My sweet son is autistic. He works at the local McDonald’s and enjoys it. He’s smart enough for Uni, lettered in academics, but we can’t afford that.
He turns 26 in February. But now the ACA as well as Medicare and Medicaid are on the chopping block, what do I do? Do I do anything or can he just not get insurance? Do I need to B force him into a dangerous factory job he will hate?
My doctor billed my old state medicaid insurance for a lab test. I don't even know how they could, since I started seeing this doctor only after I got a Marketplace plan. Now I have to pay $122.
If I called my current insurance company, could I get them to cover it, or would I have to go to my doctor and tell them to re-bill it to the correct insurance company, or am I SOL since I already set up a payment plan?
Thanks.
Hello everyone, I am new to insurance and healthcare bills as I just got out of the military.
Last month, we had to take our one year old to the ER as he was projectile vomiting so much he wasn’t breathing. Went to the ER at about 3am, we were in and out, literally. Went in, they looked at him and said “there’s a bug going around” gave him half of a 5mg zofran and sent us on our way.
A week or so later, received one bill as insurance didn’t cover all of it. The bill was for $300, labeled as “Emergency Medical Services, TX”. Paid that bill as I assumed it was normal. (There is no link on that bill to view an itemized receipt).
Today, we received another bill from the SAME VISIT. This bill was for over $500, and luckily it had an itemized receipt so I knew they were scamming the hell out of us. There were two things listed, 1. “Emergency Room Lvl 4, $2500” and 2. “Zofran 5mg x4, $370”. It was billed from “HC Houston” (the hospital we received the care from).
Two issues with above bill, 1. Why were we charged a lvl 4 room, when the care wasn’t even lvl 5? Literally in and out in 20 minutes tops. 2. We were charged for 4x 5mg zofran, and given HALF of one.
Is there a way to fight this?
A week after I had a telehealth appointment, I had to go to the same doctor's office to pick up a prescription. I figured while I was there, I might as well get a note for the telehealth appointment to give to my employer. (My employer doesn't require a note every time you use sick time, but I have enough appointments that if I didn't provide some notes, HR would start asking for them. If I were to use sick time too often without proof of appointment/illness, they would potentially start pulling from my vacation time instead of sick time.)
At first the office staff told me they don't give out doctor's notes for telehealth appointments. I had to explain multiple times that all I was looking for was a note that said I had an appointment at [x] time on [y] day before they finally agreed to it. I've never had any doctor's office give me a hard time about getting a note for an in-person appointment. Why should a telehealth appointment be any different? I still had to use time off to attend a medical appointment.
I'm guessing most of you aren't asking for doctors notes for telehealth appointments since you're typically not going to physically go to the office to get one, but for anyone that has tried, have you ever been given a hard time about it? Was this interaction a fluke, or is it "normal" for doctors offices to refuse to provide notes for telehealth appointments? I think I will be doing all appointments with this doctor in person from now on...
I go to an allergist at an allergy clinic where there are four doctors, an NP and a PA. My doctor there has awful bedside manner and response times, never remembers anything about me and has gotten several things wrong including mixing the wrong immunotherapy serum, not letting me know what was in it, and prescribing the wrong schedule (which a nurse let me know after he left).
Can I just ask to switch? I’m not sure how that works, if the clinic would reject my request or if that’s frowned upon and the new doctor wouldn’t be willing to take me. They’re the only allergy shots clinic anywhere near me so I don’t want to burn bridges here. Thank you!
Hi, I work as an outpatient speech language pathologist at a hospital. I have a patient who has shared with me he needs a procedure done (at my hospital) that requires anesthesia. The hospital is requiring someone to drive him home and stay with him in the recovery room.
This patient does not drive, has no family or other social support, and has severe expressive communication difficulties. They have told him that he cannot take the bus/uber/cab, etc. I have reached out to his social worker with no success (told me they don’t offer those services, wanted to call the office and “make sure” he couldn’t take a bus home). Services at the hospital told me Medicaid could provide someone but he applied to Medicaid and he wasn’t approved. Me and my manager have exhausted all of our hospital resources we know of.
I am trying not to overreach my scope as an SLP but social services only have availability to see him once per month and he cannot read/write emails or texts or speak on the phone. I want to provide him all the help I can within my scope and professional boundaries. Any advice or resources I’m not thinking of? Thank you!
So I’m (26m) a contractor, and only get a very small subsidy for a HDHP from work. AEP ended for them on 11/15, and since I wasn’t sure if the plan was HSA eligible I decided do decline coverage.
I did keep critical illness coverage and group accident policies through MetLife.
For 2025 the only expected health care costs I will have will essentially be psychiatry which will be effectively out of pocket under the plan I would’ve had through work.
I wanted to ask if it is a really dumb decision to just coast for a year off a group accident and critical illness plan? I know I won’t be HSA eligible, I’m just looking for truly the most bare bones coverage as I expect to be brought on full time with benefits at my current job in the next calendar year. I just want some protection if I get hit by a car, kidney failure etc.
Any help would be great !
Edit: I’m also open to getting additional coverage for accident for example with even a $50/mo premium. The lowest plan I can find that’s HDHP in California is like $230 / mo.
Hey I’ve been trying to schedule an annual exam to avoid surcharge of $500 from my insurance before the end of the year. And I am out of luck. All appointments are couple of months out any suggestions?
I'm browsing job listings for RNs in me area, and I saw the wage that Denver Health is offering for a new CNO. All I know about CNOs is that they collect millions in bonuses, and cover up any potential law suit, so I'm wondering, is there any good that they do?
Hi everyone, quick question, when do i lose medicaid insurance in illinois after turning 26? Is it at the end of the month, and do you just reapply? State of residence: IL
Follow up q as well: In addition to medicaid can you get a different dental and vision plan? For example a dental plan that will cover more with a wisdom teeth removal compared to medicaid?
My father is not a US citizen and as such does not have a US valid health insurance. He has cancer and we are looking to enroll him in a clinical trial in the US since prognosis after standard treatment isn't great. The trial is for a medicine which is to be administered almost fortnightly over 4-5 months. I've gotten a cost estimate from two hospitals which has ranged between USD 60k-80k. The biggest part of the expense appears to be radiological tests like CT SCANS. They are quoting a charge of around USD 3500. Are CT scans this expensive in the US? Are there other avenues where CT scans can be done at a lower rate? Does a clinical trial allow radiological and other lab tests to be done via a third party? I would have asked the last question to the hospitals themselves but it's very difficult to elicit a response via email which is our chief mode of communication. Any advice in this matter would greatly help us.
My open enrollment happened a little earlier than others due to my start date.
I looked at my options and none of them were very good, as co-pays/co-insurance, increased premiums, etc. on all of them.
Eventually i selected a plan that looked the most similar in coverage to what I already had.
In the materials, all of them said "Network: Standard" and my current plan also says "Network: Standard" so I did not anticipate a problem.
~
Today, I got something in the mail. Turns out, none of my doctors are covered by this plan for some reason.
Apparently, my new plan is an "EPO" which is a new term for me, I thought there was only HMO and PPO.
My guess is that even tho the Network was all listed as Standard between their PPOs and EPOs, the EPOs actually has a smaller network.
Is there any recourse since I was misled?
I have a PPO plan for another 40 days has terrible rates. I've been taking a prescription for 10 years and just need a 30 days supply. I currently have no refills on my current prescription. Are there any cheap and legit online health sites with psychiatrists that can write a prescription for me?
My provider recommended LiveHealthOnline, but they don't cover anything so it's $185.
Dark Money: Undisclosed Third Party Litigation Funding and Its Impact on Medical Technology
This article highlights how undisclosed third-party litigation funding threatens patients and medical advancements. Legal actions funded by hidden financial interests divert resources from modernization and drive up healthcare costs for everyone. Transparency is essential – when funding sources remain in the shadows, accountability is lost. How can we address the impact of "dark money" to ensure healthcare focuses on people, not profits?
US Healthcare question
My gums are not in great shape. A dentist has recommended a deep cleaning with scaling, laser curettage, and antibiotics for 8 teeth. My teeth themselves are fine, but the gums are receding quite a bit.
Antibiotics are not covered by insurance, and the dentist wants to bill $150 per tooth. This feels like a huge expense when money is tight, and I'm wondering if the quote is excessive or there's any other way of getting treatment. The entire procedure is estimated to cost about $1600.
Are the antibiotics essential? I'd rather get the treatment I need than pay for it with my health later, but $1200 in antibiotics alone is quite a lot to shoulder.
Thank you for your time and help!
I visited a Gynecologist at a University-affiliated women's health center on Wednesday, and we agreed that I would be undergoing a sterilization procedure. My provider ran a couple of dates by me to include in her form to the surgery schedulers. Potentially relevant is that I received a pap smear and partial STD testing (no blood draw) and am waiting on the test results from those.
It had sounded like it wouldn't be long before the schedulers reached out, so I gave a call the next morning around 11 to check on things. On this call, I learned that there was no form sent to the schedulers. Further calls to different leaves of the phone tree revealed that my appointment notes were not closed and that there was not a referral in them. At this point, direct contact attempts included a message to my provider through a patient portal and a voicemail for the women's health center nurse line.
One person I had spoken to advised me to call back later in the day, so I called the nurse line again around 4 and left another voicemail. I promptly received a call back letting me know that my messages had been received and that my provider had been reminded to return to the appointment notes/surgery referral. The nurse who called let me know that I would receive a call when the referral was sent.
It's now midday Friday, and...? my portal message remains unanswered and I haven't gotten a call. Would it be appropriate for me to reach out again today (say, around 4 again) to check in on the status of my referral? It feels like it should not be taking this much time/effort to resolve this, but I'm not a healthcare worker, so I wanted to get some opinions and adjust my expectations if needed.
Thanks in advance for any insights.
It’s the time of year for my jobs open enrollment period. Historically; I’ve always elected the most “premium” benefits package (no deductible, low copays, excellent emergency coverage) mainly “just in case”. On paper, totally healthy with no real problems. However, when I was younger I was in a gnarly car accident with crap insurance that financially ruined me for a long time, so; if I am privileged enough to not make that risk again, I don’t. With all that said, it’s been nearly a decade of said benefits, and I think I’ve been to a doctor twice, maybe three times outside of ordinary checkups. Thankfully, truly, I’ve never really needed them/yet. The cost differential between packages is around $300/month if I downgrade, BUT I would have an insane deductible to meet if/when I need coverage. I did the math, and the costs about the same if I were to keep the same coverage vs downgrade + deductible (that’s assuming I actually USE my benefits). I just feel like I’m kinda throwing money away, but I would kick myself if I downgraded and then something horrible happened. I guess what I’m looking for is any insight here. Has anyone made this change, for better or worse that is willing to share some insight? If it helps, I can afford the benefits, and I could afford the deductible if I needed to hit it- but I also hate playing the game of dissecting what money is going where and how that impacts my benefits. Do I just keep going as I’ve been, and hope I don’t need to use them either way? Or, downgrade and consider a supplemental FSA, or just downgrade and hope I’m blessed with another year of clean health?
Hi there,
I was just wanting to reach out to experienced Nurses(and American Nurse Anesthetists)/Doctors/Dentists and related healthcare professionals in an attempt to find some guidance on which career path is best for me.
For context, I am a 24(M) year old living in western Canada. I have prior university credits (~40 criminology). I have quite a few years of full time work experience in the service industry, including a consistent award winning restaurant in downtown Calgary, AB. I had moved back to BC during the summer, and have finally decided to make a move toward the healthcare industry. This current semester, I enrolled in some upgrading courses/refreshers for Nursing and general science (if I go that route). I have surprised myself so far and am currently sitting at >95% in the courses I am currently taking. School seems to be much more interesting than when I was in my late teens.
Generally speaking, I would prefer a career that is higher paying. I am not scared of being married to my work, but I'd prefer a job where I can (at least when I get older) have a normal sleep schedule. I do not usually become fatigued by repetitive tasks, but prefer to shake things up when I can. Prestige is a lesser motivator for me. I don't really care how people think about me, and would draw more fulfillment through improving the lives of others. Location will be important. In the early stages I'd prefer to be close to a city. The dating pool for the strictly dickly is rather poor in towns from my experience.
I have three jobs which I have shown a good deal of interest in. I'd like to explain why I have found them desirable. Maybe my reasons could influence your guidance.
Doctor: Canada has a shortage of family doctors, and I would like to help in that regard. I've always had a knack for interacting with older people. I have always found fixing things extremely satisfying. I figured medicine could be a great bridge between my great people skills and my desire to fix problems. My concerns: medical school in Canada seems to be basically impossible to get into. If I likely have to get a masters/wait a couple years to get into med school, it doesn't seem as worth it at my current age.
Dentist: I love working with my hands. Pretty much anything that I like has a degree of physical involvement. For example, my favorite things to do are play FPS, drive engaging cars, bartending, working out etc. I've wanted to get into a couple other things like archery and shooting but haven't had much time. No residency and slightly less competitive schooling compared to medicine is also a plus. And other cool specialties like endodontics and maxillofacial surg are possible. Concerns: Money is the big one here. Dental school in Canada is quite a bit more expensive than medical (I think the government subsidizes med school more?). Saturation is another huge factor. I am worried that I will financially stifle myself by incurring lots of debt and working with potentially lower wages compared to the other options.
Nurse Anesthetist: Seems to be the smartest route. It would require me to move to the united states after getting nursing experience in Canada. I am more than open to moving to the United States, as it provides more career opportunities, a larger dating pool and lower housing costs in some states. I feel that I would love nursing, just as I have loved working in restaurants, which are chaotic and require good people skills. CRNA seems to be a great path as you get to work as part of a team in the OR and from what I understand there is a shortage of anesthesia providers as well. It may not be the most visceral career, but I think I'd probably be the happiest outside of work with this one.
Please feel free to provide any input, recommendations, or point out flaws in my considerations. I have spent a great deal flip flopping between these paths.
Thank you!
My school health insurance expired because I’m on a LOA, which is common for grad school at times. I can’t be back on my school insurance until Aug 1. I am also in a weird situation where I have an income, but no employer, so I can’t rely on poverty-income plans.
Biden’s new rule limiting short term plans to 4 months in a 12 month pd puts me in a pickle. Can I get one plan for 4 months, and then a completely different plan for the remaining 4 months? Are there any other options?
Context: State: PA 30 years old Looking for a no-frills plan
California Medical Board Law says a provider has 15 days to send medical requests to a patient upon their written request.
I am having a lot of trouble getting them from a former private practice provider. After calling a few times 2 months ago, his assistant finally called back. She said she will get them to me.
A month goes by, and I did not get anything. Called back a few times, but did not get a callback.
I sent him an email, but I got an automatic reply that said he doesn't use the email anymore.
I send him a letter since I didn't realize the request had to be in writing to be considered for that law. I haven't heard anything back.
I also realized I don't have proof he got it. So I mailed him a second one this time through certified mail. The delivery was unsuccessful. I'm not sure why, but USPS says you have to reschedule the delivery, and I don't think he's going to do that.
Does anyone have any advice? I'm pretty sure without proof he got the letter, a report would go anywhere.
Edit: Forgot to add the note about the email
My stomach was killing me one day and I was out of town visiting family, so they drove me to urgent care.
The quack there told me to go to the ER because my appendix had “no more than a day or two before bursting” without doing any imaging on me.
At the ER, they do bloodwork they do a CAT scan, but diagnosed gastritis and sent me home with pantoprazole.
On the itemized bill I received the total was like 11 or 12 grand. I get that I should pay for the CAT scan at the least but that only amounted to like $4,000; I owe the hospital $1,500 for a stomach ache because some idiot scared me into thinking I needed my appendix out.
What are my chances of explaining this and getting my bill lowered? Can I ask them to recode some of the smaller chunks of the bill or argue that I didn’t need those things done to me?
I am a Southern California-based Kaiser Permanente member experiencing TMJ issues. From my research, it seems the best treatment for TMJ comes from a specialist. However, it appears that Kaiser Permanente does not have a dedicated TMJ department. The Maxillofacial department seems limited in what they can offer for TMJ treatment.
From what I’ve read, TMJ specialists typically accept medical insurance rather than dental insurance. Is there any chance Kaiser would cover the cost of my TMJ procedure if I were treated by a third-party specialist outside of Kaiser, given that such treatment is not available within their network?
If anyone has faced similar challenges or has experience with this, I would greatly appreciate your guidance.
Mainz Biomed and Thermo Fisher just announced they’re collaborating on a cutting-edge colorectal cancer screening test for global use. This is the kind of healthcare progress that’s really exciting to see!
Making screenings more accessible and reliable can literally save lives.
Knowing that these two companies are behind it makes me confident they’re going to get it right. It feels like we’re on the brink of something amazing for cancer prevention!
I live in the upper midwest part of ohio (Mansfield-Akron), and I have had the worst experience with health care professionals across the entire area. I dont blame any individual healthcare provider, but I do blame the entire US healthcare system as a whole.
First let me give you a bit of background on who I am, and why its important. I am a 27 year old male, with a undiagnosed disability that cases me severe pain through my body, concentrated mostly in my neck and head region. I also get frequent and extremely debilitating migraines. Any type of mild physical activity past say 10 minutes puts me in so much pain throughout my entire body that I need to rest for hours just to recover, and multiple days doing physical activities in a row causes me to get physically ill, as if having a flu or covid.
I have spend from 2022-2023 seeing multiple doctors from diffrent doctors offices and clinic all together, I am not going to name them for fear of doxing, but we can say all together there were over 20 individual specialists from diffrent practices that tested me, all of which came back to the same conclusion... Theres nothing wrong with me.
Test after test, month after month, nothing. Nothing wrong, here's a reference letter to another doctor who might know better. One after another, seemingly endlessly until I simply couldn't take it anymore mentally. I was going insane trying to keep myself together after tens of doctors kept looking at me like i was crazy because I was "Young" and should be healthy, when I spend every day in debilitating pain, and cant even maintain a job.
Yea I have no job at this point, my girlfriend is blessed enough that she makes decent enough money to pay for rent for both of us, but what if she couldn't??? We'd be FUCKED. I swept the floors and did the dishes in our apartment today and i felt like I was gonna pass out from only an hour of work. Has to sleep the rest of the day off, and take a hot bath to even recover.
Oh and you'd think id apply for disability and they'd help out right? We'll Ive been waiting for my disability to get approved since the beginning of this year, it takes far too long, and its far too exhausting of a process for someone like me to go through. I was lucky that I had already gone through 20 doctors and psychiatrist and counselors, or they'd probably turn my application down right away. Hell they still might not approve me considering the bullshit I've had to go though already, I wouldn't fucking doubt it.
Now my girlfriend wants me to see another doctor because my condition is getting even worse than before, and I understand she is only looking out for the best for me, but its nothing but more stress for me. Just the fucking thought of going back into that healthcare system, trying to get documents transferred from doctor to doctor. Them expecting ME to do all the fucking work, so that I can just get ANOTHER doctor to tell me there's nothing fucking wrong with me. NO im not fucking doing it again. FUCK THAT. Id rather sit at home getting worse and worse and fucking DIE than have to deal with that bullshit again.
Anyway thats my rant, have a nice day 😉
I have recently become a father in a level 1 (highest level) maternity hospital here in Germany and it was far(!) below my expectations.
So I would like to write down my personal idea of an absolutely fantastic maternity clinic. Since everyone has different needs, this is really just my personal idea. I hope that somebody can take this as an opportunity to re-examine and question the current situation in obstetrics.
The fantastic maternity clinic is located on the outskirts of a large city next to a shopping center. In the city center, the land would be too expensive to build adequately large rooms, and in the countryside there would be fewer customers, as many pregnant women do not want to risk a long journey.
The clinic building is in the middle of the site, and borders on three sides by large, ground-level, free parking spaces. Parking garages are impractical because customers do not necessarily want to climb stairs and elevators are too expensive. To prevent parking spaces from appearing dull, trees are planted between the parking spaces. On the fourth side, the clinic borders a public garden with trees, flower meadows, labyrinths, a lot of benches and a pond. At the other end of the garden is a public transport terminus and a shopping center.
There is no division into a delivery room and a maternity ward. The first few days of the postpartum period are spent in the same room where the natural birth took place.
There are only single family rooms in the maternity clinic. The expectant mother must have another person move in with her who can look after her non-medically around the clock - usually the father, partner or another family member. If no one is available, a social worker paid for by the health insurance should move in with her.
All rooms therefore have two fixed, comfortable beds for adults, with space between them for a mobile child's bed. They also have enough space to accommodate another guest bed so that another family member can move in if necessary.
There is an operating room for every four family rooms, which can be reached directly from the family room via a single door. This room is used if urgent medical measures are required during the birth or if a planned caesarean section is performed. The team in the operating room not only operates on the expectant mothers, but also looks after them and the newborns later in the postpartum period and consists of midwives, nurses and doctors (gynecologist, pediatrician, anesthesiologist).
Each family room has a mini kitchen with a kettle, refrigerator, sterilization machine and microwave. The bathroom has a shower and bathtub for water births and a washing machine.
When registering, each customer is given a list of things for the baby that they must bring with them. This includes clothing, burp cloths, diapers, formula milk for possible supplementary feeding, etc. If the customer does not want to use their own things or does not have the money for them, they must state this when registering and the clinic will lend everything to them. The question here is whether the parents-to-be are well prepared for the child, as they would have to have all of these things ready for the time after the birth anyway.
The customer also has to organize the food themselves, which can be done by the obligatory second person in the family room. Many new mothers want to eat certain special meals after the birth to stimulate milk production and support recovery. For this, you can easily use the delivery services of the restaurants located in the nearby shopping center. Missing clothes, milk bottles, thermometers, diapers, etc. can also be bought in the drugstores there. Here, too, anyone who does not have any money for this or does not want to spend money on it must state this when registering and the typical hospital food will be delivered at the expense of the health insurance.
When registering, each customer receives CTG sensors that connect to their cell phone and can be worn at all times. The measurement data is transmitted to the maternity clinic via the cell phone, so that the child can be monitored anywhere: at the customer's home, on the way to the clinic, in her family room, or when she is walking in the garden.
When registering, the customer chooses a treatment team (see above) and thus also one of the four assigned family rooms. The customer also chooses a replacement team in case the team she primarily wants is overbooked on the actual delivery date. Customers have the opportunity to get to know the treatment team personally and view their previous CVs, and statistics are also made available (births per year, complications, percentage of cesarean sections per team, percentage of induction, customer ratings).
Here too, anyone who does not want to or cannot pay for this optional service is assigned a random treatment team free of charge.
The birth plan is then discussed in detail with the head of the treatment team, both the desired course of events and the desired deviations if something does not go as planned. The birth plan is then strictly adhered to.
A birth is not an illness. Miscarriages, premature births and stillbirths are an exception (must be!). Therefore, the customer is not treated as a patient and obstetric care is not seen as primarily a medical service. Doctors are only in charge when something goes wrong. Otherwise, the customer's wish for a meaningful, shared, private, celebratory experience in the family circle is given priority.
In particular for a cesarean section it mean the following: the baby is placed skin-to-skin on the mother's breast for bonding with the umbilical cord still attached. The pediatrician watches and examines the child while he is still on the mother. Only if the child is not breathing or other urgent medical measures are required can the pediatrician take the child to their own table in the same room where the parents still can see the child. The health examinations that cannot be carried out during bonding are carried out later. The umbilical cord is only cut after the pulsation has stopped. Blood storage is of course an optional service. The mother can bond with the child throughout the rest of the operation. After that, she is moved with the father to her family room, where bonding continues.
From the moment the child returns to the family room and for the next 24 hours, a midwife is permanently on hand. And when I say "permanently", I mean it: there is a midwife in the family room at all times (they take turns on every shift change, of course). The midwife regularly puts the child to the breast and shows the parents all the steps: changing diapers, putting on and taking off clothes, interpreting different cries, taking the temperature, keeping a feeding log. The mother is also observed, trained, psychologically cared for, medication is brought and administered. Breastfeeding consultation is also provided by the midwife. If the parents have brought a carrier or a sling with them, consulting on carrying is also provided or various carriers and slings are loaned out. If the mother does not want to breastfeed from the beginning, the midwife regularly brings the warmed bottles of milk. During these 24 hours, the new parents are trained so that they can then do all of these tasks themselves.
On the second day, the midwife also closely monitors what the parents are doing. For exaple to wake them up if they are sleeping too deeply.
When the parents are discharged, they are given advice on how to correctly place the child in the baby car seat.
The basic idea is that all advice should be given without being asked and the parents shouldn't hesitate to ask more questions, because an expert always has enough time for them.
Having a permanent midwife on hand could possibly be an optional service.
Parents should be encouraged to donate clothes that have become too small, unnecessary toys, Montessori mobiles, unnecessary children's furniture, diapers in their original packaging, etc. to the maternity clinic after discharge.
The easiest way to do this would be if the maternity clinic also had a pediatrician's office and a (preferably Montessori) nursery, so that a positive customer relationship could be maintained even after the birth.
I assume that a key question has arisen while reading this: how is this financed and how do we find so many specialists?
For Germany, my personal answer would be: we should turn the hell away from the idea that our medicine is "free". We should start to pay a deductible for our treatment costs, even though we already pay 15% from our income for the health insurance. That way, more money comes into the system, more staff can be hired, and you have more money for technology and services.
For most people, pregnancy is a once-in-a-lifetime event, and the first child is often the last. In terms of its significance in your biography, this event is comparable to a wedding. In our society, it is common to spend €5,000 to €10,000 on a wedding. Yes, not every couple can afford it, but many can.
I think many families could afford this as a supplementary payment for optional services at birth. That would mean foregoing vacation for three to five years. That would be cheaper than buying a new car. Or it would only be €100 a month if you financed it as a consumer loan for 10 years. And of course the state should make these costs tax deductible.
My husband and I are at an odds on what healthcare plan to choose for next year. My employer just notified me that Sutter and Providence (the two main providers in our area) are still in negotiations with Anthem Blue Cross and are not sure if they will be in-network next year. My employer suggested I look for a different PCP, one BIG problem - all the hospitals and vast majority of doctors are through Providence or Sutter within a 30 min drive. And even WITH those two as options, appts are months out.
That being said, I am considering if we should switch to Kaiser for next year. The premiums are nearly the same - about $380 biweekly for my family of 3.
Although we have gotten good care through Sutter system, it's very expensive with the deductible and out of pocket max. I had to go to the urgent care and they charged me $250 for the doctor to tell me to go get some different over the counter meds. A recent hospital visit for my daughter was over $3,000 after insurance. Now I'm worried that won't even be an in-network option.
My husband is very hesitant on Kaiser, hearing bad stories. But I'm wondering if it's THAT much worse that it wouldn't be worth it.
thanks for any insight!
I have been on my parents insurance and I just open enrolled myself at my job for other coverage and I was given a United Here Horizon BCBS from my union. The benefits on that card for copay is high, so I was looking on getting my own primary insurance to get off my parents.
I thought I had called Horizons number, but it turned out be another health insurance/ distributor. I decided to go with hearing quotes and I settled for $248.99 after hearing different benefits for my price range. I didn't research first on my part and after looking back with providers, I seen my current provider I go to at AtlantiCare here in South Jersey wasn't listed.
I looked at Atlantic Care's accepted insurances and didn't see Good Health/First Health Network listed. I tired calling back my insurance agent and didn't pick up or main number to their customer support. I am wondering if I should cancel/refund since I possible won't be covered. This is my first insurance I signed up for and worried I won't be able to go to my providers anymore. I am already cut off my parents insurance already since I am on my own insurance.
My agent did state it was nationwide coverage, and I have dental and Compass AVB Add - on included (Prescription included)
I just completed my quote and enrollment today like 4 hours ago.
Hi everyone,
Today is the last day of open enrollment, and I’m really struggling to choose a plan. I currently have BCBS in California and have been facing a lot of issues with them this year. My employer only offers two options:
1. BCBS PPO (CURRENT PLAN)
- $750 deductible
- 20% coinsurance after deductible is met
2. BCBS CHP with HSA
- $1600 deductible
- 15% coinsurance after deductible is met
Most hospital services aren’t fully covered, and I have to pay up to the deductible (for services like specialists, ER visits, behavioral health, etc) before I can use coinsurance. I don’t expect to need a lot of hospital services, but you never know, and I don’t want to be caught unprepared.
At the same time, I’m not wealthy, and paying out-of-pocket for services is stressful. I’m currently on the PPO plan, but it’s been tough with all the extra costs, hidden fees, and lack of transparency from the insurance company.
Can anyone help me figure out which plan might be better for me? If you need any more information to clarify, I’d be happy to provide it. Thanks! :)
Hi there, I'm self employed, 29 and very healthy. I just want to get healthcare coverage that will pay for things if I have major surgery or cancer or something. And for sure want HSA eligibility. Both of these are elligible.
Can anyone weigh in between which you'd consider a tie breaker between these two?
The 4700 plan says "mercyOne" which is a local hospital to my area. EPO means it's exclusive to that hospital.
I am truly confused. Thank you.
I’m thinking about switching insurance from BCBS to UH. BCBS is already high and I’m shopping around. Any personal horror stories with UH?
All insurance companies have issues that I know. At the time, BCBS was better, but their fees are going up even more next year.
Since US Americans are in a health insurance enrollment period right now, I thought I would share a list of resources and protections for everyone who is selecting a health plan for 2025 right now. Everyone - regardless their health - in the US has the right to health insurance under the Affordable Care Act. To enroll, check healthcare.gov or its equivalent in your state:
If you want to consult with a person about your coverage, try calling the American Agent Alliance, which is a list of real insurance agents compiled by The Department of insurance. American Agents Alliance (866) 497-9222
Why can't the US simply adopt Universal Health Care while still allowing Private Health Insurance to exist?
I mean it seems like the best of both worlds to me?
People who are for it argue that private health insurance is too expensive and leads many families into massive debt.
People who are against it claim it will drastically lower the quality of the health care and make wait times to see a doctor extremely long. It would also increase overall yearly taxes on most Americans.
But why can't we have both? If an individual or a family wants to pay for private health insurance to get that "better quality" and "shorter waiting times" why can't that be an option?
I'm in the lower class and my work's health insurance plan is very expensive, but I'm healthy and young with no pre-existing conditions, so I would gladly drop my current plan for a free government one with longer waiting times. It would save me roughly $400 a month which I could set aside for a down payment on a house.
If the answer to this is really obvious then I apologize, but I've been thinking about this all day at work.
I only work part time because I am a graduate student. I was insured through my public university but they randomly dropped me without warning and when I tried to reapply they said I wasn’t eligible. I can go on ACA but the Trump administration is going to get rid of it so I can’t even do that. I’m 25 but my mom is also on ACA. My dad’s is too expensive. I don’t know what to do. I am on several medications for my mental health that I cannot function without. Is there any other choice or am I going to have to dig myself further into debt than I already am?
My job offers the “minimum value standard” for its healthcare plans that are expensive. This makes me ineligible for the advance tax credit that would make the ACA plans more affordable (in my state through Pennie) although my income is within the threshold at 32k after taxes.
Would my wife be eligible for the advance tax credit because she is unemployed? Or is she ineligible because my job allows me to add her to my insurance plan? I would prefer to have two plans to keep costs down if possible.
Thanks in advance!
Or does everyone pretty much keep it? Paper, probably but how about EMR/EHR