What is this "good insurance" of which you speak?

[TygrBright]

And how do you know you have it?

Seriously.

I'm getting more than a little curious about the people who are worried about protecting their "good insurance."

Because I know a lot of people who have insurance. And not one of them has "good" insurance.

"Good" insurance doesn't cost more per month than the payment on a top-of-the-line Mercedes sedan.

"Good" insurance doesn't force small businesses to decide between keeping all their employees and continuing to pay for the employees' insurance.

"Good" insurance doesn't let you think that you are covered, and then wave fine print under your nose that justifies them shuffling off huge bills onto your already-bowed shoulders.

"Good" insurance doesn't force you to stop, in the middle of a scary and possibly life-threatening emergency, to determine whether you can afford the ambulance, or whether you have to go to this OTHER hospital, rather than the one nearest or best for your needs.

"Good" insurance doesn't make your doctor waste painful and enraging hours on the phone arguing about why you need the procedure he recommends.

"Good" insurance doesn't make you drive to the next town to see an "in network" specialist when there is a perfectly competent specialist in your own town.

"Good" insurance doesn't carefully exclude your most expensive medications from its prescription coverage, and make you get every exception re-authorized every thirty days, requiring extra phone calls and faxes and attempts to reach your doctor's prescription authorization line.

"Good" insurance doesn't refuse coverage to your baby who is born with an expensive-to-treat congenital condition.

"Good" insurance doesn't require the hospital to kick you out one day after your mastectomy.

"Good" insurance doesn't inform you that the doctor who has treated you and your family for the last ten years and who knows all about you and has your trust is 'no longer on the preferred provider list' and you have to pick a new physician and get all your records transferred.

"Good" insurance doesn't exclude your oxygen cart, wheelchair, or other medically necessary devices and technology from coverage, or make you buy them through a provider three hours away who doesn't have them in stock and will take two weeks to get them.

"Good" insurance doesn't limit coverage of hospice and respite service for your spouse dying at home to one hour three times a week.

So. Who's got "good" insurance, anyway?

And if you don't have "good" insurance, if you just have the same old crappy, expensive, pecksniffing, greedy shitheads that the rest of us have, why are you interested in "protecting" it?

curiously,
Bright

[asdjrocky]

1. This is good stuff.

If my computer didn't have a bug that won't let me rec, I'd be the first rec for sure. Can someone rec this for me?

[Lars39]

2. Excellent, TygrBright.

[valerief]

3. I'd like to find out which insurance company rejects legit claims the least. That's what I want if I

can't have govt healthcare.

[laughingliberal]

7. I changed providers quite a bit when I was working

As I changed jobs every couple of years or so. Truthfully, even the ones I thought were 'good' eventually started playing the game of claims delays and denials forcing me to spend my time fighting.

[valerief]

11. Alas, I figured such an insurance company was a myth, too. nt

[Bette Noir]

15. Aetna, at 6%denials. I don't remember who was worst, but Kaiser was way up there.

Sorry I don't have the table for you; I heard it on the radio this morning.

[valerief]

20. Thank you!!!!! Good to know. Now I have to see if Aetna is an employer option. nt

[laughingliberal]

4. Great post! n/t

[robcon]

5. I've got good insurance. Aetna.

n/t

[moriah]

12. I've got the Choice POS II from them.... I am happy.

Even if the name makes it sound like it's awful, it's not.

$75 copay for MRI or CTs
$20 office visit copay
$40 specialist copay

The prescription coverage is actually through UHC, and for my most expensive medicine (Advair) I could buy the same thing from Canada and save about $75 every six months. (What does that say about the drug companies, eh?) But they cover it without question.

[robcon]

16. I have different copays

$25 primary physician
$35 specialist

They turned down one of my office visits, but accepted it after a phone call straightened out the paperwork.

[tammywammy]

37. I have Aetna too

No copays, you pay a percentage of the reduced insurance cost, but the company picks up the bulk of that on it's own. No copay for any preventative visit. I pay 10% of the cost on generic pills, my antibiotics I filled on Wednesday were $0.51.

[elocs]

6. "Good" insurance is generally the insurance that people have never had to use,

so they are under the delusion that their insurance is "good".

[Junkdrawer]

10. Or, most commonly, they've only used it lightly...

a broken arm, regular exams...

[elocs]

13. I have to admit that 8th grade football physicals were more like an actual physical

than the physical exams I have had lately. I had one last week and I didn't even have to take any of my clothes off. How is that possible? Besides, with insurance I have had there was no charge for an annual physical.

[Junkdrawer]

8. Heath Care Reform = Making everyone buy "Good" insurance...

That'll fix everything. Right?

[Carl Skan]

9. You can like your current insurance and still be in favor of a public option.

I'm not sure why people feel the need to turn the insurance industry into a demon.

[Bette Noir]

18. Because we've been denied care when we've been sick?

Because they won't pay for my allergy meds, but the CEO makes $100,000/hour? Because a self-employed friend pays over $20,000/year for coverage, and still had to pay several thousand $$ out-of-pocket when he spent a few days in the hospital?

Because an insurance company rep once told me, "He'd better be dead by Monday," about a 17-year-old kid on hospice?

[Dragonfli]

21. They killed my wife, that good enough for you or was she just a Pony I had no right wanting?

If you don't think they are villains then you have never had to pay for their champagne profits while they turn around and screw you out of medical care.

It is not our fault if you are naive.

[area51]

23. I'm so sorry, Dragonfli. (n/t)

[Dragonfli]

31. As am I - there is a reason this is a personal issue for me besides a moral imperative.

I have just been told I am part of the problem for telling the truth.
I was just equated with tea-baggers because I don't like how the IC death boards have permanently harmed my family.

My wife is "rhetoric" I am told.

If you had not posted as well to remind me there are still human beings around, my laptop would have just been launched through a window.

So thank you.

[Carl Skan]

29. I'm sorry for your loss but that's exactly the rhetoric I'm talking about

They didn't kill your wife, whatever the disease was killed her.

But hey, if I'm not a tea bagger disrupting public meetings or I don't call all insurance companies murderers I must be naive. I'm sick of people who are so wrapped up in their hatred that they have to insult people who haven't lost their civility as if civlity is now something to be ashamed of.

[Dragonfli]

30. Actually they did asshole, they delayed a procedure for 3 months

In that time it changed from local to metastasized. They "allowed" the operation finally, but too late to matter. NOT THE CASE WHEN THE DENIAL STARTED.

The truth is a far cry from rhetoric spouted by tea-baggers. People do die from lack of care in this country. You are naive. Or employed to come here and tell us to "leave those nice IC's alone".

This is not "fair and balanced" where both sides are equal - There is truth beyond the fictitious center where unicorns and the DLC live.

To deny truth and imply that those that speak it are the other side of two extreme teabag positions is insulting.

Go fuck yourself.

[eridani]

32. Give us an example of an insurance company that makes your health a higher priority

--that its profits. Every health insurance company operates on the Enron model. Enron wanted to produce money, not energy, so they withheld it from the market to screw ratepayers. Health insurance companies likewise make money by denying care.

[Bozita]

14. Best post today! ... Recommended.

[Laelth]

17. It's the endowment effect.

Studies show that people seriously overvalue the things that they have.

Those who have insurance now value it far too highly. Generally, it's too expensive and doesn't pay when you need it.

But it's hard to get people to believe this due to the endowment effect.

http://en.wikipedia.org/wiki/Endowment_effect



-Laelth

[miyazaki]

19. thats intersting. thanks for that link.

it certainly applies to so many things.

[eridani]

33. I think it's the fact that most people don't get expensively sick, and therefore

--don't have a clue how good their insurance is.

[Fire_Medic_Dave]

22. Apparently I have good insurance.

[nightrain]

24. knr. And also from the practitioner side--

Good coverage means that your practitioner doesn't have to make multiple phone calls to the insurance corporation, being kept on hold for 10-20 minutes, or being transferred upteen times in order to verify benefits. Or to verify that counseling sessions can occur weekly or twice/week all year if need be.

Good coverage means that if the insurance corporation has questions about a practitioner's claim that they call the practitioner rather than deny it out of hand, and then delay and delay payment to the practitioner.

Good coverage might mean that if you need to spend more time with your therapist, that there's no problem billing for a longer session, that prior approvals are not needed.

Good coverage would mean that the practitioner wouldn't have to submit and resubmit "updates" after every 12 sessions, or that the practitioner was paid for that paperwork time.

Good coverage would mean that practitioners don't have to fill out different forms for each insurance corporation, but that there's a standard form, and that electronic billing is easy and available free.

Good coverage would mean that the corporations believe the practitioners and don't require silly "updates" to prove treatment is necessary.

Good coverage would include practitioners being able to bill for their time doing coordination of patient care with other practitioners.

And there's so much more....

[Jeff In Milwaukee]

25. I used to have good insurance....

It had low co-payments ($20 for a office visit)

It allowed me to go to the doctor of my choice.

It cost less that my montly parking pass. Seriously. $60 per month.

Of course, when I had it, I was working for the government....

[Jackpine Radical]

26. Any insurance is "good insurance" as long as you don't have occasion to use it.

I don't think most people have put their insurance to the test. They think it's god because somebody tells them it's "good" based on nominal features such as low co-pays, but they don't find out what they've really got until something bad--expensively bad--happens, and then they find out about all the exclusions and prior authorizations and other tricks the insurance company has in their hat for expensive clients.

[Brickbat]

27. We have good insurance, and always have.

The carpenters union in Minnesota collectively bargains how much of the wage/benefit package will go to an administrator to, well, administer the union's excellent insurance program. Employers don't administer it; a union-friendly company does. We have never had any problems covering anything. It covers hospice, hasn't excluded medications, and has covered everything we needed while we were under it. IIRC, $5/hour from the package went to health care. I could be wrong on that. Co-pays on prescriptions were $4. I never had to make a co-pay when I had a doctor's visit.

[paulsby]

28. i have GREAT insurance, and have posted specifics about it before

in regards to wait times for surgery (within 2 weeks of injury, with a phebnomenal orthopedic surgeon), that i got in to see my primary care on the first weekday , and got an MRI appointment for 45minutes after, that i got my MRI results the EVENING i took my MRI and was scheduled for a consult with the surgeon 2 days later. the insurance has covered all my physical therapy. it covers 60 therapy appointments a year, 30 chiro's and 60 massages. ALL free. it covered 90% but once i went over a $400max payout (for the entire year, that is the moset i pay out of pocket).

surgery : free
anesthesia: free
even my sling: free

medsL\:5-7 dollars a refill (actually w/ a different company than my primary insurance.)

right now, i have just been approved for disability insurance through my union's plan, since i can't return to work for a few months. i will be taking home MORE with the disability than i did with my work (but i did put 1k a month into a deferred comp while at work).

both my primary insurance company AND my disability insurance company promptly respond to questions. my insurance company's website is available and i can easily search for specialists (even when on vacation in different cities),etc.

i fucking LOVE my insurance.

and yes, i support universal healthcare. but my insurance is wonderful. fwiw, it costs my employer about 900/month.

fwiw, they also cover my family w/ the same coverage.

my insurance is AETNA

i will give them props because they've been wonderful and FAIR people who are HONEST want to hear the good and the BAD. ideologues w/a bias only want to hear ONE side. regardless of the issue. it's a prejudice thang.

my prior companywas OK, but not GREAT. AETNA is great.

fwiw, my doctorand massage therapists also like AETNA. they say they are pretty transparent, and bill no muss no fuss and pay quickly.

[Stinky The Clown]

34. We hear you, Bright. We hear you!

KnR




edit to put in smaller image

[The Green Manalishi]

35. I have Kaiser

Good enough when I've needed it, including a few emergency hospitalizations, an outpatient operation or two and what is probably a 'normal' amount of routine stuff such as sports injuries.

Might or might not be good enough for seriously major stuff like heart transplant, but based on how I've been treated I think they have a good model.

The fact is that healthcare is *ALWAYS* gong to be rationed somehow. Either by insurance company bureaucrat, government bureaucrat or by what you can afford to pay.here's no magic wand to provide enough for everyone, it's only the mechanism that can be debated.

[Faryn Balyncd]

36. It's the insurane you THINK you have, when you think you've settled ina cherry-picked low risk group