DUmmies lie...

[Carl]

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7984931

Lorien  (1000+ posts)        Mon Mar-22-10 12:17 PM
Original message
I am self employed so I buy my own insurance
   
Over the past 12 years or so I have paid my insurance (United American Healthcare) over $78,000.00 in premiums. I have also paid tens of thousands out in deductible costs since my deductible has been 10-12k. It's hardly "Cadillac insurance", but it's the best that I could afford.

Over the past 12 years I have submitted roughly $45,000 worth of claims. The insurance company has paid out $200.00 of the claims submitted. The rest came out of pocket and was put toward the deductible, or the claim was denied.

So, for the price of a decent home I have received exactly $200.00 worth of services in 12 years. How is that "reasonable"? I'll tell you one thing; it's no longer sustainable. Most of the doctors I see now don't accept insurance because they can't afford to battle with them over paperwork. In fact, the office manager at my GP's office refuses to carry insurance because, she says, after spending all day on the phone fighting over claims that generally never get paid she sees absolutely no benefit to it. And now the health insurance reform fans want us to cheer because an additional 32 million will now be forced to pay out several grand a year for "insurance" which will likely never pay a claim. Meanwhile that money could put food on the table or keep the lights on instead on lining a CEOs pocket.

Paying a few grand a year for health CARE is quite reasonable. Paying $133,000 for $200.00 worth of health services is NOT. The American people deserve far better. Let's push for "far better" in the final version of this bill!

Almost no one questions the outlandish figures asserted or the claim.
Finally a little more info.

Lorien  (1000+ posts)        Mon Mar-22-10 01:30 PM
Response to Reply #48
52. Um, no. that 45k came out of my pocket, not through the insurance company
   The only check I ever received from them was for $200.00. I would have filed far more in claims had I had the vascular surgery I need and the heart stress tests, but I can't afford them since I can't afford the deductible. Individual plans are expensive, and if you only make $24,000 per year your choices are very, very limited.

Lorien  (1000+ posts)        Mon Mar-22-10 08:13 PM
Response to Original message
80. My point is simple: "affordable insurance" does not equal "access to health care"
   I don't have group insurance that is provided by an employer

I don't belong to an HMO

I paid what I could afford for individual insurance, which is less than $300.00 a month. I have a prescription card but my out of pocket costs for medications come to about $350 a month, even with the discounts. That's still a lot less than many people pay for medications.

If you're saying "you didn't shop around." you are wrong. I went to several websites to compare plans and interviewed a number of sales people from each suggested insurance provider. This was the best I could afford. Understand: the self employed, non-wealthy among you simply can't afford plans that don't have high deductibles. Most insurance companies DO automatically reject CLAIMS. that's the whole problem with the for profit insurance system. If you still refuse to believe me or are hellbent on being willfully obtuse on this topic, then I strongly suggest that you rent the film "SiCKO".

The "it's all your fault. You're stupid for having crap insurance" people sound exactly like the hard core Republicans that we all were debating back in the days when DU was pro Single Payer. Now that the path has been chosen, suddenly those who are pissed with the injustice of the for profit insurance system are "enemy #1". Insurance companies are suddenly seen as just, honest and reasonable, and it's all the consumers fault if the system doesn't work for them? Really?

If you are honestly sitting at your keyboards defending the insurance industry and their methods, then perhaps it's time to do a little soul searching to think about whose side you're really on.

Okay 300/month equals 3600/year and that is 43,200 for the 12 years cited not 78,000 as claimed.
Now if you are self employed and making 24,000 a year you really need to do a reassessment of your career.
One person at least makes note of the fact that they are an idiot or liar.

cbdo2007 (1000+ posts)        Mon Mar-22-10 02:22 PM
Response to Reply #66
70. This person's was "paid" according to the terms....but they have a deductible
   and they never met the deductible.

Problem is that this person has a $10,000 deductible with an income of only $24,000 per year. Personally I don't think we're getting the whole story here but if so then this person should have a family member in charge of their finances.

[Peter3_1]

WHY IS THIS FANTESY LAND STORY suprise you. Seems edamned near everything these BOZO's WRITE IS AT LEAST 60% LIE!

[Carl]

Ruh Roh Shaggy...someone has figured it out.

anigbrowl  (1000+ posts)        Mon Mar-22-10 08:37 PM
Response to Reply #80
82. Wait, what?
   You say just above that you pay 'less than $300 a month', and then discuss your out of pocket costs of about $350/mo.

Now, the first line of your OP is 'Over the past 12 years or so I have paid my insurance (United American Healthcare) over $78,000.00 in premiums.'

Now, if that were the case you would be paying $541.66 per month, or more.

I am not giving your insurance company a pass, and clearly if you need to spend so much on medication you have some kind of serious medical condition you need to deal with, but it seems I'm not the only person on this thread who is hopelessly confused by your explanation.

I know it is a major pain in the ass to get health insurance if you're self-employed, because I am too and don't have any insurance, so I've just tried to stay generally healthy and eat my occasional out-of-pocket medical costs.

But whatever the situation, you are doing a really really terrible job of explaining it. And if you have only gotten $200 back on almost $80,000 in premiums, maybe you are doing something wrong, or maybe you should contact the office of your state's insurance commissioner. Or an attorney. Or do something different, since what you are doing at the moment is obviously Not working.

 

[GOBUCKS]

I don't think this DUmmy has a real firm grasp on the concept of "insurance". He seems to think he's been cheated because he's paid out more in premiums than he's received from the insurance company. I've paid out many thousands of dollars in homeowners' insurance premiums, boat insurance premiums, and life insurance premiums, and have have collected hardly a dime. I hardly feel cheated that my house hasn't burned, or that my boat still floats, or that I am still among the living. Wait until he sees the premiums they'll have to charge if they're required by law to sell a policy to anybody who asks for one.

[NHSparky]

I don't think this DUmmy has a real firm grasp on the concept of "insurance". He seems to think he's been cheated because he's paid out more in premiums than he's received from the insurance company. I've paid out many thousands of dollars in homeowners' insurance premiums, boat insurance premiums, and life insurance premiums, and have have collected hardly a dime. I hardly feel cheated that my house hasn't burned, or that my boat still floats, or that I am still among the living. Wait until he sees the premiums they'll have to charge if they're required by law to sell a policy to anybody who asks for one.

I'll give you an idea.  I remember when automobile insurance WASN'T mandatory unless the bank dictated it per finance agreement.  As I was a lowly HS senior with a 1973 Nova worth $700 at the time, it wasn't mandatory, but I was insured just the same.  Liability insurance of 15/30K which cost me a whole $80 every six months.  On January 1st, 1984, liability insurance became mandatory in New Mexico.

My premium went up to almost $400 every six months for a car which was worth barely that.  For liability.  In 1984.

I hope you DUmmies are ready for the sticker shock, because it's coming very, very soon.

[Traveshamockery]

Methinks the DUmmie does math the same way Obamalamadingdong does - he can just wait for that vaunted 3000% cut in his health care costs per month.  

 

[thundley4]

Assuming the DUmmie story is true. How stupid would you have to be to continue carrying the same insurance company that never pays off any claims?  She's paid $78K and has only been reimbursed $200. That is either an outright lie, or she is trying to take the stupid crown from Beth.

[Texacon]

That's what happens when you think everyone is an idiot but you.  You make shit up and KNOW they won't ever figure it out.   

KC

[GOBUCKS]

Assuming the DUmmie story is true. How stupid would you have to be to continue carrying the same insurance company that never pays off any claims?  She's paid $78K and has only been reimbursed $200. That is either an outright lie, or she is trying to take the stupid crown from Beth.

Not at all. She has just been lucky to have avoided exceeding her deductible by staying healthy. One hospitalization, and the insurance company would be losing money on her. It's the concept of pooled risk, and the insurance company isn't making a very large profit at all. They average something like a 2% profit.

[thundley4]

Not at all. She has just been lucky to have avoided exceeding her deductible by staying healthy. One hospitalization, and the insurance company would be losing money on her. It's the concept of pooled risk, and the insurance company isn't making a very large profit at all. They average something like a 2% profit.

Over the past 12 years I have submitted roughly $45,000 worth of claims

That would imply that she has an almost $4000/year deductible and her insurance doesn't pay anything until she meets the full deductible.  That would require her to have agreed to a very stupid policy for over $500/month.

[NHSparky]

That would imply that she has an almost $4000/year deductible and her insurance doesn't pay anything until she meets the full deductible.  That would require her to have agreed to a very stupid policy for over $500/month.

I saw that too.  I'm paying 15 percent of my policy, the company picks up the other 85 percent.  Combined, it comes out to $500 a month for just me.  BUT...within network, PCP visits are $20, ER is $100, and specialists and hospitalizations are covered up to $1.3 Million lifetime, with no deductible.  Out-of-network annual deductible is $600/year.  This also includes prescription--$10 for 90-day supply of generics, and 25 percent of non-generics (I take Lipitor.)  I'd say I'm getting a pretty decent deal when I need it.

Too bad this plan is considered a "Cadillac" plan, and that I probably won't get to keep it.

[SSG Snuggle Bunny]

Assuming the DUmmie story is true. How stupid would you have to be to continue carrying the same insurance company that never pays off any claims?  She's paid $78K and has only been reimbursed $200. That is either an outright lie, or she is trying to take the stupid crown from Beth.

I bet a HSA would be looking pretty sweet, huh?

[Doc Savage]

Using that rational, you should have a car accident every 4-5 years to get your premiums back.  I have also paid a lot on my home owners insurance, but have not filed a claim.  Is that bad? 

[JohnnyReb]

Using that rational, you should have a car accident every 4-5 years to get your premiums back.  I have also paid a lot on my home owners insurance, but have not filed a claim.  Is that bad? 

If you can't make a profit off your insurance, why have it? [DUmmie/Mode]

[vlad335]

I'll give you an idea.  I remember when automobile insurance WASN'T mandatory unless the bank dictated it per finance agreement.  As I was a lowly HS senior with a 1973 Nova worth $700 at the time, it wasn't mandatory, but I was insured just the same.  Liability insurance of 15/30K which cost me a whole $80 every six months.  On January 1st, 1984, liability insurance became mandatory in New Mexico.

My premium went up to almost $400 every six months for a car which was worth barely that.  For liability.  In 1984.

I hope you DUmmies are ready for the sticker shock, because it's coming very, very soon.

Exactly. When the government gets involved with anything prices skyrocket. Look at college tuition