Chronic Pain Support Group
Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...
For 2016 ObamaCare insurance providers have decided to basically remove the Houston area (Houston and surrounding counties) from any decent, or affordable, health insurance in the Individual Market Place (IMP). Last summer BCBS of Texas fired the first public warning shot saying that they were going to lose $400M in the Houston area with their IMP Plans. They added that they would have to make changes, but provided no details.
Well, now that the 2016 enrollment period has opened for the IMP Plans, we now have the answer. BCBS of TX, along with all other providers (about 5 or 6), have eliminated all PPO Plans and now only offer small, highly restricted, and expensive, HMO Plans.
I will use me as an example of what is happening. First, I am only in the IMP because my former employer saw ObamaCare as a get out of responsibility exit ramp, and terminated their long promised pre-65 retirement health insurance plan (that was similar to their regular employee plan). Since I was lucky enough to be able to retire early, I have counted on this long promised insurance. Well, they ended their Plan a year ago, so I had to find insurance in the IMP. For 2015, I found a good, but expensive ($836/month), Sliver PPO Plan from BCBS of TX. With this Plan I was able to keep all my doctors and it has worked fine.
For 2016, the apple cart has been turned upside down. As mentioned all insurance companies dropped their PPO Plans, and now only offer HMO Plans, all with NO OUT of NETWORK coverage, zip, nada. That sounds bad, but it is even worse than it may first appear (see hospitals).
After reviewing what little was available, I had to make a decision on which doctors I no longer wanted. No Plan offered all my doctors, and after reviewing all the networks, I either had to throw my PCP under the bus and keep some of my specialists, or keep my PCP and lose all my specialists. I decided to dump my PCP and hope that I can find a new HMO PCP that will refer me back to my specialists that I have been seeing for years. What a deal!
In addition to removing the great majority of doctors from all the networks, they also eliminated a huge number of hospitals, and other medical facilities of all types, and I am now limited to two walk-in pharmacies (CVS & Walmart/Sams).
It gets worse: As many of you probably know, Houston is home to the world famous Texas Medical Center (TMC). The TMC is the world largest medical center with 21 hospitals (including the most famous; The MD Anderson Cancer Center), and has over 100,000 employees. The TMC is as large as the downtown business centers in many large cities. It is unbelievable just to drive through.
I will let you guess which hospitals have been removed from all Plans. You're right, the entire TMC has been eliminated, along with their satellite hospitals in the suburbs. Therefore, even though I live about 25 miles from the TMC, I will not have the coverage to be able to set foot in any of them (remember, no out of network coverage). So, it is very likely that many of you folks that live all over the world will have a better chance to access these hospitals than I will in 2016.
That is my story, but do not forget that this covers anyone applying for insurance through the IMP or directly with the insurance companies. My Gold Humana HMO Plan (there are no Platinum Plans offered by anyone) will cost me $1,039 per month with a $2,500 deductible. Even if a person has a subsidized plan, the final costs for any of the Plans will still be too high for most.
My wife is a member of a Facebook support group for her major medical problem called CIDP. One of the members in Tennessee, I believe, said that her insurance was going through the roof and was so expensive that she did not know what she was going to do. She added the Obama is the anti-Christ for what he has done to the majority of the country. I would add Harry Reid and Nancy Pelosi.
One more thing about me; I turn 65 in September, so I get to start the whole process all over again with Medicare this coming summer. Will I keep my new PCP, or change back to the one I have had for 10 years???? All my doctors take Medicare, except one; at least for now.
Well, now that the 2016 enrollment period has opened for the IMP Plans, we now have the answer. BCBS of TX, along with all other providers (about 5 or 6), have eliminated all PPO Plans and now only offer small, highly restricted, and expensive, HMO Plans.
I will use me as an example of what is happening. First, I am only in the IMP because my former employer saw ObamaCare as a get out of responsibility exit ramp, and terminated their long promised pre-65 retirement health insurance plan (that was similar to their regular employee plan). Since I was lucky enough to be able to retire early, I have counted on this long promised insurance. Well, they ended their Plan a year ago, so I had to find insurance in the IMP. For 2015, I found a good, but expensive ($836/month), Sliver PPO Plan from BCBS of TX. With this Plan I was able to keep all my doctors and it has worked fine.
For 2016, the apple cart has been turned upside down. As mentioned all insurance companies dropped their PPO Plans, and now only offer HMO Plans, all with NO OUT of NETWORK coverage, zip, nada. That sounds bad, but it is even worse than it may first appear (see hospitals).
After reviewing what little was available, I had to make a decision on which doctors I no longer wanted. No Plan offered all my doctors, and after reviewing all the networks, I either had to throw my PCP under the bus and keep some of my specialists, or keep my PCP and lose all my specialists. I decided to dump my PCP and hope that I can find a new HMO PCP that will refer me back to my specialists that I have been seeing for years. What a deal!
In addition to removing the great majority of doctors from all the networks, they also eliminated a huge number of hospitals, and other medical facilities of all types, and I am now limited to two walk-in pharmacies (CVS & Walmart/Sams).
It gets worse: As many of you probably know, Houston is home to the world famous Texas Medical Center (TMC). The TMC is the world largest medical center with 21 hospitals (including the most famous; The MD Anderson Cancer Center), and has over 100,000 employees. The TMC is as large as the downtown business centers in many large cities. It is unbelievable just to drive through.
I will let you guess which hospitals have been removed from all Plans. You're right, the entire TMC has been eliminated, along with their satellite hospitals in the suburbs. Therefore, even though I live about 25 miles from the TMC, I will not have the coverage to be able to set foot in any of them (remember, no out of network coverage). So, it is very likely that many of you folks that live all over the world will have a better chance to access these hospitals than I will in 2016.
That is my story, but do not forget that this covers anyone applying for insurance through the IMP or directly with the insurance companies. My Gold Humana HMO Plan (there are no Platinum Plans offered by anyone) will cost me $1,039 per month with a $2,500 deductible. Even if a person has a subsidized plan, the final costs for any of the Plans will still be too high for most.
My wife is a member of a Facebook support group for her major medical problem called CIDP. One of the members in Tennessee, I believe, said that her insurance was going through the roof and was so expensive that she did not know what she was going to do. She added the Obama is the anti-Christ for what he has done to the majority of the country. I would add Harry Reid and Nancy Pelosi.
One more thing about me; I turn 65 in September, so I get to start the whole process all over again with Medicare this coming summer. Will I keep my new PCP, or change back to the one I have had for 10 years???? All my doctors take Medicare, except one; at least for now.
The bill was over $20,000. The problem is more than just having insurance coverage.
They IGNORED an evolving problem that needed an MRI and X-rays and failed to even pay any attention to an issue that may need surgery which was the likely cause of the emergency visit.
They billed me $1 for two tylenol. You can purchased a bottle of 1000 BRAND name tylenol for around $12. That is around 0.01 per pill RETAIL! That is 50 times as costly just to wait 90 minutes and have a nurse deliver two pills.
The dogs meds cost me $12 for 10. Mine costs $4 per pill.
compare $1.20 - dog med
to $4.00 - human med.
What did Obama do to fix this?
PPACA was supposed to fix the high costs yes, but somewhere along the line something went wrong!
Costs are higher than ever now.
The first couple of years without health insurance I just paid cash, then that got too expensive.
Now it's often cheaper again to pay cash and not try to use increasingly weird insurance.
@Jeremy
I don't think you need to feel guilty for having a big health bill and it being taken care of. That's how it works in every other developed country- you pay your taxes when well and working then draw on benefits when in need.
It's not socialism by any means- the medications and technology are all developed by private business concerns, but governments regulate the care of citizens and especially the non-exploitation of sick, disabled, elderly, dying etc.
Oddly, Humana's website has not worked all during the enrollment period (I just rechecked). When I enter my zip code (or other Houston area codes), the website comes back with "no medical plans offered". Their HMO Plans have showed-up on both my broker's website and the Federal Exchange, but not the reported PPO.
Since open enrollment ends 12/17 and we will be out of the country from Sunday to next Sunday, I guess I will stick to the HMO Plan that I am already enrolled in. (No time to check the fine print in the reported new PPO offering).
Worst president ever. Can't believe I was taken in by him.
When you receive a med you are charged for the med, then there is sometimes a pharmacist and another professional that handles the med in the er. Rent, utilities, ect are also factored into hosiptal bills.
ER's deal with emergencys and leave other things to pcp's and specialists.
She's really happy with it.
Any business has overheads to factor into cost of goods or services.
Obama promised to make medical costs transparent ( another falsehood! )