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Gold/Mining/Energy : ECHARTERS
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To: Logain Ablar who wrote (3456)4/29/2011 12:24:18 PM
From: Sexton O Blake  Read Replies (2) of 3744
 
then you have to pay out of pocket as its not covered by insurance.

And/or it is covered by insurance but up to a prescribed amount.

Routinely run into problems with simple drugs. I would be charged $10 for dispensing fee and so much for the pills -- ultimately my insurance plan covers 90% so I pay 10%. But then (as I think everyone is out to rip me off) I check and somehow I did not get 90% back. Why?

The Tylenol 3 at the pharmacy was a charge of 0.07/pill and the medical plan covered only 0.055/pill. The pharmacy can charge whatever they want.

Remedy? Not much but changing pharmacies can be a start.

Also here in Canuckville with covered medical care, ZERO with dental which IMO a crime. Yes yes there are fine lines between medical and cosmetic, but many health related issues are related to your mouth health. Rotting teeth IMO are not good for your heart.

So the CDA (Canadian Dental Association) comes out with prescribed fees that dentists charge. Some abide by it, others don't.

This is where the insurance companies play games. They set up shop in your company and say "okay we will provide dental up 90% - co pay 10% - but we will base that on the 2005 plan." Everyone loves it. Until you get into 2010, and 2015 and 2020 when you are getting like nothing back.

I am paying a lot for my insurance (a good portion of the premium is due to dental) but at least the dental benefits are in line with the CDA yearly updates.

And a misconception - there is no medical care plan for CANADA. It is set by each province. If I go to the US or Quebec and have an accident, it is no different. In both cases, I will pay the costs, and get reimbursed only up to (or perhaps all) what Ontario would pay for similar services. Plus to save money, the Ontario government said - "who gives a crap about eyes -- let them all go blind - except the children and seniors" - so I have to pay for eye exams. And yes, some things you think are covered by Ontario medical care (OHIP) may not be covered at all. A dirty game.

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