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DFA Motorsports
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1,891 Posts
Discussion Starter #1
What Health insurance do you guys use and would you recommend them? I need new health insurance for me and my soon to be wife and am having a little trouble; anything but Blue cross because they blow. Also I need a company that provides Maternity coverage, not that I plan on reproducing any time soon but as I have been told, "Accidents happen".
 

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Killing Owls 2 stop O Rly
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885 Posts
You don't need health insurance. Obama's got it for you.
I doubt you recognize me, but its been a while since i've seen you posting (disregarding lately). What have you been up to? Back for a while or are you gonna go MIA again? =)
 

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Ludicrous speed! GO!
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100% coverage ain't gonna be cheap, but it beats paying any part of a hospital bill.
 

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Cupcake boss :p
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^^ I can vouch for that. My daughters biological father was required to supply her health insurance and sure enough he quit his job a month ago and a week later my healthy child was in the hospital with a heart condition that is now requiring surgery, a heart monitor and incredbly expensive medication. I stopped taking my own Lupus meds and RA meds to help pay for hers.


Look at it this way... I'm going to be in about 400,000+ of debt by the end of May. If not higher and I wont be asking the government to pay it off because I should have known better that he was a POS and set up my own plan for her.. pay the money for the best coverage because even if you THINK you wont need it you could get hit by a truck the next day and need care that easily exceeds your "allowed spending" then you're SOL

as for names.. I have heard good from current Dr's about them liking to deal with Amerigroup and United Health Plan. I hope you find one fast!
 

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NFA Pimp
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2,735 Posts
What Health insurance do you guys use and would you recommend them? I need new health insurance for me and my soon to be wife and am having a little trouble; anything but Blue cross because they blow. Also I need a company that provides Maternity coverage, not that I plan on reproducing any time soon but as I have been told, "Accidents happen".
Most policies will have a maternity built into them... at least all the plans I have seen.

^^ I can vouch for that. My daughters biological father was required to supply her health insurance and sure enough he quit his job a month ago and a week later my healthy child was in the hospital with a heart condition that is now requiring surgery, a heart monitor and incredbly expensive medication. I stopped taking my own Lupus meds and RA meds to help pay for hers.


Look at it this way... I'm going to be in about 400,000+ of debt by the end of May. If not higher and I wont be asking the government to pay it off because I should have known better that he was a POS and set up my own plan for her.. pay the money for the best coverage because even if you THINK you wont need it you could get hit by a truck the next day and need care that easily exceeds your "allowed spending" then you're SOL

as for names.. I have heard good from current Dr's about them liking to deal with Amerigroup and United Health Plan. I hope you find one fast!

I believe he should be available for COBRA coverage. Also, check with the recently passed American Recovery and Reinvestment Act as there are new guidelines for COBRA coverage which retros back to 09/01/2008.
 

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Ludicrous speed! GO!
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959 Posts
I believe he should be available for COBRA coverage. Also, check with the recently passed American Recovery and Reinvestment Act as there are new guidelines for COBRA coverage which retros back to 09/01/2008.
If he made the payments on the health plans himself, then yes COBRA would apply. Not sure if you can go back and say, "Heh, I kinda need to pay those 2 months back now so I can hit you with a bill."
 

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Union Proud
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656 Posts
I've got BCBS through work and it's alright. It's easy to deal with when you use it and they've got a huge provider network. We got a little screwed though because the town decided to cheap out on some of the coverages (and they're only paying 60%), so there are a few things missing that I would like to see implemented. I've always had BCBS, through various employers dating back to my parents' plans, and had no real complaints thus far.
 

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Banned
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4,495 Posts
The problem is that qualified doctors are prevented from finding a start-up position. This keeps supply low and demand high, hence all medical bills are retarded. There needs to be a way for supply to pick up to meet demand.
 

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I deal with pretty much every single insurance company you can think of and they are all a bunch of cock sucking bastards. Its like Vegas, do you actually think they are going to lose? Yes they will pay claims here and there.

The problem is that they are not regulated and so it is so easy for them to just deny claims for any reason they want. You want to read all the fine prints.

Go with one of the larger ones such as Blue Cross, United, Cigna. I am not saying they are good, just saying they are larger. Smaller ones will go under quickly.
 

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Cupcake boss :p
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I believe he should be available for COBRA coverage. Also, check with the recently passed American Recovery and Reinvestment Act as there are new guidelines for COBRA coverage which retros back to 09/01/2008.

I am sure he DID qualify for it, however since he can't be let within 100 feet of her he wont do anything he isn't forced by police or a jail sentence to do. He quit his job the month they found him and ordered the coverage/ child support.

he works under the table now.. I can send the bills to him all I want but in the eyes of the hospital and State since she is in my care regardless what the judge ruled 10 years ago I am responsible for her medical bills.
 

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Banned
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I deal with pretty much every single insurance company you can think of and they are all a bunch of cock sucking bastards. Its like Vegas, do you actually think they are going to lose? Yes they will pay claims here and there.

The problem is that they are not regulated and so it is so easy for them to just deny claims for any reason they want. You want to read all the fine prints.

Go with one of the larger ones such as Blue Cross, United, Cigna. I am not saying they are good, just saying they are larger. Smaller ones will go under quickly.
I've always been curious about this so I hope that you throw me a bone here... :)

Do you get a lot of claim denials in your practice? Is it a costly process in dealing with these insurance companies?
 

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NFA Pimp
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I deal with pretty much every single insurance company you can think of and they are all a bunch of cock sucking bastards. Its like Vegas, do you actually think they are going to lose? Yes they will pay claims here and there.

The problem is that they are not regulated and so it is so easy for them to just deny claims for any reason they want. You want to read all the fine prints.

Go with one of the larger ones such as Blue Cross, United, Cigna. I am not saying they are good, just saying they are larger. Smaller ones will go under quickly.
They are regulated, both on the state and federal level. I know, I am a Implementation Project Manager and I have to deal with them on a daily basis.

Claims is a whole other issue as it would do what type of policy the person is on, what type of company is a person is working for, how is the insurance funded, and so forth. There are set regulations that a insurance has to cover in a policy, both on the federal and state level. Usually, on a group level policy where the insurance company is at risk, they will have to follow both the state and federal laws of where the policy is issued. Groups that are self-funded, meaning they pay all their own claims, but use a carrier for their discounts and only pay them admin fees, can insure just about any procedure at any amount they want. They only have to follow Federal laws on insuring people and their laws are very broad and doesn't cover that much.
 

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I've always been curious about this so I hope that you throw me a bone here... :)

Do you get a lot of claim denials in your practice? Is it a costly process in dealing with these insurance companies?


Actually my collection rate is over 95% which is unheard of in medicine. But i serve a niche that ACTUALLY the insurance companies appreciate. When i see somebody for a 2" laceration, i bill the insurance company $200. If that same person had gone to the ER, the bill from the hospital would be $2000+. So they do not fuck with my bills. They encourage their patients to go to urgent care centers and not to go to ERs so that works to my advantage. The only time my claims get denied, is basically when my registration girls mess up and do not verify that the insurance is still valid, etc.

Insurance companies do not have time to fight small claims like that specially when it is to their benefit. No, they fight the big shit. They will deny the need for an MRI, stress test, some expensive surgery, chemo therapy, etc etc.

If you want to see how messed up they are watch Sicko by Michael Moore. Although i dont like his one sided stuff. This video is a non-Partisan about how corrupt the insurance world has become. Some of the things i dont agree with such as how great healthcare is in Canada or Cuba but his description of insurance companies in the US is spot on.
 

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Premium Member
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They are regulated, both on the state and federal level. I know, I am a Implementation Project Manager and I have to deal with them on a daily basis.
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They are regulated as much SEC "regulates" Wall Street. Insurance companies have some of the biggest lobby money available and they fucking own everybody. They can deny claims they want. They create loop holes in everything. Yes, they may follow the "regulations" but ones that were written and supported by their own lobbies.


In an economy that 95% of companies are losing money how do you think companies such as Aetna are profitable? By screwing a bunch of people. Their profits go up incrementally every quarter.

http://www.fiercehealthcare.com/story/aetna-profits-member-premium-increases/2008-07-31
 

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NFA Pimp
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I am sure he DID qualify for it, however since he can't be let within 100 feet of her he wont do anything he isn't forced by police or a jail sentence to do. He quit his job the month they found him and ordered the coverage/ child support.

he works under the table now.. I can send the bills to him all I want but in the eyes of the hospital and State since she is in my care regardless what the judge ruled 10 years ago I am responsible for her medical bills.
I would check to make sure to see if you fall into the new law.

As for getting something court ordered, I am sure it can be done. I have seen it plenty of times at my work. We have prefilled letters for such cases to prove to the court that so and so person has coverage for said dependant.
 

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NFA Pimp
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They are regulated as much SEC "regulates" Wall Street. Insurance companies have some of the biggest lobby money available and they fucking own everybody. They can deny claims they want. They create loop holes in everything. Yes, they may follow the "regulations" but ones that were written and supported by their own lobbies.


In an economy that 95% of companies are losing money how do you think companies such as Aetna are profitable? By screwing a bunch of people. Their profits go up incrementally every quarter.

http://www.fiercehealthcare.com/story/aetna-profits-member-premium-increases/2008-07-31
That report is over 6 months old. Have you seen what the healthcare stocks have been at lately? You don't even need to look. My shares are shit right now and my 401K isn't doing too well either. :(

And no, I don't work for Aetna.
 

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Premium Member
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That report is over 6 months old. Have you seen what the healthcare stocks have been at lately? You don't even need to look. My shares are shit right now and my 401K isn't doing too well either. :(

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Stocks are down well cause almost everything else is down. Now Citi is DOWN 52week high of $25 and last week it was $1.00 That is a 96% reduction. Aetna 1yr high is in the $40's and they are at $25, not that bad if you ask me:)
 
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