Does your health insurance company offer a cash or cash like rewards program?

[aprilgail]

Mine doesn't have anything like that at all- I really don't mind though since my insurance is paid 100% by my ex-employer (I am retired) -though my co-pays just went up to 25.00 from 20 they were last year but that is still pretty good and my daughter is also covered for free on it until she is 26.

 

[tvguy]

$380 to see a doctor? Holy cow. No wonder people don’t go see the dr for just the sniffles.

Yup, plus the $380 my insurance paid on top of that.
And this is one of the issues America is struggling with as the debate over Healthcare continues. Americans EXPECT to see a Doctor for just the sniffles. Folks in many countries with Universal Healthcare only see a Doctor for major illnesses. My daughter went to school for a year in the UK and had to pay to be covered by their national healthcare. When she got a cold, sinus infection or the flu, she went to the closest Pharmacy for treatment, not the Doctor. She never needed more than that, but as I understand it, you would have to be escalated through several greater levels of health providers who deemed you needed to see an actual Doctor before you could see a Doctor.

 

[kdonnel]

Yup, plus the $380 my insurance paid on top of that.
And this is one of the issues America is struggling with as the debate over Healthcare continues. Americans EXPECT to see a Doctor for just the sniffles. Folks in many countries with Universal Healthcare only see a Doctor for major illnesses. My daughter went to school for a year in the UK and had to pay to be covered by their national healthcare. When she got a cold, sinus infection or the flu, she went to the closest Pharmacy for treatment, not the Doctor. She never needed more than that, but as I understand it, you would have to be escalated through several greater levels of health providers who deemed you needed to see an actual Doctor before you could see a Doctor.

What kind of doctor is charging $760 for a sick visit?

The EOB I get show a total payment to the doctor of about $180 for a strep throat/sinus infection/or ear infection visit.

 

[aprilgail]

You have amazing insurance. We haven't had only a $25 co-pay to see a Doctor since our son was born in 1987. Our current co-pay to see the Doctor is $380.
I'm on my wife's plan because my plan is nuts. No incentives, just disincentives. There is a $2,000 surcharge for every person covered on your insurance if they smoke, and a $3,000 surcharge if a dependent is on your plan that has an option to get coverage through their employer.

Looking at an EOB of a visit to my general practitioner right now- went for a ear infection and the entire charge was 125.00- what kind of Dr charges 380.00 per visit? I can see if it is like the dermatologist and they are doing a removal (which actually did not even cost 380.00)

 

[tvguy]

What kind of doctor is charging $760 for a sick visit?

The EOB I get show a total payment to the doctor of about $180 for a strep throat/sinus infection/or ear infection visit.

Not a sick visit, an office visit. No clue what he charges for a sick visit. Last sick visit I had with a Doctor was probably 25 years ago when I had just gotten an HMO, and I have a PPO now.

 

[tvguy]

Looking at an EOB of a visit to my general practitioner right now- went for a ear infection and the entire charge was 125.00- what kind of Dr charges 380.00 per visit? I can see if it is like the dermatologist and they are doing a removal (which actually did not even cost 380.00)

Internal Medicine. And it does occur to me this is the rate negotiated with his medical group with my insurance company and they pay their half without question or protest, so it must be in line with what other Doctor's charge.

 

[tvguy]

Mine doesn't have anything like that at all- I really don't mind though since my insurance is paid 100% by my ex-employer (I am retired) -though my co-pays just went up to 25.00 from 20 they were last year but that is still pretty good and my daughter is also covered for free on it until she is 26.

That too is a good plan. We haven't had $25 co-payments in 32 years. They jumped to $50 32 years ago when our son was born. And they keep going up.

 

[havaneselover]

I get: $50 gift card for being tobacco free, $50 gift card for filling out health questionnaire, and $100 for getting flu shot and having annual check up. I cash them in for Disney gift cards.

 

[tvguy]

CORRECTION: I pulled out the EOB. My portion of the office visit was actually $301. The other $79 was my portion of the lab work bill.
It is listed as code 99214 which is defined as “office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision making of moderate complexity.”
We have new insurance as of January 1, so this may all change.

 

[indimom]

We have something similar. We get discounts if we are screened for tobacco use, get an annual health screen/checkup, and complete and online questionnaire with followup by telephone nurse. It's not much, maybe $200 off the premiums?

 

[mnrose]

The only thing I know we can get is health club reimbursement. Unfortunately, all the clubs in Minnesota only work with "Minnesota" based insurance companies. Our insurance is considered "out of state" (employer plan through Blue Cross/Blue Shield Illinois as the administrator). I guess I could get health club fees from an Illinois health club reimbursed. Seems a bit far to go to the gym though! LOL

 

[ronandannette]

$380 to see a doctor? Holy cow. No wonder people don’t go see the dr for just the sniffles.

That's exactly what I thought, and since that's just a "co-pay" how much altogether is a doctor stateside charging for an office visit?!? The last time I asked one of my doctor friends, he said Alberta Heath Care pays $90 for a routine office visit (well or sick). It makes sense that my own doctor puts a limit on the number of maladies he will discuss at a single visit (3). It's irksome and inconvenient, but I get it and I can't remember the last time he spent more than 6 or 8 minutes with me during a routine visit.

Yup, plus the $380 my insurance paid on top of that.
And this is one of the issues America is struggling with as the debate over Healthcare continues. Americans EXPECT to see a Doctor for just the sniffles. Folks in many countries with Universal Healthcare only see a Doctor for major illnesses. My daughter went to school for a year in the UK and had to pay to be covered by their national healthcare. When she got a cold, sinus infection or the flu, she went to the closest Pharmacy for treatment, not the Doctor. She never needed more than that, but as I understand it, you would have to be escalated through several greater levels of health providers who deemed you needed to see an actual Doctor before you could see a Doctor.

It's quite different here. Pharmacists don't prescribe and NPs or PAs with their own practices are almost non-existent. General Practitioners called GPs are what you would know as primary care physicians and they are the gate-keepers of all services. One cannot receive prescription drugs or access any tests or specialists without their referral. People without a GP (and there are hundreds of thousands across the the country without) access services through GPs at walk-in clinics.

 

[slpeters]

I don't really understand where these figures for stateside doctor visits are coming from. Routine office visits--as in I think I may actually need a prescription because my flu isn't getting better--are totally covered under my insurance. But I'm fairly certain even if I had no insurance my doctor would charge about $120-$160 for that, enough to maybe prevent me from going but certainly not $760. Plus if I didn't have insurance and just wanted a routine prescription I wouldn't go to my doctor I would go to a nurse practitioner and be charged $60-$80 for it.

 

[kimblebee]

CORRECTION: I pulled out the EOB. My portion of the office visit was actually $301. The other $79 was my portion of the lab work bill.
It is listed as code 99214 which is defined as “office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision making of moderate complexity.”
We have new insurance as of January 1, so this may all change.

Wait, wait, wait. You get charged by how hard the doctor has to think??

Now I think you’re just trolling. How can anyone in their right mind think that makes sense and is ok?

 

[aprilchem]

Yes - my insurance has a discount (I think it's $50/month or so) if you go to a barometric screening provided by the insurance company, have an annual check-up, and participate in health counseling provided by the insurance company.

I (and most of my faculty colleagues) do not participate in it, because we think it's a tactic for the insurance company to get access to your medical records and could potentially be used that to find ways to deny coverage for certain medical conditions. A lot of the staff do participate, and there have been certain medical conditions removed from the "covered" list in past few years that we suspect were because one or more staff members were developing chronic conditions.

 

[tvguy]

Wait, wait, wait. You get charged by how hard the doctor has to think??

Now I think you’re just trolling. How can anyone in their right mind think that makes sense and is ok?

LOL. Trolling? Google Medical Code 99214. This is the code in the universal code system every Doctor and every Insurance company in the country uses to determine payment. I didn't make it up. Does it make sense? I don't know, but both sides have agreed to this system.

I do know from my neighbor, who worked for insurance companies auditing codes that Doctors billed, that Doctors do tend to over estimate what they did. She said in a typical year she found about $5 million worth of over coding. So you are not alone in your opinion.

 

[tvguy]

It's quite different here. Pharmacists don't prescribe and NPs or PAs with their own practices are almost non-existent. General Practitioners called GPs are what you would know as primary care physicians and they are the gate-keepers of all services. One cannot receive prescription drugs or access any tests or specialists without their referral. People without a GP (and there are hundreds of thousands across the the country without) access services through GPs at walk-in clinics.

But doesn't that vary from Province to Province?

 

[shoney]

No. Our insurance is
$20 copay for any Doctor
&
$35 for Er
$250 for hospital stay

Labs and xrays no charge


I had to sit through the presentation at my job and the bottom tier was for an individual $192 every 2 weeks. 13,000 deductible with a $2000k cash card to be used in network. Yikes!!!! Glad my husband has better insurance

 

[MrsJackSparrow4Life]

Wait, wait, wait. You get charged by how hard the doctor has to think??

Now I think you’re just trolling. How can anyone in their right mind think that makes sense and is ok?

No that is the actual definition of a 99214. However, doctors in his area are charging a rediculous amount for that 99214. I work in specialty office (that can charge more than a family practitioner or internal med doctor) and a 99214 is about $300 total. Our most expensive code (not including procedures) is a 99205 for a super complicated new patient and for that we charge about $495.

 

[ronandannette]

But doesn't that vary from Province to Province?

It well could; all the doctors I know to ask are here. Health Care is provincially administered which results in 13 similar-yet-different versions. That's why it's really difficult for anyone to give a fully-accurate overview of how "things are" in Canada.