I work for a non profit. My insurance premium has doubled and I have to pay for my husbands premium at a higher rate than mine. If one spouse works and gets coverage then you sort of must pay for other spouse, anyway the rates are about the same on the “exchange”. Last year in 2015 that was about $6,000. out of my pay check to cover my hubby,with a $7,000. “family” deductible then the crazy “co insurance” (that never existed until a few years back), and after ALL that is met and we reach the holy grail of $10,000.00 Maximum (about December) the INSURANCE company will pay 100% for visits. When I dared get massage therapy (after the max was met) I got questioning phone calls from a second party about the “necessity” of the visits.
Affordable care works for the very poor, they are covered for: office visits, MRI’s, surgery, pain management, etc. for free. I need to see what doctor, hospital, anesthesiologist, lab, ect. is “in network”. When I had an emergency and phoned the ER they could not tell me if they were a “preferred provider”, so I went to the closest one. Thank GOD they were in network.
Let me digress into the whole “cost” and Explanation of Benefits. So if you have state insurance a procedure costs a whole lot less. If you are employer insured and see an out of network provider it is a whole lot more. If you see an in- network provider and are willing or able to pay it all “right now on a charge card or cash”, (right) then they will cut you a discount that has a range. About 10% for being nice and asking, 20% if charge card and 30% if you are late or get the right person on the phone. What the heck is this, LET’S MAKE A DEAL?
It is like having discounts at your favorite department store. More crazy making.
The way I see it is that the shrinking middle class is paying for the coverage of the masses. I am sad that Obama caved to the insurance companies. I have yet to see a “rebate” due the 80/20 rule. If you check this web site it explains it.
So last year between my employer contribution, my husbands premium, and our deductible we shelled out $20,000. to the insurance thief’s. The more I read on the web site the more I get angry. Why does Tricare have a pass? Why does congress get free health care for life? Why do we not go back to making insurance companies NOT FOR PROFIT? Our insurance was cheaper and better. In 1985 I paid $30 premium a month for a family of 3 with no co pays, vision, scripts, and great coverage!
I am educated ( that I paid for) and know what went wrong. I have traveled to other nations (France, UK, Canada and New Zealand) guess what they have great coverage and wonder what the heck is up with the USA. In NZ they pay 2% of income and children to age 18 are covered free. No inappropriate wait times for needed surgery.
My state insurance commissioner (who has no power to enforce) just allows rate hikes due to the “justifications” of insurance companies. Let us embrace single payer and cut the nonsense of layers of bureaucracy. Maybe if the insurance industry (and they are) did not fund politics then we could have really AFFORDABLE HEALTH CARE!
By the way, your provider hates all that crazy quilt of billing and codes!