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Old 02-14-2015, 10:14 AM
wetibbe wetibbe is offline
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Default The Obamacare lunacy:

Friends:

I just want to share some personal, recent, experience, to illustrate the extent to which the current occupant of the oval office has destroyed the health care system. And to provide some more heads up to you about your own personal health and insurance issues.

It's very extensive but I will try to condense to reasonable proportions.

First let me say that the most recent news is that the "Feds" have apparently caught over 300,000 applicants to the new Obamacare who can't provide satisfactory information about eligibility and other matters such as legal residency. And rejected them.

Second I'll relate some personal experiences. I'm retired and aged. I have a Medicare approved HMO insurer. One of the biggest in the USA. I am fortunately in very good health with no major problems at all. However, there are some minors.

The way my insurance works is that I have a PCP primary care physician. Visit fee is $20. If I see a specialist it is more. Back a few years it was $20 co-pay, then 35 then 45 and in 2015 $50 co-pay per visit.

I visited my optometrist for 11 years. No serious eye problems only exams for glasses. In 2014 things changed. The definition of an eye exam is a series of tests. In 2014 my optometrist said there cannot be any longer two tests the same day. So she scheduled me and a week later called me back again. I paid my $45 EACH time which essentially DOUBLED my co-pay. THEN I received a bill from my HMO demanding an ADDITIONAL $35 co-pay. Thus my co-pay blossomed from$45 into $80- TWO times or an increase of 380%!!!!!!!!!!!

The architect of Obamacare Jonathan Gruber testified that the passing of Obamacare was due to the stupidity of the American Voters. And further said on National TV: Lack of transparency is a political advantage. Essentially he blew the whistle on Obamacare.

My little incident with eye care is only one element of an ongoing matter There is much more currently in progress that has not, as yet, been resolved, thus I cannot yet post.

Summary of this is a heads up to you all to look out. There are really BAD things happening with your health care. Without going into lengthy detail suffice it to say that there is a prevalent effort, in my perception, for "insurance" to game the system, engage in a game of shells, three card monte. This is commonly known as upgrading data and "unbundling" wherein - at least my company - shunts from condition to condition and from regs one page to another contradicting using wide open terms such as - " and other" a non-specific catch all attorneys clever lingo.

Too I have found astonishing incompetence and data confusion wherein I can call one office that cannot find my files and another that can. Further customer support that give one answer but subsequent customer support cannot confirm and/or gives a different answer. Some of my correspondence indicates that my claims are not even understood deliberately or by ignorance. Often I speak to customer support who are not "the" person but will transfer my call. About 50% of the time this results in a person who is not the right person, or even a number disconnected. And websites no longer accessible.

I haven't as yet been able to pin it down as to exactly who is responsible and doing what to who. Thus I am stuck between trying to decide who is a blatant crook, a scam artist and a hopelessly incompetent moron.

Any input will certainly be welcome.
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Old 02-14-2015, 10:13 PM
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ilbegone ilbegone is offline
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From the beginning I thought it was designed to eventually crash and force us into a single payer, fully government operated health care system.

No evil corporate boards of directors nor evil corporate stock holders riding herd on gouging hospitals and blood sucking medical professions, and evil corporate insurance companies will be no more. Plus, with insurance companies and medical providers being forced to jack up the rates on the way out it will provide "proof" of what heartless, greedy capitalist pigs operate those companies. => Propaganda fodder for justifying nationalization of the health care industry <=

And, by now the familiar mantra... "EVERYONE HAS HEALTH CARE!"

As dismal, inept, rationed, and intrusively private information gathering as government can possibly make it.
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Last edited by ilbegone; 02-14-2015 at 10:30 PM.
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Old 02-15-2015, 11:51 AM
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Jeanfromfillmore Jeanfromfillmore is offline
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I am turning 65 in a few days, and there you have it, I'll be on Medicare. My problem is Fillmore is so far from anything. The closest hospitals are anywhere from 10 miles (not a good one) to 40 miles for a good one. And then finding which insurer will accept which doctor or which hospital. Then I take one medication that no one wants to cover and finding which one of the pharmacies they cooperate with, because there's only one, Rite-aid, here in town.
So far I've had to have my doctor write a letter stating I need this specific medication, now I have to find an insurer who will accept the fact that I require it. Discounted it's $100 for a 30 day supply (I think the actual price is $200). Even discounted that's over my budget. Just imagine if I needed a second medication. I've been receiving it free from the pharmaceutical company for two years now, but they won't continue to do that after I turn 65.

My only choice is to try to stay healthy or just die.

Actually, when I have gone to the doctor, which is not that often, I usually know exactly what my problem is and what should be done or prescribed. The biggest problem is you need a doctor to write you a prescription, that way they get their fee for a visit. I don't have too much faith in many doctors diagnosis these days. They just make an educated guess, and then you're relying on their "education"; something not exactly great these days. Then you have to concern yourself with whether the new medication is going to make things worse.

I miss being young!!!!
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Old 02-16-2015, 03:18 AM
wetibbe wetibbe is offline
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Default Mail order option.

I hesitate to post the name of my insurance company. And won't recommend it. However, When I was employed they were my employers company of choice dating back to 1970. I've seen the smaller ones come and go over they years. As messed up as mine are now the others surely must be even more catastrophic. *( I'll only say it has the word Blue in it two times. And it is the BIGGEST ).

When selecting the HMO there can be multiple choices of coverage. I took the top choice. As to filling prescriptions I live in a county North West of New York City and we have pharmacy's EVERYWHERE. But I have had problems with some and their pricing. I had Lumigan prescribed for ocular hypertension. It's EXPENSIVE. Fortunately my insurance did pay a goodly portion. Then I contacted a mail order pharmacy https://www.express-scripts.com/ and their prices were even better. You can get a 90 day supply at relatively bargain prices. It's simple. You don't have to drive. Just stay at home and renew.

Drug company's patent their medicines. When the patent expires it's available on the open market as a generic at a fraction of the price. Too there may be alternatives. I have noticed recently that there is much progress in new drugs and some older are being obsoleted and/or replaced with newer.

One drug that I got stuck with last month is for the heart. It's Xarelto. The "sale price" is $377 for a 30 day supply. With my insurance I have a deductible of $270. So my January prescription was $270. In February it dropped to $40 for a 30 day supply.

I will add that some select company's with astronomical drug prices do have a provision, for retired Medicare HMO clients, to provide drugs at significantly lower prices or free. But it is only to very low income applicants.

I'm disinclined to change insurance company's. But I have thought about it. One that I would investigate is AARP's recommended company United Health Care. *( I am an AARP member of many years but that doesn't mean that I trust them or their judgment. Truth be told I'm actually a little bit skeptical of some positions and motivations for valid reasons ).

Sadly the combination of health insurance premiums, co-pay, co-insurance, prescription medicines and the whole plethora of other matters can become ruinous financially. Obamacare seriously exacerbated the problems. Instead of making things cheaper, as promised, in reality the costs skyrocketed for everyone except the low life free loaders and pond scum. Obama wants to pick the pockets of the more affluent and fill the pockets of his low income voters.

In 2014 dealing with health costs became very significantly complicated. There is much confusion everywhere both inside the insurance company's, the nurses, the hospitals and the patients. The new rules have been written in such a manner that they are full of duplicitous contradictions, catch phrases, obscure sentences. From one page to another in the "explanation of benefits" there can easily be two statements that are subject to entirely different interpretation. Further, let the buyer beware. I am always being mis-quoted by almost everyone as to prices. It is difficult to ascertain if they are pulling an opportunistic rip off or just not informed.

Last edited by wetibbe; 02-16-2015 at 07:35 AM.
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  #5  
Old 02-16-2015, 08:20 AM
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Ayatollahgondola Ayatollahgondola is offline
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Quote:
Originally Posted by Jeanfromfillmore View Post

I miss being young!!!!
My grandfather died at 100. He'd say, you're young
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