He didn't get enough information. Every plan is different. In order to reduce premiums, carriers have released deductible first plans. Nearly all carries sell these products (I want to say every major carrier). Companies purchase them for a premium reduction.
Bman, That sucks, insurance companies have become increasingly aggressive in their denial process..... Why the richest country in the world is the only Westernized one without a national healthcare program is beyond me. Just fight your way through it.......it is all you can do. Good luck, if you need to vent, we are here for ya. DD
Do you have proof of this? Because as someone who works on these issues everyday, I've seen the exact opposite.
Just personal experiences, where things are immediatly denied, then you fight for them, and sometimes they get approved. And I am in a Blue Cross PPO........ And, correct me if I am wrong, but if a doctor takes the insurance, haven't they agreed to accept whatever payment the insurance company gives them? How is it that they can then bill the rest to the patient, I thought once they agreed to take the insurance they were agreeing that was the full payment. I am NOT a fan of Insurance, and the insurance lobbying.... Thank GOD that Tort reform legislation passed that lowered our insurance premiums....oh wait.... DD
You have to be careful when asking "Do you take xxxx insurance?" What you really should ask is "Do you have a contract with xxxx insurance?" Doctors who are contracted with insurance companies both have an agreement about how much the doctor can charge and how much the insurance will pay - hence no surprise charges. Your copay turns out to be your copay. But any doctor can "take" your insurance. That just means they'll charge what they want for your visits/procedures and bill your insurance afterward. Meanwhile your insurance will only pay $Y amount. So anything not covered by your insurance is your responsibility.
This just isn't true anymore. If you are having this problem then the physicians you are using are filing claims very poorly. The insurance plan you have (if it's PPO) is a cost sharing agreement with the "insurance company." You are responsible for your deductible up front and then a cost sharing percentage (co-insurance). The typical plan nowadays is 80/20. So you may be responsible for your deductible (let's say $1000) plus 20% of the bill up to a specific amount (usually either 2 or 3 times deductible) and then the insurance company pays 100% of the remaining amount. This all assumes you go to an in-network physician. One of the problems people run in to is they ask "Do you take Blue Cross Blue Shield." Your doctor will often say "Yes" even if they are not contracted to the BCBS network. Saying they take it is tantamount to saying "Sure, we take payment from whoever wants to give it to us." They can charge whatever they want and you can file it on your insurance's out of network services portion. Instead you need to ask "Are you a participating provider in the [insert network name here]?" Who is? But the fury is misplaced often. Insurance companies force doctors and hospitals to accept LESS payment from them than what they WANT to charge. Getting mad at the insurance company about what a hospital charges you for a baby delivery is the equivalent of getting made at your mortgage company because the seller of a house wants you pay twice the appraised value. Insurance companies are just the "bank" filling a void in what it costs and what you can afford to pay. Yeah that was a stupid red herring in the medical cost issue. Phew! Thank god you signed your post because for a minute there I thought I was talking to Ling Ling!
"Thank GOD that Tort reform legislation passed that lowered our insurance premiums....oh wait...." Agreed. One of the biggest lies put forward by the insurance lobby, chamber of commerce, Bob Perry, David Weekley, etc...
We love to do what we do once we see how much we help people. There is nothing quite as rewarding as handing someone a check that literally saves them from losing their home or car. I see it as a career helping people, that I just happen to get a paycheck for. I would get my license in Indiana and fly up there, no problemo, if you could though... Shoot, I'd do that just to sign you up directly. And, if there was any time issue, I would just refer you to a local agent that is already in your town (but if you did get me in contact with the University, I'd be there myself, no doubt). And yes, I do have several ducks in my office! Literally! They're all stuffed toys, but the proceeds from the agents purchasing them to give to clients goes to the Aflac Children's Cancer Center. All of the duck gear helps the Cancer Center in fact (I make nothing from it, no agent does). http://www.duckgear.com/
This is the rub. Some of the standardized Med Supp plans are designed and priiced to cover just this; some aren't.
