were now $70 for the same. When I called the billing dept to question it, she told me that he charges me what Medicare "allows", and that the $70 was for cash patients with no insurance. So the government is allowing doctors to cause rates to be high. What's wrong with that picture??? Fortunately my supplemental picks up what Medicare doesn't pay, or I couldn't afford to go to a doctor either!

[carole]

Woah the charges are expensive over there, i do have a community services card so i get my doctors visits at around $40 a visit, without the card is around 60, my hubby gets a 15 min visit for only $10, he just enrolled at this medical centre, if you are PHO enrolled here you also get it cheaper again.

I wish i could remember the state this was filmed in, i think it may have been kentucky, but i am not really sure.

[Taz_Zoee]

I didn't read through all the posts. But I had insurance through my employer until this past December. They had been offering two different carriers and this year dropped the carrier I was on. I didn't want to go with the other carrier (sorry I don't like Kaiser). So I went independently. It's not much more expensive for me. But then again, I am single and "fairly" young and pretty healthy overall.

[pomtzu]

Woah the charges are expensive over there, i do have a community services card so i get my doctors visits at around $40 a visit, without the card is around 60, my hubby gets a 15 min visit for only $10, he just enrolled at this medical centre, if you are PHO enrolled here you also get it cheaper again.

I wish i could remember the state this was filmed in, i think it may have been kentucky, but i am not really sure.

Yikes - that's cheap - I'm moving to NZ. Got an empty room???

Since you said Kentucky, I'm wondering if that was part of the t.v. documentary on the people of Apalachia, since I didn't see it. I'll bet it was. That would make sense then, since these people are very isolated and keep to themselves, and are not in an area that has medical care and facilities readily available. But this is not the "norm" of low income folks - it's just a "handful" and not a fair comparison of the overall system of medical care for those of low or no income.

[buckner]

Yikes - that's cheap - I'm moving to NZ. Got an empty room???

Since you said Kentucky, I'm wondering if that was part of the t.v. documentary on the people of Apalachia, since I didn't see it. I'll bet it was. That would make sense then, since these people are very isolated and keep to themselves, and are not in an area that has medical care and facilities readily available. But this is not the "norm" of low income folks - it's just a "handful" and not a fair comparison of the overall system of medical care for those of low or no income.

I'm living in the Appalachia part of Kentucky, and I'm not at all to myself or isolated. Also, we do have medical facilities. In the smaller towns and cities here, pharmacies and doctors close early and such, and in the larger towns, they can stay open all night. If the Appalachians that live in the hollers and way up in the mountains don't know about medical coverage, they don't get it because they don't desire it.
I don't know, guess I don't like stereotypes. We don't all live without medical coverage or have low income and stuff.

Personally, because I'm still a full-time student, I'm still covered by my mother's insurance. She gets ours through her work. Her job pays the majority each month, but she still gets quite a bit deducted from her pay. If I ever stop being a full-time student or when I turn 25, my insurance will cease and I will have to find my own. I'll have started my career before than, so hopefully, all will be well.
My boyfriend does not have insurance. Simply, he cannot afford it. He can't even afford to go and pay out of pocket if he is sick. Insurance is insanely high, and so are office visits!! I can't even begin telling you how many illnesses he has had that have gone untreated. He hasn't seen a real doctor in years. Not a dentist, not a general doctor, nothing.