So I finally have health insurance again

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by auditor0007, Aug 22, 2010.

  1. auditor0007
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    auditor0007 Gold Member

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    So I was accepted for my state's high risk pool insurance that has been set up through the new healthcare legislation. Now my healthcare costs are going to increase dramatically, but at least I am covered in case I ever become seriously ill.

    Here are the details. I live in Ohio. The reason I need the insurance is that I am self-employed. I had a private policy in Colorado, but when I moved to Ohio, I was denied coverage due to pre-existing condition. Same company that insured me in Colorado denied me in Ohio. Swell people, they are.

    Anyway, the rate they are charging me is $392 per month. If I were a non-smoker, the rate would be $293. I've actually quit, but it was just recently, so I still have to claim being a smoker. No problem with that, for now. My deductible is $2500 per year, but doctor's visits are covered with a co-pay, and I have prescription drug benefits.

    So, how much will the insurance companies lose on me with my pre-existing condition? Nothing at all. In fact, the only payouts they will have is for a couple of doctor visits per year, less my co-payment. I am not on any prescription medication, and all of my other healthcare needs will fall under the $2500 deductible. Truthfully, costwise it would have been much cheaper just to remain uninsured, but then again, I now have the comfort of knowing that I am covered if something should serously go wrong, and that is what insurance is for.

    Here is the thing that bothers me, and this holds true for any insurance. Now that I am covered, I will be billed at the discounted rates the insurance company has set up with my providers, and I will be forced to use only the providers that are in my "network of providers". Those discounted rates are much higher than what I have been paying while I was paying out of pocket.

    Now I do have an option. If my provider is in my network, then I can still pay cash, and I can then submit the paid bill to the insurance company to go toward my deductible. This would allow me to continue paying the reduced rates I get by paying cash. The only thing is that the forms I need to fill out are ridiculously complex. Now I understand why 30% of our costs go towards administrative fees. The paperwork is a nightmare. Not sure what I'm going to do yet. I am thinking I may just not tell my healthcare providers that I am insured and continue paying out of pocket. If I have a big medical expense, then I'll just have to eat the $1000 to $2000 that would have gone against my deductible. So long as I don't have a large bill, then I'll probably save myself an extra $1000 to $1500 per year.
     
  2. bromiley
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    bromiley Rookie

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    Hey! thats good. Its really very important.. I need to take the health insurance policy or mediclaim policy for my wife age of 28. Pleae advise which one is the best and can when the treatment can be done with that policy.
     
  3. Charles_Main
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    Charles_Main AR15 Owner

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    I still do not have insurance. I am just thrilled that I must now Get it or pay a fine. I still can't afford it and prices have skyrocket because of the Health care bill.

    Yeah I am loving it so far.
     
  4. xotoxi
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    xotoxi Platinum Member

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    Explain this to me.

    Generally, patients that are paying cash end up paying the highest rates, as the discounted rates are given to the insurance companies. We would give the cash paying patient a 30% discount if they paid at the time of service, which would usually get them to the insurance reimbursement rates...but they would never be less than the insurance rates.
     
  5. Charles_Main
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    Charles_Main AR15 Owner

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    Pretty simply really. The doctors and hospitals make up for the fact that they have to service Millions on Medicare and Medicaid at controlled and reduced rates, By Raping those who can pay.

    The insurance companies get the discounts because they have the buying power. That is kinda the whole idea with Insurance. You get large groups together and they can collectively bargain for lower rates.
     
  6. Greenbeard
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    Greenbeard Gold Member

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    Define "now."
     
  7. johnrocks
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    johnrocks Silver Member

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    We've had a high risk pool in this State, it's how I am able to get insurance but it's high as hell, not complaining though, it's high for a reason....people in high risk pools are;well; high risk, they are sick or are in a category that greatly increases their odds of needing health care like obesity.
     
  8. Douger
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    Douger BANNED

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    Aint it great living in " the greatest nation on earth" ?
    I go to the eye doc, today, and get my glasses lenses replaced.
    Cost ? ZERO. Well... my insurance is $20 a month.
    OOOOOPz. I need my blood pressure meds too.
    Yeah ZERO.
     
  9. Mr. H.
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    Mr. H. Diamond Member

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    My employer doesn't cover my health insurance and the company I was with cancelled my policy, then put me on a new catastrophic plan. The premiums are less than half what they were but the deductible is now $25,000/year. That's right - $25,000/yr.
     
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  10. Charles_Main
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    Charles_Main AR15 Owner

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    lol you know what I meant. When it goes into effect I have to get insurance or pay a fine I mean tax, I mean fine.

    Exactly what has, or will this bill do to make it more affordable for me to cover my family?
     

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