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  #16   ^
Old Fri, Dec-06-19, 12:04
Grav Grav is offline
Senior Member
Posts: 1,469
 
Plan: Banting
Stats: 302/187/187 Male 175cm
BF:
Progress: 100%
Location: New Zealand
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Quote:
Originally Posted by bkloots
Why is health care so complicated?

Because obfuscation ensures the preservation of the status quo. It compels people for whom the system becomes too complicated, to trust in those who say they know better and assume that they really do.
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  #17   ^
Old Fri, Dec-06-19, 13:30
WereBear's Avatar
WereBear WereBear is online now
Senior Member
Posts: 14,602
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
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Quote:
Originally Posted by bkloots
WereBear, your story is appalling. What's with THAT??? It sounds like "So die already." I suppose that's the unspoken answer for many people with difficult--or even not so difficult--health issues. Not acceptable!


I think they get away with so much because they are doing this to sick people.

Even when you are a well person caring for a sick person, it is so much to deal with, and makes so little sense, that it just can't be fought.

However, what might be called my "ace in the hole" was this wonderful board, where I learned so much about health I was able to figure out ways of helping myself.

I'm on the personal hook for all kinds of supplements and therapy, but at least I get value for money.
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  #18   ^
Old Tue, Jan-14-20, 13:42
DaisyDawn's Avatar
DaisyDawn DaisyDawn is offline
Senior Member
Posts: 363
 
Plan: Higher P/Moderate F + C
Stats: 152/146.6/130 Female 66
BF:
Progress: 25%
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We've had high deductible, HSA insurance for years now and pay out of pocket for most medical expenses. What I've found is that a doctor visit is less than $100-$300 depending on what it's for. Med center/urgent care is less than $200 usually, not counting lab tests if you need them to send something out. Lab tests vary but we've gotten bills up to $300 for one test (that was when dd was being tested for MRSA I believe). Most have been under $100 though.

Xrays are cheap. Mammograms aren't too bad either- last year I had both a 3D mammo plus an ultrasound one. Both advance tests with the film and the specialist to look over everything was less than $1,000 without insurance kicking in, using an in-network provider.

With an HSA set-up we put $115 a week out of my husband's paycheck into the account, (it's auto-deducted and deposited). Right now our account is sitting at a balance of around $2,000, (just used it for a root canal for my husband a few weeks ago, which was $500 oop, so that brought it down a bit from where it was).

Here's the kickers-

Prescriptions. We have an rx discount program built into our insurance, using an in-network pharmacy, and two of my kid's Ritalin rxs (generic) are $9 a month. BUT, when my husband switched jobs this fall we had a 1 month insurance gap and I had to pay out-of-pocket without the discount. Those $9 rx's went up to $60 a piece. (side note-the oop costs of rx do count towards our deductible and once we hit our deductible rx is covered at 100%).

My son has an epi-pen for a bee allergy. Our pediatrician got us into a free program, otherwise epi-pens are around $600 each and they expire every year.

Hospital. We've paid for ER visits several times out of pocket-to walk in the door it's $1,000 dollars, before anything is done. That's just for triage admittance and nursing staff/basic usage of supplies. ER doctors/specialists are billed separately. Anesthesiologist needs are billed separately. Anything like setting bones, stitches etc is extra. Anything like CT scans are extra.

And then if you're admitted or require more complex treatment the costs jump substantially. That's why I'm a huge fan of high deductible insurance/HSA plans. The HSA allows you to set money aside for smaller medical costs and your deductible, but you have the high deductible insurance plan in case of emergencies/bigger medical events.

My dd had a head injury 3 years ago, due to a freak accident. In the ER triage she had stitches and a CT scan. She was seen by an intern doctor, who did her initial exam and stitches, his supervisor doctor who calmed him down when he messed up the staples and then they called in a specialist to look at her CT scan/check in on what was happening, (it was a children's hospital and they a have a rule that any time a kid comes in with a head injury they call in a specialist to be on site in case emergency surgery is needed etc. Thankfully my dd's skull fracture was small enough that no surgery was needed!). They also had a child care specialist with us the whole time, who helped keep my daughter distracted/calm.

My daughter was then admitted for one 'night', (we went in at 9pm and didn't get admitted for overnight till around midnight). The following morning the head specialist came in and ran some visual/cognition tests to see the extent of her concussion, a CNA bathed her/cleaned up her head (I think this lady did the most work out of all the people who saw us, it took almost an hour to work the dried blood out of my dd's long hair!). We were released that afternoon and our pediatrician took out the staples ($200) and we saw the head specialist one more time as a follow up, at her office, (less than $200).

The ER/hospital stay and everything that went along with it, not counting follow-up care, was almost $40,000. Our high deductible was $8,000 and at the time of the accident we had around $6,000 left towards it. The hospital has zero interest/no fee payment plans and were very helpful in working us through that. We then paid off the $6,000 in two years, using our HSA mostly for the monthly payments. It didn't really put a hardship on our regular budget, but it was a bit stressful wondering if something else big would come up before we could pay it off!

You can also use your HSA to cover vision, dental, prescriptions and best of all orthodontics (I have 2 kids in braces currently, and a 3rd who's done with treatment, whew!). I love having money sitting in our HSA account, available anytime we need it and then accumulating when we don't

All of my family is healthy/healthy weight. All of our medical costs have come from either accidents or sickness or preventative care. None of these costs would have been eliminated by following certain dietary guidelines. There's soooo much that goes into the medical costs equation and it covers so many different areas. Quite staggering to try and think it all through!

Last edited by DaisyDawn : Tue, Jan-14-20 at 13:59.
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  #19   ^
Old Tue, Jan-14-20, 14:39
Bangle Bangle is offline
Senior Member
Posts: 358
 
Plan: Atkins, Dr. Westman
Stats: 267/167/145 Female 5'4"
BF:
Progress: 82%
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Our health care system is so complicated. I am fortunate to have Medicare and a supplemental plan from my employer (large school district) that I was able to carry into retirement. It has done a good job of covering my needs and medications.

However, both my husband, myself and my mother have been hospitalized in the past few years for surgeries or illness, and the paperwork can drown and confuse anyone. All of these doctors you have never heard of begin billing you directly and immediately, before Medicare and your supplemental insurance have had time to submit their payments. The average person might pay those bills rather than hold them for the months that it might take for all the insurance payments to pay out. Fortunately, my husband is used to working with this kind of thing, and he handled, arranged and organized all the billing statements and responded to the requests. My elderly mother would never had been able to maneuver or understand the billing (nor would I) and know that she should NOT pay until the insurance company had either paid or refused to pay an item. It was quite a job just to keep up with the multitude of bills and understand what is finally due.

I worry for people who are uneducated, elderly or disabled in some way that have no one to do this for them. My mother is 95 with some dementia. Thank goodness she has us to pay her bills, do her taxes and manage her medical care. What about those who have no one?
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  #20   ^
Old Tue, Jan-14-20, 14:53
DaisyDawn's Avatar
DaisyDawn DaisyDawn is offline
Senior Member
Posts: 363
 
Plan: Higher P/Moderate F + C
Stats: 152/146.6/130 Female 66
BF:
Progress: 25%
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Quote:
Originally Posted by Bangle
Our health care system is so complicated. I am fortunate to have Medicare and a supplemental plan from my employer (large school district) that I was able to carry into retirement. It has done a good job of covering my needs and medications.

However, both my husband, myself and my mother have been hospitalized in the past few years for surgeries or illness, and the paperwork can drown and confuse anyone. All of these doctors you have never heard of begin billing you directly and immediately, before Medicare and your supplemental insurance have had time to submit their payments. The average person might pay those bills rather than hold them for the months that it might take for all the insurance payments to pay out. Fortunately, my husband is used to working with this kind of thing, and he handled, arranged and organized all the billing statements and responded to the requests. My elderly mother would never had been able to maneuver or understand the billing (nor would I) and know that she should NOT pay until the insurance company had either paid or refused to pay an item. It was quite a job just to keep up with the multitude of bills and understand what is finally due.

I worry for people who are uneducated, elderly or disabled in some way that have no one to do this for them. My mother is 95 with some dementia. Thank goodness she has us to pay her bills, do her taxes and manage her medical care. What about those who have no one?


We've had the opposite experience with billing-it takes forever to get them in! With my dd's injury we'd think we were done and then another one would randomly come in the mail, ugh. It took around 6 months for everything to go through our insurance and then get to us/get added to our payment plan.

A few years ago my other dd had to have sinus surgery. We got a random anesthesiologist bill 9 months after the fact

I do a lot of online tracking now for our medical stuff. I can see in real time in our medical insurance patient portal, as things are processed/what we owe. We have the option to pay any balances directly through the site, or we can wait for a paper bill to come in the mail. Our old HSA had a fantastic website/patient portal attached to it, and our new HSA is set up directly through our bank, so I can look at our account anytime online or just go into a bank branch if I have any questions.

Our dental insurance also has an online patient portal, as does my primary care doctor and my kid's pediatrician and then orthodontist office. When we had the hospital payment plan set up they also had a pretty nice website that I used to get current balances, a breakdown of costs, pay our monthly payment etc. My husband's doctor is the only medical provider that we use, that's still old school and if we have a bill/question, I have to go in and talk to them in person.
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