Medical insurance and health care in your country

TastyReuben

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For me it is great to see someone who cares for their partner. Enough said.
Oh, we drive each other crazy sometimes, but we've been doing that for 32 years. :)

When she had her heart attack at an out-of-state conference, I moved heaven and earth to get up there, and when she woke up, she said, "You're here?"

"Where the hell else would I be?" 😕

That's us in a nutshell. :laugh:
 

TastyReuben

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Ok, caseydog was talking about negotiated prices between hospitals and insurance companies, I just got a bill today, so here's a good example.

My wife had to go in for a routine blood draw for (I think) a thyroid check. The bill I just got shows the full retail price of $122.08. That's what we would have paid if we'd just walked in off the street with no insurance.

The negotiated insurance price...$16.20. Since I haven't met my deductible yet, I'm responsible to pay that. If I'd already met my deductible, that bill would be for about $3.

This is just for the lab work, though. I'm still going to get a bill for the doctor's appointment.
 

caseydog

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Another thing to keep in mind with for-profit healthcare - your MRI at one hospital can be much more/much less than a hospital 30 minutes down the road.

I have the usual mid-50's health concerns, while MrsTasty is a healthcare bonanza. We learned pretty quickly, once we started paying for this test and that test, that all hospitals are not created equal.

Back in 2015, they found a growth on my wife's pituitary gland, so her endocrinologist wanted a test done to get a baseline on size. Of course, she wanted the test done at her facility. Since her clinic was an hour away, we asked about having it done locally and just having the results sent to her.

"Yes...you could do that, but I don't recommend it. My techs know what I look for and what I need to see, and it's in-house, and there is no monkey business in getting me the results. I have them immediately."

$4200, and I paid $2500 of it (my deductible at the time).

The following year, she wanted the same test, to measure any growth. The only reason we pushed back the second time was because the tech who administered the test the first time really messed up my wife's arm trying to find a vein, so this time, we didn't ask, we said, "We're doing this at our local hospital."

$1300. A year later, same exact test. Difference: big city hospital versus little country hospital. Exact same test.

Yep. I learned the hard way that for something like a CT Scan, you need to shop around. Like you say, the difference can be thousands of dollars.

CD
 

caseydog

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I'm sorry Mate that is scandalous in my opinion. One of the factors of good health is not worrying, one of the factors of getting better is not worrying.

I have pretty much the same insurance as TR from BCBS, but I am self-employed. My monthly payment for just me is about $600. My annual deductible is $3500, and max out of pocket is $7,500. My co-pay is 20-percent, like TR's.

CD
 

Burt Blank

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I have pretty much the same insurance as TR from BCBS, but I am self-employed. My monthly payment for just me is about $600. My annual deductible is $3500, and max out of pocket is $7,500. My co-pay is 20-percent, like TR's.
I was in the high tax bracket because of declared income, so correspondingly my NI was high. NI is for your state pension and unemployment benefit. Through period of my working life the government launch scheme that allowed you to pay additional amounts directly into your pension pot I did. I also started a private pension quite early. I never claimed any benefit but I never begrudged some of my NI going to the unemployed. I do not begrudge still paying tax on my income in the UK.
As I stated all our medical bill here get sent back to the UK for payment, this helps the UK NHS because my treatment and meds cost about 40% less than in the UK. Doctors here will only prescribe heavy duty pain killers here like "oxy" on very rare occasions. My arthritis is more manageable here because of the weather. If I need it they will sent me to one of the states spar treatment centers for mud baths etc.
$600 a month, even when the exchange rate was $2 for £1 pound is robbery. What happens when you retire ?
 

caseydog

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$600 a month, even when the exchange rate was $2 for £1 pound is robbery. What happens when you retire ?

We pay something referred to as "Payroll Tax" here, on top of Federal Income Tax. If you work for an employer, they pay 7.5-percent of your income, and you pay 7.5-percent. I am my own employer, so I pay the whole 15-percent.

That money goes to Social Security and Medicare. I can collect full benefits at age 67, or partial benefits as early as 62.

CD
 

rascal

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We pay something referred to as "Payroll Tax" here, on top of Federal Income Tax. If you work for an employer, they pay 7.5-percent of your income, and you pay 7.5-percent. I am my own employer, so I pay the whole 15-percent.

That money goes to Social Security and Medicare. I can collect full benefits at age 67, or partial benefits as early as 62.

CD

We get superannuation here at 65, I get it in 19 months. I don't need it but I'll take it. I've worked two jobs at once for a few years then full time ever since. Never been on a benefit or out of work in my whole life. I think I'm entitled to it. :)

Russ
 

HairyHeaven

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I find it fascinating that something as basic as health care can be so very different across the world.
We are so lucky in Australia to have a great healthcare system with our "Medicare". Basically general medical is free*

I can go to a medical clinic and see a qualified doctor (not of my choice) & not pay a cent. The government covers the cost of the consultation (which is around $55). I choose to go to my preferred health care provider, she charges me around $90 per visit, but then Medicare gives me back the $55 consultation fee so I'm only out of pocket the difference. If I need to get blood tests done then that's all included in the cost.

If my doctor (either my preferred or from a clinic) sends me for an x-ray then I have to pay for it, unless it is a service provided by that clinic.
Medicare also provides an annual optical check, but it doesn't cover glasses / lenses etc, nor does it cover dental. Specialists are not generally covered by Medicare, some will "bulk bill", but there's often a long waiting list to see them. Medicare does have allowances for special treatments, particularly mental health programs.

If I fell off a ladder & broke my hip & got taken to hospital, then everything that happens to me in that hospital as part of my treatment is covered. Drs, nurses, food, medication, x-rays, surgery, anaesthetic etc. I would be in a shared ward, and get the doctor that the hospital assigns to me.
The only thing I have to pay is for the ambulance.

Medicare doesn't cover elective surgery, and the waiting lists for non-urgent surgeries are ridiculously long. My mum (who doesn't have private cover) has been on a waiting list for 18 months for a basic cataract operation.

Then there's additional private health cover, and if I choose to have private cover, then the levy I pay on my taxes for health cover is reduced. With private cover I can choose to have basics only (ambulance, private hospital, doctor of choice), or add extras as required (everything from basic optical, through to obstetrics to prosthetic limbs). Because I can have my doctor of choice I also generally don't have the issue of sitting on a waiting list for non-urgent surgery.

Personally I have private cover with basic add-ons (dental, optical, physiotherapy) but will probably have a look at my options in the next 5 years or so as I get older. I've only had to use the 'general' part of it twice, once for an out-patient procedure at a private practice - I paid the $500 excess for what would have cost me nearly $3000 otherwise, and the other for an ambulance fee. I could have had the procedure done under Medicare, but I would have been waiting at least 3 months for it.

It costs me about $150 a month, probably a lot more than the difference in the tax levy I pay, but for me it's peace of mind. Plus I have shocking eye-sight, so I get my medicare-covered annual checkup, and my private covers my glasses (generally a new lens prescription every two years), plus my additional ophthalmologist tests & costs.


*Free being on the understanding that it's actually paid for by my taxes
 

Duck59

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We do quite well in Scotland, even compared to England. Eye tests and prescriptions are free. The dentist I use is NHS - many of my friends in England can't get an NHS dentist. A check up and scrape-and-polish costs me about eleven quid, which is pretty good. Little wonder that many of us campaign so hard to save our health service.
 

TastyReuben

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Today was a fun one - allergy test for MrsTasty.

I won't know what today's visit and test will cost, but the verdict was that she could benefit either from weekly shots or drops under the tongue every eight weeks.

Shots require an office visit, 45 minutes away, each week (and you get charged for the office visit plus the shot). Drops, you do at home.

Shots are covered by insurance. Drops are not.

By the time you work it out, shots are nearly the same cost as the drops. 🤷🏻‍♂️
 

Morning Glory

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Today was a fun one - allergy test for MrsTasty.

I won't know what today's visit and test will cost, but the verdict was that she could benefit either from weekly shots or drops under the tongue every eight weeks.

Shots require an office visit, 45 minutes away, each week (and you get charged for the office visit plus the shot). Drops, you do at home.

Shots are covered by insurance. Drops are not.

By the time you work it out, shots are nearly the same cost as the drops. 🤷🏻‍♂️

What do these drops/shots do? I've not heard of such a treatment.
 

caseydog

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What do these drops/shots do? I've not heard of such a treatment.

I got allergy shots as a kid. They are kind of like vaccines. They use allergens to reduce your sensitivity to allergens out in the world -- at least that is how I understand it.

CD
 

TastyReuben

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What do these drops/shots do? I've not heard of such a treatment.
From the Mayo Clinic:

"Allergy shots are regular injections over a period of time — generally around three to five years — to stop or reduce allergy attacks. Allergy shots are a form of treatment called immunotherapy. Each allergy shot contains a tiny amount of the specific substance or substances that trigger your allergic reactions. These are called allergens. Allergy shots contain just enough allergens to stimulate your immune system — but not enough to cause a full-blown allergic reaction.

Over time, your doctor increases the dose of allergens in each of your allergy shots. This helps get your body used to the allergens (desensitization). Your immune system builds up a tolerance to the allergens, causing your allergy symptoms to diminish over time."
 
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