So what do you think the answer is?

[Bandit]

I think the whole insurance industry is a total scam.

It is... & I don't know if it will ever be fixed because it has been so screwed up for so long that most have just accepted the flaws & lies. Employer paid insurance is regulated a little different than self pay because the government has made certain rules that make it better but self pay insurance is a battle forever.

[erinb1975]

if someone else smokes you do not get charged for that, they do & they pay extra for insurance, not you.

Actually, as Jolly said, we DO all pay for the smokers (and all other "avoidable" health conditions, heart disease, diabetes, etc), in the form of increased costs from hospitals to cover overhead, and in the form of increased premiums from insurance if they are insured.

Which in my eyes makes it all the more ridiculous that insurers don't pay for preventitive things such as smoking cessation modalities (medication, therapy, etc.). Alot of them pay a percentage, but it would save millions in the long run if they were to cover those types of things 100%.

[Bandit]

Actually, as Jolly said, we DO all pay for the smokers (and all other "avoidable" health conditions, heart disease, diabetes, etc), in the form of increased costs from hospitals to cover overhead, and in the form of increased premiums from insurance if they are insured.

Which in my eyes makes it all the more ridiculous that insurers don't pay for preventitive things such as smoking cessation modalities (medication, therapy, etc.). Alot of them pay a percentage, but it would save millions in the long run if they were to cover those types of things 100%.

I know what you are saying is true but what I am saying is also true,...

What I mean is, insurance charges smokers extra & higher premiums. they don't charge everyone the same rates. You will pay 50 to 100 more per month if you smoke than someone who does not smoke. If you do not smoke, then you pay less than what smoker pays.
But that is not right either because while it may be true smokers are higher risk for certain things, some smokers never use a dime of health insurance.
This is the same way they look at policies for workmans compensation, depending on what your job is, there will be different rates that the company will pay.

But while we are talking about who pays what...get this...One of the girls I work with had insurance that only covered the cost of her delivery if the child was born sick. If the baby was born healthy then she had to pay the entire charges for everything of being in the hospital. Did you ever here of that one? I think that is similiar to emergency with admittance & if you are admitted they will pay if not admitted, then they will not pay.

She goes, "Thank God my little boy was born with asthma."

[Bandit]

I am not sure if people are charged more for being over weight but I do remember that being one of the questions and it is probably true that if you are certain pounds over for what your weight should be, then you get charged higher premiums.
Anyone know?


So now, what about all the people who have a job working in a paint factory? It has been well proven that breathing all those fumes & chemicals after 20 years they become cancer patients or have some type of medical problems from it. Should they be charged higher premiums too?

[erinb1975]

It is probably true for consumer health insurance that there are different rates for smokers, however with most employer offered plans that I am familiar with there is no difference in rates. Not that there shouldn't be. I don't disagree that people who choose to ignore medical advice and quit self destructive activities should be charged a higher percentage.

Painters who suffered damage due to working conditions would be covered under workers comp. My husband has had treatment for that exact cause.

Insurance can be crazy I guess..makes me feel lucky I am well covered. $125 a month for my husband and I...10/25 copays, 35 for specialists, 35 for urgent care and 100 for ED....

[Bandit]

That is because the government is regulating what happens between employer & insurance company. Self pay is on their own & get no breaks.


My friends husband has cancer from working in the paint shop. After 32 years they are closing the door & now he has no insurance to deal with it.

[Bandit]

Insurance can be crazy I guess..makes me feel lucky I am well covered. $125 a month for my husband and I...10/25 copays, 35 for specialists, 35 for urgent care and 100 for ED....

125 for two people is well covered insurance? (not to me it isn't ) Is an employer picking up the rest?
If not, you will want to double check the out of pocket & ded.

You can get low co & low scripts for little of nothing but when the serious stuff happens that is where you really want to be covered & that is when it gets very expensive. Of course we never think of it & pray we stay healthy.

I am self pay for everything & I really do not have that kind of money, so I am going to be a bit more critical than someone who has insurance paid for them.

[erinb1975]

I have had a 60,000 hospital bill and paid nothing. Likewise with a 35,000 cardiac ablation. I have one routine prescription and pay 14.00 every 3 months. No deductible (just above mentioned copays), unlimited lifetime max. So, it is really good insurance in my eyes at least.

[Bandit]

I have had a 60,000 hospital bill and paid nothing. Likewise with a 35,000 cardiac ablation. I have one routine prescription and pay 14.00 every 3 months. No deductible (just above mentioned copays), unlimited lifetime max. So, it is really good insurance in my eyes at least.

You are telling me that you pay 75.00 (half of 125 for two people) a month they pay a 60,000 bill with no deductible & no out of pocket?


Please show me where & with whom I may obtain this type of policy.

Omission is deception. Sorry, but unless your employer is picking up the rest there is no such thing as 100% coverage for a 60,000 hospital bill for only 125 per month for two people. Until you show me where this policy exists for everyone I will be laughing from here to kingdom come

[erinb1975]

I am sure it is an employer subsidized program, like pretty much all employer benefits. Isn't that how all plans offered through employers work?????

Wasn't intending to deceive. I work at a major university medical center. In the 3 or 4 hospitals I have worked in I have never had to pay a cent for a hospital admission (and I have had my share). I do consider benefits and choose jobs that provide good insurance. My parents taught me well...

It seems we have strayed from the original purpose of the thread. Suffice to say that something needs done with the current system for those not lucky enough to have good insurance.

[Bandit]

I am sure it is an employer subsidized program, like pretty much all employer benefits. Isn't that how all plans offered through employers work?????

I am sure it is

[Dirk Squarejaw]

There is no medical insurance plan for 19.15 a month unless your employer is picking up the rest so I hope you do not have any real problems because don't expect any coverage for that price. You might get reimbursed for 200.00 a night if you are ever in the hospital on a $20,000 per night bill. What is your deductible? 50,000 a year?

That's why when I began looking for a job in my field, I chose a job somewhere where the pay was about $2k less per year, but the insurance plan was 95%/5%. I think it may be 92%/8% now, but I pay $19.15/pay. A friend of mine lives 30mi away and is in the sweet spot as far as teacher's pay goes in Indiana, but by the time he pays insurance he brings home less than I do. If I ever relocate, I'll be doing the same thing and looking to see where the balance is between pay and insurance premiums and go from there.

[Bandit]

That's why when I began looking for a job in my field, I chose a job somewhere where the pay was about $2k less per year, but the insurance plan was 95%/5%. I think it may be 92%/8% now, but I pay $19.15/pay. A friend of mine lives 30mi away and is in the sweet spot as far as teacher's pay goes in Indiana, but by the time he pays insurance he brings home less than I do. If I ever relocate, I'll be doing the same thing and looking to see where the balance is between pay and insurance premiums and go from there.

I understand. I have also always had jobs that pay my insurance and I can say I have also been on all sides of this.

Most Americans have health insurance through their employers. But, employment is no longer a guarantee of health insurance coverage.

http://www.nchc.org/facts/coverage.shtml

As America continues to move from a manufacturing-based economy to a service economy, and employee working patterns continue to evolve, health insurance coverage has become less stable. The service sector offers less access to health insurance than its manufacturing counterparts. Further, an increasing reliance on part-time and contract workers who are not eligible for coverage means fewer workers have access to employer-sponsored health insurance.

Just don't count on a job to always be paying your insurance. If that job is always there for you then great, if not then you can expect it not, ...I have a friend who has been with UPS almost 30 years, makes awesome money & pays nothing for his insurance...but if you know, they are making big moves to rid of everyone over 50 years old so they cannot retire with those insurance plans for life...and this is how business operates today in America.

[Bandit]

You can get a cancer only plan for 5.00 a month but you will not be getting any coverage for it. It would make things easier understood when someone says I pay xx.xx a month and my employer picks up the rest.

The group plans do not get better rates but they are better governed. In fact when I was applying they make sure we understand that we can be canceled at any time for any reason as this policy is self pay & is not regulated by the government through an employer group plan.

AMISLANDER explained three different sides to all of this very clearly here:

http://www.bkforum.com/showpost.php?p=142000&postcount=29

I pay $50/mo. which is two pay periods and I have Aetna, PPO. My employer picks up the rest.

[MajorMike]

What I'm talking about when I say Id pay $300 a month for good healthcare, I meant if the company paid $200 and I paid $300, Id do it in a heartbeat then pay the $20/mo I pay now for crappy healthcare.