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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: Cogito who wrote (63412)	5/4/2008 9:38:50 PM
From: epicure	Read Replies (1) \| Respond to of 542110

I'm so sorry. Are these not preferred providers you are dealing with? I know that with preferred providers the customary fee is the only fee they can charge- and the whole thing is written down to that level. I think I have mentioned that we have the most expensive insurance my husband's company offers. That insurance changed in January- and now there is no copayment- but they only pay 80% of all bills, when you go to preferred providers. When you go out of network they pay 80% of customary fees. There is a cap on the amount you need to pay in one year- it's 5k for in network, and 9k for out of network- and then the bills are paid at 100%, but still, that could really hurt some families- if they even had this kind of insurance. The company has set up an HRA (Health Reserve Account) to cover the first 1k of 20% payments, so it's only your next 4k (in network) or 8k (out of network) that you must pay 20% of. But still- after being covered at 100%, it doesn't seem like such a great deal, considering how much it costs.

To: Cogito who wrote (63412)	5/4/2008 10:23:43 PM
From: JohnM	Read Replies (1) \| Respond to of 542110

Allen, I'm sorry to hear this. But the drill sounds familiar. I had an operation for a small facial cancer about 4 years ago. After some time I started getting the same bills. And it was complicated because, with me, there are three tiers involved: my wife's insurance which covers me as well, Medicare, and a Medicare supplemental from my former work place. The outcome was some left over bills, not staggering as yours appear to be, but worrisome. I had the personnel officer at my former college contact the insurance firm who contacted the billing doctors and hospitals and got it worked out. I was led to believe that hospitals and doctors bill maximum, knowing they will get some sort of set fee. Some then try to recover the difference from the patient. It's part of my constant refrain that the system is just a mess, a horrible mess, and much needs to be done. As you know, my preferred system is a single payer, universal health care. But, back against the wall, I'll take any of a number of improvements. But all of them should be aimed at taking care of issues like yours.