TOTALLY GEEKED!

Members Login
Username 
 
Password 
    Remember Me  
Post Info TOPIC: Stupid health insurance


On the bright side...... Christmas is coming! (Mod)

Status: Offline
Posts: 27192
Date:
Stupid health insurance
Permalink  
 


So I have a recurring prescription I fill every month that has always been covered under my plan at 100%.  Today I go to pick it up and they tell me it's $99 because I haven't met my deductible, yet.  WTH?  It's OCTOBER.  I've been filling it every month w/o having to pay.  So I call and they me that a generic for my medication is now available, so they will cover the generic at 100%, but if I want to stick with the name brand, I have to meet my deductible and pay a co-pay after that.  So, I tell the pharmacist to give me the generic and she says...."there is no generic for this drug in our system".  It's Walgreens.  How are they not going to have the drug in their system.  So I call back my insurance company and she tells me it just got approved THIS MONTH.   So I tell her to switch me over to the Humana pharmacy line - I'll order it through them.  Guess what?  They don't have it, either - it doesn't even show available to order, yet.  NOBODY has been able to get it, yet, and my insurance company will only pay for the drug that is not available.  Grrrrrrr.  

Stupid insurance company.  I'll check with my doctor in the morning to see if he has samples to carry me through until the generic is actually available, or I'll raise hell with the insurance company.  AND I'm going to complain to the insurance commissioner. 



__________________

LawyerLady

 

I can explain it to you, but I can't understand it for you. 



Owl drink to that!

Status: Offline
Posts: 4799
Date:
Permalink  
 

A very similar thing has happened to me with my pills and I feel your frustration!

__________________

Was it a bad day?

Or was it a bad five minutes that you milked all day?



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

It's happening to a whole lot of people.

I have a cousin who has to take anti rejection meds, same runaround.

__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Great cook-happy wife-superb fisherman

Status: Offline
Posts: 4846
Date:
Permalink  
 



Same thing here. A tiny tiny tiny bottle of eye drops for
my glaucoma AFTER Humana insurance is $96! The vial
will last me only about one month (both eyes), so I'll
have to pay $96 every stupid month! And there is no
generic! What do they want to have happen? Go blind?



__________________
I love helping people


Great cook-happy wife-superb fisherman

Status: Offline
Posts: 4846
Date:
Permalink  
 



And its another $99 for a two-pack of Epi-pens. What would
the insurance companies rather pay? Epi-pens? Or ER plus
two days ICU plus another day in a regular hospital room?



__________________
I love helping people


My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

Weeding out the sick.

I have Humana, too.

So far I can still get my meds, but it's going up every year.



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Guru

Status: Offline
Posts: 3029
Date:
Permalink  
 

Wasn't Obamacare supposed to fix all of this?

*please don't throw things at me*

__________________


Rib-it! Rrrib-it!

Status: Offline
Posts: 24026
Date:
Permalink  
 

Why is everyone paying for epi pens? You know you can get a coupon to cover the copay.

__________________


“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!”
Maya Angelou



Frozen Sucks!

Status: Offline
Posts: 24384
Date:
Permalink  
 

The issue here is the insurance company changing their tiered system throughout the plan year. Mine had been doing that too. We are all screwed and it is the the result of the ACA. Companies can no longer charge what a service or product actually costs, they have to make up for losses on other items.

__________________

Sometimes you're the windshield, and sometimes you're the bug.

Frozen is the bestest movie ever, NOT!



Nothing's Impossible

Status: Offline
Posts: 16913
Date:
Permalink  
 

I gave in and changed drugs so i could have one that came in generic form. I was having nightmares at refill time due to the hassle.

__________________

A person's a person no matter how small.



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

I know what to do_sometimes wrote:

The issue here is the insurance company changing their tiered system throughout the plan year. Mine had been doing that too. We are all screwed and it is the the result of the ACA. Companies can no longer charge what a service or product actually costs, they have to make up for losses on other items.


 Yep.

My question is, Trump has said he would over turn ACA, but can that even be done at this point?

This is why private business should stay private and not made mandatory by law.



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Give Me Grand's!

Status: Offline
Posts: 13802
Date:
Permalink  
 

And remember, your premiums will increase 25% next year. All due to insurance companies dropping out of the ACA.

LL, we are having the same problems. Sigh

__________________

I drink coffee so I don't kill you.

I quilt so I don't kill you.

Do you see a theme?

Faith isn't something that keeps bad things from happening. Faith is what helps us get through bad things when they do happen.



On the bright side...... Christmas is coming! (Mod)

Status: Offline
Posts: 27192
Date:
Permalink  
 

lilyofcourse wrote:
I know what to do_sometimes wrote:

The issue here is the insurance company changing their tiered system throughout the plan year. Mine had been doing that too. We are all screwed and it is the the result of the ACA. Companies can no longer charge what a service or product actually costs, they have to make up for losses on other items.


 Yep.

My question is, Trump has said he would over turn ACA, but can that even be done at this point?

This is why private business should stay private and not made mandatory by law.


 He said he would repeal it and replace it with a more suitable law.  Whatever that means.



__________________

LawyerLady

 

I can explain it to you, but I can't understand it for you. 



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

I'd like to see some of his plans. So far, it's all been just talk.



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Guru

Status: Offline
Posts: 2643
Date:
Permalink  
 

Hypothetically, I will gladly ship my unopened box of Epi pens that expire in January (I think) to a peep in need. I just need an address. I never even opened to read the instructions.

__________________

Life is short.  Live it to the fullest.



Frozen Sucks!

Status: Offline
Posts: 24384
Date:
Permalink  
 

lilyofcourse wrote:

I'd like to see some of his plans. So far, it's all been just talk.


 Well at least he will try. Any reform is going to take a long while to implement. If Hillary gets in, she will finalize the intent and turn it into a government run system.



__________________

Sometimes you're the windshield, and sometimes you're the bug.

Frozen is the bestest movie ever, NOT!



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

I know what to do_sometimes wrote:
lilyofcourse wrote:

I'd like to see some of his plans. So far, it's all been just talk.


 Well at least he will try. Any reform is going to take a long while to implement. If Hillary gets in, she will finalize the intent and turn it into a government run system.


 I'm for Trump.

But I have serious doubts about him, too.

I don't believe he is going to do as much as people would like to think.

I think he is a lot of hot air.

He isn't presenting any real plans.

Honestly, I'm wondering if we are missing something important and being distracted with the smoke and mirrors.

 

 



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

And it's already a government run system.

__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Frozen Sucks!

Status: Offline
Posts: 24384
Date:
Permalink  
 

lilyofcourse wrote:

And it's already a government run system.


 At least the doctor's and nurses are privately employed.



__________________

Sometimes you're the windshield, and sometimes you're the bug.

Frozen is the bestest movie ever, NOT!



Hooker

Status: Offline
Posts: 12666
Date:
Permalink  
 

As long as we keep a Republican House and Senate, it doesn't matter if the beyotch wins. They will thwart her at every turn. Obama has accomplished VERY little since losing the House and Senate.
And they would still have to approve her nominees for SCOTUS. She's going to be forced to pick moderate judges.

__________________

America guarantees equal opportunity, not equal outcome...



Rib-it! Rrrib-it!

Status: Offline
Posts: 24026
Date:
Permalink  
 

jlbear71 wrote:

Hypothetically, I will gladly ship my unopened box of Epi pens that expire in January (I think) to a peep in need. I just need an address. I never even opened to read the instructions.


 I have about twenty of them.  Hypothetically, I would do the same.



__________________


“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!”
Maya Angelou



Owl drink to that!

Status: Offline
Posts: 4799
Date:
Permalink  
 

I take some pills that cost me about 150 a month after insurance. Finally they came out with a generic version but the cost hasn't gone down because it's so new. In fact, with the name brand I was able to use a coupon to get a discount but now I can't even use that because of the new generic option. So now I'm really *&$@%#

__________________

Was it a bad day?

Or was it a bad five minutes that you milked all day?



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

I know what to do_sometimes wrote:
lilyofcourse wrote:

And it's already a government run system.


 At least the doctor's and nurses are privately employed.


evileye Or are they...dundundunnnn evileye



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Guru

Status: Offline
Posts: 10458
Date:
Permalink  
 

Ugh, trying to switch my insurance now. Misery.

__________________


Member

Status: Offline
Posts: 198
Date:
Permalink  
 

In my state there is one specialist for something covered under ACA. It's over 4 hours from where we live. They have accepted no new patients when ACA was enacted and the people have on that waiting list since will never be seen. There is rumor the specialist will not be covered next year. What are the patients supposed to do now?

__________________


Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

lilyofcourse wrote:
I know what to do_sometimes wrote:
lilyofcourse wrote:

I'd like to see some of his plans. So far, it's all been just talk.


 Well at least he will try. Any reform is going to take a long while to implement. If Hillary gets in, she will finalize the intent and turn it into a government run system.


 I'm for Trump.

But I have serious doubts about him, too.

I don't believe he is going to do as much as people would like to think.

I think he is a lot of hot air.

He isn't presenting any real plans.

Honestly, I'm wondering if we are missing something important and being distracted with the smoke and mirrors.

 

 


 Well some of us have been saying that exact same thing for months and we were shushed. I think that's exactly what's happening. He is all vague generalities and no actual plans. Not saying that I approve of the alternative, but I think a lot of people are just following Trump without asking the questions you are asking. 



__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

just Czech wrote:

And remember, your premiums will increase 25% next year. All due to insurance companies dropping out of the ACA.

LL, we are having the same problems. Sigh


 Depends on what state you live in. Indiana's costs are going down by 3%. 



__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

Mellow Momma wrote:
lilyofcourse wrote:
I know what to do_sometimes wrote:
lilyofcourse wrote:

I'd like to see some of his plans. So far, it's all been just talk.


 Well at least he will try. Any reform is going to take a long while to implement. If Hillary gets in, she will finalize the intent and turn it into a government run system.


 I'm for Trump.

But I have serious doubts about him, too.

I don't believe he is going to do as much as people would like to think.

I think he is a lot of hot air.

He isn't presenting any real plans.

Honestly, I'm wondering if we are missing something important and being distracted with the smoke and mirrors.

 

 


 Well some of us have been saying that exact same thing for months and we were shushed. I think that's exactly what's happening. He is all vague generalities and no actual plans. Not saying that I approve of the alternative, but I think a lot of people are just following Trump without asking the questions you are asking. 


 Still rather have Trump doing nothing than Hillary doing anything.



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

That's the thing...he won't be doing nothing. He will be causing chaos. He doesn't do nothing.

__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

So do you think Hillary would be better?

Why?



__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



Guru

Status: Offline
Posts: 9186
Date:
Permalink  
 

I was just talking to a woman who has been real sick. Because she is working and still can't afford insurance she is having a tough time paying her medical bills. She is not impressed at all with obamacare. She can't afford insurance.

__________________


My spirit animal is a pink flamingo.

Status: Offline
Posts: 38325
Date:
Permalink  
 

Neither of my kids can afford it.

But if they don't have it, they get fined.

So, we have to go through a long process of proving they can't afford it and they don't qualify for any help of any kind to get a letter so they can avoid the fine.

It's ridiculous.

__________________

A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.



On the bright side...... Christmas is coming! (Mod)

Status: Offline
Posts: 27192
Date:
Permalink  
 

Mellow Momma wrote:
just Czech wrote:

And remember, your premiums will increase 25% next year. All due to insurance companies dropping out of the ACA.

LL, we are having the same problems. Sigh


 Depends on what state you live in. Indiana's costs are going down by 3%. 


 Ummm, where are you getting that?

 

 

From the Indiana Business Journal - 

 

Individual health insurance costs are expected to climb across Indiana in 2017 as insurers continue to grapple with rising health care expenses and a market that was only recently overhauled by the federal Affordable Care Act.

Many who purchase coverage through insurance exchanges created under the law are eligible for subsidies or tax credits to offset rising costs. But those who make too much money to qualify for federal help will have to pay the full price of coverage—an amount that could nearly double in some cases. That could spell a steep increase for a group of consumers that can include small-business owners who haven't set up coverage through work, early retirees, and people who can't get coverage through a spouse's employer.

Anthem, one of Indiana's largest insurers, is seeking premium hikes ranging from nearly 20 percent to 41 percent for coverage it sells on and off the Affordable Care Act's public insurance exchanges. That would mean an average increase of about 29 percent, under a rate request the state's Department of Insurance has until Aug. 23 to approve.

The company covers fewer than 100,000 people with individual insurance plans sold both on and off the exchange in Indiana, spokesman Tony Felts said. That's a small part of the company's 3.5 million customers statewide, many of whom get insurance through their employer.

Felts said Anthem is seeking the premium hikes mainly due to factors not unique to Indiana: people are using more medical services; drug costs, especially for specialty medicines, have climbed; and an ACA reinsurance provision that helped insurers pay for large claims is going away.

Other insurers—including IU Health Plans, Care Source Indiana and MDwise Marketplace—are seeking smaller average increases that range from about 10 percent to about 15 percent. Physicians Health Plan of Northern Indiana, a small insurer, is seeking a 25 percent average rate increase.

Jonathan Mayo, a broker for Gregory & Appel in Indianapolis, is worried about the premiums some of his customers may see for 2017.

"I think it's going to be ugly," he said.

 

Industry watchers say one reason for the increases is that temporary government programs designed to provide financial support to insurers are ending. On top of that, some insurers have pulled out of Indiana, reducing competition that can help keep premiums down. Others underpriced their plans in an attempt to capture market share, or failed to accurately anticipate the needs of their customer base.

"If somebody is coming to you with a 40 percent rate increase. ... usually it suggests the previous rates were underpriced or there was significant shift of people that caused those rates to be shifted," said David Axene, an insurance industry consultant, who added: "In trying to anticipate the future ... sometimes you come in low."

Health insurers have faced several challenges in building their exchange business. Their initial wave of customers generated higher-than-normal claims in part because some of the uninsured had not used the health care system for years and were waiting for coverage to help pay for needed care.

Insurers also have struggled in many markets to add younger consumers who don't use as much health care and could balance those more expensive patients. Insurers say they also have been hurt by expensive patients who sign up outside regular enrollment windows and later drop coverage after they have received care.

Axene said it's most important to focus on what an insurance plan costs, as opposed to the percentage a premium increases in a given year.

Contrasted with some other states, Indiana consumers are making out comparatively well.

A recent analysis of nine states by the consulting firm Avalere Health found that Indiana's average anticipated premium increases were on the low end. The most popular type of plan is expected to increase by about 6 percent for a 50-year-old male who is a non-smoker. Other mid-to-low range plans are expected to cost roughly the same or even decrease a fraction.



__________________

LawyerLady

 

I can explain it to you, but I can't understand it for you. 



On the bright side...... Christmas is coming! (Mod)

Status: Offline
Posts: 27192
Date:
Permalink  
 

Mellow Momma wrote:

That's the thing...he won't be doing nothing. He will be causing chaos. He doesn't do nothing.


 No, he won't.  He'll do what he does - he'll hire competent people to do the jobs that need doing.  You know, rather than Hillary doling those positions out to people she owes, whether she is qualified or not.

Hillary is bought and paid for.  Trump is not.  



__________________

LawyerLady

 

I can explain it to you, but I can't understand it for you. 



Guru

Status: Offline
Posts: 9186
Date:
Permalink  
 

Lawyerlady wrote:
Mellow Momma wrote:

That's the thing...he won't be doing nothing. He will be causing chaos. He doesn't do nothing.


 No, he won't.  He'll do what he does - he'll hire competent people to do the jobs that need doing.  You know, rather than Hillary doling those positions out to people she owes, whether she is qualified or not.

Hillary is bought and paid for.  Trump is not.  


 Obama  care is a failure, it is collapsing  as we speak.  Hillary  called Obama care hillary  care and it will be more of the same under her. 



__________________


Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

This morning on the news it showed the rates for the top increasing states and it showed that Indiana was decreasing by 3%. I don't recall the source of their info, I was getting ready for work, but it distinctly said that not every state was going to have an increase in rates on their exchange plans. Some states were flat and some were decreasing. I will try and find the source.

__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

kff.org/health-reform/issue-brief/2017-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/


This shows Indiana's premiums are actually down 4% from the previous year.

__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



Sniff...sniff, sniff. Yay! A Bum!

Status: Offline
Posts: 7536
Date:
Permalink  
 

That chart clearly shows that some states have a HUGE increase and some have a nominal increase or even a decrease. It all depends on how well the insurance companies predicted the average age and medical need of the population in the state that was uninsured and would sign up. If the insurance company predicted poorly they need to raise their rates to compensate for it. If they predicted well, they don't need to.

__________________

Out of all the lies I have told, "just kidding" is my favorite ! 



On the bright side...... Christmas is coming! (Mod)

Status: Offline
Posts: 27192
Date:
Permalink  
 

Mellow Momma wrote:

That chart clearly shows that some states have a HUGE increase and some have a nominal increase or even a decrease. It all depends on how well the insurance companies predicted the average age and medical need of the population in the state that was uninsured and would sign up. If the insurance company predicted poorly they need to raise their rates to compensate for it. If they predicted well, they don't need to.


 You are looking only at the Obamacare silver plan before subsidies.   If you look at the comment you quoted, she was talking about insurance premiums in general.  They are going UP A LOT and it's a direct result of having to deal with the ACA and its myriad issues. 



__________________

LawyerLady

 

I can explain it to you, but I can't understand it for you. 

FNW


Guru

Status: Offline
Posts: 18703
Date:
Permalink  
 

My premiums have doubled since ACA was passed.

__________________

#it's5o'clocksomewhere

Page 1 of 1  sorted by
 
Quick Reply

Please log in to post quick replies.



Create your own FREE Forum
Report Abuse
Powered by ActiveBoard