Health Insurance

[SpringmomTx281]

Can any one refer me to a good health insurance provider? I about had it with United Healthcare. Thanks

[FamilyGal]

Do you have choices through your work or are you seeking it on your own? I am very happy with Humana, but it is through my dh's employer.

My daughter and her husband also have Humana and pay out of pocket for it. ($1,500/mo for the three of them:eeek:!) She said the coverage is good though and has been happy with it.

[Wilson]

We used http://www.ehealthinsurance.com/ to shop around. We're currently with Aetna, through dh's company although they don't pick up any of our premiums. Don't forget to check here: http://www.twfg.net/

[Cook57]

Can any one refer me to a good health insurance provider? I about had it with United Healthcare. Thanks

The very ugly facts are the health insurance market for coverage purchased "outside employer or some other association or group" by the individual is really almost prohibitive Or very high deductible little coverage. Also they will make you "pay" for being "new" policyholder. To me premiums like $1200 plus per month are just unbearable and really I consider them a "rip-off".

This situation came about of course because years ago the government gave big incentives to companies to tie health insurance to employment, which it should NOT be connected with; because now many, many companies have stopped offering coverage.

So what to do? Try anyway possible to get coverage with a group/association/government agency. etc. For instance most associations (like Chamber of Commerce) have group coverage for members. Maybe you can join an association related to work (or not) just to get the coverage. Also check government County/State to know if some new "insurance plan" has started recently.

Of course you know this , but do everything you can to stay healthy. Our health care "situation" is scary.

[baby duck]

The very ugly facts are the health insurance market for coverage purchased "outside employer or some other association or group" by the individual is really almost prohibitive Or very high deductible little coverage. Also they will make you "pay" for being "new" policyholder. To me premiums like $1200 plus per month are just unbearable and really I consider them a "rip-off".

This situation came about of course because years ago the government gave big incentives to companies to tie health insurance to employment, which it should NOT be connected with; because now many, many companies have stopped offering coverage.

So what to do? Try anyway possible to get coverage with a group/association/government agency. etc. For instance most associations (like Chamber of Commerce) have group coverage for members. Maybe you can join an association related to work (or not) just to get the coverage. Also check government County/State to know if some new "insurance plan" has started recently.

Of course you know this , but do everything you can to stay healthy. Our health care "situation" is scary.

This is what we pay to cover me and Little Bit on the employer insurance!

Of course, it is a small company and he covers DH completely, which legally he doesn't have to do. I think the company is paying out the nose to cover DH, too.

Conroe ISD has gone the self-insured route for years, with an insurance company managing the account for them. The account always seems to be negative, and the rates per person goes up every year. I don't know what the answer is. . .

[msmichellemiller]

We're with Blue Cross Blue Shield thru my SO's company. Maybe you could check out their website (bcbstx.com) for what they have to offer individuals and what-not.
I like this 'flex account' thing we have where once a year we kick out a chunk of money and then we're issued this medical 'debit' card for all of our OTC purchases. We can also use it for co-pays and deductibles.

[mamaof2]

I have a friend that sells insurance and he has a low cost insurance plan that sounds good. You can call him and get more info on it, his info is below. We would look into it if hy husbands work did not offer insurance.

Larry Clark
Regional Manager
Office: 936-321-8959


I have the e-mail he sent us with some of the details and I can post it here if that is OK or if you are interested I can PM you the info.

[TripleA]

Wow - it is amazing what some people are having to pay! We cover the whole family through DH's work and it costs us $295 a month. It's the BCBS PPO through the University of Texas (DH works for MD Anderson), and we have been very happy with our coverage.

My SIL has coverage for her 2 kids through some company that offers plans for individuals. I think it starts with a "U", but I know it's not United Healthcare.

[msmichellemiller]

Wow - it is amazing what some people are having to pay! We cover the whole family through DH's work and it costs us $295 a month. It's the BCBS PPO
Yeah, that's what we have! After reading some of what the others pay, I think $295 is awesome.

[Cook57]

The very ugly facts are the health insurance market for coverage purchased "outside employer or some other association or group" by the individual is really almost prohibitive Or very high deductible little coverage. Also they will make you "pay" for being "new" policyholder. To me premiums like $1200 plus per month are just unbearable and really I consider them a "rip-off".

This situation came about of course because years ago the government gave big incentives to companies to tie health insurance to employment, which it should NOT be connected with; because now many, many companies have stopped offering coverage.

So what to do? Try anyway possible to get coverage with a group/association/government agency. etc. For instance most associations (like Chamber of Commerce) have group coverage for members. Maybe you can join an association related to work (or not) just to get the coverage. Also check government County/State to know if some new "insurance plan" has started recently.

Of course you know this , but do everything you can to stay healthy. Our health care "situation" is scary.

There is just one Very Important detail I forgot IF you purchase Individual, not group, insurance policy. Please read every word of the complete policy, Do Not rely on what the company and/or agent says, because when you have a claim you will be tied to what the "fine print" says, not what the salesman/company rep said.

Purchasing an individual policy puts much more stress and all the "investgative work" on you because Individual Health Policies are Not Standardized in Texas.

[baby duck]

Ditto what Cook said. We looked at individual for Little Bit and I. Unfortunately, we would have to purchase riders to cover "extra" things (like maternity). Since we knew we were having more, and we don't know what the future will bring with Little Bit, we decided this wasn't a very safe route for us.

[Cook57]

The City of Houston has new site for this. Their work putting it together revealed just how much of the problem the Insurance Companies are.

"Elena Marks, the mayor's director of health and environmental policy, said the swelling ranks of the uninsured are severely stressing local hospital emergency rooms and driving up medical costs for those with insurance.

Marks spent months with a team of researchers and actuaries who price health plans for insurance companies in the hopes of creating a new type of health plan.

Those experts said it was possible to create a health plan with good medical coverage at much lower prices than anything offered on the market today while still giving a healthy profit to insurance companies. Marks said the city solicited insurers, asking them to offer more affordable plans in Houston. Not one would do it."

ClickHereComparePlans (HoustonHealthChoice.com)


ClickHereArticle (http://www.chron.com/disp/story.mpl/headline/metro/5741246.html)

[baby duck]

That's my understanding as to why CISD is self-insured, also. No one wants to touch 'em.

[turtle]

Years ago, when my DH was doing independent contracting, we were so frustrated because we couldn't find individual insurance that covered materity. We have group coverage through his company now. (Not that we've needed maternity, but it's nice to be prepared, right?) :wink2: DH has his own company, and we now see how expensive it is for companies to offer insurance benefits to their employees. In a small company like his, just having one employee with a lot of health issues and claims really jacks up the cost for the company. A friend of ours had to shut down his business mostly for that reason. Anywaaays, it's just a shame it has to be so expensive. :ohno:

[baby duck]

I am so grateful that DH's employer provides insurance. I just did a quick count and I think that there is only 10 employees, so I know he doesn't have to. And besides DH (and me and Little Bit), I know that there are a couple of employees or dependents that have serious issues, so what he pays to keep us insured is ridiculous.

[amyalta]

Those who have employer cover are so lucky! We needed individual policy cover as DH will be self employed with no employees, and we were turned down by EVERY insurance company in Texas - DH because he has had Kidney Stones and suffers from Sleep Apnoea, and I because I have high BP, high cholesterol and I take HRT! Our only option turned out to be the Texas High Risk Pool, which is going to cost us - $18.848 a year, plus $6000 deductible!

Sure hope it's going to be worth it to move to Texas - we almost moved to Massachusetts because of this!

[Wilson]

Your situation sounds like my MILs. It's almost worth it to go to work at Starbucks or another company that offers benefits to p/t employees just for the health coverage. It sucks. I've considered it as well, just to get off my dh's employer coverage.

[amyalta]

Those who have employer cover are so lucky! We needed individual policy cover as DH will be self employed with no employees, and we were turned down by EVERY insurance company in Texas - DH because he has had Kidney Stones and suffers from Sleep Apnoea, and I because I have high BP, high cholesterol and I take HRT! Our only option turned out to be the Texas High Risk Pool, which is going to cost us - $18.848 a year, plus $6000 deductible!

Sure hope it's going to be worth it to move to Texas - we almost moved to Massachusetts because of this!

[amyalta]

Those who have employer cover are so lucky! We needed individual policy cover as DH will be self employed with no employees, and we were turned down by EVERY insurance company in Texas - DH because he has had Kidney Stones and suffers from Sleep Apnoea, and I because I have high BP, high cholesterol and I take HRT! Our only option turned out to be the Texas High Risk Pool, which is going to cost us - $18.848 a year, plus $6000 deductible!

Sure hope it's going to be worth it to move to Texas - we almost moved to Massachusetts because of this!

[TXrose]

Can any one refer me to a good health insurance provider? I about had it with United Healthcare. Thanks


We have UHC and we've never had a problem, we pay for the PPO option and granted, it's not as good as it was 15-20 years ago. We never had to pay a deductible if we used in network like we do now plus for tests in a hospital they only pay 80% they used to pay 100%. But for 3 of us hubby only pays $400/month and his company is self insured. If I took mine through school it would be just the same UHC but I think it would cost me more if I remember right.

[Cook57]

"Sure hope it's going to be worth it to move to Texas - we almost moved to Massachusetts because of this!

Yes; another unfortunate reality is that each State can have much different programs available; much different individual state assistance and health coverage mandates.

Have relative in MA; and their assistance/programs much more generous than TX; BUT huge heating/housing/winter related costs of living there.

$19000 premium plus $6000 deductible is absolutely outrageous. And our politicians have excellent health insurance, low premium, with of course big subsidies from us taxpayers.

[TXrose]

And when you reach 65 you have no choice by to take Medicare, and if you don't have or can't afford supplemental insurance you end up paying a lot out of your pocket because Medicare is very restrictive and sometimes it's hard to find a doctor willing to take it.

[amyalta]

Yes, very valid points. I don't know if anyone wants to discuss / debate this with me, but would anyone be willing to fill me in on why so many Americans are so very, almost violently, anti a universal health care system? When one mentions this, they seem to almost froth at the mouth and use terms like 'Socialism! Un-American! Never!!!' yet they seem happy to pay for it for the vast armies who serve the government! They also say 'UK Health Service isn't free, you pay for it in huge taxes.' Is it because the vast majority of Americans can smugly say they are covered by their employer?

When I was researching US/UK cost of living, I got a friend who is an Actuary, and finds this sort of thing easy, to do me a little calculation of what I, middle-aged mum of 3 who has worked 17 years full time and 8 part time, and my late grandfather, 88 when he died and who worked 39 years full time, actually paid into the Health service, and what we took out, including in my case 3 births, 4 miscarriages, 2 operations, 3 medications etc etc... and also factoring in what we would have 'lost' through not 'investing' that money - here's what he came up with - Melanie = total lifetime so far paid to NHS = £108,000 / total lifetime so far taken out from the NHS = £755,000. Michael, total lifetime paid into NHS = £311,000 / total lifetime taken out from NHS = £930,000.

And I would add, that even if I and my grandad had not 'got our money's worth' so spectacularly, we would still have been proud (yes, proud) to pay our contribution towards the health of those who are too young, too sick or too old to pay for themselves.

[schnauzermom]

The questions you pose are very hard to answer. You may have noticed that we are in the middle of a huge election process here and the country is basically divided into three camps. So we are not really agreeing on much right now. So I'll give you my thoughts. It's capitalism, the wealthier you are the better health care you receive. I think most Americans view nationalized health care as welfare. Many of us also believe in small government and a national health care plan would create a huge government. The medical community, physicians etc are a big lobby and do not want Uncle Sam dictating how much they get paid. So I think it basically comes down to capitalism. I'm sure I could think of lots of other reasons but this is what comes to me first.

Any one else want to share their opinion?

[amyalta]

I'm sure you're right about capitalism! The 'big government' thing is a fascinating issue - Americans hate it but the US govt. has grown so vastly over this administration! And I don't see it decreasing in size anytime soon...

[schnauzermom]

I'm sure you're right about capitalism! The 'big government' thing is a fascinating issue - Americans hate it but the US govt. has grown so vastly over this administration! And I don't see it decreasing in size anytime soon...
You'll have to check out Wilson's thread in politics about the popularity of the current administration. Besides adding Homeland Security I'm not sure how much the government itself has actually gotten bigger. The national debt, yes, but governmental agencies themselves? Not sure that "grown vastly" is reality or perception.

[Cook57]

...DH because he has had Kidney Stones and suffers from Sleep Apnoea

Several people who had sleep apnoea problems, mentioned they tried a "mask" with steady stream of air which keep passages open during sleep and they got HUGE relief...don't know but worth investigating with doctor if he has not.

[Cook57]

Yes, very valid points. I don't know if anyone wants to discuss / debate this with me, but would anyone be willing to fill me in on why so many Americans are so very, almost violently, anti a universal health care system? When one mentions this, they seem to almost froth at the mouth and use terms like 'Socialism! Un-American! Never!!!' yet they seem happy to pay for it for the vast armies who serve the government! They also say 'UK Health Service isn't free, you pay for it in huge taxes.' Is it because the vast majority of Americans can smugly say they are covered by their employer?

Just couple points: Yes, employer provided health care is really a big part of the problem. It worked well for decades; but not now because employers are cutting WAY BACK each year on benefits, but still they receive government tax breaks for offering it, and those that have good employer coverage "line up/oppose" those who do not.

Interestingly, the government run Traditional Medicare works smoothly really; BUT the government is ruining it by cutting back on payments to Doctors and giving more to Insurance Companies.


The Insurance/Drug companies have the politicians by the throat. They want favorable Legislation and subsidies (and they get it) while retaining freedom to deny coverage/claims as they see fit.


The insurance companies will NEVER IMO be part of a solution because they want freedom to decide who gets coverage and how much is paid and to whom.

The fact that our Congress and other politicians have the best health plans our money can buy tells me that they know exactly what the solution is; but because they are "owned" by insurance and drug companies they will not do what is best for ordinary citizens.

I wonder what those Americans who sing private insurance company praises will do when these companies insist on providing coverage and pay claims based on genetic testing, family history, extensive pre-coverage physicals?

[TXrose]

Interestingly, the government run Traditional Medicare works smoothly really; BUT the government is ruining it by cutting back on payments to Doctors and giving more to Insurance Companies.




Not really. Medicare doesn't pay as much as you think. You don't realize it until you have it. My parents have paid more out of their pockets because of Medicare and then had to get reimburse by the supplemental insurance they have and that has a huge deductable because the supplemental insurance is so expensive. Before they turned 65 they were on a regular insurance policy and it was less than their supplemental policy. Also there is NO perscription benefit with Medicare, my parents perscription benefit comes from their supplemental insurance that they pay for.

So right there the Government has proven they can't run a healthcare system or insurance plan.

Medicare is a government run "insurance" and it totally sucks.

Medicaid is for those who qualify with "income restraints". It is government funded, it covers MORE than Medicare which we are forced to take when we turn 65.


The questions you pose are very hard to answer. You may have noticed that we are in the middle of a huge election process here and the country is basically divided into three camps. So we are not really agreeing on much right now. So I'll give you my thoughts. It's capitalism, the wealthier you are the better health care you receive. I think most Americans view nationalized health care as welfare. Many of us also believe in small government and a national health care plan would create a huge government. The medical community, physicians etc are a big lobby and do not want Uncle Sam dictating how much they get paid. So I think it basically comes down to capitalism. I'm sure I could think of lots of other reasons but this is what comes to me first.

Ok Universal Healthcare. I have friends who live in Canada and I hear such horror stories about people not being able to get treatment for things quick enough that they come to the states and pay out of their pocket for things like Cancer treatments, surgery that isn't elective and things they have to wait to get done in Canada under the Healthcare system there. Do we really need the government (with all their ineptness) to handle our health care system? No I don't think so, I don't think that it's just the medical community or physicians telling me where and when I can go and what I can get done. But we do need to find a way to make healthcare affordable for everyone. In the last year the tests I have had to take have been very high in cost for something that takes about an hour to do. I can't believe that they expense of the machines or the technicians time for just me can be that high, especially when during that time they have about 10 other people there for the same test.

[Wilson]

:jawdrop: Dh's company had a meeting about insurance today - we thought for sure we were going to get yet another hike, but it looks like we're actually going to be paying a little less, have more choices and coverage! I'm shocked....

[Candleman]

Yes, very valid points. I don't know if anyone wants to discuss / debate this with me, but would anyone be willing to fill me in on why so many Americans are so very, almost violently, anti a universal health care system? When one mentions this, they seem to almost froth at the mouth and use terms like 'Socialism! Un-American! Never!!!' yet they seem happy to pay for it for the vast armies who serve the government! They also say 'UK Health Service isn't free, you pay for it in huge taxes.' Is it because the vast majority of Americans can smugly say they are covered by their employer?

When I was researching US/UK cost of living, I got a friend who is an Actuary, and finds this sort of thing easy, to do me a little calculation of what I, middle-aged mum of 3 who has worked 17 years full time and 8 part time, and my late grandfather, 88 when he died and who worked 39 years full time, actually paid into the Health service, and what we took out, including in my case 3 births, 4 miscarriages, 2 operations, 3 medications etc etc... and also factoring in what we would have 'lost' through not 'investing' that money - here's what he came up with - Melanie = total lifetime so far paid to NHS = £108,000 / total lifetime so far taken out from the NHS = £755,000. Michael, total lifetime paid into NHS = £311,000 / total lifetime taken out from NHS = £930,000.

And I would add, that even if I and my grandad had not 'got our money's worth' so spectacularly, we would still have been proud (yes, proud) to pay our contribution towards the health of those who are too young, too sick or too old to pay for themselves.
IMO it's not the Governments responsibility to provide FREE healthcare to anybody that can work and afford their own. The Government is not and should not be in the healthcare business. Their job is to protect and defend the country.

It's good to know you are coming to America ready to donate to those that can't afford their own needs and services. We have many good agencies that are in dire need of donations.

Your examples from your Actuary are a good reason "OUR" government should not be in the healthcare business. Most Americans enjoy the freedom to choose who they want for healthcare and when they need and want a procedure done. We DO NOT need some schmuck in DC telling us when we can see a Dr.

Now if the Government will refuse healthcare to all Lawyers we could see a reduction in test, after test after test, prior to any procedure. Lawyers like John Edwards have done more harm to healthcare than anyone else involved.

What's the difference between a dead rattlesnake in the road and a dead Lawyer in the road?



There are skid marks before the rattlesnake!!!!!

Moral to the story: not all snakes are looked upon as equal.

[amyalta]

Everyone loves tp hate lawyers, Candleman, until they need one themselves.

[amyalta]

Yep, he has one of those! Apparently this was the very reason he was turned down - use of one, we were told, demonstrates an unacceptable level of risk.

[amyalta]

The point is, Candleman, that many Americans do not enjoy the freedom you mention! What about my husband, who is American through & through but was denied any health care cover? What about my sister in law, who paid through the nose for a plan but got cut off when the cost was too high?

As for Medicare / governments responsible for health and so on, the US govt has one nice little scam: a US citizen has to pay tax on his income no matter where it is earned, and my DH dutifully files US tax returns, and has done so for 31 years, but this does not entitle him to Medicare!

[TXrose]

The point is, Candleman, that many Americans do not enjoy the freedom you mention! What about my husband, who is American through & through but was denied any health care cover? What about my sister in law, who paid through the nose for a plan but got cut off when the cost was too high?

As for Medicare / governments responsible for health and so on, the US govt has one nice little scam: a US citizen has to pay tax on his income no matter where it is earned, and my DH dutifully files US tax returns, and has done so for 31 years, but this does not entitle him to Medicare!


Actually everyone pays Medicare tax and everyone at age 65 gets Medicare.
This is off the Medicare site Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant

Note: You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits. For more information, please visit our

Both my parents were basically forced on to Medicare, they could not keep private insurance.

Medicaid is different and it is income based. A lot of people get these confused.

[Candleman]

The point is, Candleman, that many Americans do not enjoy the freedom you mention! What about my husband, who is American through & through but was denied any health care cover? What about my sister in law, who paid through the nose for a plan but got cut off when the cost was too high?

As for Medicare / governments responsible for health and so on, the US govt has one nice little scam: a US citizen has to pay tax on his income no matter where it is earned, and my DH dutifully files US tax returns, and has done so for 31 years, but this does not entitle him to Medicare!

WHO?
It is not possible to be denied "ANY" healthcare.

[Wilson]

She said "health care cover"(age)

[FamilyGal]

Several people who had sleep apnoea problems, mentioned they tried a "mask" with steady stream of air which keep passages open during sleep and they got HUGE relief...don't know but worth investigating with doctor if he has not.

I have a CPAP. It worked great for me. Now that I have lost weight though, I don't have the apnea as bad and I need it retitrated.

[FamilyGal]

:jawdrop: Dh's company had a meeting about insurance today - we thought for sure we were going to get yet another hike, but it looks like we're actually going to be paying a little less, have more choices and coverage! I'm shocked....

Same thing happened to us. We couldn't believe it either! Less premium and more coverage. That is the first time in fifteen years. Usually, the price goes and the coverage goes. down.

[amyalta]

It's most kind of you, 'Texas Rose.' to look all that up and send it on. Would that it were all correct, however! The US system is absolutely specific - paying US tax from abroad entitles you to Social security benefits, but it does not entitle you to Medicare. Work done abroad, and taxes paid therefrom, are not classified as 'Medicare eligible employment' even if you are a USC.

[TXrose]

It's most kind of you, 'Texas Rose.' to look all that up and send it on. Would that it were all correct, however! The US system is absolutely specific - paying US tax from abroad entitles you to Social security benefits, but it does not entitle you to Medicare. Work done abroad, and taxes paid therefrom, are not classified as 'Medicare eligible employment' even if you are a USC.


Then Medicare tax wasn't paid because if you pay Medicare tax then you are supposed to get Medicare, unless you fall in that group that retired before Medicare tax came into existence, it was not always there. Of course, I think it's a joke (Medicare) and we should be able to chose whether or not to pay for and take Medicare or keep our private insurance only.

[IndianSpringsGuy]

Can any one refer me to a good health insurance provider? I about had it with United Healthcare. Thanks

I have not gone through the replies, but I was wondering what the problem is with United Health Care. It does the job for me, but there are situations with certain doctors where the doctor causes issues, not the heath care provider who has a contract with the doctor and sometimes I find the doctor not honoring the contract.

[TXrose]

We have UnitedHealthcare do (and have for years). We haven't had any problems other than co pays are more and now we have a deductible even with PPO doctors.

[amyalta]

Thanks again, but the USSS is quite specific - if you are a USC working abroad & still paying US tax, you are not entitled to Medicare. If you have 40 credits you are entitled to Social security only. Whatever that may be!

[schnauzermom]

Don't you only pay tax once you go over a certain amount? I think that is why, you may not be paying into FICA. I always thought that living abroad allowed you to save lots of money since you only pay tax on a portion of your income.

[amyalta]

No, living abroad does not save you money! You have to pay the 40% + tax rate we have in the UK anyway, and you get certain exemptions for US tax - if you have been filing US returns for 10 years you can be entitled to Social Security, but not Medicare - to get that, the work has to be carried out in the US itself (or abroad for a US employer).

[schnauzermom]

Look I don't mean to be rude but it sounds like your husband knew the tax, medicare etc. situation and chose to stay living overseas. He could have become a British citizen or he could have come back here much sooner, right? I thought though that the foreign tax credit was so that Americans don't get double taxed, but I've never lived overseas so I don't really know for sure. You might want to try thinking a little more positively about the new place your choosing to move to. You might find that it's not really as bad as you think. Just a little unsolicited advice.:)

[amyalta]

Thanks for the advice. Moving back was not really possible until now - kids, job etc! The double tax thing is indeed so that you don't pay tax twice, but although it covers you for Social security in any one of the countries you choose to live in, it will not cover Medicare. In contrast, UK covers you no matter where you worked, as long as you are resident.

[TXrose]

Thanks for the advice. Moving back was not really possible until now - kids, job etc! The double tax thing is indeed so that you don't pay tax twice, but although it covers you for Social security in any one of the countries you choose to live in, it will not cover Medicare. In contrast, UK covers you no matter where you worked, as long as you are resident.


Then he wasn't paying Medicare tax, it's a totallly separate tax from Social Security. On my paycheck, my husband's paycheck and son's paycheck it says Social Security tax $$$$$ then there is a line that says Medicare Tax $$$$$.