#1 Consumer Comment
AUTHOR: Thomas - Anderson (U.S.A.)
SUBMITTED: Thursday, January 31, 2008
POSTED: Thursday, January 31, 2008
Anyway, if you do not yet have a disqualifying aliment like diabetes, you had best start shopping for real medical insurance now, unless you can tolerate being self-insured and thereby pay your own $17,900 bills. High blood pressure, asthma, and other pre-existing conditions will not, of course, be covered.
I will admit that a $17,900 bill for a one-hour outpatient knee surgery, if it were REALLY SIMPLE, sounds more than a mite high.
Read Consumer Reports' Jan 2008 issue to learn about other peoples' medical insurance woes. even with "reputable insurance companies". One favorite trick you will read about these insurance companies playing is that they "close a book of business" to new insureds, thereby triggering a policy death spiral. "Reputable insurance companies", come to think about it, may be an oxymoron.
Hmmm... that $15,240 you have paid in premiums would almost cover your $17,900 bill.
B/t/w if you have Blue Cross/Blue Shield policies in one state and you move to another state, you must buy all new Blue Cross/Blue Shield policies, which means all the ailments that your old BC/BS policies had paid for then become pre-existing conditions under your new policies and are therefor not covered.
The Republicans are AGAINST a single-payer medical insurance plan (the government) and FOR buying medical insurance from private insurers so that "we can all have choice"? Awww, gee, how kind of them.
#2 Consumer Suggestion
AUTHOR: Jim - Anytown (U.S.A.)
SUBMITTED: Wednesday, February 06, 2008
POSTED: Wednesday, February 06, 2008
Thomas you got a few things kind of right and a few things wrong.
"You will never get really useful medical insurance for $254/month if you are 40 years old...."
Please, he can buy a HSA compatible PPO with under $4000 ANNUAL out of pocket max (note annual not per occurance like that Mega crap) for well under $150 a month. And with a reputable company.
"Anyway, if you do not yet have a disqualifying aliment like diabetes, you had best start shopping for real medical insurance now, unless you can tolerate being self-insured and thereby pay your own $17,900 bills. High blood pressure, asthma, and other pre-existing conditions will not, of course, be covered."
He's in California, there is no exclusion or rider on health insurance. It's pass or fail on total health out here. If he has HBP or asthma or something else it depends on the carrier and underwriting. He might get a rated PPO plan but still may obtain coverage.
"I will admit that a $17,900 bill for a one-hour outpatient knee surgery, if it were REALLY SIMPLE, sounds more than a mite high."
That's a normal range for orthroscopic knee surgery. High end in California outpatient about $22k. Low end about $15.5k.
"Read Consumer Reports' Jan 2008 issue to learn about other peoples' medical insurance woes. even with 'reputable insurance companies'. One favorite trick you will read about these insurance companies playing is that they 'close a book of business' to new insureds, thereby triggering a policy death spiral. 'Reputable insurance companies', come to think about it, may be an oxymoron."
Yes, come companies do close down plans and replace them with new plans. All current clients on that plan are allowed to switch to a newer plan with no underwriting or, when available, remain on the old plan.
"Hmmm... that $15,240 you have paid in premiums would almost cover your $17,900 bill."
Just about, yes. Although he's still out over $2k.
"B/t/w if you have Blue Cross/Blue Shield policies in one state and you move to another state, you must buy all new Blue Cross/Blue Shield policies, which means all the ailments that your old BC/BS policies had paid for then become pre-existing conditions under your new policies and are therefor not covered. "
This is absolutely NOT TRUE. All members of the BCBS Association (all 50 states) MUST make available a plan of individual insurance for members of another Blue moving to their state, regardless of whether they are on individual or group Blue coverage. It is called an "interplan transfer" and is guaranteed-issue under association rules. Usually they use their individual conversion plans if it needs to be GI arrangement. A subscriber has the right to request a new underwritten plan in the new state, but if declined may choose an interplan tranfer option.
Additionally, Anthem currently offers full reciprocation on Blue plans in California (Blue Cross), Nevada and Colorado and will be expanding this to other anthem states. That means anyone moving from one to the other of those three states is entitled to a plan as closely matching their home state plan as possible, again with NO UNDERWRITING.
"The Republicans are AGAINST a single-payer medical insurance plan (the government) and FOR buying medical insurance from private insurers so that 'we can all have choice'? Awww, gee, how kind of them."
I can see why this mentality would appeal to you as you obviously know very little about health insurance.