New healthcare thread...

[TIDE-HSV]

Since it took over the Ukraine war thread and I was part of the hijack. In reference to the French system, I need to emphasize that the Germans have a similar system and do not have the corruption problem that France has. And, the corruption in France goes far, far beyond the healthcare system. In fact, Switzerland has a hybrid system which works. All of the systems have one thing in common - they all require 100% participation. It's the only thing that works...

 

[jthomas666]

We pay a lot of money for premium-tier BC/BS, and the coverage flat out sucks. Granted, I've been on PEEHIP for most of my life, so my experience is skewed, but if this is the best you can get, I shudder to think of the kind of coverage people with less income can afford.

 

[NationalTitles18]

We pay a lot of money for premium-tier BC/BS, and the coverage flat out sucks. Granted, I've been on PEEHIP for most of my life, so my experience is skewed, but if this is the best you can get, I shudder to think of the kind of coverage people with less income can afford.

I'd rather deal with California's Medicaid insurance (known as Partnership Health Plan in the northern counties) than BC/BS - not even joking.

We have the fewest issues with (wait for it)... Medicare.

Need a medically indicated referral or test? Just order it and send the order where it needs to go if Medicare is primary.

 

[crimsonaudio]

I have quite a few friends throughout Europe and for the most part, they really like their government health care. But there are downsides.

I also wonder whether our government is more corrupt than most of theirs. I do know that due to the two-party system it's more sharply divided.

I know of a few doctors out where I live that do not accept Medicare due to the mandated (lower) payouts than they get from standard insurance companies. Not sure this is a bad thing for the insured, however - healthcare costs are out of control for a reason...

 

[Chukker Veteran]

I’ve had good luck with my insurance over the years. I’ve had two colon resections, fairly major operations, with no problems with billing. My first time I had a blue cross policy as a primary policy before I qualified for Medicare. I don’t remember getting any bills at all although I’m sure I had some fairly minor expenses. The second time I had Medicare with a backup Blue Cross…I never saw the first bill. I got a few notices saying I might be billed for a specific amount, but never was.

I’ve had my eyelids lifted, torn an ACL and now I’m dealing with heart issues in the past six months but still I’m not getting hit with bills.

 

[Padreruf]

I’ve had good luck with my insurance over the years. I’ve had two colon resections, fairly major operations, with no problems with billing. My first time I had a blue cross policy as a primary policy before I qualified for Medicare. I don’t remember getting any bills at all although I’m sure I had some fairly minor expenses. The second time I had Medicare with a backup Blue Cross…I never saw the first bill. I got a few notices saying I might be billed for a specific amount, but never was.

I’ve had my eyelids lifted, torn an ACL and now I’m dealing with heart issues in the past six months but still I’m not getting hit with bills.

I am on Medicare with UHC/AARP plan for full pay what the former does not. It is the best plan I have ever seen. PT scans, MRI's, surgeries, radiation, etc....all without anything more than an annual 200 copay from each of us. I no longer worry about going to the doctor or hospital. I apologized to my primary physician for the small amount he is paid compared to what he bills Medicare. He just laughed -- said that he did well enough and his Medicare patients were the best.

 

[TexasBama]

I’m signing up for Medicare in the next couple of weeks.

 

[TIDE-HSV]

I’m signing up for Medicare I the next couple of weeks.

Congrats! You'll love it...

 

[Bazza]

 

[4Q Basket Case]

We should have a good comparison…..Mrs. Basket Case turned 65 earlier this year and is now on Medicare, with a BC/BS supplement plan.

I’m still on BC/BS of Alabama retiree medical from my former employer. It’s the same premium coverage that I had while working. But because retirees (all members of the OFC) are calculated as a separate pool, it’s significantly more expensive than it was when I was working.

We were fully aware of that, planned for it, and incorporated it into our retirement decision. Still expensive, but we have the money set aside in a sequestered account, and really don’t think about it.

Anyway, neither of us have had any problems with denials, slow-walking payments, etc. Though so far we’ve remained pretty healthy and haven’t really put the coverage to the test. We’ll see how it goes when a serious health issue arises.

On a tangential issue: We also have a long term care policy through Genworth. It isn’t designed to provide full LTC coverage — would cover most of Assisted Living, and maybe half of Skilled Nursing.

They clearly don’t want to provide coverage anymore (I don’t think they underwrite new policies at all), and are raising the premium at each annual renewal. Latest bill is an increase of $1,125, for an eye-watering total of a bit over $8,600 for one year of coverage.

I’m not sure we’re going to renew, but it’s a tough decision — save almost $9K a year, but risk $4K a month for AL, or $7K a month for SN.

 

[Chukker Veteran]

I’m a big advocate of planning ahead but I also have learned life can sometimes come at you sideways with difficulties you couldn’t anticipate.

The best laid plans of mice and men…Man plans and God laughs.

For a policy that insures against long term care that runs $8,000 per year, I think in my situation it makes more sense to self insure. I can see how it would be a tough call.

Hey Basket, you have a writing style that serves you well. I enjoy reading your posts.

 

[Go Bama]

I am on Medicare with UHC/AARP plan for full pay what the former does not. It is the best plan I have ever seen. PT scans, MRI's, surgeries, radiation, etc....all without anything more than an annual 200 copay from each of us. I no longer worry about going to the doctor or hospital. I apologized to my primary physician for the small amount he is paid compared to what he bills Medicare. He just laughed -- said that he did well enough and his Medicare patients were the best.

You and I have exactly the same coverage. Mine has been a God send. I go to the doctor about twice a month for one reason or another. They're always scheduled visits. So far, I've only been out of pocket about $200 in the past year.

My biggest issue is the daily chemo I take is not completely covered, yet is so expensive, I can't afford it. For you rich people that think you can, it runs $16,000 per month. There are foundations which help and if you get approved, you pay either zero, $10, or $50. Right now I'm not paying anything but my grant runs out next month. Because of this, I usually just take a half dose unless I'm feeling poorly. If if feel great, I completely skip the dose that day. The medicine is called Xtandi, and it does an amazing job. My PSA went from in the 90's to .3 in a matter of months. I've literally started working less to be able to qualify for the grants.

 

[92tide]

You and I have exactly the same coverage. Mine has been a God send. I go to the doctor about twice a month for one reason or another. They're always scheduled visits. So far, I've only been out of pocket about $200 in the past year.

My biggest issue is the daily chemo I take is not completely covered, yet is so expensive, I can't afford it. For you rich people that think you can, it runs $16,000 per month. There are foundations which help and if you get approved, you pay either zero, $10, or $50. Right now I'm not paying anything but my grant runs out next month. Because of this, I usually just take a half dose unless I'm feeling poorly. If if feel great, I completely skip the dose that day. The medicine is called Xtandi, and it does an amazing job. My PSA went from in the 90's to .3 in a matter of months. I've literally started working less to be able to qualify for the grants.

i'm sorry you are having to go through such a hassle to get the meds and treatment you need.

 

[Go Bama]

i'm sorry you are having to go through such a hassle to get the meds and treatment you need.

Well, the good side of it is that I feel good. The meds have sapped me of energy (it's a chore to get on the bike these days) and I have about as much body hair as a porn actor. But at this age, who cares? I'm able to work, play in the band, and enjoy my family. That's all a man can really hope for.

 

[4Q Basket Case]

I’m a big advocate of planning ahead but I also have learned life can sometimes come at you sideways with difficulties you couldn’t anticipate.

The best laid plans of mice and men…Man plans and God laughs.

For a policy that insures against long term care that runs $8,000 per year, I think in my situation it makes more sense to self insure. I can see how it would be a tough call.

Hey Basket, you have a writing style that serves you well. I enjoy reading your posts.

It’s not an easy financial call either way. We watched Mrs. Basket Case’s mother run through almost all of her assets with a 3-year stay in Assisted Living, and a blessedly short time in Skilled Nursing — Lewy Body dementia is every bit as cruel as Alzheimer’s.

The only good thing about the dementia was she didn’t realize what was going on. She thought she was rich, the ALF was her mansion, and all the staff and residents worked for her. Believe me, she was far from rich.

And thanks for the shout-out on writing. I had some good teachers over the years, both in school and at work.

The most important thing they taught me was that, provided you don’t take it to ridiculous excess, short paragraphs really help with clarity.

 

[jthomas666]

A big issue for our coverage in Georgia is that each school system negotiates it's own health plan--unlike Alabama, where AEA negotiates for all public school systems--and thus has a lot more leverage. Don't know why GEA doesn't do something similar...

 

[TIDE-HSV]

It’s not an easy financial call either way. We watched Mrs. Basket Case’s mother run through almost all of her assets with a 3-year stay in Assisted Living, and a blessedly short time in Skilled Nursing — Lewy Body dementia is every bit as cruel as Alzheimer’s.

The only good thing about the dementia was she didn’t realize what was going on. She thought she was rich, the ALF was her mansion, and all the staff and residents worked for her. Believe me, she was far from rich.

And thanks for the shout-out on writing. I had some good teachers over the years, both in school and at work.

The most important thing they taught me was that, provided you don’t take it to ridiculous excess, short paragraphs really help with clarity.

Did she develop Parkinson's symptoms before the LBD?

 

[Padreruf]

You and I have exactly the same coverage. Mine has been a God send. I go to the doctor about twice a month for one reason or another. They're always scheduled visits. So far, I've only been out of pocket about $200 in the past year.

My biggest issue is the daily chemo I take is not completely covered, yet is so expensive, I can't afford it. For you rich people that think you can, it runs $16,000 per month. There are foundations which help and if you get approved, you pay either zero, $10, or $50. Right now I'm not paying anything but my grant runs out next month. Because of this, I usually just take a half dose unless I'm feeling poorly. If if feel great, I completely skip the dose that day. The medicine is called Xtandi, and it does an amazing job. My PSA went from in the 90's to .3 in a matter of months. I've literally started working less to be able to qualify for the grants.

That is the issue for us all...are you aware of the LLS.org group and their grants? Don't know if they do prostate, but they have several areas they cover, including mine.

 

[Go Bama]

That is the issue for us all...are you aware of the LLS.org group and their grants? Don't know if they do prostate, but they have several areas they cover, including mine.

There is a group of three women that work at the Kirkland Cancer Center where I go for treatment. They have bent over backwards for me helping me obtain the medicine I need. I'll mention LLC.org next time I'm there, but I have my doubts since LLC stands for Leukemia and Lymphoma society.

A sincere thank you for making me aware of the organization. It's worth a shot.

 

[4Q Basket Case]

Did she develop Parkinson's symptoms before the LBD?

She did. And as you know, there is a strong feeling that they’re the same disease; it’s just a matter of which presents first.

In her case, Parkinson’s did. The dementia was there, and she was on a long slow glider path down mentally.

Then she fell, and broke up her whole left side like Humpty-Dumpty. The dementia went from a slow downward slide into a power dive. Really brought home that physical trauma can accelerate mental decline.