Going without Healthcare

Health, Fitness, Insurance, ...
Jason
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Re: Going without Healthcare

Post by Jason » Tue Jul 17, 2018 7:06 am

Based on OP's logic, he might as well go all out and say "I'm going to focus on becoming a better driver in order than I don't have to pay for my car insurance." Well, if he owns a car.

ThisDinosaur
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Re: Going without Healthcare

Post by ThisDinosaur » Tue Jul 17, 2018 8:36 am

https://www.washingtonpost.com/blogs/po ... 946568f045

Medical bills may actually only "cause" about 4% of bankruptcies. That doesn't mean you shouldn't cover your ass, though. One thing you could do is shop around *as if* we were living in a free market healthcare system. Approach this godawful mess the way Harry Browne would.

https://finance.yahoo.com/news/5-ways-t ... 21261.html
http://truecostofhealthcare.org/blog/

For prescriptions, shop online or call local pharmacies and ask what your drug costs for someone without insurance. You will frequently pay *less* than someone with insurance. (Insurance companies have contracts with pharmacies and benefit managers to jack up the price.)

You can do the same thing with doctors, lab tests, imaging tests, and specialists. If your doctor prescribes a test or procedure, ask him for the Billing Code. Then call around to ask for the self-pay price. (If you tell them you have insurance, they will not know the price. Because it depends on your plan's specific contract with each in-network provider.)

Insurance should ONLY be used for catastrophes. You don't use insurance to pay for your lentils, don't use it for your antibiotics either.

EdithKeeler
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Re: Going without Healthcare

Post by EdithKeeler » Tue Jul 17, 2018 9:19 am

For prescriptions, shop online or call local pharmacies and ask what your drug costs for someone without insurance. You will frequently pay *less* than someone with insurance. (Insurance companies have contracts with pharmacies and benefit managers to jack up the price.)

You can do the same thing with doctors, lab tests, imaging tests, and specialists. If your doctor prescribes a test or procedure, ask him for the Billing Code. Then call around to ask for the self-pay price. (If you tell them you have insurance, they will not know the price. Because it depends on your plan's specific contract with each in-network
I’m just wondering if you’ve ever actually done this. Because that’s really common advice, but it’s also really hard to do.

I do it a lot in my job. I’ve also tried it for myself when we first went to our high deductible plan and it was touted as an “opportunity” to save money.

Here’s what i’ve run into:
—“X is the person you need to speak with—I’ll have him call you.” (He never does).
—“You would have to talk to our billing company XYZ” which is based in another state and pretty much wont talk to you without an account number.
—The honest answer: “we have no idea what it would cost because our billing department handles that and have different rates for every carrier, etc.”
—Another honest answer: “somewhere in the range of X and Y, depending on what they find/do. However, we can work with you on payments.”

It would be really nice if you could call and say “what do you charge for a colonoscopy” and they tell you a flat fee. But it’s not a restaurant menu.

I do recommend for prescriptions asking your doctor for samples. My mom takes Eliquis, which is very expensive, and when she hits the Medicare “donut hole” it cost about $275 a month. Her doctor know, and he’ll usually give her a month’s worth of samples when she comes in, which helps defray costs. Also, of course, ask your doc to prescribe generics where possible.

ThisDinosaur
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Re: Going without Healthcare

Post by ThisDinosaur » Tue Jul 17, 2018 9:40 am

@Edith
Yes, I do this for prescription drugs and lab tests.

By contrast, I recently called to schedule a second-opinion appointment for my wife. I asked them what a single visit would cost, but I also told them I had insurance. They had no idea the cost and said I should call my insurance company. I did so and they didn't know either. I conferenced called the insurance rep and doctor's office. They exchanged billing codes while I listened in order for the insurance rep's computer system to spit out prices.

ThisDinosaur
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Re: Going without Healthcare

Post by ThisDinosaur » Tue Jul 17, 2018 9:44 am


Mister Imperceptible
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Re: Going without Healthcare

Post by Mister Imperceptible » Tue Jul 17, 2018 9:26 pm

What about medical tourism? If I can hop on a plane to Costa Rica, and see a US-trained doctor who is offering private care that is unaffordable to most locals but is dirt cheap for me because of the exchange rate....well, why not? I haven’t done much research but with the individual mandate gone for 2019 I am strongly considering foregoing health insurance.

Who knows, the idealist Costa Rican doctor who returned home to take care of her tribe might have a rockin’ body and I can wake up to her calling me Calvin Klein.

Clarice
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Location: California

Re: Going without Healthcare

Post by Clarice » Tue Jul 17, 2018 9:34 pm

ThisDinosaur wrote:
Tue Jul 17, 2018 9:40 am

I asked them what a single visit would cost, but I also told them I had insurance. They had no idea the cost and said I should call my insurance company. I did so and they didn't know either. I conferenced called the insurance rep and doctor's office. They exchanged billing codes while I listened in order for the insurance rep's computer system to spit out prices.
@ThisDinosaur:

That's the thing - the medical help is fractured and bureaucratized beyond all recognition (by a normal person). :roll: You think - I'll come and ask for advice. They think in terms of CPT codes. Every simple little thing becomes complex and over-sized by the way of CPT codes. Until your wife comes, presents a specific case, and they address it they normally don't want to lock themselves into a set amount in the hopes that something comes up and they can bill more. The system is opaque to keep the outsiders out and money in. :twisted:
Last edited by Clarice on Tue Jul 17, 2018 11:06 pm, edited 1 time in total.

EdithKeeler
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Joined: Sun Sep 01, 2013 7:55 pm

Re: Going without Healthcare

Post by EdithKeeler » Tue Jul 17, 2018 10:00 pm

Mister Imperceptible wrote:
Tue Jul 17, 2018 9:26 pm
What about medical tourism? If I can hop on a plane to Costa Rica, and see a US-trained doctor who is offering private care that is unaffordable to most locals but is dirt cheap for me because of the exchange rate....well, why not? I haven’t done much research but with the individual mandate gone for 2019 I am strongly considering foregoing health insurance.
That plan will work GREAT if you fall off a ladder and break your leg, or have a car accident and your face is smashed in.

I admit that because of stuff in my personal life right now, plus my work life, I'm a bit obsessed with medical stuff. I absolutely HATE how convoluted our system is, and hate the frustrations of dealing with health insurance.

But boy, I sure am glad I have a good plan and money in my health savings account.

Farm_or
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Re: Going without Healthcare

Post by Farm_or » Wed Jul 18, 2018 6:37 am

Years ago, my son had spent four days in a hospital. I had a literal 1 1/2 inch thick stack of numerous bills to work through. My mother was doing medical coding at the time and I asked for her help.

There were numerous "errors" that were hidden in the codes. They double charged and charged for completely unrelated services! When I finally got through to a talking head at my insurance company, they were nonchalant - uninterested.

They were paying the bulk of the errors. Why were they not interested in the "errors" that I and my mom worked hard to uncover? Something fishy there...

EdithKeeler
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Re: Going without Healthcare

Post by EdithKeeler » Wed Jul 18, 2018 8:39 am

They were paying the bulk of the errors. Why were they not interested in the "errors" that I and my mom worked hard to uncover? Something fishy there...
I can tell you why: the cost of correcting the errors is greater than the benefit. And/or the cost of the errors is ultimately factored into what the insurance company agrees to pay providers.

I work in property casualty insurance, and we do this in different ways, but on a smaller scale (we don’t have the kabillions of transactions that medical insurers have).

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Michael_00005
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Location: East coast USA

Re: Going without Healthcare

Post by Michael_00005 » Thu Aug 02, 2018 7:09 pm

I’m just wondering if you’ve ever actually done this. Because that’s really common advice, but it’s also really hard to do.
I did this a few years back for what I thought might have been a broken bone in my foot, and was considering an MRI. 1st off the doctor's office was surprised the question was even asked given there was health insurance. Lots of run-around for them to finally give a quote, 1 or 2 days later. Their quote was ~ $2,300 , so I called a few others places; one medical imaging lab priced it at ~ $400. After asking them why it was comparatively very cheap, they said they don't deal with insurance, just cash.

@ Mister Imperceptible
What about medical tourism?
This would be my plan as well, but it would require (very helpful) doing your homework ahead of time, also a good idea to visit the doctor or office before healthcare is needed. The one thing that would not be covered is emergency, but it's only a real problem for expensive procedures. Given the deductible and monthly savings the most common emergencies would not be a factor in the decision.

There are many things not to like about health insurance, one of the more offensive is that it almost feels like blackmail. If we continue to blindly accept the corrupt system, how will things ever change?

A lot of the freedom to choose comes from living a healthy lifestyle, otherwise I'd likely be in the camp of paying for health insurance. As things stand, a decision would only be made after looking at costs, and local healthcare options - post corporate.

ThisDinosaur
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Joined: Fri Jul 17, 2015 9:31 am

Re: Going without Healthcare

Post by ThisDinosaur » Fri Aug 03, 2018 8:06 am

https://www.vox.com/policy-and-politics ... na-lawsuit
The India-born surgeon decided he would open his own imaging center in Winston-Salem, North Carolina, and charge a lot less. Singh launched his business in August and decided to post his prices, as low as $500 for an MRI, on a banner outside the office building and on his website.

There was just one barrier to fully realizing his vision: a North Carolina law that he and his lawyers argue essentially gives hospitals a monopoly over MRI scans and other services.

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