There must be a pony in here somewhere.

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Warren
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Re: There must be a pony in here somewhere.

Post by Warren » 09 Oct 2017, 10:46

Painboy wrote:
09 Oct 2017, 10:34
Dangerman wrote:
09 Oct 2017, 08:45
I just want pricing at time of service.
Sing it brother!

Seriously this is easily the worst thing about the insurance/provider partnership to me. If I ask for a price for something I don't want to hear it costs somewhere between $50 and $750. That's not something I can realistically plan for.
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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 13 Oct 2017, 08:50

💃🏻💃🏻💃🏻

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Mo
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Re: There must be a pony in here somewhere.

Post by Mo » 13 Oct 2017, 11:07

Why has no one brought up that now what will happen is that the insurance companies will sue the government for money that the law says the government is obligated to pay. Everyone focuses on the fact that Obama was broke the law by distributing unappropriated funds, but similarly, Congress broke the law by not appropriating money that the law obligates them to spend.
his voice is so soothing, but why do conspiracy nuts always sound like Batman and Robin solving one of Riddler's puzzles out loud? - fod

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Aresen
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Re: There must be a pony in here somewhere.

Post by Aresen » 13 Oct 2017, 11:19

Mo wrote:
13 Oct 2017, 11:07
Why has no one brought up that now what will happen is that the insurance companies will sue the government for money that the law says the government is obligated to pay. Everyone focuses on the fact that Obama was broke the law by distributing unappropriated funds, but similarly, Congress broke the law by not appropriating money that the law obligates them to spend.
"There was no money, but the government spent it anyways."

That sounds familiar.
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Kolohe
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Re: There must be a pony in here somewhere.

Post by Kolohe » 13 Oct 2017, 13:23

Mo wrote:
13 Oct 2017, 11:07
Why has no one brought up that now what will happen is that the insurance companies will sue the government for money that the law says the government is obligated to pay. Everyone focuses on the fact that Obama was broke the law by distributing unappropriated funds, but similarly, Congress broke the law by not appropriating money that the law obligates them to spend.
Between this and the debt ceiling shenanigans, we're way overdue on a reckoning on the revenue and spending provisions of the Constution that we haven't seen since the impoundment and deficiency issues were settled (?)

(And there's still in the offing the constitutionally problematic nature of a trans-national carbon tax set solely by international treaty.)
when you wake up as the queen of the n=1 kingdom and mount your steed non sequiturius, do you look out upon all you survey and think “damn, it feels good to be a green idea sleeping furiously?" - dhex

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Jennifer
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Re: There must be a pony in here somewhere.

Post by Jennifer » 27 Oct 2017, 22:53

Hmm, another problem with our current system of health insurance divided by state (which among other things means most people's insurance only covers their own area): since Las Vegas is a tourist attraction in a way that previous mass shooting events were not, a lot of the people injured at the Mandalay Bay shooting were from out of state, with medical insurance that doesn't cover hospitals in Nevada.

EDIT: Link: http://money.cnn.com/2017/10/25/pf/insu ... 141AMStory
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D.A. Ridgely
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Re: There must be a pony in here somewhere.

Post by D.A. Ridgely » 27 Oct 2017, 23:40

Serious question. How many people on the Gryll have health insurance that limits their coverage to health care only in their state or, as Jennifer puts it, area? I mean, I get that non-preferred providers would incur the higher deductible / co-pay, but that's true in-state, too. I have always assumed that such coverage is nationwide. In fact, my particular coverage is good (obviously within limits) overseas, as well.

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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 28 Oct 2017, 09:25

D.A. Ridgely wrote:
27 Oct 2017, 23:40
Serious question. How many people on the Gryll have health insurance that limits their coverage to health care only in their state or, as Jennifer puts it, area? I mean, I get that non-preferred providers would incur the higher deductible / co-pay, but that's true in-state, too. I have always assumed that such coverage is nationwide. In fact, my particular coverage is good (obviously within limits) overseas, as well.
I have New York state-based insurance coverage because of my work being based there and it's never been a problem for me here in Illinois.
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Jennifer
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Re: There must be a pony in here somewhere.

Post by Jennifer » 28 Oct 2017, 13:35

When I lived in Connecticut and taught in Massachusetts, I could only see doctors in Massachusetts, but I think there was some coverage (not full Massachusetts-level) for out-of-state emergencies.
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JasonL
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Re: There must be a pony in here somewhere.

Post by JasonL » 28 Oct 2017, 18:08

I have a coverage differential out of network but I can go wherever.

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Pham Nuwen
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Re: There must be a pony in here somewhere.

Post by Pham Nuwen » 28 Oct 2017, 22:18

I'm a Kaiser Permanente guy now. They seem to know what's up and basically say fuck md and hospital groups.
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JasonL
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Re: There must be a pony in here somewhere.

Post by JasonL » 29 Oct 2017, 09:49

Their model is interesting to me. I think they do what they can in a jacked up system.

I couldn't recall exactly how it worked but basically for me office visits are covered 90% after deductible in network and 70% covered out of network. There is a separate deductible and out of pocket maximum for out of network. All in network spend counts toward out of network limits and vice versa.

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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 29 Oct 2017, 12:59

Yeah, mine basically works like that, it's just that in- vs. out-of-network doesn't seem to have much to do with the state. It's ultimately Blue Cross and I assume they have something overarching, though I actually have no idea if that's the case.
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Jennifer
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Re: There must be a pony in here somewhere.

Post by Jennifer » 30 Dec 2017, 00:29

"Myself, despite what they say about libertarians, I think we're actually allowed to pursue options beyond futility or sucking the dicks of the powerful." -- Eric the .5b

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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 11 Jan 2018, 12:10

Just found out from work our premium is up 25% this year. ffffffffffffffffffffffffffffffff
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JasonL
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Re: There must be a pony in here somewhere.

Post by JasonL » 11 Jan 2018, 17:03

We went from $48 bi weekly to $52 bi weekly for individual HDHP + HSA plan.

EDIT $48 to $52 not $42 to $52.

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lunchstealer
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Re: There must be a pony in here somewhere.

Post by lunchstealer » 11 Jan 2018, 17:08

I don't have anything deducted for health insurance. Mine is still 100% covered by our $1000/mo allowance.
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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 11 Jan 2018, 17:17

I don't pay the premium myself, but I still get taxed on half of it. And all of it's cash not in my paycheck.
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Painboy
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Re: There must be a pony in here somewhere.

Post by Painboy » 11 Jan 2018, 18:06

Yeah my insurance premiums went up by 10-15% but I choose kind of a weird plan. There's only a $850 deductible but there is no "cheap" doctor copays. If you go to the doctor I'll get hit with a charge that I would normally only pay if you had used up your initial doctor visits on another plan. But after the deductible is met the insurance then covers 80% of those costs going forward.

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Warren
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Re: There must be a pony in here somewhere.

Post by Warren » 11 Jan 2018, 18:29

JasonL wrote:
11 Jan 2018, 17:03
We went from $48 bi weekly to $52 bi weekly for individual HDHP + HSA plan.

EDIT $48 to $52 not $42 to $52.
I went from $300/mo to $340/mo for individual HDHP.
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Jennifer
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Re: There must be a pony in here somewhere.

Post by Jennifer » 29 Jan 2018, 20:36

Here's a new sleazy trick insurance companies are pulling: refusing to pay for ER visits after-the fact if the company decides they were not "true" emergencies. Basically, patients are expected to correctly diagnose themselves

https://www.vox.com/policy-and-politics ... ppropriate
Brittany Cloyd was doubled over in pain when she arrived at Frankfort Regional Medical Center’s emergency room on July 21, 2017.

“They got me a wheelchair and wheeled me back to a room immediately,” said Cloyd, 27, who lives in Kentucky.

Cloyd came in after a night of worsening fever and a increasing pain on the right side of her stomach. She called her mother, a former nurse, who thought it sounded like appendicitis and told Cloyd to go to the hospital immediately.

The doctors in the emergency room did multiple tests including a CT scan and ultrasound. They determined that Cloyd had ovarian cysts, not appendicitis. They gave her pain medications that helped her feel better, and an order to follow up with a gynecologist.

A few weeks later, Cloyd received something else: a $12,596 hospital bill her insurance denied — leaving her on the hook for all of it. ... Cloyd has her health insurance coverage through her husband’s job. His company uses Anthem, one of the country’s largest health insurance plans. In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.

The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case. The policy has so far rolled out in four states: Georgia, Indiana, Missouri, and Kentucky....
Great, just great. What Georgia resident has two thumbs and Anthem insurance?
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Jennifer
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Re: There must be a pony in here somewhere.

Post by Jennifer » 29 Jan 2018, 20:47

If I were a conspiracy theorist, I'd think whichever Anthem person invented this policy was actually a secret agent working to bring about single-payer in this country. Possibly working in collusion with Matt Welch's doctor. It's like they're going out of their way to demonstrate "See, America? You can do all the responsible things, have insurance, check prices in advance ... and NOTHING YOU DO MATTERS. Bwa ha ha ha."
"Myself, despite what they say about libertarians, I think we're actually allowed to pursue options beyond futility or sucking the dicks of the powerful." -- Eric the .5b

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nicole
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Re: There must be a pony in here somewhere.

Post by nicole » 30 Jan 2018, 09:23

So glad more people than ever are forced to buy their products.
"Fucking qualia." -Hugh Akston

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JasonL
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Re: There must be a pony in here somewhere.

Post by JasonL » 30 Jan 2018, 09:28

I have no real problems imposing a coverage differential on unnecessary ER visits. You don't want everyone going to the ER all the time and they totally do. Not paying at all is unreasonable, but like the article says, the states are doing a form of this already - imposing a medicare penalty on unnecessary ER visits.

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Mo
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Re: There must be a pony in here somewhere.

Post by Mo » 30 Jan 2018, 10:13

I agree that unnecessary visits should have a coverage differential, but there should be some semblance of what is considered unnecessary. Like good faith ER trips should be covered. Something like the ovarian cyst thing should be covered. Either that or insurance companies should have consequences if someone makes the wrong decision. All the money saved from coverage should handle legal settlements.
his voice is so soothing, but why do conspiracy nuts always sound like Batman and Robin solving one of Riddler's puzzles out loud? - fod

no one ever yells worldstar when a pet gets fucked up - dhex

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