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Thread: Big health insurance rate hikes coming in 2016

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    Default Big health insurance rate hikes coming in 2016

    http://www.cnbc.com/id/102811143
    http://finance.yahoo.com/news/obamac...090020397.html

    No surprise here. With the high rates of sick people signing up and the various mandates, the money has to come from somewhere. First my plan was discontinued altogether and replaced with a crappier plan for the same money. Now I'm going to pay a higher premium for my mediocre plan so that I can subsidize the care of others. I already pay $12,000 per year for a family plan with co-pays, high deductibles and referrals required for everything. Even a 20% hike would add $2,400 to that tab.

    I am absurdly frustrated now.

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    Default Re: Big health insurance rate hikes coming in 2016

    Does this come as a surprise to anyone?

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    Default Re: Big health insurance rate hikes coming in 2016

    Does this come as a surprise to anyone?
    Trying to say this as non-politically as possible ... the answer is yes, the government !!!

    The early math simulations they ran guesstimated that X percent of younger Americans would sign on for public health exchange insurance coverage in lieu of going without insurance plus having to pay a 2.5% tax penalty. The early math simulations they ran also guesstimated that X percent of younger Americans would be earning high enough incomes that their actual out of pocket insurance premium payments ( net of taxpayer funded low income premium subsidies ) would significantly exceed the dollar value of health insurance benefits actually consumed ... so that a fair number of those younger Americans would wind up financially subsidizing older, sicker Americans. The gov't was wrong on both counts.

    As was discussed from the 'beginning', if ACA regulations allow a young person without health insurance to be diagnosed with an expensive to treat illness, but also allow that young person to sign up for ACA insurance coverage the next day at exactly the same monthly premium cost despite their diagnosis, there is little financial incentive to pay ACA insurance premiums before they actually become seriously ill !!! The 2.5% ACA penalty tax causes little financial 'pain' if the annual income of the young person is in the < $40,000 ballpark ( which is the case for the VAST majority of younger Americans ).
    Last edited by Melonie; 07-07-2015 at 01:21 PM.

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    Default Re: Big health insurance rate hikes coming in 2016

    I already posted in another thread dealing with health coverage that Aetna is seeking an 18% rate increase for my plan.

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    Default Re: Big health insurance rate hikes coming in 2016

    I'm not surprised at all. Last year my contract employer tried waiting to see how many people would sign up for their shit insurance before announcing what the monthly premiums would be.
    "There are different kinds of darkness. There is darkness that frightens, the darkness that soothes, the darkness that is restful. There is the darkness of lovers, and the darkness of assassins. It becomes what the bearer wishes it to be, needs it to be. It is not wholly bad or good."
    - The Court of Mist and Fury

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by Eric Stoner View Post
    I already posted in another thread dealing with health coverage that Aetna is seeking an 18% rate increase for my plan.
    You did indeed. It sucks that you may be forced to drop your employee health coverage. I only have a few employees and so far I've been able to dodge the bullet on offering health insurance. Like you, I am limited as to how quickly I can raise our service rates. The added complication for me is that my employees are in multiple states. I'm just not sure if I will ever be able to offer decent insurance to my employees at an affordable rate.

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by lynn2009 View Post
    Last year my contract employer tried waiting to see how many people would sign up for their shit insurance before announcing what the monthly premiums would be.
    I'm guessing that they needed to know the numbers before they could get firm prices from the insurance carrier.

    Nowadays it is very difficult to offer decent insurance unless an employer is big enough to have real negotiating power or has thick profit margins. As I mentioned above, I cannot offer good insurance to my handful of people and I may never be in a position to do so, at least without reducing salaries somewhat to help compensate. The mandates are making premiums on good policies obscene. I'm lucky that my current employees are older with spouses who get insurance through work. But when I start filling the ranks with younger people, I may have to build in a fixed "insurance contribution" component to their compensation and have them shop for their own policies through the exchanges. This really sucks.

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by rickdugan View Post
    I'm guessing that they needed to know the numbers
    Yes but is this a normal thing at smaller organizations? I never heard of it before, I couldn't believe they would even try it. Sounds like letting a dealership choose the price of a car after you're committed to it.

    In any case I'm lucky I am currently still able to get good coverage through a different vanilla employer.
    "There are different kinds of darkness. There is darkness that frightens, the darkness that soothes, the darkness that is restful. There is the darkness of lovers, and the darkness of assassins. It becomes what the bearer wishes it to be, needs it to be. It is not wholly bad or good."
    - The Court of Mist and Fury

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    Default Re: Big health insurance rate hikes coming in 2016

    Yes. It is quite normal. The more employees the likelier it is that the per person cost will be lower. The more people in the plan the more dispersed the risk. Unless all employees are elderly , overweight and heavy smokers.

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    Default Re: Big health insurance rate hikes coming in 2016

    For right now I will be able to afford to offer health insurance BUT not if these rate increases continue. We've all been very healthy. I had to go into the hospital for relatively minor knee surgery. Frankly I thought I should have been in and out but I think it was part of self-protection for the surgeon and hospital to admit me . I Know that they billed Aetna for over $20,000 for about a 30 hour stay and that Aetna paid a fraction of that according to its contract rate. I had to pay a co-pay to my surgeon and the anesthesiologist ( even though I was awake throughout ).

    Btw , my plan covers prescription drugs as many others do. I did a little price comparison between what my prescriptions cost here in the U.S. vs. what the same stuff costs in Canada. In Canada the drugs are anywhere from 25 to 75 % cheaper depending. Admittedly a relatively small sample but still. Question : Why don't the insurers gang up on the drug companies and get the same deals that the Canadians do ? Yes, yes , I know all about the shitty deal Bush the Dumber and the Congress pushed through on Medicare drug coverage but why is that writ in stone ? I doubt very much the drug companies are selling their products at a loss in Canada and other countries that negotiate drug prices with the manufacturers.

    Melonie - Just a guess but where you are living I'll bet prescription drugs are a lot cheaper than in the U.S. ? I know you can buy a lot of stuff over the counter down there than in the U.S. Any "prescription tourism" like the old folks getting on buses to Canada here in the U.S. ?
    Last edited by Eric Stoner; 07-08-2015 at 10:29 AM.

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    Default Re: Big health insurance rate hikes coming in 2016

    Melonie - Just a guess but where you are living I'll bet prescription drugs are a lot cheaper than in the U.S. ? I know you can buy a lot of stuff over the counter down there than in the U.S. Any "prescription tourism" like the old folks getting on buses to Canada here in the U.S. ?
    Yes many drugs are available over the counter down here 'way south of the border'. Price levels for generic drugs are 'bargain basement'. I have however noticed that the effectiveness of certain drugs I have purchased over the counter down here isn't quite the same as the same drugs I used to obtain via prescription in the USA.

    In regard to pharma tourism, I'm too far south of the border for that. While vacationing US guys may stock up while they're here, nobody comes all this way just for the cheap drugs. Pharma tourism is a 'Tijuana' thing ( i.e. cross-border day trips ) ... or at least it was until border violence levels started to get crazy.

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    Default Re: Big health insurance rate hikes coming in 2016

    Yeah but that doesn't seem to be a problem in Canada i.e. folks get the real thing and not counterfeit drugs.

    My real point is the increasing costs of health care. According to Paul Krugman ( Krugie ! ) et. al. medical costs have been going down. Funny how he NEVER says where he gets his numbers for THAT ! Maybe the same people who have so much trouble calculating the real unemployment rate ... Oh never mind. One of the supposed benefits of Obamacare was supposed to be LOWER medical costs. And it is not the doctors who are getting fat. Not the primary care physicians at any rate. Not even close.

    Obama and others repeatedly promised that the average family of four would see a REDUCTION in health care costs of $2500 when in fact they are looking at a minimum increase of at least $6700 over the first ten years. Not to do an "I told you so " but some of us at least questioned how we could possibly insure some 30 million additional people ( not all of whom were young and relatively healthy * ) and not see substantial rate increases. The cost of insuring these additional people had to come from somewhere. From the health insurers ? O.K. and then they obviously passed the higher costs along in the form of higher premiums . From various governments ? O.K. and where did they get the money ? Higher taxes. And it wasn't just more participants but the expanded coverage i.e. what the policies were required to cover regardless of whether or not the policyholders wanted or needed things like breast pumps, PAP smears and pre-natal care.


    * In this country "healthy " is a relative term given our high rates of obesity , drug use ( prescription and illegal) and other unhealthy behaviors. Not to mention our high rate of gun violence, car accidents and suicide. All that being said, adults under age 30 are indeed relatively healthier than those over 50.
    Last edited by Eric Stoner; 07-09-2015 at 07:06 AM.

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    Default Re: Big health insurance rate hikes coming in 2016

    ^^^ there's also a big 'question mark' regarding being billed for just your own actual costs of medical treatment, versus being billed not only for your own actual costs of medical treatment but also for 'shifted' costs incurred by other patients who can't / won't pay.

    (snip)) A recent article in the Los Angeles Times reported a CT scan of the abdomen costs about $2,400 for patients insured by Blue Shield of California, while the Los Alamitos (Calif.) Medical Center cash price is only $250. That is a 89% discount by my calculation.

    2) Another local California hospital charges insured patients $415 for blood tests that cost only $95 in cash. This time it’s a mere 77% discount.(snip)

    Down here way south of the border, virtually all medical treatments are conducted on a 'cash' basis. No cash, go to the gov't run clinic for 'free' treatment.

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by Melonie View Post
    Trying to say this as non-politically as possible ... the answer is yes, the government !!!
    No, you are trying to be political. In most other western countries, the government is a lot more involved in healthcare than in the US, and they spend far less money per-person on health care than we do here. They also live longer and have lower infant mortality rates.

    Quote Originally Posted by Melonie View Post
    The early math simulations they ran guesstimated that X percent of younger Americans would sign on for public health exchange insurance coverage in lieu of going without insurance plus having to pay a 2.5% tax penalty. The early math simulations they ran also guesstimated that X percent of younger Americans would be earning high enough incomes that their actual out of pocket insurance premium payments ( net of taxpayer funded low income premium subsidies ) would significantly exceed the dollar value of health insurance benefits actually consumed ... so that a fair number of those younger Americans would wind up financially subsidizing older, sicker Americans. The gov't was wrong on both counts.
    No, there were a decent number of young Americans that signed up. In 2014, 28 percent of enrollees were 18 - 34.
    http://www.newrepublic.com/article/1...-massachusetts

    Quote Originally Posted by Melonie View Post
    As was discussed from the 'beginning', if ACA regulations allow a young person without health insurance to be diagnosed with an expensive to treat illness, but also allow that young person to sign up for ACA insurance coverage the next day at exactly the same monthly premium cost despite their diagnosis, there is little financial incentive to pay ACA insurance premiums before they actually become seriously ill !!! The 2.5% ACA penalty tax causes little financial 'pain' if the annual income of the young person is in the < $40,000 ballpark ( which is the case for the VAST majority of younger Americans ).
    It doesn't work that way. You can only sign up during certain times of the year, and the insurance doesn't take effect immediately. You can't just get sick one day, and sign up for health insurance the next.

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    Default Re: Big health insurance rate hikes coming in 2016

    Oh, and I forgot one of the best part about my Aetna $12,000 per year family plan: almost nobody wants to take it. Apparently this is not uncommon with the new individual plans issued under the new mandates. In order to do everything possible to make them seemingly affordable, the health insurers are squeezing the doctors as well. A good discussion of this phenomenon is included in the article below:

    http://www.usatoday.com/story/news/n...tors/17747839/

    I had to switch my kids' pediatrician as well as the primary care physicians for my wife and I. The one decent pediatrician in the area accepting our plan had us on a waiting list before they finally took us. And the kids preventative dental services on our plan are worthless unless we want to take them 30 miles away to a dentist in the hood, so I'm shelling out another $1,000 per year out of pocket for that now.

    Our previous plan - again no longer even offered - covered all of our preferred doctors and dentists and even had a dental insurance component. In this brave new world of expensive mandates, I guess our old plan was simply not commercially viable if it was made ACA compliant.

    So next year I'll get to pay $14,500+ for a plan that charges me copays and high deductibles, makes me get referrals for everything and nobody wants to take. Did I mention how frustrated I am?

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    Default Re: Big health insurance rate hikes coming in 2016

    I don't blame you for being frustrated. There is so much waste in our healthcare system, between administrative costs, unnecessary procedures, and overcharging, that is driving up costs for the average American. This past winter, I slipped and cut myself, and needed five stitches. I went to the ER, and a physician's assistant spent about five minutes putting the stitches in. The hospital bill for the five minutes work came to over $700.

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    Default Re: Big health insurance rate hikes coming in 2016

    I find blue cross blue shield to be one of the better carriers. Most doctors take bcbs and they cover a lot of different ailments. May be worth a little extra for them.
    “Cook for him like a housewife, fuck him good like a nympho….pay the rent and the car note, he invests in me like crypto”

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by eagle2 View Post
    I don't blame you for being frustrated. There is so much waste in our healthcare system, between administrative costs, unnecessary procedures, and overcharging, that is driving up costs for the average American. This past winter, I slipped and cut myself, and needed five stitches. I went to the ER, and a physician's assistant spent about five minutes putting the stitches in. The hospital bill for the five minutes work came to over $700.
    To be crystal clear, I am frustrated because the resources I was devoting to providing strong coverage and the best possible medical care for my own family are being diverted to subsidize expensive mandates and the care of others. I am frustrated because I cannot seem to find an individual plan option that gives me what I had before for my family, no doubt since a plan like that would not be commercially viable with the new mandates. These new requirements not only drastically increased my costs, but have made it much harder to achieve the same quality of care for my family.

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    Default Re: Big health insurance rate hikes coming in 2016

    I'm sorry that things have gotten worse for you, but there were millions of Americans that were far worse off than you are, including some who were very sick, and were going without medical care because they didn't have health insurance. If I have to make some sacrifices so that these millions of Americans can obtain health insurance and have access to decent healthcare, I don't mind, as long as I know I will be able to get healthcare myself when I need it. If you feel differently, you're entitled to your opinion. That's all I'm going to say on the matter, before this discussions becomes too political.

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    Default Re: Big health insurance rate hikes coming in 2016

    My husband is dodging a bullet on this for 3 more years. His employer raised all their payments last year but got the prices locked in for 4 years. I can only imagine how bad it will be then though.

    However, our preventative co-pays were raised. Many more types of visits count as "Specialty" so that makes the co-pay higher. Tests and procedures that were covered by the co-pay now have additional charges. I could go on forever listing all the changes...

    I understand that the model used for Canada or the EU is not perfect, but I would rather pay about 10% more in taxes and know I don't have to worry if something happens. Pipedreams

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    Default Re: Big health insurance rate hikes coming in 2016

    In 2007 I paid 241/m for my employees, full, no employee contribution.

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    Default Re: Big health insurance rate hikes coming in 2016

    there were a decent number of young Americans that signed up. In 2014, 28 percent of enrollees were 18 - 34.
    Again trying to stay on the economic side of this discussion, my original point was that too few young healthy Americans were PAYING INTO the ACA insurance pool to help 'subsidize' premium costs for older, sicker Americans. While your point is technically true, it skips over an essential detail that signups do not automatically equal net payment of premiums.

    Young Americans signing up for ACA insurance doesn't help to reduce premium costs if those young Americans are 'consuming' more dollars worth of medical insurance benefits than they are paying out of pocket in premium costs. A Heritage study turned up this summary statistic ...

    (snip) 71 percent of the combined increase in health insurance coverage during the first half of 2014 was attributable to 25 states and the District of Columbia adopting the Obamacare Medicaid expansion. (snip)

    Obviously, Expanded Medicaid health care benefits do not require the payment of an insurance premium !!! Additionally, the out of pocket premium costs for slightly higher earning Americans in the 200% of FPL ( = about $25k annual income for a single person ) are just a tiny fraction of the unsubsidized actual cost of ACA health insurance premiums ( tiny as in < $10 per month ). With the widespread documentation confirming average incomes of the 25-34 age group being lower than older age groups, this leads to an inescapable conclusion that younger healthier Americans are NOT net contributors to the ACA insurance pool which the gov't had originally projected they would be !!!


    You can only sign up during certain times of the year, and the insurance doesn't take effect immediately. You can't just get sick one day, and sign up for health insurance the next.
    As a self-employed dancer or camgirl, yes you can !!! The SHOP small business exchange signup rules aren't the same as the rules for the personal exchanges. And even on the personal exchanges, stating an income level which qualifies for Expanded Medicaid eligibility allows for immediate coverage.
    Last edited by Melonie; 07-09-2015 at 03:53 AM.

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    Default Re: Big health insurance rate hikes coming in 2016

    Quote Originally Posted by eagle2 View Post
    I'm sorry that things have gotten worse for you, but there were millions of Americans that were far worse off than you are, including some who were very sick, and were going without medical care because they didn't have health insurance. If I have to make some sacrifices so that these millions of Americans can obtain health insurance and have access to decent healthcare, I don't mind, as long as I know I will be able to get healthcare myself when I need it. If you feel differently, you're entitled to your opinion. That's all I'm going to say on the matter, before this discussions becomes too political.
    And tens of millions of people are now worse off than they were before, with declining benefits and more expensive plans. I am a believer in the notion that nobody should have to die simply for lack of health care, but I also believe that there had to be a far less bloated, more surgical approach to fixing that.

    When health insurance is made so expensive that most people cannot afford it without subsidies, there is a serious problem. When insurance companies have to squeeze doctors so badly just to make it work that they end up creating a class of policy that almost nobody wants to accept, there is a serious problem. When millions of people struggle to use their insurance because they cannot afford the high deductibles that have now become a fact of life in the individual marketplace (so-called "under-insurance"), there is a serious problem. When millions choose no insurance at all because they make too much to get a subsidy, yet still cannot afford a decent insurance policy, there is a serious problem.

    This thing is a bloody mess and, IMHO, needs a serious overhaul.
    Last edited by rickdugan; 07-09-2015 at 05:27 AM.

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    Default Re: Big health insurance rate hikes coming in 2016

    The problem with the complaining about Obamacare is that insurance costs were nearly a vertical line before it was passed. To complain of increasing costs and blame it on ACA ignores this basic fact.

    http://www.forbes.com/sites/danmunro...thcare-charts/

    http://economix.blogs.nytimes.com/20...h-policy/?_r=0


    One huge problem is that cost controls were deliberately not built into the law, primarily hoping for Republican support, which never materialized.

    They should have just passed single payer and got it over with

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    Default Re: Big health insurance rate hikes coming in 2016

    I've had similar experiences to both Rick and Eagle. Like Eagle I cut myself and went to the E.R. for just TWO stitches. No X-rays; no bloodwork. Just two stitches and a tetanus shot. Amount billed to Aetna for a ONE HOUR E.R. visit - over $2000. I don't know what the cash price for same would be BUT somewhere in the archives is a post about a hospital in Oklahoma ( ? ) that only deals in cash i.e. they do not take any insurance and their prices for various surgical procedures are as much as 50 % cheaper than other hospitals. Why ? Well obviously they don't have to cover the costs of people who get treatment and can't pay.

    Like Rick Dugan, when I switched to Aetna I had to fight with them to keep my primary care physician. Who took Aetna and was in Aetna's network. Yet Aetna tried to transfer me to some guy I didn't know , never heard of and whose office was much further away. After paying my PCP a couple times out of my pocket in cash I was FINALLY able to get Aetna to switch me back to my original doctor. Why the snafu ? Why the attempt to force me into the arms of another doctor ? I have no idea. They said something to the effect that my doctor was "oversubscribed" and that I'd have to wait until there was an opening.

    Rather than banter back and forth with various ideas for improving the system I think it is best to focus on the current realities and exchange ideas on how to cope with things as they are. That includes ways to invest to profit from the current mess if possible.

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