Health insurance

[The motor guy]

So it appears that health insurance providers dropped the ppo plans that doctors would only take. There are only like 2 doctors in all of Houston who accept HMO plans. So it seems like people who don't have insurance from their employer are sol now? Now we get to spend 200 bucks on an office visit. The insurance guy I talked to on the phone said more doctors will be likely to accept HMO for 2016 since all the insurance companies no longer provide that PPO plan to individuals. The only people who can provide the PPO plans are employers giving insurance to their employees. [censored]?

 

[zzyzzx]

Originally Posted By: motor_oil_madman
Now we get to spend 200 bucks on an office visit.


Only $200???

 

[Leo99]

Does this affect you personally? Are you looking for a solution or just ranting in general?

 

[The motor guy]

Yeah it affects me personally, curious as to what others do? I know last year I had to pay twice as much for insurance every month to get the ppo plan cause nobody accepted hmo. At least my premium went down $10/month.

 

[JHZR2]

I have an hdhp. So I pay the first few thousands out of pocket, which is how insurance should be. It has made us emphasize cost (yes you can ask for pricing and you can negotiate), and planning, as well as being smart about not expecting something so stupid as all other insureds paying your bill to have the doctor tell you that you have a cold.

Reality too is that many doctors are overpaid, many provide low value, and if the insurance companies are changing formats to provide lower cost approaches, market forces will make the doctors come in line. Plenty of them have loans, debts, and like to eat too. Sure I have multiple friends who have started over $300k/yr, but if in the new scheme they play tough and don't see enough patients, they won't have billable hours and they won't earn their money.

 

[philipp10]

Man I feel for you. That sucks. Sorry I can't help.

 

[Leo99]

Originally Posted By: JHZR2
I have an hdhp. So I pay the first few thousands out of pocket, which is how insurance should be. It has made us emphasize cost (yes you can ask for pricing and you can negotiate), and planning, as well as being smart about not expecting something so stupid as all other insureds paying your bill to have the doctor tell you that you have a cold.

Reality too is that many doctors are overpaid, many provide low value, and if the insurance companies are changing formats to provide lower cost approaches, market forces will make the doctors come in line. Plenty of them have loans, debts, and like to eat too. Sure I have multiple friends who have started over $300k/yr, but if in the new scheme they play tough and don't see enough patients, they won't have billable hours and they won't earn their money.


Hopefully, market forces will be in play and when doctors that don't accept certain insurance plans lose pts and revenue they will be forced to expand the insurance plans they accept. Unfortunately, this this doesn't help people waiting for the market to adjust.

 

[crazyoildude]

i pay for my own health insurance ...its my wife myself my housekeeper and one daughter $3400.00 BCBS that is a Very Good HMO With BCBS copays $20.00 $30.00 for a specialist which i get waived from most of the doctors i use because a couple of family members are doctors and its sort of a courtesy like having the gold pba card ,,lol.. My housekeeper qualifies for obama care for free but she had a cancer scare and i wanted the best doctors so i pay for her insurance (she is part of our family now).. If she had obumma care she might have died.
Am i getting ripped of course i am but i need the best because there are no second chances in life sometimes. Both my wife and myself are self employed so at least it is a tax deduction.
With health insurance you get what you pay for weather you believe it or not, in some cases its live or die sad to say.

 

[goodtimes]

Employer plans are largely HMOs. Where do all those tens of thousands of Houston workers with HMO insurance go to see a doctor if doctors don't take HMOs? I am pretty sure if you go to the HMO websites instead of calling an insurance agent and getting wrong information, you will finds hundreds of doctors in the HMO network. Also pretty sure they offer insurance to individuals.

 

[crazyoildude]

I was not offered a decent ppo my best bet was an hmo which is not a problem because if i want a referral i have doctors that will do what i wish..

My wife used to have group insurance at her job but the other two partners wives work for the State and get ok insurance from there.

 

[69GTX]

As of last year my self-employed HMO coverage for a family of 2 healthy, normal weight, active, non-smoking and non-drinking adults cost me $13K/yr. That starts with a $10,000 deductible ($5K per person). It's absurd. That was the most affordable plan with minimal coverage in my entire state. That with ACA. It's now basically catastrophic health insurance or nothing. You basically pay for everything during the year except 80% of an annual physical. When I first obtained this plan in 2009 it was $5K/yr. Has gone up around 15% each and every year.

 

[Joe_Power]

You're probably the same guy that is anti Union. Your employer says they'll take take of you, and you believe it. Keep telling yourself that. I'm Union, pay ZERO for health insurance.

 

[The motor guy]

Originally Posted By: zzyzzx
Originally Posted By: motor_oil_madman
Now we get to spend 200 bucks on an office visit.


Only $200???


What do you mean only $200?

 

[Nyogtha]

Originally Posted By: JHZR2
I have an hdhp. So I pay the first few thousands out of pocket, which is how insurance should be. It has made us emphasize cost (yes you can ask for pricing and you can negotiate), and planning, as well as being smart about not expecting something so stupid as all other insureds paying your bill to have the doctor tell you that you have a cold.

Reality too is that many doctors are overpaid, many provide low value, and if the insurance companies are changing formats to provide lower cost approaches, market forces will make the doctors come in line. Plenty of them have loans, debts, and like to eat too. Sure I have multiple friends who have started over $300k/yr, but if in the new scheme they play tough and don't see enough patients, they won't have billable hours and they won't earn their money.


Thankfully for those of us with chronic health issues (including my wife who has never smoked and doesn't drink but developed breast cancer at an early age), there are choices without a high deductible. I'm all for choices rather than dictating to everyone how things "should be". We don't go to Dr.'s for colds either.

Less choice, less freedom. But clearly not everyone believes in freedom of individual choice. There are always those who believe everyone should be free to ONLY choose the same choice they make.

 

[Wolf359]

Originally Posted By: motor_oil_madman
Originally Posted By: zzyzzx
Originally Posted By: motor_oil_madman
Now we get to spend 200 bucks on an office visit.


Only $200???


What do you mean only $200?


I think he means it's cheap. I got a bill once for $1500 for an office visit, saw the doctor for like 10 minutes. Of course once the insurance got done with it, it was pretty low and all I had to pay was my co-pay.

 

[Mr Nice]

Originally Posted By: Joe_Power
You're probably the same guy that is anti Union. Your employer says they'll take take of you, and you believe it. Keep telling yourself that. I'm Union, pay ZERO for health insurance.


Unions have good benefits.

 

[jmsjags]

I am in the military and qualify for Tricare Reserve Select- $200 a month for my wife and I. The health insurance plans offered through my employer start around $300/mo for a high deductible and go up from there. I really do sympathize with the people paying exorbitant amounts of money each month for health insurance. It is my hope that a single payer system will be adopted soon so that people will not need to stress over this anymore.

 

[HerrStig]

Originally Posted By: Joe_Power
You're probably the same guy that is anti Union. Your employer says they'll take take of you, and you believe it. Keep telling yourself that. I'm Union, pay ZERO for health insurance.
Those "gold plated" plans aren't going to be "free" much longer. Didn't the union boss tell you that? It's called the Cadillac Tax. Obama has been passing out waivers to keep you boys fat, dumb, happy and "voting right" but the party's about over. They NEED dough from you to pay for the handout seekers.

 

[The motor guy]

Originally Posted By: crazyoildude
i pay for my own health insurance ...its my wife myself my housekeeper and one daughter $3400.00 BCBS that is a Very Good HMO With BCBS copays $20.00 $30.00 for a specialist which i get waived from most of the doctors i use because a couple of family members are doctors and its sort of a courtesy like having the gold pba card ,,lol.. My housekeeper qualifies for obama care for free but she had a cancer scare and i wanted the best doctors so i pay for her insurance (she is part of our family now).. If she had obumma care she might have died.
Am i getting ripped of course i am but i need the best because there are no second chances in life sometimes. Both my wife and myself are self employed so at least it is a tax deduction.
With health insurance you get what you pay for weather you believe it or not, in some cases its live or die sad to say.


Is that for the whole year?

 

[The motor guy]

Originally Posted By: Nyogtha
Originally Posted By: JHZR2
I have an hdhp. So I pay the first few thousands out of pocket, which is how insurance should be. It has made us emphasize cost (yes you can ask for pricing and you can negotiate), and planning, as well as being smart about not expecting something so stupid as all other insureds paying your bill to have the doctor tell you that you have a cold.

Reality too is that many doctors are overpaid, many provide low value, and if the insurance companies are changing formats to provide lower cost approaches, market forces will make the doctors come in line. Plenty of them have loans, debts, and like to eat too. Sure I have multiple friends who have started over $300k/yr, but if in the new scheme they play tough and don't see enough patients, they won't have billable hours and they won't earn their money.


Thankfully for those of us with chronic health issues (including my wife who has never smoked and doesn't drink but developed breast cancer at an early age), there are choices without a high deductible. I'm all for choices rather than dictating to everyone how things "should be". We don't go to Dr.'s for colds either.

Less choice, less freedom. But clearly not everyone believes in freedom of individual choice. There are always those who believe everyone should be free to ONLY choose the same choice they make.


Well it all depends on how often you go and how much medicine. If I needed meds all the time and went to the doctors frequently like some people do then I would pick a plan that has a lower deductible and just pay more per month. My concern is I have insurance I can't even use cause doctors won't take it. Might as well not have any and pay out of pocket for office visits and then make a "reasonable effort to pay" if I get hospitalized. Might as well work the system, that's what everyone else does. When you can rack up a 50,000 dollar bill and then pay $10/ month why bother.