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Strategies & Market Trends : Young and Older Folk Portfolio
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To: QTI on SI who wrote (21834)11/3/2025 11:45:14 AM
From: Max2.09 Recommendations

Recommended By
agniv
BasketballJ
Celine1
Chowderfan
Comeonretirement

and 4 more members

  Read Replies (4) of 23248
 
In my opinion, our health care system is. broken. My wife is younger and not yet on medicare her premium is $1500/month with a deductible of $1750 (With Blue Shield). Fortunately my retirement benefit kicks in $300 towards that fee. 2 years ago my Wife had to go to the emergency room with a broken Clavicle. She got and XRay and 10 minutes with the doc that told her she had a broken Clavicle and that she needed to go see an Orthopedist. She also got a sling to stabilize her arm.

When we got the statement back from Blue Shield, the cost of the Emergency room visit was roughly $10K !!! But through the insurance management the fee was reduced to $900.

The next year my Retirement insurance optioins changed over to Aetna. My wife Clavicle did not heal properly and she needed a bracket installed. She was in a lot of pain. The doc put the bracket in and then we got a denial of payment from the Anesthesiologist portion of the operation because the pain doc was not "In-Network". Mind you this was done in the hospital and nobody had any choice which Anesthesiologist to use. We had to appeal with a letter and there was some back and forth. Finally the pain doc bill ($900) was paid.

Then the bracket situation caused her shoulder to be frozen so she could no lift her arm. The Orthopedist said that she need a "Manipulation" to break up the scar tissue. This was about $3,500 and Aetna balked at approving the procedure. They said it was not medically necessary. After a couple letters from both the Ortho guy and my wife, Aetna finally relented and paid for the manipulation.

The good news is my wife is fully recovered and has full range of motion. The bad news is that this was a completely unnecessary struggle consuming a lot of effort on our part. Especially so considering the huge premium we are paying. For my Medicare supplement and wife's $1750 deductible policy, the full cost is over $2,250/month. Fortunately my retirement benefit kicks in $800 so that is appreciated.

I can't imagine how those less fortunate than us must deal with these huge numbers. From what I am reading here, things are only getting worse.
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