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I have health insurance, but I cant afford the copays or meds

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mdmc Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:15 PM
Original message
I have health insurance, but I cant afford the copays or meds
So I still end up getting my medical service at clinics and Emergency Rooms.
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DesertFlower Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:19 PM
Response to Original message
1. wow. that sucks.
our co-pays are not too bad, but the deductible is and the co-pays do not count toward the deductible. so if one of us needs an MRI we have to pay for it. our deductible is $714 each. we do have drug coverage which is pretty good.
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midnight Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:20 PM
Response to Original message
2. Another reason that just because one has insurance means that
they can afford it or worse yet get treatment. I hope that this is an issue that finally gets the attention it deserves.
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DesertFlower Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:23 PM
Response to Reply #2
4. that was one of the points
michael moore was trying to make with "sicko". i hope every american sees the movie.
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havocmom Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:33 PM
Response to Reply #4
6. Lots of horror stories of people paying insurer for years
then denied coverage when they need it as more and more aggressive actions taken to deny on technicalities or ridiculous decisions.

What we have, with for profit insurers, it medical care decided by the bean counters. Anyone who thinks requiring workers who have been losing real wages for years to buy insurance they honestly cannot afford will solve the medical care problems in this nation is just plain blind to the circumstances of a vast majority of working people.
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electron_blue Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:22 PM
Response to Original message
3. Just curious - how does going to the E.R. get you out of copays?
My copay is double if I go to the e.r. Do you have zero copay for an e.r. trip?
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Echo In Light Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 05:32 AM
Response to Reply #3
13. Many of them have yet to go the clinic "Quick Trip" route where $ is FIRST and FOREMOST
They bill you. And yes, unfortunately was in that very situation twice over the last month.
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electron_blue Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 10:09 AM
Response to Reply #13
19. I see - they can be billed in the e.r. Can you not get billed for regular or clinic co-pays?
They do where I live. They say you should pay all co-pays up front, but in reality you can be billed.
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alfredo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:27 PM
Response to Original message
5. That's the preferred situation for the insurance companies.
That really sucks.

Are you a veteran? If you are, get your ass down to the VA. You will need your 2007 W-2 's, and/or 1099's. Your DD 214 will be needed. Make an appointment.
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gateley Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:43 PM
Response to Original message
7. This is what concerns me about the health plans being proposed -- "affordable"
health care.

If you have insurance through your employer, and paying premiums, it would be assumed you could handle the copay and prescriptions.

So heath care ISN"T affordable for you, even though on paper it would indicate that it was.

Kucinich's plan is the only one that seems to really cover EVERYONE.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 02:08 PM
Response to Reply #7
25. You could go to one of the government plans, as I understand these proposals.
I don't know what they would envision the premium would be, however, I think that the copay should be modest, like $5 or $10 per visit. If you cannot afford that, you would probably go on Medicaid, but not if your salary put you out of reach of that. However, as I read HRC's plan, she would expand Medicaid's reach so perhaps you would qualify there.

In any case, I think the point is that these plans would want to work with people to get the best plan for them. It doesn't mean that you wouldn't have to budget your money; after all, you do pay your taxes. It would be more like your electric bill or any other necessary commodity.
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madrchsod Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-03-08 09:48 PM
Response to Original message
8. shit my wifes won`t pay my hospital bills from 6 months ago
the billing office lady said that her insurance company is one of the worse in pulling this crap. i have to call her tomorrow and find out if they paid yet. what this company does it not pay then the bill so it will either be paid by me or turned over to collection.
she told me that even the insurance companies that used to pay on time are doing the same thing now..and we still want insurances companies to insure us with our tax dollars? i think not
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knitter4democracy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 10:32 AM
Response to Reply #8
20. Many wait a year now.
At least for the big bills, hoping they can find some technicality that lets them off. It's disgusting.
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wolfgangmo Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:54 PM
Response to Reply #20
27. But wait, it get's better.
My wifes clinic just got a letter from Blue Cross/ Blue Shield which said they are withholding payment until our bill is paid. Given that they pay us and not the other way around we got clarification. Here is what they said.



They had disallowed a procedure retroactively for 3 years. That's right. There was a procedure we had approval for, that was paid for, for 3 full years and suddenly they have disallowed that procedure and so we will not get paid for new BCBS patients until that debt is paid off - it shouldn't take much more than us treating patients for free for 6 or 8 months.


I checked with some other clinics and they all had a similar story from different companies. Screwed. It not just for patients anymore.
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knitter4democracy Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Feb-06-08 09:21 AM
Response to Reply #27
29. A hospital in Lansing dropped BC/BS entirely after a year's worth of crap.
They were a year behind in paying almost all of their bills to the hospital, and so the hospital dropped them, saying the company was in violation of their contract with the hospital. BC/BS wised up fast and figured it out, paying their bills and getting back in the hospital's good graces.

I think more need to do that. Strength in numbers.
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dawniedarling Donating Member (14 posts) Send PM | Profile | Ignore Sun Feb-03-08 10:18 PM
Response to Original message
9. pashaw
all are out of my reach.

I can offer a good, universal health care plan though.

Execise, decent food and don't put your dirty hands in your face!
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TexasObserver Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 01:40 AM
Response to Original message
10. And that will be true for most who are forced to buy it
That's why the insurance industry approach that Clinton promotes is fool's gold.

The insurance will not pay for most of your ordinary medical needs. You will be paying premiums AND your routine medical trips. The insurance won't kick in until you're above a certain level. When it does, it will pay everyone but you - hospitals, doctors, and prescription drug companies.

That bill isn't about universal health care. It's about providing the insurance industry another government mandated chance to fleece the poorest people, the least able to throw money away.

Here's an idea: If you break a bone or need an angioplasy, you get one. If you don't have insurance, the government pays according to a schedule it establishes. If following the billing you are determined to have annual income in excess of 20 times the medical charges, you have to contribute some portion of the bill. Otherwise, you go home and don't have to file bankruptcy, like so many Americans must.

Call it the War on Unreasonable Medical Costs, and put it in the Defense Budget.
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kineneb Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 02:29 AM
Response to Original message
11. Share-of-Cost per month:$285. Income: $1200/mo.
I have to use California's program for the rural, medically-indgent poor, called County Medical Services Program (CMSP). The program has a top income of $934/mo., a sum which has not been adjusted for 10 years; coverage only kicks in after spending the share of cost. Many facilities will not even accept the program coverage, so I have to hope they have a sliding scale.

Uh, no, I do not go to the doctor very often. And now I am on the free medications programs from the drug companies, or I could not afford my medicines.

Hubby qualifies for Medicaid and Medicare because he is disabled. But I do not qualify for either.
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radfringe Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 05:26 AM
Response to Original message
12. healthcare VS health insurance plans
not necessarily the same thing.

many countries have "free healthcare", it's paid for by the government through taxes paid by it's citizens

the majority of those who do have health insurance are paying for it out of their pockets, payroll deduction co-pay or paying for the whole thing directly. even medicare/medicade requires a "deduction" or 'co-pay' in some circumstances

of the plans I've seen - health insurance companies are still in the loop. this doesn't mean HEALTH CARE will improve, just means the money goes through an additional set of hands before being deposited in an insurance company's bank account.

all I'm saying is when we talk about or ask politicians about HEALTH issues, we need to make a distinction between health CARE and health INSURANCE

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madmom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:35 AM
Response to Reply #12
17. EXACTLY..get the insurance lobby out of the equation!
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wolfgangmo Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:57 PM
Response to Reply #17
28. Insurance ....
Companies need to be made illegal. The practice of Insurury needs to be illegal. We need a law that makes it legal to shoot at insurance executives and salespeople.

Put insurance back in the hands of honest bookies, where it belongs.
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fencesitter Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:11 AM
Response to Original message
14. Yup, me too.
I have insurance, but in order to afford the premium I have had to accept higher and higher co-pays. I'm up to a $2000. annual deductable and a 80/20 split to the first 15,000. So, if I use my insurance, it will cost me 7000.00. Of course this means if the doc sends me for tests, I can't afford to go 'cause I would have to pay for them. I have no prescription plan either.
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:15 AM
Response to Original message
15. Yep.
I pay my portion of the premium for the plan offered by my employer every month.

I didn't use it at all for 3 years, because of the copays.

Last summer I dutifully made the appointments, and made the rounds.

I stopped $1500 later, and never did get the routine female health checks I've done without for 5 years now.

I am doing without the prescribed meds for a newly diagnosed condition, because I can't keep up the $125 they are costing me every month.

And I supposedly have the "good" insurance; at least, that's what they told me when I handed over the insurance card last summer.
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Le Taz Hot Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 09:27 AM
Response to Reply #15
18. Re; Your 'scripts.
The dreaded Wal Mart (as much as I hate to say this), has a list of prescriptions for $4.00. Yes, I know it's predatory and yes I understand that as soon as they get their hooks on enough people who have changed over their prescriptions they will raise the price, BUT, you might want to see if your meds are on that list. My Albuterol was (when I was, again, uninsured) and it was literally a life-saver.
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:38 PM
Response to Reply #18
26. They're not.
But thanks for the suggestion; it was worth a try, anyway.

:hi:
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madokie Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 08:22 AM
Response to Original message
16. it used to cost 20 bucks or so to go to the dr without insurance now with insurance the copay is 20
bucks so how is it we are better off now with insurance. It looks to me like the only thing that is different is now the insurance companies are making a real killing rather that just making a killing. All I can say is I just think my lucky stars that I have the VA which I can proudly say I did not use until my 54th birthday when I was hospitalized for a week with a DVT in my left leg. It still cost us 1068 bucks for that 6+ days co-pay.
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jhain Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 11:19 AM
Response to Original message
21. self employed here. Premiums more than my mortage
which means I also can not afford the co-pays/ meds/

Sorry, kids- we can't go to the dr because we have to pay the health insurance premium.

BTDT.
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Lorien Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 11:33 AM
Response to Original message
22. Here too as well
with a $5,000 deductible, I'm not covered for much unless I need something major. :-(
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Neshanic Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 11:37 AM
Response to Original message
23. Same here. Talk to your doctor, mine is pretty good about taking the copays later.
You may be surprised. Also ask about getting sample packs of the drugs you are taking. It helps.
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cutlassmama Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Feb-04-08 01:05 PM
Response to Original message
24. I'm on 22 meds (took myself off one). The co-pays for all these
together literally eats my lunch. I pay between $300-$400 a month. I know that seems comparably small, but I'm on SSDI which we all know is below poverty line. Since I'm also on disability retirement from my employer, I have to use their prescription plan instead of Medicare Part D. Anyway, the co-pays are killing me. If I didn't need the meds to stay alive, I wouldn't take any of them.
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