The Swamp

Any of you guys in the insurance field or work close enough with HR in your work to advise me on a couple of quick questions regarding workplace health enrollment / ACA stuff?

BSF is quite confused.

I tried to PM you but my message got stuck in the Outbox. I may be able to help you; send me a PM and I'll give you my email address.

delivered. I PMed back. If you don't receive let me know.

Some of you may have followed along with my exciting rabies adventure on FB. LSS for everyone else: I got bit (mangled thumb) by a Boston fucking Terrier of unknown origin and had to get a post-exposure rabies vaccine. The ER is pretty much the only place you can go to get the initial series of shots, because the immunoglobulin needed to activate the vaccine is super-expensive or difficult to store or uncommon or something. Despite being assured by my provider that I would be fully covered (after a bit a bit of a scare when the looked up the pre-exposure vaccine and told me I wouldn't be covered) I've been sweating out the time waiting for the claim.

It finally came through, and the hospital billed my provider over $16K, of which they agreed to pay just over $5K, of which I'm responsible for $765, of which $665 went against my deductible (which my company covers via a HSA) so I'll be out out of pocket no more than $100. Phew.

That's a relief, but man - $16,000!

I got to open a hospital down there. Seems like easy money.

Was it clear my Facebook joke was about you trying to personally neuter neighborhood dogs?

mister d wrote: ↑Thu Mar 01, 2018 8:14 am Was it clear my Facebook joke was about you trying to personally neuter neighborhood dogs?

If you have to ask...

Pruitt wrote: ↑Thu Mar 01, 2018 8:12 am That's a relief, but man - $16,000!

I got to open a hospital down there. Seems like easy money.

Except the insurance immediately told them that was 11k too much.

A_B wrote: ↑Thu Mar 01, 2018 9:24 am

Pruitt wrote: ↑Thu Mar 01, 2018 8:12 am That's a relief, but man - $16,000!

I got to open a hospital down there. Seems like easy money.

Except the insurance immediately told them that was 11k too much.

That's a relief, but man - $5,000!

Seriously, is there any other business where they could lower the cost by 70% and still make a killing?

A_B wrote: ↑Thu Mar 01, 2018 9:24 am

Pruitt wrote: ↑Thu Mar 01, 2018 8:12 am That's a relief, but man - $16,000!

I got to open a hospital down there. Seems like easy money.

Except the insurance immediately told them that was 11k too much.

Imagine if you were some poor uninsured sap who tried to tell the hospital they were billing too much, and get them to lower the charge. Think that would work?

Fuck those Trumplidites who want to kill Obamacare.

sancarlos wrote: ↑Thu Mar 01, 2018 1:24 pm
Imagine if you were some poor uninsured sap who tried to tell the hospital they were billing too much, and get them to lower the charge. Think that would work?

Fuck those Trumplidites who want to kill Obamacare.

Actually, if you are uninsured, hospitals will always negotiate down bills. The system is insanely stupid. Insurance companies negotiate pricing individually with providers, so providers need to jack up the bill so insurance companies can make their customers think they are saving them a fortune. Plus when they treat indigent patients who can't pay, they can write off the losses, so this way they get bigger credits that work towards covering the unpaid bills.

Pruitt wrote:Seriously, is there any other business where they could lower the cost by 70% and still make a killing?I got to open a hospital down there. Seems like easy money.

In full disclosure, the hospital Rass went to is part of the system my wife works for. They are non-profit and rely heavily on donations. Unlike any other industry, hospitals are required to serve customers even when they know they won't get paid. If an uninsured person walks into the ER, and the hospital knows they have no ability to pay, they get the same treatment as everyone else. Part of the inflated prices is the need to cover costs for patients who can't afford to pay. Yet another problem in the US healthcare system that would be resolved by moving to a single payer system.

Ah. I didn't know that.

sancarlos wrote: ↑Thu Mar 01, 2018 1:24 pmImagine if you were some poor uninsured sap who tried to tell the hospital they were billing too much, and get them to lower the charge. Think that would work?

If you were a *poor* uninsured sap who tried to tell the hospital they were billing too much, you'd probably be able to negotiate down, since a bankruptcy filing wouldn't do the hospital any good.

BTW, my longtime Senator, the "Honorable" Orrin Hatch, announced today that people who suppored Obamacare were "dumbasses."

So I just called his office and reamed out the guy who had to answer the phone. I asked him why I was a dumbass for being glad my secretary won't lose health coverage when her pre-existing condition makes it impossible for her to work. I even pulled the "aren't we all supposed to be Christians?" card and asked why the Senator didn't think the suffering of millions was important.

Okay, maybe a little overboard. But fuck him.

Steve of phpBB wrote: ↑Thu Mar 01, 2018 5:14 pm

sancarlos wrote: ↑Thu Mar 01, 2018 1:24 pmImagine if you were some poor uninsured sap who tried to tell the hospital they were billing too much, and get them to lower the charge. Think that would work?

If you were a *poor* uninsured sap who tried to tell the hospital they were billing too much, you'd probably be able to negotiate down, since a bankruptcy filing wouldn't do the hospital any good.

BTW, my longtime Senator, the "Honorable" Orrin Hatch, announced today that people who suppored Obamacare were "dumbasses."

So I just called his office and reamed out the guy who had to answer the phone. I asked him why I was a dumbass for being glad my secretary won't lose health coverage when her pre-existing condition makes it impossible for her to work. I even pulled the "aren't we all supposed to be Christians?" card and asked why the Senator didn't think the suffering of millions was important.

Okay, maybe a little overboard. But fuck him.

Ordinarily I'd say it's wrong to take it out on the person answering phones, but he chose to work for Orrin Hatch, he deserves it.

In 6th grade I had to write a letter to a senator and I wrote to Orrin Hatch. Can't remember what the hell it was about.

P.D.X. wrote: ↑Fri Mar 02, 2018 5:20 pm In 6th grade I had to write a letter to a senator and I wrote to Orrin Hatch. Can't remember what the hell it was about.

Dear Senator Hatch,

Why did your parents give you such a stupid ass name? Do they still hate you?

Sincerely,

BoyBleu

duff wrote: ↑Fri Mar 02, 2018 7:07 pm

P.D.X. wrote: ↑Fri Mar 02, 2018 5:20 pm In 6th grade I had to write a letter to a senator and I wrote to Orrin Hatch. Can't remember what the hell it was about.

Dear Senator Hatch,

Why did your parents give you such a stupid ass name? Do they still hate you?

Sincerely,

BoyBleu

Just remembered naive LittleBoyBleu asked him to reintroduce wolves or protect them or something. Basically as effective.

Good news is I was offered a job, which I'm hoping to start in 2 weeks. Bad news is I have surgery on Thursday. My plan is to give my 2 weeks notice to the job I'm leaving on Monday, but I don't know if there is a risk my coverage for the surgery gets messed up. Anyone know anything about this and if there is anything I should do?

Your health insurance generally will last through the end of your termination month. Should probably check for sure though.

Maybe someone can explain this to me... My son's doctor gave him a prescription and told me that even with insurance it will likely be prohibitively expensive. He said if it's more than $30, don't pay for it, and he'll order it from a specialty pharmacy. Brought the script to CVS and after insurance it was $450 for a tube of ointment. Doctor called it in to the mail order pharmacy. They said my insurance won't pay them, but they can apply a coupon and send it for $35. WTF? I'm guessing it's some sort of manufacturers coupon, but this makes absolutely no sense. Curious what CVS would have charged someone without insurance.

Sounds like a GoodRx type of situation. I don't know how it works but it does on the one script I have that isn't covered. You could download the app and put the drug name in and it will tell you if they have a discount for it.

I bet it's Crisco

Ryan wrote: ↑Thu Jan 18, 2024 3:10 pmI bet it's Crisco

That should work wonders for acne.

He needs those star patches that are apparently cool to wear in public and I'm sure work really well.

A_B wrote: ↑Thu Jan 18, 2024 3:01 pm Sounds like a GoodRx type of situation. I don't know how it works but it does on the one script I have that isn't covered. You could download the app and put the drug name in and it will tell you if they have a discount for it.

You don't even need to download the app, their website will tell you. And it may not be the best deal, as my wife found out firsthand recently.