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Old 12-05-2009, 09:26 PM   #21
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I called Oxford back and confirmed the rate is locked for 12 months. I also called BC sales and they have no haggling interest. So I am now waiting for billing to call me back to see what the cancellation policies are. Oxford enrollment is the 1st and 15th for each month, I would like to do the 15th but I want to confirm BC will pro-rate the month. I compared apple to apples and I don't see any difference in coverage between the plans.

What makes no sense is BC of NJ is a non-profit organization. So how is it possible for Oxford to offer a better rate?
What policy did you get from Oxford? And what was the BC (I'm assuming Horizon BC) were you using before? Was it just you or a family?

I only ask because I use the Horizon BC's HMO plan with Deductable & Co-Insurance. We use two single coverage plans for me & DW. I looked at eHealthInsurance and couldn't find any Oxford plan that was less expensive.
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Old 12-06-2009, 09:44 AM   #22
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WOW, over $8K/yr for an individual....at what point do you decide to do without? I think I would seriously consider it.
TJ
If you're in good health I'd considering moving to a lower cost state before I'd go alfresco. You could probably cut that insurance bill in half or more.
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Old 12-07-2009, 05:26 PM   #23
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The rate is high for the OP but we don't know all the details. We are in NJ and just switched in Oct. from Aetna to BC/BS (self-employed, just the 2 of us in the business) and we have a family policy (4 kids and both of us) for which we pay $621 per month with the deductible being a few thousand dollars.

We switched because Aetna was going up into the $800's per month.
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Old 12-07-2009, 08:46 PM   #24
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we have a family policy (4 kids and both of us) for which we pay $621 per month with the deductible being a few thousand dollars.
How did you manage that? The cheapest thing on e-healthinsurance for a family of 4 is $700 for a "basic and essential" plan (and in NJ, "basic and essential" insurance covers neither basic nor essential health care).

Dare I hope that you can actually find lower rates than what I've seen on the inter-web?
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Old 12-08-2009, 09:01 PM   #25
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You could always do as many do. Just do not have it. When my parents came up health insurance was no big deal. You got sick you paid what it was worth. The problem today hospitals inflate the price to pay for those who do not pay. It would be nice to operate a business like that. When customers cannot pay then charge those who can. You think I am wrong then see what hospitals charge for band-aids. oldtrig
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Old 12-08-2009, 10:14 PM   #26
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Paying $392 to BC for 2 of us here in MN for 10,000 each deductible (ages 59 & 60) rates increase with age.
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Old 12-08-2009, 11:11 PM   #27
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The problem today hospitals inflate the price to pay for those who do not pay.
It's even worse than that. If you go in as a cash customer, you'll be billed at a much higher rate than a patient who has insurance. And both of you will be paying for the individuals who can't or don't pay.
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Old 12-09-2009, 05:15 AM   #28
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It's even worse than that. If you go in as a cash customer, you'll be billed at a much higher rate than a patient who has insurance. And both of you will be paying for the individuals who can't or don't pay.
Those people need to have their own insurance
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Old 12-09-2009, 01:15 PM   #29
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I can't see going without health insurance. You might be healthy now, but what if you get cancer while you have no insurance? Your life savings can disappear very quickly.

Our coverage is an HSA plan around $300/month for 2 35-year-olds, with a $5700 deductible. For a few years we didn't come close to the deductible, but we smashed through it this year and almost hit it last year. Cash price for my shoulder surgery was somewhere around $30,000.

I'd trim a whole lot from my budget before I tried going bare of health insurance. Even though the chances of horrible health issues might be pretty low, the downside risk is too much for me to contemplate taking that chance.
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Old 12-09-2009, 03:21 PM   #30
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I can't see going without health insurance. You might be healthy now, but what if you get cancer while you have no insurance? Your life savings can disappear very quickly.
IIRC, the average cost of cancer treatment back in 2000 was $32K, brain cancer was 50+K. Lets assume today that would be 50-75K. The question is at what point do you just opt out of HI, and put the money away for the possibility of a severe illness. If HI is 10K/year, then in 5 years you would have enough to self insure. Obviously, these are only averages and the higher costs could far exceed 100K, but at some point you will say, I'll take that chance.
For example, most people don't have disability insurance, so even if you have HI to pay the costs, if unable to work, you may be in the poor house. What's the phrase, you paid for a ticket, you take your chances.
Regarding paying top dollar for health care if you don't have insurance, here is one option I found on the web, but have no experience with:
How the Plan Works
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Old 12-09-2009, 09:07 PM   #31
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Last week I had pain medicine filled (kidney stones ) and went back to pick it up later. When I paid I noticed the price went from $5 to $26. I was in pain so I paid and went home. My wife noticed the increase and got me to go back. There are two people in this town with the same name and they got me mixed up with the other. The other person did not have health insurance and I do. Why would they give me a discount ? when I have health insurance that pays most of it anyway. Is that fair? I say heck no. This needs to stop. Because they knew I had caught them in a mess they called me at home later and said I would be give a $20 gift card when I return. Of course I got it but again it is not fair. I did a little research and found that the person with the same name as me is on Medicare, he is four years older than me (67). I found that out when I went back for the gift card. I should call someone about this but what good would it do. Because I have health insurance I got a big discount. I guess when I get on Medicare I will have to pay much more for prescriptions. What a mess this country is in. oldtrig
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Old 12-10-2009, 11:28 AM   #32
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Originally Posted by teejayevans View Post
IIRC, the average cost of cancer treatment back in 2000 was $32K, brain cancer was 50+K. Lets assume today that would be 50-75K. The question is at what point do you just opt out of HI, and put the money away for the possibility of a severe illness. If HI is 10K/year, then in 5 years you would have enough to self insure. Obviously, these are only averages and the higher costs could far exceed 100K, but at some point you will say, I'll take that chance.
For example, most people don't have disability insurance, so even if you have HI to pay the costs, if unable to work, you may be in the poor house. What's the phrase, you paid for a ticket, you take your chances.
Regarding paying top dollar for health care if you don't have insurance, here is one option I found on the web, but have no experience with:
How the Plan Works
TJ
I think you're seriously underestimating costs. Disclaimer: I have no first-hand knowledge of cancer costs. The following came up on a Google search:

Quote:
Weighing the high cost of cancer care - Cancer- msnbc.com
Drug prices are a growing issue for every disease, especially for people who are uninsured. But cancer sticker shock is hitting hard now, as a list of more advanced biotech drugs have made treatment rounds costing $100,000, or even more, no longer a rarity. Also, patients are living longer, good news but meaning they need treatment for longer periods. The cost of cancer care is rising 15 percent a year, Lichter notes.
Quote:
http://www.usatoday.com/news/health/2008-10-12-cancer-costs_n.htm
COSTS FOR FIRST YEAR OF CANCER TREATMENT

The cost of cancer care has increased dramatically in recent years both for patients and for their insurance plans. Depending on a person's insurance plan, patients could be on the hook for tens of thousands of dollars, experts say.
20032006Percent increase
Paid by health plan$37,504$57,65754%
Paid by patient$2,434$5,094109%
Source: HealthCore data presented at American Society of Clinical Oncology conference
Quote:
What Does It Cost to Have Cancer? | AlixNorth.com
Keep in mind that this is nine months of treatment for early-stage breast cancer in a 40-year old woman with a strong family history.
Total cost of care billed: $224,725
Total paid by insurance: $134,110
Total paid by patient: $5,706
I think you're talking more in the multiple hundreds of thousands of dollars over the course of a few years to deal with cancer. At least that's the assumption I'm making when deciding to keep health insurance.
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Old 12-17-2009, 07:34 AM   #33
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IIRC, the average cost of cancer treatment back in 2000 was $32K, brain cancer was 50+K. Lets assume today that would be 50-75K. The question is at what point do you just opt out of HI, and put the money away for the possibility of a severe illness. If HI is 10K/year, then in 5 years you would have enough to self insure. Obviously, these are only averages and the higher costs could far exceed 100K, but at some point you will say, I'll take that chance.
For example, most people don't have disability insurance, so even if you have HI to pay the costs, if unable to work, you may be in the poor house. What's the phrase, you paid for a ticket, you take your chances.
Regarding paying top dollar for health care if you don't have insurance, here is one option I found on the web, but have no experience with:
How the Plan Works
TJ
I don't know where you're getting that info from, but a year of cancer treatments could easily exceed $300k and could reach over $1 million for some types of rare diseases.

The rates the OP posted are high because they are in New Jersey. The rates for NJ & NY, are much more expensive than other states with full underwriting. I know NY is guaranteed-issue community rating, pretty sure that NJ is also, but I could be wrong.
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Old 12-17-2009, 11:52 AM   #34
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I don't know where you're getting that info from, but a year of cancer treatments could easily exceed $300k and could reach over $1 million for some types of rare diseases.
See attachment...
Attached Files
File Type: pdf cancer_costs.pdf (100.4 KB, 6 views)
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Old 12-17-2009, 09:50 PM   #35
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On some strange level this post is wierd in the sense that there are still against health care / insurance reform. I'm not saying I agree with everything being proffered by these so-called fools , sorry , I mean representatives, but we damn sure better do something as a nation fast or no one will be able to afford the premiums...what happens then

My solution is simple, quick, and no rocket science....offer everyone who wants it the same plan Congress has...DAH !!!! This shouldn't even be up for debate. Just expand the plan to include everybody and charge the same rates. If its good enough for Congress its good enough for me. If 50, 75 or 100 million folks wrote to Washington and demanded then we'd see some results, QUICK. However, Americans are being bamboozled by the fake partisonship and BS that keeps us divided....what suckers we are !
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Old 12-18-2009, 08:40 AM   #36
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It should be noted that the cost that an insured patient pays for treatment is far different from that paid by someone that doesn't have insurance. For instance, I had surgery in October and the surgery center billed $7416 for the use of the facility. My insurance paid $791.24 and I paid $383.86. An uninsured person would have had to pay $7416. (791.24+383.86) + 531%(791.24+383.86) = $7416

I think there should be a law put in place that would make it illegal to charge two people differently for the same procedure within the same facility. I find the current behavior highly unethical.
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Old 12-18-2009, 08:59 AM   #37
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On some strange level this post is wierd in the sense that there are still against health care / insurance reform. .... but we damn sure better do something as a nation fast or no one will be able to afford the premiums...what happens then
I keep hearing this repeated, but it is a gross distortion IMO. Many of us are 100% in favor of reforms, but we are not in favor of the present proposals. Big difference. There isn't anything "strange or weird" about that at all - have you read/studied the bills?

I don't think there is much of anything in the proposals to contain costs (some say just the opposite), so that does not address your second issue at all. Going from the frying pan to the fire would be "doing something", but not want we want/need. Let's be careful what we wish for - we need real solutions, not just "action".

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I think there should be a law put in place that would make it illegal to charge two people differently for the same procedure within the same facility. I find the current behavior highly unethical.
Would you outlaw buying clubs like Sam's and Costco? Hotel "loyalty" programs, etc?

I agree it's a problem, but I don't think more laws addressing the symptoms rather than the causes are the solution.

-ERD50
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Old 12-18-2009, 09:00 AM   #38
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Overall health insurance company profits in 2008 were 2.2%.
Not sure how these things work: was that before or after bonuses, dividends, 7-figure executive salaries, saturation marketing costs?
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As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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Old 12-18-2009, 09:53 AM   #39
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Would you outlaw buying clubs like Sam's and Costco? Hotel "loyalty" programs, etc?

I agree it's a problem, but I don't think more laws addressing the symptoms rather than the causes are the solution.
No, but then again I believe that buying a lightbulb or a pair of shoes is different than buying health care.

So what "causes" a facility to charge one person more than another?
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Old 12-18-2009, 10:09 AM   #40
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So what "causes" a facility to charge one person more than another?
I'm not an expert, everything below is what I've heard from others.

I believe the differential pricing is the result of negotiated contracts. Some insurers (Medicare?) specifically stipulate that no other payer can be charged a lower rate for any service. So, if a hospital has signed a bunch of these contracts, then the individual who comes to the door with cash and no previous contract or arrangement is gonna get nailed.

Some doctors have set up small clinics that are cash only. The doctors and the patients are very happy with the arrangement. The fees are moderate, the doctors get to practice medicine with very little back office overhead, etc. But, they couldn't offer these low rates to walk-in customers if they also saw insured people, because they'd be in violation of the contract ("None of your customers can be charged less than what we paid you for the people we insure.")

We already don't have a free market in insurance. Maybe the government intrusion of mandating a "same price to all customers regardless of payment by cash or insurance" requirement would decrease the cost and friction of getting people to spend their own money for medical care, and thereby reduce the costs. I'd have to explore the consequences more to know if this was a good thing. But it would go hand-in-hand with requiring price transparency, which I think that would be a major step forward in creating an efficient market and thereby drive down costs more effectively than government caps.
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