Government run health care

[Lady's Human]

That has nothing to do with .gov. It's how insurance is written, period.

Roll your eyes all you want, reality is reality.

[Edwina's Secretary]

Give it up LH. Some people just don't want to understand reality.

After all, brain surgery will probably be covered in the plan as well and .......!

[Cataholic]

A true, but odd, insurance event.

I get an EOB for J's 5 year check up- something that should be covered without cost to me- under the 'new' plan. I see all but $70 is covered, and the whole bill is $500 something. An amount that I found outrageous, btw. We were there for 15 minutes of the doctor's time. But, I digress.

So, I called the insurer (Anthem) and asked about the $70 charge, and wondered why it wasn't 'free'. The woman (very nice) told me that only well visits are paid in full (and actually, they aren't close to being paid in full, but at a contracted for amount). I told her that I had scheduled the visit one month in advance, and that it was a well visit. She asked, seriously, "well, did you talk about anything besides well visit things?"

LOL. Well, yes, we did. J had another sinus infection, and the doctor, while performing the typical 5 year check up, checked his ears and saw fluid. And, wrote a prescription (for which I paid- out of pocket, $114 or $115 for a 20 day supply), noting in the the chart another sinus infection. And, he billed it separately.

I don't blame the doctor. He HAS to bill for every single event (like the 4 shots and the administration of the 4 shots...). But, that is crazy.

[Grace]

So, I called the insurer (Anthem)

I saw something about Anthem insurance and the State of Maine on the news the other day. I had never heard of them prior to that.

I found this from the Bangor Daily News.

[Edwina's Secretary]

Anthem Blue Cross - or just Anthem is the new name of what was Blue Cross or Blue Cross/Blue Shield.

Insurance companies have been merging, buying each other and changing names.

In some states it is still simply Blue Cross/Blue Shield I believe.

[Marigold2]

That is how everyone bills. A seperate fee for a seperate look-see.
Sorry I know that is lame. But that is the way it is done, it's legal, it's the norm.
If you go into a grocery store thinking that you will buy eggs and then pick up some bread you will be charged for both. Not just the eggs.
If you take your car in for an oil change and a tire rotation you will be charged for both.
When you go to the dr or hospital you will have indivual charges for all line items. Otherwise people would be in there for hours, can you check my ears, I have this mole, (can you remove it), my neck cracks, I have a foot fungas, my heart races, my eyes are blurry, I have the runs on other days I can't go. It goes on and on and on on.
There are some simple things we can do.
1) Use birth control. 1/3 of all births are now welfare babies. The cost is in the billions.
2) Don't smoke.
3) Watch your weight and exercise.
Just doing small things if people would take better care of themselves would ease the health care problem greatly.
When you see a crack mom giving birth to her 5th child and it to0 will have mental and physical problems you can imagine that this family alone with cost a million to support before they are 18.
Today I had an inner city man call and ask if we took Care Source I said "no I am sorry we don't" and he said F&^K you!! We all got a good laugh. What ya gonna do, either you laugh at the ignorant fool or you feel sorry for them and I have been in this business too long to feel pity for people like that.

A true, but odd, insurance event.

I get an EOB for J's 5 year check up- something that should be covered without cost to me- under the 'new' plan. I see all but $70 is covered, and the whole bill is $500 something. An amount that I found outrageous, btw. We were there for 15 minutes of the doctor's time. But, I digress.

So, I called the insurer (Anthem) and asked about the $70 charge, and wondered why it wasn't 'free'. The woman (very nice) told me that only well visits are paid in full (and actually, they aren't close to being paid in full, but at a contracted for amount). I told her that I had scheduled the visit one month in advance, and that it was a well visit. She asked, seriously, "well, did you talk about anything besides well visit things?"

LOL. Well, yes, we did. J had another sinus infection, and the doctor, while performing the typical 5 year check up, checked his ears and saw fluid. And, wrote a prescription (for which I paid- out of pocket, $114 or $115 for a 20 day supply), noting in the the chart another sinus infection. And, he billed it separately.

I don't blame the doctor. He HAS to bill for every single event (like the 4 shots and the administration of the 4 shots...). But, that is crazy.

[blue]

That has nothing to do with .gov. It's how insurance is written, period.

Roll your eyes all you want, reality is reality.

Group policies are absolute BS, they make it cheaper for the company selling the insurance and not making the product cheaper for the consumer. .gov thinking is group policy and it will cost us more. Men in Mass dont need IVF insurance but they have to pay for it anyway, and the cost of insurance has gone Up in Mass since insurance coverage became mandatory.

Getting rid of group policies for individuals will make insurance Co's work harder, but it can make policies for individuals cheaper.

You may be willing to pay for insurance you dont need, but Im not. Oh wait, I dont have insurance, and I think .gov healthcare is a bad idea.

[Lady's Human]

Getting rid of group policies for individuals will make insurance Co's work harder, but it can make policies for individuals cheaper.

You may be willing to pay for insurance you dont need, but Im not. Oh wait, I dont have insurance, and I think .gov healthcare is a bad idea.

Okay, let's write an individual policy......

You're a male, (cost just went up, we have a tendency to take lousy care of ourselves), some former mil experience (cost just went up again, tend to be risk takers), over 30 (Cost rises again).......ad nauseum. Exactly how does that make a policy cheaper, unless you're an 18 to 20 something male in good physical shape with no outside risk factors added in?

Group policies are written to spread the risk of the coverage over a larger group, and mitigate the risk of an individual. The bigger the group, the less impact one individual will have on the costs of the group.

[Edwina's Secretary]

Don't forget the brain surgery....

[blue]

Okay, let's write an individual policy......

You're a male, (cost just went up, we have a tendency to take lousy care of ourselves), some former mil experience (cost just went up again, tend to be risk takers), over 30 (Cost rises again).......ad nauseum. Exactly how does that make a policy cheaper, unless you're an 18 to 20 something male in good physical shape with no outside risk factors added in?

Group policies are written to spread the risk of the coverage over a larger group, and mitigate the risk of an individual. The bigger the group, the less impact one individual will have on the costs of the group.

You are a member of a union arent you?

[Edwina's Secretary]

LH...the part of this that really has me chuckling is....the proposal to have "individual insurance" is closer to the communist concept of healthcare than ANYTHING that has come out of Washington.

Wouldn't that be called..."from each according to his ability - to each according to his need?"

Looks like we may have found a ....

[blue]

For clarity Individual Insurance would be paid for by the Individual, not .gov.

[Lady's Human]

You are a member of a union arent you?

And that has exactly what to do with anything?

Oh, I forgot, we're all thugs intimidating the town hall attendees.

You're an electrician, aren't you?

[blue]

And that has exactly what to do with anything?

Group thinking, cant get a good contract or job on your own.

Oh, I forgot, we're all thugs intimidating the town hall attendees.

Where did I say all union members are thugs? Only the union members beating people up at TH meeting were the thugs.

You're an electrician, aren't you?

I am a licensed electrician, and I have never been a union member. I can make my own deals for work, I dont need some union suit to do it for me.

[Lady's Human]

Blue, I'm going to leave it at this:

You have no earthly clue who you're speaking with or what you're speaking about.