Keep in mind that the alternative is, that when you feel sick, you go to the Doctor, and he hands you a $200 bill.Think about it... $150/month. For fucking insurance!
This isn't food, or shelter. It's some "cloud" thing that says someone will help you get medical care, when you become sick 60 years later.
FUCK insurance.
I'd rather have a few bucks cash.
-John
No fucking Federal Government, No Insurance Companies, and for sure, No Lawyers.
Keep in mind that the alternative is, that when you feel sick, you go to the Doctor, and he hands you a $200 bill.
You need an operation, and you hand the Doctor $10,000 and ask him to do you particularly good.
No fucking Federal Government, No Insurance Companies, and for sure, No Lawyers.
-John
We tried that system. It failed most of the people most of the time.Keep in mind that the alternative is, that when you feel sick, you go to the Doctor, and he hands you a $200 bill.
You need an operation, and you hand the Doctor $10,000 and ask him to do you particularly good.
No fucking Federal Government, No Insurance Companies, and for sure, No Lawyers.
-John
Originally Posted by Zorkorist
Think about it... $150/month. For fucking insurance!
This isn't food, or shelter. It's some "cloud" thing that says someone will help you get medical care, when you become sick 60 years later.
FUCK insurance.
I'd rather have a few bucks cash.
-John
I pay $550 a month for insurance.
I had to go the the ER recently, got over $52,000 in medical bills.
Insurance only covered $9,000.
Explain to me what I am paying over $500 a month for again.
snip
I pay $550 a month for insurance.
I had to go the the ER recently, got over $52,000 in medical bills.
Insurance only covered $9,000.
Explain to me what I am paying over $500 a month for again.
I pay $550 a month for insurance.
I had to go the the ER recently, got over $52,000 in medical bills.
Insurance only covered $9,000.
Explain to me what I am paying over $500 a month for again.
Originally Posted by Zorkorist
Think about it... $150/month. For fucking insurance!
This isn't food, or shelter. It's some "cloud" thing that says someone will help you get medical care, when you become sick 60 years later.
FUCK insurance.
I'd rather have a few bucks cash.
-John
I pay $550 a month for insurance.
I had to go the the ER recently, got over $52,000 in medical bills.
Insurance only covered $9,000.
Explain to me what I am paying over $500 a month for again.
I'm going to call BS on that. Funny thing is that if you had negotiated directly with the hospital and ignored insurance you could have almost certainly gotten them to knock off far more than $9,000. In that case you're paying for absolutely nothing.
So if your story is made up you're a liar, if it's true you're am idiot.
I've never seen someone who gets so excited about being a victim.
Where do you see me getting excited about being a victim?
We crashed on the Florida turnpike and taken by ambulance to a Hospital out of Network.
Neither one of us were in any shape to be asking, hey is this in United Healthcare's network.
Where do you see me getting excited about being a victim?
We crashed on the Florida turnpike and taken by ambulance to a Hospital out of Network.
Neither one of us were in any shape to be asking, hey is this in United Healthcare's network.
I'm going to call BS on that. Funny thing is that if you had negotiated directly with the hospital and ignored insurance you could have almost certainly gotten them to knock off far more than $9,000. In that case you're paying for absolutely nothing.
So if your story is made up you're a liar, if it's true you're am idiot. I've never seen someone who gets so excited about being a victim.
Their car insurance actually does.
While I don't know the details of your plan, virtually all plans have an emergency exception for out of network providers, and being taken out of a car wreck by an ambulance certainly sounds like one of those. If you were so disabled by a car wreck that you couldn't make that decision and they denied you an emergency exception anyway, sue them.
Regardless of the status of your emergency exception however, I will flat out guarantee you that you could have negotiated a smaller bill with the hospital. Usually the cash payer discount is at least 25% and many times can be 50% or more. You left a lot of money on the table the way you went about it. Foolish.
Actually most didn't. Out of network is out of network, emergency or not for most plans unless you have a new plan that started in 2011.
The way all out of network care is. You pay co-pay, + co-insurance on the allowable charges and the insurance picks up the rest. Anything charged above the allowable charges are 100% on you.
And more than likely his bill was already adjusted downward to the insurance rate.
What are you basing this on? While once again we would have to see the exact plan this is simply not accurate from everything that I know about health insurance. Dave, link us to your plan details so we can look! I would bet a great deal that his has some sort of emergency exception.
I know quite a lot about how medical billing works as I had to deal with taking care of almost $200,000 worth of medical bills a few years back.
40 out of 50 states allow balance billing.
Every plan I have EVER had, only covers up to the "allowable" amount, the amount the insurance company sets for whatever service. Anything above the allowable is 100% on the insured.
Where are you getting this information? After a quick check, it seems that balance billing is illegal in almost every state. Regardless, your original argument was that he didn't have emergency coverage at all. Now are you arguing that his emergency coverage is there, but insufficient? Emergencies are covered as in-network.
Uh. No balance billing is ONLY limited/prohibited in 10 states. I don't know where the fuck you are getting your information. You are wrong. Completely and totally wrong on how emergency care and out of network works.
I think what you are just confused.
Ok prior to the healthcare law, insurers were allowed to charge more for out of network care co-pay and co-insurance. They are no longer allowed to charge higher co-pay/co-insurance.
But again that co-pay and co-insurance is JUST ON THE ALLOWABLE AMOUNT. In an emergency situation the same co-pay and co-insurance as you would in network, on the ALLOWABLE AMOUNT. Anything above the allowable amount is 100% on the insured.
This is just not accurate. I don't think you know what you're talking about? Again I have to ask, where are you getting this information? You are referring to balance billing for out of network costs, while emergency costs are viewed as in-network. Balance billing for in-network costs is illegal almost everywhere. (including Florida where he claims this happened)
Balance billing is all about what the allowable amount is and how much insurance pays. Charges over that must be eaten by the provider for in-network care in almost all cases. Most plans treat emergency visits as in-network care, therefore our good friend Dave could not be balance billed. I'm not sure what the confusion is here?
It may be true (albeit unlikely) that Dave's plan does not have that emergency exception. It could also be that Dave's plan has shitty requirements for using it that he did not follow and now may be on the hook for. It's not possible to know without seeing his plan, but I find it unlikely that he will link it here because then he won't be able to complain about it.
Sigh. You still don't know what you are talking about. You are still wrong.
Let me google that for you
http://lmgtfy.com/?q=out+of+network+emergency+care
Again the if you live in the states that allow balance billing, you get billed the balance. Emergencies are only treated as in network for CO-PAY and CO-INSURANCE ONLY.
BCBS, UnitedHealthcare, Atena, all only cover up to allowable amounts on out of network care even on emergencies. Look up a god damn policy instead of spouting what you think you know/what you think is correct.
Speaking of looking up a god damned policy, had you bothered to check Aetna's website you would see that the vast majority of their policies do not balance bill for emergency services. Period. For charges on top of copays and co-insurance. This was true prior to the passage of the health care bill. They called it their 'hold the member harmless' policy!
Seriously guy, before you start getting all angry and pulling that stupid LMGTFY crap you might want to be sure that you know what you're talking about. It just makes things worse when your own examples disprove your argument.
Speaking of looking up a god damned policy, had you bothered to check Aetna's website you would see that the vast majority of their policies do not balance bill for emergency services. Period. For charges on top of copays and co-insurance. This was true prior to the passage of the health care bill. They called it their 'hold the member harmless' policy!
Seriously guy, before you start getting all angry and pulling that stupid LMGTFY crap you might want to be sure that you know what you're talking about. It just makes things worse when your own examples disprove your argument.
EDIT: I see you at least edited your post to correct yourself. Yes, after the actual 'emergency services' are done you must be transferred to an in-network hospital. That's not what we were talking about though.
*sighs*
Fucking pointless.
https://www.aetna.com/health-reform-connection/questions-answers/emergency-room-services.html
Yes. Out-of-network providers may balance bill patients for the difference between the providers' charges and the amount collected from the plan or issuer. The regulations indicate that out-of-network emergency services must be reimbursed at the greater of the in-network rate (or median rate if there is more than one), the applicable out-of-network reimbursement, or 100 percent of the Medicare rate.
http://www.aetna.com/individuals-fa...ces/claims-coverage/out-of-network-rates.html
Aetna’s take and action
Aetna already applies an in-network cost share to emergency services provided by non-participating providers and does not require pre-authorization for such services.
We are expanding our “hold the member harmless” approach to our Traditional Choice and Open Choice plans, the only plans for which it was not previously in effect. We are making this change regardless of grandfathered plan status. This means that if members receive balance bills, for cost share amounts from non-participating providers for emergency services, we will review, and members will not be held responsible for the difference.