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I am so frustrated. I am sitting here on hold (like I have been most of the morning) with BCBS. I've been disconnected five times and had to start from scratch. Well, the idle mind is the devil's playground. At this point I am about to burst with frustration.
My husband and I have had an individual policy with BCBS for about five years because we are self employed. We are in our mid fifties and my husband takes meds for high blood pressure (meds that work). Other than that we have no chronic conditions. His meds cost about $15 a month, without insurance coverage.
I take no prescription meds at all.
Our PREMIUM has been around $600 a month. This includes a basic dental plan.
Remember when Obama told us, "If you like your plan, you will be able to keep your plan?" Well, about a year ago, we got one letter in the mail from BCBS telling us that our plan which we'd had since 2010 had been discontinued but they were rolling us over to a new plan - with the exact same benefits and conditions. Our premium went up slightly. We were not contacted any other way and were not even really aware of any changes because we got ID cards with the exact same group and ID numbers and everything went on as before.
Well, come to find out, when BCBS "changed" that plan (no changes by the way - just a "new plan") that negated our 2010 plan - which had the exact same conditions and benefits - so the "new" plan could be discontinued this year. Following me so far?
Anyway, so of course we get the discontinued letter and we have to get a "new" plan - one that covers pregnancy and childbirth. I am 52 and have had a hysterectomy so I really don't need this coverage. So already, I know that I'm paying for someone else's coverage.
But to add insult to injury, the same plan will not cost us $562 more per month! That's right - about $1150 a month. This is with a $5000 EACH deductible!
Now - as if that wasn't bad enough, I have a friend who has no health insurance. He tore his Achilles tendon a month or so ago. Now, this interested me because I tore MY Achilles tendon earlier this year so I know the ropes, and the supposed costs, on this one. Like me, he had to have an MRI. Like me, he had to have reconstructive surgery on the tendon. Like me, he will have to have about a month of rehab after he gets out of the boot.
In order for me to have the surgery, I had to write a check for $5000 upon admission, for the day surgery. At the same hospital, he was told "Since you don't have insurance, you can have the surgery for $2500 if you pay today." Now keep in mind, not only did I have to write a $5000 check - I was also paying $600 or so a month on insurance premiums - as well as co pays and an 80/20 split meaning that I also paid 20 percent of any costs above the deductible. My total out of pocket costs for health care last year, with ONLY this one incident (which I recovered quickly from) came to over $12,000.
So several issues are at play here.
1) I don't need prenatal/pregnancy/childbirth care so why am I paying for it?
2) Why is it legal for BCBS to cancel a grandfathered plan and reinstate an identical plan which now makes it legal for them to cancel the "new" (identical) plan under the Affordable Care Act, thus entailing a $562 per month increase?
3) Why can someone with NO INSURANCE pay $2500 for a service that I paid about $7000 for WITH insurance?
SO FRUSTRATING!
Last edited by KathrynAragon; 12-09-2014 at 11:42 AM..
So true! Our plan changed and it ended up costing us an extra $3,000 a year more before out deductible kicks in plus increased monthly payments. Sure Obama said we could keep our plans if we liked them but he didn't say or explain that they would no longer be profitable enough for the suppliers to keep offering them. Someone has to pay for the uninsured and it is us. In our state no one was declined medical care, no one. This fix just wasn't we needed.
So true! Our plan changed and it ended up costing us an extra $3,000 a year more before out deductible kicks in plus increased monthly payments. Sure Obama said we could keep our plans if we liked them but he didn't say or explain that they would no longer be profitable enough for the suppliers to keep offering them. Someone has to pay for the uninsured and it is us. In our state no one was declined medical care, no one. This fix just wasn't we needed.
I agree - and guess who's laughing all the way to the bank? Not the doctors, not the hospitals - THE INSURANCE COMPANIES.
So much for "Big Business" not corrupting Washington. I think BCBS has Washington in it's back pocket - and has for a long time.
I agree - and guess who's laughing all the way to the bank? Not the doctors, not the hospitals - THE INSURANCE COMPANIES.
So much for "Big Business" not corrupting Washington. I think BCBS has Washington in it's back pocket - and has for a long time.
That's why the Health Sector of the stock market - funds, etfs, etc. - is going gangbusters - and has done for about ten years, now. You can't fight the big boys, so you may as well join them. Buy a health sector fund (PRSHX) or ETF (XLV, VHT, IYH).
You'll be happy you did. Lion's share of double digit % returns in my retirement funds have come from just this one investment - in an otherwise cash heavy and conservatively invested nestegg. For now, I'm happy.
Of course you are; ACA is pools with one size fits all. It does not change anything as far as cost but adds other needs to yours. BCBS is non-profits by state not same in nany state really. Really insurance is allow 20% profits gross before cost .That is same as before with BCBS. Its based on claims. Tho they say with confusion and losses by insurance with exchanges by state or federal Obama has allow them 22% this year. All insurance are pools and only way to reduce is by lowering claims amount in any pool or coverage changes which is out with ACA. Provider cost is by inflation including employees; facilitiy; supplies etc and more advanced more expensive procedures. Someone does pay deductible;co-pay for instance they make it up by raising cost. They do not really write it off except in theory. Non-profit hospitals can't afford to. The difference in ACA pools from others is that everyone does not pay the same for same coverage. Some is taxpayers and some in the in pool for what they do not want or need.
I agree. Anthem/Blue Cross has been steadily increasing rates for years in our state for individual policy holders. (There are several threads on the P & OC forum about it in other states as well, dating back to early 2010.) Rate hikes for our individual policies started getting worse around 2005-6, and have become increasingly unaffordable.
1) I don't need prenatal/pregnancy/childbirth care so why am I paying for it?
The ACA is a re-distributive law. And yes that means that some people will be subsidizing the health care of others. But surely you knew this already.
Not wishing to sound mean, but elections have consequences and the ACA is part of that process. Maybe the GOP will be able to change that in 2016 otherwise its here to stay....
That is the way insurance works. The insurance model really only works well to cover statistically rare catastrophes. It's a lousy model for health care coverage and especially for health maintenance coverage because that's 100% claim risk.
It seemed affordable (barely) before because the companies were excluding the even higher risk prospects (such as a young friend of mine who has a brain tumor that has to be cut back every two or three years--she had no chance of coverage previously).
But that's how the insurance game works. Low-risk pays for high risk.
The situation isn't helped by the fact that hospitals have absolutely no rationality in their pricing. They don't have the slightest idea how much a given procedure actually costs them to provide.
A few years ago, a TV news team shopped Chicago area hospitals for a straightforward appendectomy. The costs ranged from $1,500 to $25,000--and the difference between the hospitals certainly did not justify that spread.
When my mother had an auto accident and needed brain surgery, the hospital fitted her with a leather protective helmet that looked exactly like the old-school football helmets. It was just harness leather with a felt lining. I check the inside label--it was made in South Korea.
The hospital billed $2,000 for that helmet. I took pictures and took them to a local custom livery and bridle shop (this was SW Oklahoma--cowboy country) and asked them how much to custom-make that helmet. They quoted me $500.
Now, I've been to South Korea. I've bought leather goods in South Korea. I know there is no way in Hades that helmet cost over $200, even if it had been FedExed specially for my mother. And the same thing custom-made in the USA would have only cost $500.
Hospitals pull their prices out of their rear ends.
That is the way insurance works. The insurance model really only works well to cover statistically rare catastrophes. It's a lousy model for health care coverage and especially for health maintenance coverage because that's 100% claim risk.
Good point.
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