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Thread: health coverage

  1. #1
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    health coverage

    Hello all,
    I really realy hope that this does not spark a debate, but I am looking for suggestions on health plans. I am not covered by my employer and need to find something that will cover major things such as ambulance and ER visits. What companies or kind of coverage have you been happy with? Thanks.

  2. #2
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    I've been happy with the options from Blue Shield. Been self employed for 10+ years.

    The problem with the "major emergency" plans is that they aren't too bad on the monthlies, but when you do go in for an emergency( life flight, ambulance, ICU) you still need to pay a big chunk out pocket. Compared to the total bill, you're only out a fraction of the cost, but you better have a handy 5-10K laying around.

    Monthlies+deductible+max annual out of pocket expense can equal some serious cash if things go bad for you.

    That being understood, Blue Shield PPO has been easy to navigate. Simple to go see any in plan health professional. No hassle on MRIs, CTs, specialists etc.

    I opted for a plan with decent coverage and low monthlies.

    One year I had a lifeflight from a "non system provider" and 11 days in the ICU=$7k out of pocket.

    One month into the next calender year I did the same thing again=another $7k.

    A bargain all things considered, but OUCH.

  3. #3
    King of Middle Earth
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    I've been with Kaiser Permanente since day one of my pathetic life and I kept it after I went self employed. I've got clients who work for them so I get plenty of skinny from them at the foundation.

    Anyway, as far as HMO's go, it's a good one. You do have to pay for emergency visits and ambulance rides, but I think it's a copay plan.
    fee-fy-fo-fum...

  4. #4
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    Quote Originally Posted by baklamente
    Hello all,
    I really realy hope that this does not spark a debate, but I am looking for suggestions on health plans. I am not covered by my employer and need to find something that will cover major things such as ambulance and ER visits. What companies or kind of coverage have you been happy with? Thanks.
    Kaiser and Blue Shield/Cross/whatever seem to be the biggest. I had to go to an ER once with Kaiser and it was pretty simple. Right now I have Blue Shield because it's a little cheaper and makes it easier to find a provider out in the boondocks...Kaiser doesn't cover anything in San Luis Obispo, for example.

  5. #5
    King of Middle Earth
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    Kaiser doesn't give you the oppertunity seek medical coverage for simple things in places like SLO town but they do cover you ANYWHERE in the USA if you have an emergency!
    I had a severe reaction to poison oak once when I lived in SLO town a while back. My face had swollen so big that I could not even see! I looked like Rocky Balboa after a championship fight.

    Anyway, I was driven to the emergency room at General Hospital there and treated. Kaiser argued about covering the out of area hospital visit but I wrote them a nasty letter to prove my case and they agreed to pay. I am as good as a lawyer when it comes to proving my case in writing! And I HATE lawyers!!! LOL!
    fee-fy-fo-fum...

  6. #6
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    thanks for the replies

    It is nice to hear from people with experience on these things. I looked into the plans that were mentioned and am more confident in choosing one now. I don't really go to the doctor much, only emergencies, so it is nice to know that I can get coverage for when I travel.

  7. #7
    on the path most traveled
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    Quote Originally Posted by Norman Clydesdale
    One year I had a lifeflight from a "non system provider" and 11 days in the ICU=$7k out of pocket.

    One month into the next calender year I did the same thing again=another $7k.
    Holy crap! 2 life flights within a year's time? That's some hard riding.

  8. #8
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    I had an EMR room visit without coverage last year.

    Total bill for transport less than a couple miles and laying in the hall on a gurney for a couple hours and a couple tests was 8K. Not pleasant to deal with but everyone has discounted their invoices pretty substantially. The hospital's payment plan option on the other hand is designed so you don't have time to pay them before it is past due so they can demand full payment as soon as you are the least bit late. I recieved receipts for payment and late notices the same day both sent the day after the bill was due. Bad business model.

  9. #9
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    Yeah,
    I have lost faith in the health care industry after I got a $12k bill for a 4 hour walk-in ER visit. Before I could blink they were trying to send me to collections. The worst part is that they continued with tests after they already felt that I was fine to go home ("Miscommunication" between staff). One of the bills was for a $495 consultation from the doctor that came to the ER to try to convince me to stay overnight for more tests. There is nothing I can do about it, but it is surely a terrible way of caring for patients.
    thanks again for the advice.

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