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mojo84 wrote:I firmly believe a lot of the reason we're in this situation we're in now is because we started expecting insurance to cover routine and minor medical expenses.

Zackly right--insurance USED TO be something you bought "just in case" you had an unexpected problem and needed assistance with the bucks. But now it's morphed (warped?) into something entirely different hasn't it.

What we have had instead is "group healthcare" where you pay monthly and an "insurance company" e.g. Blue Cross has negotiated discounted services and pays providers for those because you're a card-carrying, dues-paying client of their.

This arrangement shouldn't be called "insurance" IMHO. And as for the Affordable Care Act, I do prefer the alternate names people have used, for example in this very thread...

TomsTXCHL wrote:

mojo84 wrote:I firmly believe a lot of the reason we're in this situation we're in now is because we started expecting insurance to cover routine and minor medical expenses.

Zackly right--insurance USED TO be something you bought "just in case" you had an unexpected problem and needed assistance with the bucks. But now it's morphed (warped?) into something entirely different hasn't it.

What we have had instead is "group healthcare" where you pay monthly and an "insurance company" e.g. Blue Cross has negotiated discounted services and pays providers for those because you're a card-carrying, dues-paying client of their.

This arrangement shouldn't be called "insurance" IMHO. And as for the Affordable Care Act, I do prefer the alternate names people have used, for example in this very thread...

I believe we are in the situation we are right now because we somehow permitted the socialist party to take control of Washington by claiming to be Democrats. Then we permitted a muslim terrorist, who is determined to bring down the American way of life, to become the supreme leader. But hey, that is just the way I see it all.

Hate to tell you but most companies actually underpriced this year for competitive reasons. Real prices (based on the claims experience) won't show up for a year or two. Be afraid.

This issue started long before the current dictator in chief took office. He has just seized the opportunity to "change" the country.

Being in the insurance business for over 15 years and my wife close to 25, we were talking and laughing last night about how much we are hearing and seeing people say how much they "liked" their insurance plan and coverage. Not too long ago, you would be very hard pressed to find someone that didn't hate their coverage and insurance company to the point of cussing them.

I'll be the first to say, the system needed fixing but it didn't need this. Prime example of be careful what you ask for. Until we get a handle on the cost of care and treatment, the cost of insurance will just continue to skyrocket.

mojo84 wrote:This issue started long before the current dictator in chief took office. He has just seized the opportunity to "change" the country.

..."Abraham"...

I'll be the first to say, the system needed fixing but it didn't need this. Prime example of be careful what you ask for. Until we get a handle on the cost of care and treatment, the cost of insurance will just continue to skyrocket.

I agree. What they have done here is comparable to burning your house down because you don't like the furniture.

Mojo, had we talked eight years ago I assure you I had nothing but praise for Aetna and their handling of my many, many claims. Now I have BCBS and although I haven't made many large claims, the costs have skyrocket and they refuse to pay at all for many of the things Aetna paid 100%.

Medical imaging was one of those things Aetna paid in full. My oncologist wants me to get annual PET scans, but BCBS will not pay since I have been in remission for over 5 years, (yet Aetna didn't mind paying on year 6.) So I will play their game and get CT scans twice a year even though my doctor says they are practically useless - especially since the radiologist refuses to use IV contrast on me due to me having only one kidney.

My costs have gone up, service has gone down. Yes, I miss my old insurance plan and provider.

Jaquar,
Glad to hear you had some good experiences in the past. We as agents do not get to hear that very often. You know how it is, people talk about the bad.

As with your recent and future claims, may I suggest if you haven't already, explore with your doctor and radiology group how they are coding your scans. That MAY make a difference in your favor. Coding is key in many instances. If it's been in remission for five years, coding it as preventative instead of diagnostic MAY make the difference between covered or not.

Mojo,

Thanks for the tip, I will pass it on to the person who schedules the scans and have them try it again. It has been a couple years since I had a PET, but maybe they can give it another go with the insurance company.

I have 35 years in hospital financial management and I will give you the benefit of what I know free of charge. The nfo is this...Its going to get worse. If you want to know how much worse get yourself a A copy of the ACA "Obamacare" regulations and read it. Obviously relying on the president or possibly your state or federal representatives to tell you the truth isn't wise.

Stratman,

With his imperial scepter, he's often changed much regarding the so-called ACA.

Are the regulations reliably protected from his Presidential/Majestic decree?

mojo84 wrote:This issue started long before the current dictator in chief took office. He has just seized the opportunity to "change" the country.

Being in the insurance business for over 15 years and my wife close to 25, we were talking and laughing last night about how much we are hearing and seeing people say how much they "liked" their insurance plan and coverage. Not too long ago, you would be very hard pressed to find someone that didn't hate their coverage and insurance company to the point of cussing them.

I'll be the first to say, the system needed fixing but it didn't need this. Prime example of be careful what you ask for. Until we get a handle on the cost of care and treatment, the cost of insurance will just continue to skyrocket.

For my wife's Humana policy, we would be one of the ones that liked an old policy. It was only $245/month. It had a $5000 deductible, and 70/30 until another $5,000 out of pocket was reached. It had reasonable copayments for office visits and other services. Lest $10,000 sound like too much out of pocket, when my wife had her rotator cuff repaired in June, the bill for 4 hours at the Baylor outpatient surgery center in Trophy Club was over $23,000. Add to that the surgeon's fee, the anesthesiologist fee, all the physical therapy, etc., etc., and we got a comparative bargain. Yes, $10K is a lot of money, but almost anybody above the poverty level can beg or borrow that $10K if they have to. (We took it out of our retirement account.) No, it's not easy, but it is doable, and that much out of pocket was offset by the fact that for the past few years, the annual cost of her health insurance has been affordable. We didn't go so broke paying for a more expensive plan that we couldn't afford the $10K when it became necessary.

Exactly!

Obama purchased Obamacare today. Wonder if he got a subsidy?

He didn't actually purchase it. It was just a symbolic stunt to make people think he is participating. His healthcare is taken care of by the military docs at our expense. Not sure about his family's though. Maybe that is who signed up on it.

mojo84 wrote:He didn't actually purchase it. It was just a symbolic stunt to make people think he is participating. His healthcare is taken care of by the military docs at our expense. Not sure about his family's though. Maybe that is who signed up on it.

Yes, I know it's a stunt. Doesn't mean he didn't purchase a policy that won't get used, though. If he SAID he purchased a policy, and he actually didn't, then he's lying again...