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Joined: Aug 2002
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What amazes me is with those kind of deductibles the premiums are so high.

What did everybody expect when the insurance company has to sign
everybody up for the same price regardless of pre-existing conditions. It does not make sense to sign up an new patient that may be terminal ill from cancer, at the same price as a 20 year old that is in good health, but that is what the Government is forcing them to do. miles


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Originally Posted by milespatton
Quote
What amazes me is with those kind of deductibles the premiums are so high.

What did everybody expect when the insurance company has to sign
everybody up for the same price regardless of pre-existing conditions. It does not make sense to sign up an new patient that may be terminal ill from cancer, at the same price as a 20 year old that is in good health, but that is what the Government is forcing them to do. miles


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Originally Posted by Stan V
Coins is after you meet your deductible....

say deductible is $5000, then you start the coinsurance not to exceed out of pocket

Any accident coverage available? Generally most ins companies will pay (or at least offer it) 100% of accidents.


^^^ That's a good question that I'd also like to know the answer to.

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That's a good question that I'd also like to know the answer to.


Insurance companies are in business to make money and Obama and his helpers are trying to legislate that away so they will have the only insurance in town. Subsidized by the taxpayer. miles


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Originally Posted by UtahLefty
in the interests of full disclosure, here's the rest of the quote:

[Linked Image]


so those monthly premiums are for a family of 5, in a very healthy "community rating" community of vets.

whichever one of those you might choose, you're looking at $25,000 to $30,000 a year minimum in premiums + deductible for an in network incident. $40,000 to $50,000 if you had an out-of-network incident.

even if you hand no incident in a year, that's $12,000 to $25,000 in premiums. every year

who in their right mind would do that ??

cray cray!


The IRS is going to have to hire another 16,000 employees just to rack up and collect the penalties of all the Americans who are gonna say "up yours democrats" and refuse to sign up. I see how the deficient is going to be paid off. kwg


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Originally Posted by fish head
Originally Posted by Stan V
Coins is after you meet your deductible....

say deductible is $5000, then you start the coinsurance not to exceed out of pocket

Any accident coverage available? Generally most ins companies will pay (or at least offer it) 100% of accidents.


^^^ That's a good question that I'd also like to know the answer to.



under obamacare ? no.

however, it does appear you can still purchase accident insurance through your auto insurance company.

I did find this, however:

Originally Posted by .gov
Out-Of-Network Emergency Services
Q15: Public Health Service Act (PHS Act) section 2719A generally provides, among other things, that if a group health plan or health insurance coverage provides any benefits for emergency services in an emergency department of a hospital, the plan or issuer must cover emergency services without regard to whether a particular health care provider is an in-network provider with respect to the services, and generally cannot impose any copayment or coinsurance that is greater than what would be imposed if services were provided in network. At the same time, the statute does not require plans or issuers to cover amounts that out-of-network providers may "balance bill". Accordingly, the interim final regulations under section 2719A set forth minimum payment standards in paragraph (b)(3) to ensure that a plan or issuer does not pay an unreasonably low amount to an out-of-network emergency service provider who, in turn, could simply balance bill the patient.
Are the minimum payment standards in paragraph (b)(3) of the regulations intended to apply in circumstances where State law prohibits balance billing? (Similarly, what if a plan or issuer is contractually obligated to bear the cost of any amounts balance billed, so that the patient is held harmless from those costs?)
No. As stated in the preamble to the interim final regulations under section 2719A, the minimum payment standards set forth in paragraph (b)(3) of the regulations were developed to protect patients from being financially penalized for obtaining emergency services on an out-of-network basis. If a State law prohibits balance billing, plans and issuers are not required to satisfy the payment minimums set forth in the regulations. Similarly, if a plan or issuer is contractually responsible for any amounts balance billed by an out-of-network emergency services provider, the plan or issuer is not required to satisfy the payment minimums. In both situations, however, patients must be provided with adequate and prominent notice of their lack of financial responsibility with respect to such amounts, to prevent inadvertent payment by the patient. Nonetheless, even if State law prohibits balance billing, or if the plan or issuer is contractually responsible for amounts balance billed, the plan or issuer may not impose any copayment or coinsurance requirement that is higher than the copayment or coinsurance requirement that would apply if the services were provided in network.


In short, it says plans cannot charge more for out-of-network ER services than they would charge for in-network ER services. (all co-pays and deductibles apply)

It does give them the ability to question whether it truly was an emergency though, and the option to deny payment for stubbed toes and sore throats.

What's also interesting is that it defers to state law on the question of "balance billing" --- where the hospital bills the patient the difference between what they charged you and what the insurance paid.



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