What kind of health insurance do you have?

[Glenda]

After reading this thread:

"Goddamit, Sick People shouldn't have to beg for help in America!"
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=104x4222064

it makes me wonder, what kind of health insurance do you guys have?

[catmandu57]

1. We have the ever popular

Just don't get sick plan.

[TheFarseer]

3. hey, I'm on that plan too!

If I ever get hired on permanent at work (I've been there 6 months) I'll have pretty good coverage so I've heard.

[blondeatlast]

2. I have a substandard PPO and two chronic health conditions.

My family has declared bankruptcy over medical expenses once--and I consider myself extremely fortunate.

This is a sick situation in this country. HR 2235 just passed and the slide toward eliminating the tax incentives for employers to provide health coverage is increasing in speed.

We are nearing a crisis, America.

[wishlist]

4. Good plan through Govt job but I pay $3000/yr premiums plus copays etc

I am fortunate to have good coverage however it takes a big chunk of my income for the premiums and there are a lot of out of pocket expenses because of the deductibles, copays and miniscule dental coverage. However my husband and I have both been hospitalized several times for serious conditions and surgery in past ten years so it has been vital to have this or else we would have been saddled with tens of thousands more in charges.

Unfortunately I only expect things to get worse as far as higher premiums that cover less and less of the charges each year.

[Catt03]

18. me too

great insurance but over $5,00 in yearly premiums.

Of course if I use the damm thing and change policies, I would be excluded from everything but a blood test.

It's just "social control"...and it's a bitch.

[kedrys]

5. I'm self-employed, so I'm using the s.o.'s crappy HMO

Every year, it gets worse. The most recent outrage was their denial of payment for a prescription my doctor wrote for my depression and generalized anxiety disorder. They said it was too expensive, and before they'd pay for it, I have to have tried two (!) other meds for at least one month each. So I'm having to take stuff that doesn't work nearly as well for 2 months before I can MAYBE get my hands on the stuff that works. Meantime, I'm barely well enough to work most days, and if I don't bill hours, we're sunk.

F*cking bean counters are practicing medicine without a license, assholes. :mad: :grr:

[ikojo]

6. I work for an HMO but my insurance is so...so....

I hope I don't get sick because my doctor will have to fight with the HMO to get anything authorized.

Just because one works for an insurance company does not mean one has good insurance. They are really pushing the HSA's (Health Savings Accounts) as a way for employees to "share" the cost of healthcare with the employer. So, not only are we being asked to do the bulk of saving for our retirement, continue to educate ourselves but now we also are expected to put aside money out of an already meager paycheck just in case we become ill.

Oy vey! When will Americans take to the streets and say off with their heads?

There are more working class people than there are of the upper class and rich people.

The numbers are clearly on our side.

[jus_the_facts]

7. none..and haven't had any for 20 years.....

:nopity:

[woodsprite]

8. We have a good health plan right now, but

each time they go thru open enrollment, we get a new card that has higher copays listed and the list of drs. does seem to shrink a bit. It's still better than most. The big draw for us in choosing this was that you still got to pick your own doctors. It's Blue Cross/Blue Shield comprehensive family coverage.

Since hubby and I both work the same place, the workplace is still paying for full family comprehensive because it's cheaper than paying for 2 separate individual policies. We make out well as long as we continue to work at the same place. When we delivered our son, we didn't call for preauthorization since it was an emergency. Preauthorization was not what we were most concerned with at the moment. They didn't bat an eye. I have heard that other policies are not that forgiving.

[converted_democrat]

9. My family has no insurance.........

Thank you, Glenda, for bring this is issue up. I think it needs more attention. Thank you so much. This really is an important issue for American families.
:pals:

[rndmprsn]

10. NONE since i was laid-off two years ago.

i go to a clinic and am able to get 70% off visits and such, thank god for this as its def helped out.

[fasttense]

11. Does PPO and POS mean point of service? You don't have to see

a health care manager?

I have the military health plan for retirees, it is ok. I just keep wondering when brush will reduce it or do away with it.

[Glenda]

12. Yeah...

and PPO stands for Preferred Provider Organization. I don't know what the difference is between PPO and POS. Maybe someone else can illuminate

I think they both have lists of preferred providers, where if you go to docs on their list, you just pay the $15 (or whatever) copay. If you go to people not on their list, they will pay 70-80%, and you pay the other 20%-30%. Plus, you don't have to ask for referrals to specialists, like you would in an HMO. You can go to whoever you want. It's just whether you pay the $15 copay, or the 20% copay.

[fasttense]

14. Thanks Glenda, I wasn't sue. n/t

[livinginphotographs]

29. I can't pass up a chance to be useful....

:)

HMO - requires referrals to specialists (this is where the beancounters start practicing medicine), does not cover any providers who are not in the network

POS - still works like an HMO, but covers out-of-network providers, although you will have to pay more an out-of-network visit

PPO - probably the best, you don't have an HMO breathing down your neck, and although you'll pay more for out-of-network visits, you have the option to see participating or a non-participating provider

[Glenda]

31. I still don't get the difference between POS and PPO

It looks like they both pay for out-of-network providers (at lower rates than in network)...

Are they different in whether you do or don't need referrals?

How is it that the POS works more like an HMO than the PPO? Do POSs deny more stuff, and make you get more authorizations up front?

I've only been on PPOs.

[livinginphotographs]

32. You're completely right.

A POS requires referrals and involves the insurance company in directing your care, like an HMO, whereas a PPO does not require referrals and pretty much leaves your care up to you, except for things like hospital preauthorization. Does that make sense?

[Glenda]

34. In what ways do HMOs and POSs direct your care?

Now you see how little I really know, and how helpful your knowledge is to me :)

I believe that HMOs and POSs force you to get a PCP. And in some, you can change that person daily if you wanted to. Others, maybe you can change once every 6 months? Also, the specialists a PCP refers you to might have to be linked with the PCPs associated hospital?

Tell me what you know about how HMOs and POSs direct a person's care?

Thanks :)

[tammywammy]

13. Aetna HMO

Through my parents, so I'm not sure how much it costs. But it's awesome. I've had back problems since I was 18 (bulging disk) and they've never declined to cover any MRIs or physical therapy. I've also had a pap smear come back abnormal, and Aetna's never declined the extra tests that came with that either.

I'm worried because in September I'm moving to the insurance the company I work for has. I hope that it's as good as Aetna's been to me.

[alfredo]

15. I get mine through my union, NALC.

The National Association of Letter Carriers.

[XboxWarrior]

16. Never had it.......

Dont think I ever will.

[alfredo]

26. I didn't until I got married.

Priorities changed a bit then.

[madrchsod]

17. blue cross/blue shield

about 4000 a year. 500 deductible which i found out that since i have alot of check-ups for heart problems it is worth every penny-785 dollars for blood work-up?

[Lars39]

19. I'm on COBRA @ $439/month.

The rest of my family don't have insurance because we can't afford it on top of the COBRA payments and medical bills.
My insurance ends 10/31, and I have no idea what will happen then.
We've been gathering our paperwork to file bankruptcy. :cry:

[leftofthedial]

20. substandard PPO

I pay it ALL myself

[yankeedem]

21. You forgot one poll entry

"Live in a country where health care is a right, not a privlege"
Which would be the US if the Republicans didn't oppose everything that takes a dime out of their pockets and gives it to the poor and middle class.

[catabryna]

22. When my husband was alive,

The company he worked for paid a substantial portion of the premiums for our health insurance. We had several options to choose from, but chose what I called the "cadillac" plan and put a greater share of our own money toward the coverage. It was/is a very good policy and I can guarantee you that, had we not had this plan, we'd be screwed since bankruptcy is no longer an option. I, alone, would have been responsible for several hundred thousand dollars in medical bills.

Now that we have continued with COBRA coverage, I pay the entire cost of this policy for myself and our son at a cost of $700.00 per month. However, after seeing how a catastrophic illness can ruin a family, I do whatever needs to be done to keep this coverage.

Everyone should have access to the treatment my husband received for his cancer and it makes me sick just knowing that others don't have it. It's just another indication that all of us are just one step away from the poor house at any time.

[Glenda]

23. Here are some articles I found on # uninsured

*** 1998 ***

"The Census Bureau estimates that 44.3 million people in the United States, or 16.3% of the population, had no health insurance in 1998 -- an increase of about 1 million people since 1997."
http://www.acponline.org/uninsured/lack-exec.htm


*** 2001, 2002 ***

"The sluggish economy and rising health costs are combining to cost more people their health insurance, with 75 million uninsured at some point during 2001 or 2002, a study finds.

Typically, the number of uninsured Americans is reported at about 41 million -- those without health insurance for all of 2001"
http://seattlepi.nwsource.com/national/111000_insurance05.shtml


*** 2002, 2003 ***
"More than 80 million Americans lacked health insurance for all or part of 2002 and 2003, almost double the number of Americans who were without health insurance for the entire year of 2002, according to a new report from Families USA.

Based on current figures from the U.S. Census Bureau, the health care consumer advocacy organization found that 81.8 million Americans - or one out of three people younger than 65 - had no health insurance for a period of time during 2002 and 2003. Of the 81.8 million individuals, more than 65 percent were uninsured for six months or more.
…
The Families USA report broke the numbers down even further by state, with more than one out of three of the total population of Texas younger than 65 uninsured for some or all of 20022003 - the highest rate in the country. Following Texas were New Mexico, California, Nevada, Louisiana, Arizona, Mississippi, Oklahoma, Alaska, Florida, Arkansas, North Carolina and New York."
http://www.medicalnewstoday.com/medicalnews.php?newsid=12370

[Glenda]

27. Graphs

From
http://covertheuninsuredweek.org/

"Over one-half (56 percent) of all uninsured working adults are employed full-time throughout the year." (2003)


"In 2004, workers paid on average $47 per month for employee-only coverage and $222 per month for family coverage."

[enough]

24. Self-employed -- have good coverage but it COSTS an arm and a leg.

We are both 61. The premiums are sky-high. At this age, this very expensive coverage seems to be the only thing available. We would rather pay less for a high deductable, because we use the medical system hardly ever. But not eligible for the high-deductable insurance programs that we have seen, because of a pre-existing condition that no longer exists.

Every month we wonder if this will be the last we will be able to pay the premium, and it gets paid on a credit card more often than I like to admit.

I would really be interested in any leads anyone has on high-deductable insurance that does not exclude for previous history.

[Al-CIAda]

25. I think its called the 'VooDoo doll, leaches, and faith based Plan". n/t

[Lady Effingbroke]

28. I have the increasingly popular faith-based health insurance, i.e.

"pray you don't get sick", coupled with this in case of catastrophic illness.

[livinginphotographs]

30. I've been lucky.

Haven't been without insurance for several years except for occasional breaks in employment.

Most of my friends, however, have been uncovered for as long as I can remember, and my brother is on a pretty shitty plan that he still pays a relatively large amount for. I've got one friend that will accidentally break a finger or something and he just waits for it to heal up instead of seeing a doctor.

My belief is that the right is not going to have much longer to defend their corporate buddies by calling anyone who offers an alternative to private healthcare a "socialist." People are only going to take so much of this bullshit.

[julialnyc]

33. none at the moment

but I just got married, so I am in the process of being added to my husband's (I work free-lance and am not eligible for insurance through my own work).

[Cleita]

35. You missed Medicare which most people over 65 have.

This is my insurance along with a medigap insurance. Both cost me about $250 a month, but they do pay for almost everything, except much of the expense of prescription drugs so far and dental. I am waiting for the other shoe to drop and for the Bush administration to start meddling with this as they are trying to meddle with Social Security.

If that happens most seniors I know won't be able to afford medical care at a time in their lives that they need it the most.

[Swamp Rat]

36. none n/t

:(

[mountebank]

37. Student health plan (crappy) and wife has none (too expensive) n/t

[MountainLaurel]

38. Tolerable except that

Because I now work for a religious employer, my plan doesn't cover my central medical expense: birth control. So, that'll be out of pocket starting this month.

[lies and propaganda]

39. thats pretty fun.

I barely can spell insurance.

[RebelOne]

40. I guess I can consider myself fortunate.

I work for a very large media corporation with a few thousand employees, so the group insurance is quite inexpensive. I have medical insurance that covers me about 90%, dental insurance (which sucks, as it doesn't cover a whole lot), eyecare insurance that is quite good and life insurance that will pay my survivors an amount equal to my yearly salary (my salary sucks also, so my beneficaries won't inherit too much). But for the entire package, I pay less than $100 a month.

[LeftyMom]

41. Me: kaiser (HMO) free through work

LeftyKid: I just got him signed up for a California's Healthy Families program. He gets a Blue Cross PPO plan for $4/ mo and $5 copays for meds and office visits (up to a max of $250 a year, further expenses are 100% covered.)

LeftyDad: The don't get sick plan. He's finishing up the training he needs to apply for a job with better pay and benefits so we can get him covered and move LeftyKid to his plan if it makes sense to do so.

[DemBones DemBones]

42. Though our HMO is basically good, I dislike the

fact that we can only see 'approved' doctors if we want them to pay.