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Topic: MEDICAL INSURANCE EXPLAINED! (Read 264 times) |
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LadyElaine
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Q. What does HMO stand for?
A. This is actually a variation of the phrase, "HEY MOE." Its roots go back to a concept pioneered by Moe of the Three Stooges, who discovered that a patient could be made to forget the pain in his foot if he was poked hard enough in the eye.
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Q. I just joined an HMO. How difficult will it be to choose the doctor I want?
A. Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors in the plan. The doctors
basically fall into two categories--those who are no longer accepting new patients, and those who will see you but are no longer participating in the plan.
But don't worry, the remaining doctor who is still in the plan and accepting new patients has an office just a half-day's drive away and a diploma from a third world country.
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Q.Do all diagnostic procedures require pre-certification?
A. No. Only those you need.
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Q. Can I get coverage for my preexisting conditions?
A. Certainly, as long as they don't require any treatment.
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Q What happens if I want to try alternative forms of medicine?
A. You'll need to find alternative forms of payment.
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Q. My pharmacy plan only covers generic drugs, but I need the name brand. I tried the generic medication, but it gave me a stomach ache. What should I
do?
A. Poke yourself in the eye.
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Q. What if I'm away from home and I get sick?
A. You really shouldn't do that.
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Q. I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right
in his/her office?
A. Hard to say, but considering that all you're risking is the $20 co-payment, there's no harm in giving it a shot.
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Q. Will health care be different in the next century?
A. No, but if you call right now, you might get an appointment by then.
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Sean_C
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #1 on: Jan 21st, 2006, 1:35pm » |
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Thats my plan too ROTFLMMFAO
Cheers 
Sean..............
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BMoneeTheMoneeMan
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #2 on: Jan 21st, 2006, 1:44pm » |
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ROFLMAO!!!
Boy, thats the truth!
Thanks for the laugh, I needed that.
PF wishes
BMonee
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"Fool me once, shame on, shame on you. Fool - can't get fooled again"
Think of how stupid the average person is, and then realize half the population is stupider than that.
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Grandma_Sweet_Boy
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #3 on: Jan 21st, 2006, 2:11pm » |
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I'm thinkin' there are many differences between your plan and mine - and then I'm thinkin' perhaps y'all oughta consider a move up north across that friendly border! LOL!
I sure do hope that all of what you put in there is a joke in which case it's funny as all get out. If there's the least bit of serious stuff there - then it's scary as hell.
Carol
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Charlie
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #4 on: Jan 21st, 2006, 4:52pm » |
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Pretty good E.
Sounds like mine. They were evil.
Charlie
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BarbaraD
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #5 on: Jan 21st, 2006, 8:50pm » |
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Carole, she's kidding but it's all too true....
The one I was in dropped all my docs and forgot to tell me, so I figured it was cheaper to pay the docs than an insurance co that didn't pay anything, so I dropped them and kept the docs. Got tired of all those "inelgible" no payment forms coming back.
If it weren't so darn cold up NORTH, I'd really consider moving up your way..... just for the medical benefits....
Hugs BD
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Grandma_Sweet_Boy
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #6 on: Jan 21st, 2006, 8:54pm » |
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So - explain to me as I'm just a dumb Canuck  . Are you saying that "they" whomever "they" may be, can actually tell you what doctor's you get to see? Please tell me that I've misunderstood that part.
You can't just go to your own physician and hand him the name of a specialist and have him arrange for you to see said specialist?
Two years ago, I had a horrible problem with tennis elbow and was able to be seen by an orthopedic surgeon who was one of the doctor's that treat a major league ball team. Can't you guys pick and choose like that?
I'm so sorry to be this ignorant of your health care, but it intrigues me.
All sane answers are appreciated - heck even the insane ones!
Carol
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Sean_C
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #7 on: Jan 21st, 2006, 9:07pm » |
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She's right Carol. I had Aetna insurance before I went to Tufts, now I have Blue/Cross. However I left Aetna because I went to the ER over a weekend, and was denied payment of the claim because I forgot to inform my Primary Care and get a referal within 72 hours. I protested it and the Hospital continued to bill me until I actually paid it.
So I changed to Tufts, they were great but they increased me to 1950 per month this year so I had to go with Blue/Cross for 1800 per month. BC/BS seems to be working out great except I have high co-payments IE; Colins eye drops were a 45 dollar co-payment and the prescription only costs 65 dollars to buy. But I can just about be accepted anywhere as long as my PC gives me the referal and that was the most important to us..
Did that make sense 
Sean..................................
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| « Last Edit: Jan 21st, 2006, 9:18pm by Sean_C » |
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Grandma_Sweet_Boy
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #8 on: Jan 21st, 2006, 9:24pm » |
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Holy Crap, Sean!!!! Pack up and move north, my friend.
So I go to the emergency department here - get seen by a doctor, given prescriptions if required - and go to the drugstore to get prescription filled.
I pay nothing at the hospital - and when I go to the drugstore, I pay 20% of the cost of the script.
I can go where I like for physiotherapy, massage, chiropractic, etc. without a referral and my health plan through work pays 80% of any of that treatment.
I do pay for health care but I likely don't pay in a year what you pay in a month.
In Bill's case, because he's older 'n' dirt, he only pays the cost of filling a prescription and his senior's drug card takes care of the rest of it.
I don't get that you seem to have no choice as to who you see.
So, if you have to be hospitalized for anything - does it cost you money out of pocket for anything?
Damn, this is way too confusing! 
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Sean_C
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #9 on: Jan 21st, 2006, 11:09pm » |
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on Jan 21st, 2006, 9:24pm, Grandma_Sweet_Boy wrote:| So, if you have to be hospitalized for anything - does it cost you money out of pocket for anything?Damn, this is way too confusing! |
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My plan cover the following and I know not everybody has my circumstances but this is what they will offer to us.
ER visit I p/u the first 200 dollars
Continued stay in hospital I p/u 120 dollars per day there after
Perscriptions I pay full amount for first fill up to 200 dollars, Non generic thereafter 75%, generic 25% thereafter. But always full amount for a new medication for the first time in a twelve month period.
Doctors visit I pay 30 dollars.
I know it doesn't seem fair but they lose money with me and still insure me.
Sean...............................
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fubar
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Re: MEDICAL INSURANCE EXPLAINED!
« Reply #10 on: Jan 22nd, 2006, 3:33am » |
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Not all plans suck here, but most get a little worse every year. I have had the same GP for the last 20 years, and he has been in every plan I had to switch between. My son's surgery was over $15,000 and I think I paid a total of about $200 between all the doctors and hospital. They don't cover nearly enough meds, but recently they started covering 12 triptan doses/month instead of 6, so that was cool.
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"He who has a why to live for can bear almost any how." -- Friedrich Nietzsche
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