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What good is this health insurance with no copays? - Pollyanna

Posted: Jan 30, 2014

My portion of a routine office visit is $160! R U serious? No copays with this insurance plan. Why have the insurance. With this income level who can afford to darken the door of a doctor's office?

My portion of the bill for 1 week in the hospital - sm

[ In Reply To ..]
is $78,000. That's just for hospitalization. My "insurance" paid $2000 toward the $80,000 bill. I did not even have a surgery. The 7 days were spent in a regular hospital room, not ICU or anything. In addition, I owe about $6000 for the doctors and labs and imaging. Good thing I had insurance, huh?

Edited: Sorry - forgot to say I do not work for Nuance, but it looks like my company offers equally wonderful medical insurance.

WOW! Was this in 2014? - sm

[ In Reply To ..]
If I'm correct, our insurance at Nuance has no co-pay, but a $2500 deductible and then 80/20 (or 75/25) coverage (I forget which one). It doesn't sound as if you have that type of plan? If not, do you have Obamacare or something else? At any rate, my heart breaks for you. I am so sorry, and I certainly hope you are physically better.

Not the OP but. . . - sm

[ In Reply To ..]
I have the $2500 deductible and while I get a "discount" for using in-network providers, it is around $100 for me to go to the doctor. You cannot get obama care if you are offered a valid health plan by your employer and what we have is considered a valid plan. They saw something on my mammogram and I ended up paying $800 for an US and read by a radiologist. I had another bad month where I racked up $800 in charges for seeing an ophthalmologist (not for eye glasses or anything) and an ortho. It costs me $117 for a 15-min med check with my psychiatrist.

Insurance - OP

[ In Reply To ..]
Yes, I'm better now. Thanks for asking!

I have an indemnity plan through my employer. It only pays a set amount a year for some services, but it is extremely poor coverage. For instance, while I was in the hospital, the plan paid zero for in-hospital doctor visits. This does not make sense to me. Another example of the coverage is it only pays $50 a year for an annual screening mammogram. I actually qualified for a free mammogram through my county's health department because I'm so underinsured that, in their view, I'm as good as uninsured.

contact anyone and everyone - Shocked

[ In Reply To ..]
including the TV news consumer advocate in your area about your ridiculous bill and make the hospital justify the bill. $11,428 a day, w/o surgery??? Whose yacht did you just pay for?

Insurance - anon

[ In Reply To ..]
When I signed up for insurance, which is why I have been going through this heck, I realized it is cheaper to buy a policy outside of the company. I have to pay $10000 in premiums and deductibles before I get one benefit. Buying a plan on my own is cheaper and I have a co-pay for office visits, plus I can make more per hour.

Insurance companies are right up there with MTSOs - when it comes to scamming people. (nm)

[ In Reply To ..]

Again the dislike - who dislikes this?

[ In Reply To ..]
What, you think that is good and fair, having no co-pays?

I live for the day when all these garbage "grandfathered" plans are out the door and we can go through the exchanges. Anyone know if/when that will happen?

I've said it before and I will say it again: These high deductible, low premium policies are fine for well off people who can actually come up with the dough if they need to, but for the likes of us on the current starvation wages any MTSO offers these days, all they are is an incentive to NEVER go to the doctor at all.

Thanks, Nuance, for caring so much about your employees you are actually ENCOURAGING them to NOT take care of themselves.

The free physical and free mammogram are worth nothing because what happens if something is wrong? Then you are on the hook for the cost of going to the specialist and x-rays and anything else you need and who can afford thousands like that?

These plans stink.

New hire questions - Rags

[ In Reply To ..]
I'm still within my first 90 days of date of hire. I haven't even looked into insurance. I have had no medical insurance for the past year as I was unemployed and forced to take this job. (My unemployment benefits ran out. Should have gotten the Federal extension, but they discontinued that as of December 2013.) My last two jobs since 2012 paid around $30 an hour, not in transcription mind you, but I was laid off from both of them for lack of work in this economy.) Am I to believe that now that I am working in "a job" albeit for pennies, that I am stuck with the Nuance insurance? That I have no choice to shop around for what I can afford, if anything?

They have two I think, the low prem/high deduc - and the HMO

[ In Reply To ..]
Frankly, both of them were prohibitively expensive to my mind, the low premium one because you are pretty much literally better off with nothing, the other one had very high premiums. I used to gladly pay higher premiums for more inclusive coverage, but I used to make good money. Now they have screwed the pay down to near minimum wage, how can they expect us to pay premiums that are half or more of our pay?

Had my husband not gotten reasonable insurance through his job I think we might have gone uninsured simply because we just cannot afford it and paid the penalties.

This is why I wish they would let everyone participate in the ACA. I think if your health insurance through your company costs more than 9.5% of your salary you can go with the exchanges, but they get around that by offering that low premium one.

Every time I check ehealthinsurance and calculate the subsidies, any policy seems much more inclusive and far cheaper than any of these grandfathered policies, even good ones like my husband's.

The Nuance ones seem exactly like the ones last year, so I am puzzled if they comply with the ACA or they don't have to yet because of the grandfathering, because the ones I see available through the exchanges seem better both in cost and coverage.

When people say they get private insurance, I tried that once and those policies seemed to be full of holes as well, but some on here do seem to think they are okay, so maybe I just had some bad ones? They never stop hounding you with phone calls either.

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