Healthcare Thread - Non political. Just venting and getting some feedback

Sorry to hear that George - it must be murder for her to go through...........

Question: are you using ACA?
Because I've heard similar stories.

Before I retired I was pretty good friends with the Personnel VP. His daughter had a similar problem. Constant headaches everyday preventing her from basically leaving the house. One doctor suggested Botox. It worked.

As I recall - I believe her's were migraines.
[Botox & Headaches]('https://americanmigrainefoundation.org/resource-library/botox-for-migraine/')

I too am self employed and watched my rates go up , these words continue to echo in my ears ' If you like your Doctors you can keep them " ....
Good luck George ,your rates are OUTRAGOUS .. A pox one everyone who voted for this current system ... By the way 'they' all get free Healthcare .........

> Sorry to hear that George - it must be murder for her to go through...........

Question: are you using ACA?
Because I've heard similar stories.

Before I retired I was pretty good friends with the Personnel VP. His daughter had a similar problem. Constant headaches everyday preventing her from basically leaving the house. One doctor suggested Botox. It worked.

As I recall - I believe her's were migraines.
[Botox & Headaches]('https://americanmigrainefoundation.org/resource-library/botox-for-migraine/')
Trust me there is nothing you can find that we haven't tried. Including what you've mentioned. They are not migraines.

> I too am self employed and watched my rates go up , these words continue to echo in my ears ' If you like your Doctors you can keep them " ....
Good luck George ,your rates are OUTRAGOUS .. A pox one everyone who voted for this current system ... By the way 'they' all get free Healthcare .........
I can't think of that piece. Trying to keep politics out of it, but I guess it's inherent.

Off topic a little, but wish Barb well from me.

> I can't think of that piece. Trying to keep politics out of it, but I guess it's inherent.
> I can't think of that piece. Trying to keep politics out of it, but I guess it's inherent.
Unfortunately George , its all political ... Health Insurance rules are made by politicians ..........All of my Self Employed friends where forced off their plans when the ACA was implemented ..... I have always believed that those who vote / voted for these plans should be forced to abide by them .....

Sorry to hear George, hope you find a good resolution. My job involves interacting with Medicaid, Medicaid managed care and commercial carriers.
We have payments recouped all the time for services provided, with the reason being the patient's enrollment was 'retroactively terminated". We provide them with a copy of*** their*** authorization of coverage for the date on which they were seen, they respond "it doesn't matter". The stuff they get away with I call CODB - cost of doing business.

> Off topic a little, but wish Barb well from me.
Will do Mike.

Insurance companies are not your friend...they will fight you tooth and nail....and they are the reason rates are high and have been going thru the roof for decades....of course the recent prediction OF something better replacing the ACA was BS!! They don't want "something better" for the avg Joe.....the sooner we die the better after we leave the work force....we are just "overhead" AND A DRAIN to those bastids. Why insurance companies are not sued when the patient expires from their lack of service is beyond me.

Also since I belong to a group where 4000 members are insured we can bring leverage on those bastids when they deny service....and it works.......

there should also be some oversight agency that you can file a complaint with

> Insurance companies are not your friend...they will fight you tooth and nail....and they are the reason rates are high and have been going thru the roof for decades....of course the recent prediction OF something better replacing the ACA was BS!! They don't want "something better" for the avg Joe.....the sooner we die the better after we leave the work force....we are just "overhead" AND A DRAIN to those bastids. Why insurance companies are not sued when the patient expires from their lack of service is beyond me.

Also since I belong to a group where 4000 members are insured we can bring leverage on those bastids when they deny service....and it works.......

there should also be some oversight agency that you can file a complaint with
We've gone every route possible. I was stuck in my home for about a year and I was consumed with it. I don't know the answers, but something needs to break. When it was me that was one thing, but now they're doing it to my wife and it's really pissing me off.

I guess cabin fever doesn't help;)

you need to get on Medicare George - it's been my experience that they pretty much take any doctor's recommendation - have never been turned away - only costs around $180 a month for Part B - you'll need a supplement probably - office visits, hospitals - pretty much about everything except prescriptions & eye & dental care is covered - that is also available through Medicare as well - don't know the cost for those plans but its got to be cheaper than $2700 a month

I took out a Dental Plan through AARP - not too pricey ($190 a quarter) but it only covers 50% of the dental charges.
Prescriptions are covered by my ex Employee Plan through United Healthcare. They also act as my supplemental Insurance covering whatever Medicare doesn't. I got this coverage from Estee Lauder when I retired. All Free of Charge. All for the rest of my Life.

> you need to get on Medicare George - it's been my experience that they pretty much take any doctor's recommendation - have never been turned away - only costs around $180 a month for Part B - you'll need a supplement probably - office visits, hospitals - pretty much about everything except prescriptions & eye & dental care is covered - that is also available through Medicare as well - don't know the cost for those plans but its got to be cheaper than $2700 a month

I took out a Dental Plan through AARP - not too pricey ($190 a quarter) but it only covers 50% of the dental charges.
Prescriptions are covered by my ex Employee Plan through United Healthcare. They also act as my supplemental Insurance covering whatever Medicare doesn't. I got this coverage from Estee Lauder when I retired. All Free of Charge. All for the rest of my Life.
I'm 63, that kicks in at 65.

> As a private business owner and under 65 years old, my healthcare for my wife and I cost us $2700 per month, with an out of pocket of $5,500 each year. How it got here I'll never know. I'm a middle-class guy and this is my largest expense. The killer for me is the way they add insult to injury and refuse everything our doctors recommend.

When I was in the middle of cancer treatment, that included a team of over 12 doctors that had to be on my plan, they notified us we had 2-weeks to find a new carrier because they were closing shop in New York. It was a Cigna company Health Republic. At that point, we had to scramble to find another company that would accept the same team. Hell, I was in the middle of radiation and chemotherapy and the last thing I wanted to do was change doctors. So I co-signed for everything and I'm still fighting it today. I'm actually seeing bills from things that should have been paid in the past. They refuse every scan my doctor tells me I need and just about everything they can.

As you can imagine it is bad enough struggling to survive let alone dealing with this shit.

Now my wife is dealing with a rare newly diagnoses called a New Daily Persistent Headache. She has had a horrible headache each and every day for the past 4 1/2 years. We've been to numerous doctors, and anything they want to be done, insurance doesn't agree with. It's a constant battle and I know I'm not the only one going through it.

And no offense, but please don't make any suggestions for the headache cure as this is a totally different animal and we've seen every specialist on the east coast and they just don't know enough about it yet.

Today we find out that will not pay for some special testing on her that was requested by our newest neurologist.

I hate dealing with an insurance rep telling me they know more than the doctor. That is where we are today.

Do you have a story to tell?


The worst part of all is dealing with the moron doctors offices that make mistakes saying i have to pay for something like a lab test and my insurances covers it all i pay is the fee of $25.00. To get them to correct it and fix it is like Fighting a fire with gasoline. Wife and I both went through it:mad:
I’m currently paying $1,960 a month for wife, daughter and I. That’s a hard hit when it comes out of your check weekly. I got Oxford gold plan, just switched from Emblem health. But every year it goes up. Can’t catch a break.

> I'm 63, that kicks in at 65.

well hurry up & get old like me.........................

> Will do Mike.


Me as well George, please tell Barbara i wish her my best.

> Me as well George, please tell Barbara i wish her my best.
Will do my friend.

Healthcare is truly a shit show. I’m in and out of facilities all day. I see a lot of nonsense.

What’s even crazier is how companies are pushing High Deductible Health Plans on their employees. I weighed out my options when I selected my plan this year, but I really don’t think it made sense for me. In a few years maybe but now.

> Insurance companies are not your friend...they will fight you tooth and nail....and they are the reason rates are high and have been going thru the roof for decades....of course the recent prediction OF something better replacing the ACA was BS!! They don't want "something better" for the avg Joe.....the sooner we die the better after we leave the work force....we are just "overhead" AND A DRAIN to those bastids. Why insurance companies are not sued when the patient expires from their lack of service is beyond me.

Also since I belong to a group where 4000 members are insured we can bring leverage on those bastids when they deny service....and it works.......

there should also be some oversight agency that you can file a complaint with
For guys Like George and Fishingguy , good hardworking folks the ACA is broken ............

I know George said non-political, but when it comes to health insurance politics is what spawned it so the subject can't be avoided. Basically the ACA is another grand income distribution scheme where the middle class has to pay for the coverage of the economically depressed clases. Whether you agree with tat redistribution scheme or not, that's what it is.