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  1. #121
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    Quote Originally Posted by SonnysMom View Post
    I for one do not understand medicare. I'm suppose to sign up for it. Right now, I don't need it. My husband isn't retiring and he has good employer sponsored ins. So since I don't need it, why am I punished if I don't sign up for it within a certain time interval? This has been going on with medicare for eons.
    What's the purpose except to waste taxpayer dollars. The govt should be encouraging people to delay retirement and medicare for as long as possible just like they do for SS. Makes no sense to me.

    Except that you will be enrolled and paying a monthly premium and not receiving much by way of Medicare benefits. If your husband is actively working and your are covered under his insurance then Medicare is secondary to his insurance. For the most part his insurance will pay more than the Medicare allowed amount. If that happens the Medicare payment will be $0. Medicare will generally only pay if there is something Medicare covers and your primary insurance does not cover.
    They are trying to start getting some of your premiums into the system without having to pay out. What they don't want to happen is to be getting no premium from you from age 65 to 68 then have you get really sick, so your husband retires and now you enroll and Medicare is primary. They want and need your premiums for when you are 65-68 years old and healthy or the other insurance is covering your costs. Medicare is like any other insurance- a risk pool.
    I believe that you can wait to enroll in Medicare but your premiums if you enroll late will be higher and your opportunities to enroll are limited. Medicare enrollment is not my forte, I know more about once a person is enrolled and the interplay of Medicare and other insurance.
    In summary, if you enroll before you retire or before your spouse retires and either of you have Medicare it is a win for Medicare. Medicare gets your premiums but has little to none that they have to pay out for you as the other insurance is primary.
    Hmmm... so that means I have to pay a premium on something that isn't even effective. My husbands co ( a large multi national corp) sent a letter saying if we sign up for a prescription drug plan thru medicare then our drug coverage thru our private ins will be compromised. Hmm... why do I feel this is a shell game and I'm the loser.



  2. #122
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    Sep. 7, 2009
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    Lexington, KY
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    Quote Originally Posted by fordtraktor View Post
    There are also a growing number of doctors who don't take insurance. You have to submit everything on your own, which I imagine is a huge pain. When I was in DC finding a good pediatrician in my Bethesda area that actually TOOK insurance was not easy.

    And docs that you pay a large lump sum to be a client. My grandparents do this and are happy as clams with the results as they get super-fast, thorough service and lots of attention.
    That's the way it used to be with many doctors. I know my daughter's pediatrician, 30 years ago, didn't accept insurance. I paid and then submitted for reimbursement.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant



  3. #123
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    Sep. 7, 2009
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    Quote Originally Posted by pezk View Post
    Hmmm... so that means I have to pay a premium on something that isn't even effective. My husbands co ( a large multi national corp) sent a letter saying if we sign up for a prescription drug plan thru medicare then our drug coverage thru our private ins will be compromised. Hmm... why do I feel this is a shell game and I'm the loser.
    That may be because the govt. doesn't negotiate prices with pharma. Something I hope that will be changed in this next term.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant


    1 members found this post helpful.

  4. #124
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    Aug. 25, 2007
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    Quote Originally Posted by ser42 View Post
    Now that CMS' 2013 Physician Fee Schedule (PFS) is out, I'm looking at a 33% cut in reimbursement for my most common (about 85% of my practice) procedure. Joy.

    I do agree with the others that Obamacare, while imperfect, is a step in the right direction, but I really don't see how docs are going to stay afloat with these continued cuts in reimbursement.
    I do. A physician will eventually become a "public utility." You'll be employed by the state or by a corporation chartered by the state. You'll be paid "what you are worth."

    In the alternative you might, as a condition of your medical license, be required to see a certain number of "state paid" patients at a set rate. You can have private pay patients, assuming you have the time to do so. A variation of this model exists today in the legal profession where, in some places, lawyers are obligated to take criminal cases for indigent clients. Rates paid for these cases are quite low in most places.

    In the end, no matter how they do it, it's not going to work out well for the physicians.

    G.
    Mangalarga Marchador: Uma Raça, Uma Paixão


    2 members found this post helpful.

  5. #125
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    Mar. 24, 2004
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    Pottstown, PA (East Coventry)
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    Quote Originally Posted by pezk View Post
    Hmmm... so that means I have to pay a premium on something that isn't even effective. My husbands co ( a large multi national corp) sent a letter saying if we sign up for a prescription drug plan thru medicare then our drug coverage thru our private ins will be compromised. Hmm... why do I feel this is a shell game and I'm the loser.
    Yes, the premium you would pay to Medicare while your are covered by your husband's insurance would likely not provide you with much if any benefit. However all insurance, including Medicare, is a risk pool. In a way it is a giant ponzi scheme, healthy people pay premiums to support the sick people. We just need to keep more healthy people paying to support the sicker people.

    As far as the letter from your employer stating that signing up for Medicare D will compromise the employer based insurance is making me go HMMMMMM. If memory serves me there is federal legislation that makes it illegal to induce an employee or dependent of an employee to drop the employer based insurance coverage so that Medicare would become primary. I am unclear on how enrolling in Medicare Part D would negatively impact your employer prescription plan- as long as you use the employer prescription plan as primary.

    I am not sure if you need to enroll in Medicare B or Medicare B & D when you first become eligible. Medicare A should be automatic.
    Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)



  6. #126
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    Jan. 4, 2007
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    TX
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    Don't let it surprise you if your income is over so much, you will be paying Medicare premiums every month also, as they replace your insurance as a primary insurance.

    Then you also have to keep paying some insurance as a secondary to cover what Medicare doesn't cover.
    That one can continue to be your DH insurance, ask about that.

    Many business here with several employees with benefits are not employing anyone over 65 any more because of the paper nightmare it creates.

    Remember, there is no action without reaction.


    3 members found this post helpful.

  7. #127
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    Aug. 6, 1999
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    Georgia
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    Thanks for all your responses. Two of my friends are actually ER doctors and they are the most upset by this and in talking to them, it got me really thinking. Frankly, I am not a fan of the way insurance is currently handled. We were paying more for insurance for a family of 4 than we were paying for our mortgage. My husband has a "pre-existing condition" (non-terminal/ non-life threatening) and we have been absolutely kicked in the butt over and over in regards to rates because of it. When we tried to switch, he was denied several times. I had to switch with the kids and also had a difficult time because I had a broken elbow. Yes, it was a bad break and required 3 surgeries, but I am fine now. 100% functional with no additional treatment now or in the perceived future. I finally got insurance for less by switching carriers, but it was a rough road. That being said, I think we need insurance reform. I do not think Obamacare is the answer.


    1 members found this post helpful.

  8. #128
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    Aug. 18, 2004
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    Quote Originally Posted by Bluey View Post

    Many business here with several employees with benefits are not employing anyone over 65 any more because of the paper nightmare it creates.

    Remember, there is no action without reaction.
    That's illegal.

    But your other points are taken.



  9. #129
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    Aug. 6, 1999
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    Georgia
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    Quote Originally Posted by ser42 View Post
    That's illegal.

    But your other points are taken.
    Illegal... but who can police it? A company interviews 10 people and can pick any person and dismiss any of the others for any reason. It might be because of their age, but they can say it's because they don't have the right experience. I am not at all saying that is ok, but it is a fact and is going to be some of the fallout that will be happening moving forward.


    1 members found this post helpful.

  10. #130
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    Nov. 6, 2002
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    Henrico, NC 36 30'50.49" N 77 50'17.47" W
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    Quote Originally Posted by BlueEyedSorrel View Post
    I'm a physician, just graduated in May, and internal medicine resident at a big university academic medical center in the midwest. My hospital provides a TON of "free" care..notice that the free is in quotes. The vast majority of the unviersity physicians I've met were maybe not pleased with every detail of the ACA, but are generally in favor. By law, if you don't have insurance and you come to the ER, we have to treat you, including admitting you to the hospital if it's not safe to send you home. Most of those bills either can't be collected or only a fraction of the cost is collected. If the person is unemployed or very poor, it's simply not worth it to go after them, so the cost gets written off as charity care or otherwise absorbed by the hospital. My institution is state and federally supported. If you don't want your taxes going to pay for other people's healthcare, guess what? It's already happening, just in a way that is incredibly inefficient and wasteful, costs more money in the long run and in some cases costs people their LIVES because they couldn't get preventative care.

    In 5 months since starting residency, I've seen many patients who didn't have insurance, were having serious symptoms and waited until things got too bad to ignore to come to the hospital. Several were ultimately diagnosed with terminal cancer, but types that we have good screening tests for, and reasonable treatment options IF we catch things early........that is, if you have insurance and access to care. For those that say society has no obligation to provide healthcare to its citizens, you haven't had a fellow human being look you in the eye and say, "Tell it to me straight--is this going to kill me? How long do I have?" I have, even though I'm "just" the intern. My patients rarely care that I've had the MD for less than a year. One of these patients asked me if there was any way we could have caught his cancer sooner. When I said yes, there are ways to screen, he interrupted me and said "but I didn't have insurance, and now I'm going to die because of it." He was right. It's very easy to say let 'em die, until you're the one delivering the news.

    BES
    Thank you very much for posting this. I don't know what it's going to take for people to see the full picture. It's really disappointing that there are so many short-sighted, selfish people. It really is so simple. I hope we can do what is right, and move on to something else.


    5 members found this post helpful.

  11. #131
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    Aug. 18, 2004
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    Quote Originally Posted by Just My Style View Post
    Illegal... but who can police it? A company interviews 10 people and can pick any person and dismiss any of the others for any reason. It might be because of their age, but they can say it's because they don't have the right experience. I am not at all saying that is ok, but it is a fact and is going to be some of the fallout that will be happening moving forward.
    No policing, but companies that do this consistently are opening themselves up for lawsuits. Who knows, maybe lawyer and settlement fees will cost less than actually employing those over age 65. I say that without sarcasm.



  12. #132
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    Nov. 18, 2010
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    california
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    4,652

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    Quote Originally Posted by BlueEyedSorrel View Post
    I'm a physician, just graduated in May, and internal medicine resident at a big university academic medical center in the midwest. My hospital provides a TON of "free" care..notice that the free is in quotes. The vast majority of the unviersity physicians I've met were maybe not pleased with every detail of the ACA, but are generally in favor. By law, if you don't have insurance and you come to the ER, we have to treat you, including admitting you to the hospital if it's not safe to send you home. Most of those bills either can't be collected or only a fraction of the cost is collected. If the person is unemployed or very poor, it's simply not worth it to go after them, so the cost gets written off as charity care or otherwise absorbed by the hospital. My institution is state and federally supported. If you don't want your taxes going to pay for other people's healthcare, guess what? It's already happening, just in a way that is incredibly inefficient and wasteful, costs more money in the long run and in some cases costs people their LIVES because they couldn't get preventative care.

    In 5 months since starting residency, I've seen many patients who didn't have insurance, were having serious symptoms and waited until things got too bad to ignore to come to the hospital. Several were ultimately diagnosed with terminal cancer, but types that we have good screening tests for, and reasonable treatment options IF we catch things early........that is, if you have insurance and access to care. For those that say society has no obligation to provide healthcare to its citizens, you haven't had a fellow human being look you in the eye and say, "Tell it to me straight--is this going to kill me? How long do I have?" I have, even though I'm "just" the intern. My patients rarely care that I've had the MD for less than a year. One of these patients asked me if there was any way we could have caught his cancer sooner. When I said yes, there are ways to screen, he interrupted me and said "but I didn't have insurance, and now I'm going to die because of it." He was right. It's very easy to say let 'em die, until you're the one delivering the news.

    BES
    Thank you. I think so many people take preventative health for granted but not many people have $2,000-3,000 dollars in the checking account to get a battery of tests performed. My HR person at work lost her house to medical bills for her daughter. She has insurance but they refused to care for her daughter's specific problem. If was sad because we all knew her daughter had some condition and when it was diagnosed I never realized that she had to pay for all of her cognitive treatment. Her daughter is much better, early cognitive treatment is so much more effective, but she lost the house she and her husband had in the process of paying for the treatment.

    I am supportive of the Affordable Healthcare Act and yes, we all have been paying the care of those without insurance all along.


    4 members found this post helpful.

  13. #133
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    Jan. 26, 2010
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    http://globalpublicsquare.blogs.cnn....g-health-care/

    Did anyone see this special on healthcare around the world on CNN? I did and thought it was a fascinating look at all of the pros and cons of all of the systems throughout the world.



  14. #134
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    Quote Originally Posted by Beentheredonethat View Post
    http://globalpublicsquare.blogs.cnn....g-health-care/

    Did anyone see this special on healthcare around the world on CNN? I did and thought it was a fascinating look at all of the pros and cons of all of the systems throughout the world.
    The start of that article lost me when they throw out there raw numbers and try to compare between different systems using those.
    That already tells me which way the wind will be blowing in their documentary.



  15. #135
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    Glad you made a judgment on really good information without understanding it. Try watching the report.


    2 members found this post helpful.

  16. #136
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    May. 11, 2004
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    Quote Originally Posted by Beentheredonethat View Post
    http://globalpublicsquare.blogs.cnn....g-health-care/

    Did anyone see this special on healthcare around the world on CNN? I did and thought it was a fascinating look at all of the pros and cons of all of the systems throughout the world.

    Maybe Im missing something or it is my computer or me.. but the link you provided goes to an article tell about a tv program tht was on back in March. Or am I missing something... But I do not see figures to compair, or "raw numbers" tht Bluey says she saw..
    Its probably me...computer stupid here...
    Friend of bar .ka



  17. #137
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    Apr. 20, 2011
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    804

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    I haven't read all the posts, and I'm not 100% versed in Obamacare-- but I am in the thick of it with a seriously ill husband who is fighting for his life, AND we're fighting the insurance co who will not approve our facility for his stem cell transplant. All of his care is covered by our insurance where he is being treated, EXCEPT for the transplant. Insurance company wants us to finish his chemo where we are, then transfer his care to one of three different facilities, ALL of which are twice the distance from our home. I'm talking 1 1/2 - 2 hrs drive, current facility is 40-45mins. It all has to do with the "negotiated" rate the insurance will pay. Dollars and cents. Bottom line. And while I understand that, facility we're at is willing to go with the negotiated rate. AND we have a copy of a bill insurance paid, charge was in the vicinity of $9500, amount allowable-- $14,500, amount PAID? $14,500.
    So, I don't get it at all. I do know the stress of worrying where he'll have to go is another layer of stress that's already at the top of what we can handle, it's not like we're talking about a hangnail for heaven's sake, he has a serious illness!
    I remember being a kid, my dad worked for Electric Boat, we had benefits where if we needed to go to the Dr or hospital, we went. Didn't need a referral, or pre approval, we just went, got taken care of, went home and healed. And I'm pretty sure that they had small, if any premiums. We pay good money to have the insurance policy we have, to get care, we just want the care we pay for.

    Rant over.


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  18. #138
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    Aug. 18, 2004
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    Quote Originally Posted by gabby.gator View Post
    I haven't read all the posts, and I'm not 100% versed in Obamacare-- but I am in the thick of it with a seriously ill husband who is fighting for his life, AND we're fighting the insurance co who will not approve our facility for his stem cell transplant. All of his care is covered by our insurance where he is being treated, EXCEPT for the transplant. Insurance company wants us to finish his chemo where we are, then transfer his care to one of three different facilities, ALL of which are twice the distance from our home. I'm talking 1 1/2 - 2 hrs drive, current facility is 40-45mins. It all has to do with the "negotiated" rate the insurance will pay. Dollars and cents. Bottom line. And while I understand that, facility we're at is willing to go with the negotiated rate. AND we have a copy of a bill insurance paid, charge was in the vicinity of $9500, amount allowable-- $14,500, amount PAID? $14,500.
    So, I don't get it at all. I do know the stress of worrying where he'll have to go is another layer of stress that's already at the top of what we can handle, it's not like we're talking about a hangnail for heaven's sake, he has a serious illness!
    I remember being a kid, my dad worked for Electric Boat, we had benefits where if we needed to go to the Dr or hospital, we went. Didn't need a referral, or pre approval, we just went, got taken care of, went home and healed. And I'm pretty sure that they had small, if any premiums. We pay good money to have the insurance policy we have, to get care, we just want the care we pay for.

    Rant over.
    It's true, insurance companies are already basically dictating where you get your care. I happen to work in hospitals that are on the more expensive side, but are regarded as some of the best in the country. Insurance companies make their insured pay a higher co-pay to come to these hospitals. We're seeing a slight decline in volume now as patients go to the less expensive places. From both professional and personal experience, I don't believe these less expensive hospitals are quite as good as where I work. Everyone should be insured, yes, but we should have the freedom to seek our care where we want. Not all docs/hospitals/etc are created equal.


    2 members found this post helpful.

  19. #139
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    Apr. 20, 2011
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    Quote Originally Posted by ser42 View Post
    It's true, insurance companies are already basically dictating where you get your care. I happen to work in hospitals that are on the more expensive side, but are regarded as some of the best in the country. Insurance companies make their insured pay a higher co-pay to come to these hospitals. We're seeing a slight decline in volume now as patients go to the less expensive places. From both professional and personal experience, I don't believe these less expensive hospitals are quite as good as where I work. Everyone should be insured, yes, but we should have the freedom to seek our care where we want. Not all docs/hospitals/etc are created equal.
    we've learned this exactly. had we gone to the facility we're at now, rather than the local hospital/oncologist, we wouldn't BE at the point we're at, he would have been treated with a newer mix of meds, and his lymphoma wouldn't have come back so soon, OR he would have had the treatment he's getting now, and their goal is to CURE him, not just put him in remission. We also found out the first oncologist was FIRED due to so many unfavorable ratings from his patients, talking and dealing with him was like dealing with a dead fish.

    We've already decided to stay at our facility, even if we'll have to be responsible for 30% of any uncovered charges. We'll lose our house, probably, but better than losing his life, and my sanity.



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