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Cideous

The irony of practicing medicine and having TERRIBLE access to it?

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$700/month.  That's what I pay for my family. Me, wife, kid at a large organization.

$4000 deductible $6000 max out of pocket....no copays, all deductible and then co-insurance.  This is their "low deductible option".  Basically the best they offer, and It's complete shite...

 

Basically I have to spend $4k before I start seeing any real benefits short of paying BCBS's "negotiated rates".

 

 

Frustrated by this I really struggle with the irony that we as Providers of Medicine have in general just awful access to the very system we feed.  With the extreme stress this field enacts on us, if any one group should have an easier time accessing the help needed to stay healthy, it's us.  

Medical care, mental health (haha good luck with getting quality mental health care without being judged if anyone finds out), help with addiction?   Yea...again good luck.  Is it any wonder so many providers seem to suffer in silence both physically and mentally? 

Where is the "provider hotline" that we can call for help when we need it? I really wish it existed.  Until then I see friends and colleagues suffering in every way possible a person can suffer.  It's hard to watch and ironic in the worst way possible.

 

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I'm with Rev on a faith based cost sharing plan. So far it's been good and I've not needed to trigger the cost share.  I work for a clinic where all my visits are half price, including labs.  An office visit is $39  (we are a $39 office visit clinic).  We do not take insurance.  We have a large client base and it is so good to work with the staff.  We are practicing medicine....kinda like the old time family doc clinic.

patients love it and they come here even when they have insurance and get quick access plus low cost labs.  We see a good number of patients from  the other 2 large health systems in the area .  In fact, patients get their lab orders sent over to us so they can save $$$$$ on their labs.  They still need to see a provider here.  We also have low cost US ($100 per exam and interpretation) and xrays $125 per xray includes interpretation).   Its a good deal

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^^^. Faith based cost sharing right up until you have a heart attack and rack up $200k in bills in a week?  How does that then work...?

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3 hours ago, Cideous said:

^^^. Faith based cost sharing right up until you have a heart attack and rack up $200k in bills in a week?  How does that then work...?

With Samaritan, I think their max is 100k, unless you pay for $1m coverage which is like $35/month more for a family.  Beyond that, they put you on a prayer list and ask for voluntary donations--there is no such thing as an "out of pocket max"--again, NOT insurance--so you can still end up in medical bankruptcy despite getting most normal catastrophes covered very well.

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59 minutes ago, rev ronin said:

With Samaritan, I think their max is 100k, 

Is this a lifetime max? 

I could blow through that just paying for Levitra. 

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For years I've fought with insurance companies as a provider. Then, this year as a patient, with more than 800K in bills, we still only had to pay our max out-of-pocket of $2000. I am deeply grateful for that.

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Advantages to being a government employee - largest US employer - good rates.

I cover the whole family for about $650 a month.

It is Kaiser, the devil I know - and I know how to make it work.

$250 deductible per person, $1000 max family deductible.

$30 office visit copay

$15 dollar generics 

My husband's entire total knee cost us out of pocket - $450.

I cannot complain. 

And we use Flexible Spending pre-tax dollars at max $2500 per year for copays, dental copays, glasses, etc

My husband got VEBA - had to learn about that - another type of flexible spending from a pool of sorts - very confusing but it has a running balance and doesn't have calendar limits like Flexible Spending. We paid anything beyond Flex Spend out of that account.

Small practices or small groups have limited purchasing power and that sucks.

I can start the war of words and ideals again - I am not opposed to a National Health System.

 

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On 9/4/2019 at 1:04 PM, Cideous said:

$700/month.  That's what I pay for my family. Me, wife, kid at a large organization.

$4000 deductible $6000 max out of pocket....no copays, all deductible and then co-insurance.  This is their "low deductible option".  Basically the best they offer, and It's complete shite...

 

Basically I have to spend $4k before I start seeing any real benefits short of paying BCBS's "negotiated rates".

 

 

Frustrated by this I really struggle with the irony that we as Providers of Medicine have in general just awful access to the very system we feed.  With the extreme stress this field enacts on us, if any one group should have an easier time accessing the help needed to stay healthy, it's us.  

Medical care, mental health (haha good luck with getting quality mental health care without being judged if anyone finds out), help with addiction?   Yea...again good luck.  Is it any wonder so many providers seem to suffer in silence both physically and mentally? 

Where is the "provider hotline" that we can call for help when we need it? I really wish it existed.  Until then I see friends and colleagues suffering in every way possible a person can suffer.  It's hard to watch and ironic in the worst way possible.

 

That's a high deductible health plan. Hopefully you are taking advantage of an HSA. Does your employer offer anything towards an HSA? Also, preventative coverage is always free like yearly physical, vaccines, well baby visits, etc. even if you have not paid deductible at all.

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40 minutes ago, AbeTheBabe said:

That's a high deductible health plan. Hopefully you are taking advantage of an HSA. Does your employer offer anything towards an HSA? Also, preventative coverage is always free like yearly physical, vaccines, well baby visits, etc. even if you have not paid deductible at all.

No HSA is offered and that is their "best" plan.  And fyi, although the yearly physical is included any and ALL blood work is not and can cost hundreds of bucks.  The whole thing is shameful, especially for a provider and their family.

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8 hours ago, Reality Check 2 said:

Advantages to being a government employee - largest US employer - good rates.

I cover the whole family for about $650 a month.

It is Kaiser, the devil I know - and I know how to make it work.

$250 deductible per person, $1000 max family deductible.

$30 office visit copay

$15 dollar generics 

My husband's entire total knee cost us out of pocket - $450.

I cannot complain. 

And we use Flexible Spending pre-tax dollars at max $2500 per year for copays, dental copays, glasses, etc

My husband got VEBA - had to learn about that - another type of flexible spending from a pool of sorts - very confusing but it has a running balance and doesn't have calendar limits like Flexible Spending. We paid anything beyond Flex Spend out of that account.

Small practices or small groups have limited purchasing power and that sucks.

I can start the war of words and ideals again - I am not opposed to a National Health System.

 

I would give up a kidney to have access to Kaiser here in Texas.  Our insurance is terrible here.  And by terrible I mean the worst in the country....like 50 out of 50.  We have the highest rate of uninsured here in Texas vs the entire country.  Now that's impressive.

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9 hours ago, Reality Check 2 said:

I am not opposed to a National Health System.

We have a couple of them, and they generally suck.

The VA is one.  Don't know many people who use it who would say it's a great system.  I just made an appointment for my PCM for an acute on chronic shoulder injury, think I have a labral tear.  I can get into her (a NP) in 2 months.  Would NEVER let a VA surgeon touch me, or most other specialists.  But the pharmacy is nice because they will mail you anything in 1-2 weeks.  Sounds like a long time, but that's still faster than pulling a tab in the waiting room.

Military healthcare system - I'm retired, so I use that as well.  Somewhat similar to the VA, even worse pharmacy processes and wait times, although vast improvements in this since we have been at "war" for the past 18 years.  But anyone who has ever served has heard "take two (800 mg each!!) motrin and hydrate...you'll be fine!".

Medicaid/Medicare is another type of National Health System.  Medicaid pays so poorly that too-many docs won't touch it, and it's "free" so it's blatantly abused by a too-many patients.  Medicare is good, well except for the out of pocket costs....

The Indian Health Service - yeah, top notch health care.

 

10 hours ago, Cideous said:

A prayer list.  

I think you missed the part where you can get a million for $35/month.  And the donations from the "prayer list"

 

1 hour ago, Cideous said:

No HSA is offered and that is their "best" plan.

You can set up your own investment HSA through Optum bank.  


The fundamental problem with the delivery of healthcare in the United States (and everywhere else) is that there will ALWAYS be a greater demand for healthcare than a supply OF healthcare, which means it MUST be rationed. We can ration it by spreading out the financial costs, or we can ration it by bureaucracy, or we can ration it by waiting lists, or we can ration it by "death panels".  Pick your method, but there will ALWAYS be winners and losers when it comes to rationing.
 

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10 hours ago, CJAdmission said:

Is this a lifetime max? 

I could blow through that just paying for Levitra. 

Not sure.  I think it's per covered condition.  We've had one false alarm ER visit and one kidney stone (mine) in the past three years, but both have been paid at 100%--NO out of pocket costs to me--because they count the discounts you negotiate (e.g., by paying cash as uninsured) as part of your portion.

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10 hours ago, Cideous said:

A prayer list.  

Ok, thanks for the clarification.

I said it was faith-based.  So, when you have non-covered expenses that they can validate, they put those up for their voluntary 'member assistance fund'' and some of them get highlighted in their newsletter, and those needs can get paid for based on people donating above and beyond the minimum expected.  You're also expected to enclose a note with the checks you send to other members, and most people do it.  I didn't, until our first medical need and I started getting notes to us and reading how thoughtful other people were, and then I started doing it regularly.

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Current active duty PA. Saw this post and laughed to myself, because I've been complaining about this to my spouse for the past few weeks. My assigned "primary care manager" retired a few months ago. When I got back from deployment this past spring, I was due for my pap. Well let's just say it's now September, and I haven't been able to make an appt. I've spent cumulatively an hour on the phone with Tricare on 3 occasions the past week trying to switch my PCM so that I can get an appt, and was told they couldn't help me because no clinic on base is accepting new patients. WTF? My PCM literally RETIRED and is GONE. All I wanted to do was switch my care to the clinic I currently work at so that the NP there, who told me they are willing to take me as a patient, can just do my pap and refill my ocp. I'm the easiest patient ever,  I never need anything....except an occasional ocp refill and a pap every 3 years? Out of principle, I decided to give the Tricare lady a piece of my mind, knowing good and well she's just the messenger. Told her I'm a provider and active duty service member, and explained how unbelievable it is to me that I can't, at the moment, walk down the hallway to that NP and have them do my pap/ocp refill. I was FURIOUS. Only now starting to cool off from the whole thing. Issue still has not been resolved. Anyway, just venting here. This is just a small piece of what it would look like to have national health care for all. It's for the birds.

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$700/month.  That's what I pay for my family. Me, wife, kid at a large organization.
$4000 deductible $6000 max out of pocket....no copays, all deductible and then co-insurance.  This is their "low deductible option".  Basically the best they offer, and It's complete shite...
 
Basically I have to spend $4k before I start seeing any real benefits short of paying BCBS's "negotiated rates".
 
 
Frustrated by this I really struggle with the irony that we as Providers of Medicine have in general just awful access to the very system we feed.  With the extreme stress this field enacts on us, if any one group should have an easier time accessing the help needed to stay healthy, it's us.  
Medical care, mental health (haha good luck with getting quality mental health care without being judged if anyone finds out), help with addiction?   Yea...again good luck.  Is it any wonder so many providers seem to suffer in silence both physically and mentally? 
Where is the "provider hotline" that we can call for help when we need it? I really wish it existed.  Until then I see friends and colleagues suffering in every way possible a person can suffer.  It's hard to watch and ironic in the worst way possible.
 
Wow, good plan. You must not be from California.

Sent from my SM-N975U using Tapatalk

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On 9/6/2019 at 9:47 PM, Cideous said:

No HSA is offered and that is their "best" plan.  And fyi, although the yearly physical is included any and ALL blood work is not and can cost hundreds of bucks.  The whole thing is shameful, especially for a provider and their family.

You can open an HSA on your own with anyone(i.e. Fidelity) as long as you have a HDHP.  Definitely take advantage of it.  Let it grow tax-free and then withdraw it tax-free after retirement to "pay" for all those medical bills you had along the way.

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44 minutes ago, cinntsp said:

You can open an HSA on your own with anyone(i.e. Fidelity) as long as you have a HDHP.  Definitely take advantage of it.  Let it grow tax-free and then withdraw it tax-free after retirement to "pay" for all those medical bills you had along the way.

Even if I have employer health care?

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2 hours ago, Cideous said:

Even if I have employer health care?

Yup, doesn't matter where you get your insurance from. Even if you don't use it as an investment account, it's worth it to contribute the max and use for your healthcare expense due to the tax savings.  Since your family is on your plan, you can contribute 7K per year. Here's some more info:

https://www.investopedia.com/articles/personal-finance/082914/rules-having-health-savings-account-hsa.asp

Edited by AbeTheBabe
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On 9/4/2019 at 3:04 PM, Cideous said:

$700/month.  That's what I pay for my family. Me, wife, kid at a large organization.

$4000 deductible $6000 max out of pocket....no copays, all deductible and then co-insurance.  This is their "low deductible option".  Basically the best they offer, and It's complete shite...

 

Basically I have to spend $4k before I start seeing any real benefits short of paying BCBS's "negotiated rates".

 

 

Frustrated by this I really struggle with the irony that we as Providers of Medicine have in general just awful access to the very system we feed.  With the extreme stress this field enacts on us, if any one group should have an easier time accessing the help needed to stay healthy, it's us.  

Medical care, mental health (haha good luck with getting quality mental health care without being judged if anyone finds out), help with addiction?   Yea...again good luck.  Is it any wonder so many providers seem to suffer in silence both physically and mentally? 

Where is the "provider hotline" that we can call for help when we need it? I really wish it existed.  Until then I see friends and colleagues suffering in every way possible a person can suffer.  It's hard to watch and ironic in the worst way possible.

 

And why are you paying this? What are you getting from this? Check out Samaritan, Christian Care Ministries or Medi-share.  

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12 hours ago, camoman1234 said:

And why are you paying this? What are you getting from this? Check out Samaritan, Christian Care Ministries or Medi-share.  

Not everyone qualifies; each have their own limitations on membership and "coverage" (again, not insurance)

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