High Deductible Health Insurance Plan

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have a high deductible plan. For example, I just paid a $25 co pay for a sick visit and will probably get a bill for about $100 for taking my kid in for a sick visit and flu/strep test. They give you the insurance rate, but then you pay the difference. It's not free by any means like you are probably used to. Out of network I pay the whole thing.
If I submitted my therapy bills, which are $230 a week, I would get $0 back, and only about $70 each time goes toward deductible.
Took my kid to physical therapy, they charged my insurance about $400 for basically doing nothing, and I was responsible for $150. It's such a racket.

What’s the racket, exactly? Who are you to say a physical therapist “basically” does “nothing?” If you have a shitty PT change … but that’s not a “racket” or even an insurance issue.

Yup---definately "not a racket". A PT or PTA is working with you the entire hour you are there 99% of the time in my experience. They can only be working with one patient. So $150/hour for someone with that training is reasonable. You are also paying for the receptionist, the billing staff, the facility space, all the equipment they have, along with the knowledge and experience of someone with 3 years of a DPT program. My acupuncturist gets $120 for an hour appt, but they are only with me for 15 mins or so of that hour (rest is you lying there with the needles in). so heck yeah, a PT should likely be getting even more IMO for the full hour of working with you. Whereas an acupuncturist can see 3-4 patients per hour, just staggered starts (and they are NOT overpaid--it's the PT who is underpaid)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Something to watch out for is that certain hospitals (especially teaching hospitals that serve a lot of highly needy patients) really squeeze insured patients to make up for all the free care they provide. If you have a standard insurance, it can be totally fine—the hospital is in network and so I don’t pay any more than I would anywhere else. But if you have a HDHP, you are going to be paying a lot more of the jacked up prices.

I agree that HDHP can be cost effective if you keep in mind the premium savings. But you do have to be cognizant of healthcare prices with them (which is by design).

If the hospital is in network with your insurance, you still get to pay the same “agreed to rate” that your insurance pays. You don’t pay more. If a procedure/test is $1200, but your insurer agrees to pay $800, you would only pay the $800 on an HDHP as long as you stay in network.

The funny joke is that if you ask what discounted cash price is for the test/procedure it can cost you less than what you pay towards your deductible based on the "negotiated" discount of your insurance plan. If it costs more, it's only a little bit more which is still not going to justify paying expensive premiums. It's basically a very expensive catastrophic insurance plan.

Overinflated prices shown on your bill are complete racket and not what they would charge to a cash patient. This happened to me personally and there are many social media videos on this with people going through their medical bills and comparing discounts provided by insurance with the cash patient discounts medical providers give you.

And the won’t let you pay the cash price if you have insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:HDHP is almost always a better deal, but you have to get used to shelling out money knowingly vs. it all being taken out of your paycheck without you paying attention.

It's not at all the better deal if you have a lot of medical costs.

Yes it is. The premiums plus the out of pocket max for an HDHP are almost always less than premiums plus our outlay with a PPO.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a high deductible plan. For example, I just paid a $25 co pay for a sick visit and will probably get a bill for about $100 for taking my kid in for a sick visit and flu/strep test. They give you the insurance rate, but then you pay the difference. It's not free by any means like you are probably used to. Out of network I pay the whole thing.
If I submitted my therapy bills, which are $230 a week, I would get $0 back, and only about $70 each time goes toward deductible.
Took my kid to physical therapy, they charged my insurance about $400 for basically doing nothing, and I was responsible for $150. It's such a racket.

What’s the racket, exactly? Who are you to say a physical therapist “basically” does “nothing?” If you have a shitty PT change … but that’s not a “racket” or even an insurance issue.

Yup---definately "not a racket". A PT or PTA is working with you the entire hour you are there 99% of the time in my experience. They can only be working with one patient. So $150/hour for someone with that training is reasonable. You are also paying for the receptionist, the billing staff, the facility space, all the equipment they have, along with the knowledge and experience of someone with 3 years of a DPT program. My acupuncturist gets $120 for an hour appt, but they are only with me for 15 mins or so of that hour (rest is you lying there with the needles in). so heck yeah, a PT should likely be getting even more IMO for the full hour of working with you. Whereas an acupuncturist can see 3-4 patients per hour, just staggered starts (and they are NOT overpaid--it's the PT who is underpaid)

You've never had a PT send you off to do shoulder or leg exercises on your own while they help another patient or hop on the computer? All of my appointments were like this.

[Anonymous]

For those of you who say you are "cash pay" how does that work? I didn't think providers would even take you without insurance.

[Anonymous]

Sounds like the HSA people have never had a terrible HSA administrator. I did it once and vowed never to again. The card they gave me didn't work and it was a pain to get reimbursed. And then we had lose it or use it at end of year? How on earth are you rolling these over and never drawing down the funds? How do they grow?

[Anonymous]

We've had a HDHP for about 10 years. This past year, I suffered a broken wrist in early February that required two surgeries. We met the deductible almost immediately and then hit the maximum out of pocket around the middle of the year due to all the follow up visits and PT. Once we hit the max, we didn't pay another dime for any medical appointments. Even by reaching the maximum, it was still cheaper than if we had a traditional PPO.

We do pay for all of our medical expenses with our HSA. This past year was the only year we've spent all the HSA contributions for the year plus some that were built up. In the past ten years, we've probably only spent about 1/3 of what we save in our HSA.

Our plan covers well visits 100% - year physicals; colonoscopy after age 50; mammograms; blood work; anything considered part of the well visit. My high blood pressure meds are free. When we've had to get an antibiotic, they usually run just a few dollars. The only expensive medicine I can think of was my DS' acne medicine.

We've never had a problem with the plan and I can't imagine we'd ever go back to a regular PPO unless we don't get a choice.

[Anonymous]

Anonymous wrote:Sounds like the HSA people have never had a terrible HSA administrator. I did it once and vowed never to again. The card they gave me didn't work and it was a pain to get reimbursed. And then we had lose it or use it at end of year? How on earth are you rolling these over and never drawing down the funds? How do they grow?

You are confusing an HSA account with an FSA account. FSA has to be used by March of the following year. HSA rolls over indefinitely.

[Anonymous]

Anonymous wrote:For those of you who say you are "cash pay" how does that work? I didn't think providers would even take you without insurance.

Besides, it defeats the purpose, then you won’t meet your deductible. Might as well bite the bullet, especially if you have a family and will need medical care. I don’t see the point of getting a “cash” price.

[Anonymous]

Anonymous wrote:Sounds like the HSA people have never had a terrible HSA administrator. I did it once and vowed never to again. The card they gave me didn't work and it was a pain to get reimbursed. And then we had lose it or use it at end of year? How on earth are you rolling these over and never drawing down the funds? How do they grow?

Two different things. If you are on a HDHP you are eligible for an FSA which rolls over and is triple tax advantaged. But you can only have it on a HDHP. Smart people are not withdrawing from it at all.

https://www.metlife.com/stories/benefits/whats-the-difference-between-an-FSA-and-an-HSA/#:~:text=The%20main%20differences%20between%20HSAs,FSAs%2C%20and%20HSAs%20are%20portable.

[Anonymous]

Anonymous wrote:And the won’t let you pay the cash price if you have insurance.

Many places like GWU MFA and Providence Hospital (in 2023) will not even do business with you if you insist on paying cash. Hell GWU MFA will totally give you the runaround if you insist on asking for the cash price.

[Anonymous]

Anonymous wrote:

Anonymous wrote:And the won’t let you pay the cash price if you have insurance.

Many places like GWU MFA and Providence Hospital (in 2023) will not even do business with you if you insist on paying cash. Hell GWU MFA will totally give you the runaround if you insist on asking for the cash price.

That's terrible. How are we supposed to be informed consumers? Universal health plan, at once.

[Anonymous]

Anonymous wrote:

Anonymous wrote:And the won’t let you pay the cash price if you have insurance.

Many places like GWU MFA and Providence Hospital (in 2023) will not even do business with you if you insist on paying cash. Hell GWU MFA will totally give you the runaround if you insist on asking for the cash price.

+1 it's why that self employed R was so thankful for ACA.

https://www.azcentral.com/story/news/politics/arizona/2017/01/14/sedona-jeff-jeans-obamacare-aca-cnn-paul-ryan/96553138/

Jeans told Ryan that he has campaigned for Republican candidates and, when the ACA was passed, told his wife that he would close his business rather than comply. The real-estate company he and his wife owned operated in two Midwestern states.

"Then, at 49, I was given six weeks to live with a very curable type of cancer. We offered three times the cost of my treatments, which was rejected. They required an insurance card," Jeans said. "Thanks to the Affordable Care Act, I’m standing here today alive.

As a former R, and self employed person myself, I'm also very grateful for Obamacare. If Rs cared about small businesses and people, they would not be so quick to want to repeal ACA. They just hate it because Obama came up with it. Political rant over.

[Anonymous]

I really don't know how you all do it. I need a mammogram. E-mailed a clinic in EU (my friends are checking a few more clinic for me) and will get it done for $200. Tickets to EU are $500 and I get to see my family.
The clinic wrote 170 euroes two times to make sure I noticed the 'high cost'.
The only reason I'm paying for a health plan in US I won't even use, is to avoid DC fine. It's $630 a month and I guard my insurance card more than my SS number or credit cards. I want nobody to have it and nobody to use it.
Now I got a HSA debit card in the mail that I will never use or even activate. It might accrue a fee even if I don't activate it.
My kid inherited an HSA. We were told that the person who passed away should have logged into the account to get the tax documents or the minor child who inherited it.
After I called and they promised to send out the tax documents, they still didn't. Why do I even want to go near an HSA. It's not a triple tax savings/advantage for us. Nobody considers that some of don't benefit from it because of our low tax expense. HSA is pain for us.
If I offer to pay cash and not use my insurance, I'm turned down by a doctor or get several bills after I leave the office. Doesn't matter if I ask for the final bill over and over again and record it all.
Once we got a bill for dentist we paid 2 years earlier. Luckily it was on credit card. I have so many stories of extra bills and we only go for yearly check ups for the kid. I skip some of mine.
Dealing with the health care in US will kill me, not any disease.

[Anonymous]

Anonymous wrote:I really don't know how you all do it. I need a mammogram. E-mailed a clinic in EU (my friends are checking a few more clinic for me) and will get it done for $200. Tickets to EU are $500 and I get to see my family.
The clinic wrote 170 euroes two times to make sure I noticed the 'high cost'.
The only reason I'm paying for a health plan in US I won't even use, is to avoid DC fine. It's $630 a month and I guard my insurance card more than my SS number or credit cards. I want nobody to have it and nobody to use it.
Now I got a HSA debit card in the mail that I will never use or even activate. It might accrue a fee even if I don't activate it.
My kid inherited an HSA. We were told that the person who passed away should have logged into the account to get the tax documents or the minor child who inherited it.
After I called and they promised to send out the tax documents, they still didn't. Why do I even want to go near an HSA. It's not a triple tax savings/advantage for us. Nobody considers that some of don't benefit from it because of our low tax expense. HSA is pain for us.
If I offer to pay cash and not use my insurance, I'm turned down by a doctor or get several bills after I leave the office. Doesn't matter if I ask for the final bill over and over again and record it all.
Once we got a bill for dentist we paid 2 years earlier. Luckily it was on credit card. I have so many stories of extra bills and we only go for yearly check ups for the kid. I skip some of mine.
Dealing with the health care in US will kill me, not any disease.

What is this dribble? FYI, mammograms in the US are free if you have a health care plan.