http://demopedia.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6160076Oh my.
The cross-bearing carpetbagging maternal ancestress:
Raven (1000+ posts) Mon Jul-27-09 10:58 AM
Original message
I have never had a problem with my health insurance, never.
Over the years I've been in group plans including Blue Cross and Harvard Health and for a few years I had an individual policy. I have never had a problem getting the treatment I needed. In 2001 I had major surgery which came after a battery of tests. Nothing was ever questioned and I never had to get anything pre-authorized.
I am trying to figure out why my experience has been so different from other peoples' experience with health insurance. Is it because I happened to have good insurance carriers? Does it have something to do with being in the Boston area?
I am a strong supporter of reform and the public option but I wonder how many people are out there like me and I wonder if they can't relate to the problems in the system because they've never had them.
I don't think it had anything to do with the insurance carrier or being in the fetid stinking Boston area; I think it had much more to do with that the maternal ancestress came from a wealthy family.
ejpoeta (1000+ posts) Mon Jul-27-09 11:07 AM
Response to Original message
2. i think it depends on your insurance and also what exactly you had done.
I think that part of it might have to do with where you live. I am not sure about this, but I believe some states have laws regarding insurance companies and what they must cover. I know that recently a law was passed in NY that makes insurance companies have to have the same copay for mental health appointments as they do for any other specialist. This decreased my copay to go to counseling from $20 to $10, and we had to fight with the mental health clinic to make them see that. They were still trying to charge us the $20. Though, now that we switched insurance they want me to somehow afford $50. so I haven't been going which is bad for me because I am pregnant and am not taking my meds as a result and have been more depressed.... uggh. but i digress. I think the state laws may have some effect on what is covered.
Another thing is that I think we are worse off insurance wise than we were in 2001 even. Insurance companies have been very busy raising rates and changing their rules on everything. So something that they gave you no hassle about in 2001 might be a problem today. I may be wrong, but it makes sense to me that this would be happening because of skyrocketing costs. I wonder if you would have been given a hassle about all those tests if it were today. And I cynically wonder if you would have even been told about the tests today because it seems that some of that goes on as well.
onehandle (1000+ posts) Mon Jul-27-09 11:07 AM
Response to Original message
3. Neither have I. Interestingly it has often remarked to me that I have a pretty premium policy.
This is from doctor's offices and hospital administrators when I check in.
I have been with Blue Cross forever. Lucky me.
I would give it up for a European style system in a minute, though.
On edit: Things have gotten more expensive.
11 years ago I had an overnight hospital stay with surgery.
The bill was 25 grand. I paid $75.
Last year I had an overnight stay again, but just for tests and observation.
The bill was 12 grand. I paid $1200.
Office visits used to be free, now they start at $20.
Hello_Kitty (1000+ posts) Mon Jul-27-09 11:11 AM
Response to Original message
6. Was the individual policy expensive?
One of the reasons many people go uninsured is because they don't get anything through work and what they can get on their own has a high premium and huge deductibles and copays.
Raven (1000+ posts) Mon Jul-27-09 11:36 AM
Response to Reply #6
19. I thought so. From 2004 to 2006 it was about $1000 a month for just me.
Now, I'm a smoker so that may have been a part of it. At the time I looked into the NH Insurance Pool and that was pretty expensive too and didn't have very good coverage.
Cleita (1000+ posts) Mon Jul-27-09 02:21 PM
Response to Reply #19
47. That's half my income. For those of us who are income poor, it's a burden and if you have to add drugs to it, it becomes unaffordable. However, before I qualified for Medicare, I was paying $500 a month for Blue Cross coverage that most of my doctors wouldn't take. I submitted my own bills and never got back anything because of a large deductible. So mostly I was giving them $6,000 a year for nothing. Oh, and I'm not a smoker.
"Income poor" -- apparently some new primitive euphemism.
supernova (1000+ posts) Mon Jul-27-09 11:31 AM
Response to Original message
16. It might have to do with the fact you practice law
Law firms usually get what they want from service providers.
I'm glad you haven't had a problem, and I'm also appreciative of the fact that you are aware that you are among the lucky.
My sister, alas, who is of a similar age to you, doesn't see the point on HC reform. She has never had a problem either. She's retired from Ma Bell. So thanks to unions, her insurance has always worked just fine. Though, she's unaware of the connection. Her insurance is hunky dory so she doesn't thing "socialized medicine" is the way to go. But she told me a couple of weeks ago at the day surgery clinic that because of cost, she switched to a high deductible policy, 5K out of pocket every year. The day surgery was going to cost her about $1200.
I really hope she doesn't suffer a catastrophic illness and discovers just how inadequate her insurance now is.
Me, I have a pre-existing condition, so I'm always in the "you gotta waite 18 months for your coverage to come fully online." camp. And being a contractor, I have many "new" jobs.
Something must change. This is Dickensian!
kentuck (1000+ posts) Mon Jul-27-09 11:34 AM
Response to Original message
18. If you presently work...and lose your job or quit, it may not be so easy to keep your present coverage? Also, if there is a pre-existing condition, you may not get covered at all. However, for a very high charge, you can keep your present insurance thru COBRA, if you can afford it. And your medicines will be extraordinarily high, if you are on medication. There are a lot of problems that need fixed.
Raven (1000+ posts) Mon Jul-27-09 11:44 AM
Response to Reply #18
23. So right! You don't get to my age without some sort of "preexisting condition."
What a catch 22 that is.
Yeah. One of the "pre-existing problems" the maternal ancestress has is her heir.
I bet at times the maternal ancestress wishes she was young enough to do this over again, bearing another heir since the first one is such a loser.
mmonk (1000+ posts) Mon Jul-27-09 12:38 PM
Response to Original message
35. I probably can name two (tell me if I'm wrong).
1. You don't have a family member with a disability denied by insurers.
2. You don't pay your full premium and/or deductable costs.
Also, age has a lot to do with cost burden and rejection of coverage.
Raven (1000+ posts) Mon Jul-27-09 12:48 PM
Response to Reply #35
36. You are correct on both with a small exception...my law firm offered top of the line health insurance with no deductables and no co-pays and no deductions from paychecks. This was from 1991 to 2003. It was killing us financially at the end. We provided that benefit because we felt it was the right thing to do but I'm not sure we could have kept it up for much longer.
I'm 63 and work for a small town in NH. We have Harvard Pilgrim with an $8.00 a month payment and fairly reasonable co-pays.
This idea that age would enter into coverage rejection amazes me. It's like a life insurer refusing to cover you because you're going to die someday.
The bottom line, I guess, is that insurance companies aren't insurance companies anymore.
It's an enormous bonfire.
