My husbands work went to a high deductible plan because it was cheaper... they have left it to us
to negotiate with doctors and hospitals as far as paying off balances but will not begin paying anything
until we pay the first $2400...
our part of of monthly premiums are about $100 less than we had to pay for CIGNA coverage ...we
have diverted that to an HSA checking account that can only be used for medical expenses and the
company advanced everyone $2400 for this year and it is being paid back to the company $200 each month ...
they were going to give everyone with family coverage $2400 and individuals $1200 but realized how much
it was going to be so instead deposited it as an interest free loan... once met it will pay 80% of most charges
and after $4800 is paid out of pocket will pay 100% of most charges...
all medicines have to be paid in full and turned in at the end of the year and if deductibles have been met
they will reimburse us a portion... we do get a discount which brings most drugs down about 40% and
some even more ...
I have it worked out with my regular doctor to let them run things thru and insurance will apply any discounts
and then pay the balance ... but before insurance picks up we have to spend the $2400... it has been totally
confusing and has been a headache ... the man that came down to explain things to everyone pretty much
said they were making it hard so people would not go to the doctor as often...
which in ways is good because one man at work with an Aaflac supplement that pays to him not the doctor or
hospital would take his child to the ER for dumb things ... she had a splinter under her finger nail and he was
talking about taking her to the doctor but said he would wait til after the office was closed and go to ER
because Aflac would pay him a $125 ER amount...the ER bill was paid in full as an accident ...
(the policy paid 80% of illness) it was a little over $600 ... an office visit would have been $79 I know
since we use the same doctor ... he would have had a $20 co-pay and Aflac would have paid him a $50
office visit payout...thsi was under CIGNA which paid better ... so CIGNA was out almost $600 and he
made $125 ... where if he had taken the child to the office he would have only pocketed $30 after
taking in to account the $20 co-pay and CIGNA would have only been out $59 to the doctor office
so by abuse by some we all suffer... and I don't mean just those of us at this work place , but everyone who
has to pay for insurance ... the hospitals and doctors and insurance companies charge more to make up for
money they lose or pay out due to abuse like this
and on top of it all he let the child (6 years old) sit there with a splinter of wood running under her fingernail
up into her finger (it was about and inch long) and suffer just so he could make a buck
... some
people are so stupid ...
We have Blue Cross Blue Shield of Tennessee /network S ... other network designations pay differently
enough ranting ...insurance dealings just make my blood boil
I did hear back and he thinks that the doctor associated with the anethesiologist group would be the right
one and luckily he is in Nashville ... I have to call him tomorrow and will talk to either him or his nurse
technition to see if he is the right choice ... things are moving fast and I am glad of it ... may take a couple
weeks to get in but what's a couple weeks after about 6 months of trying to get co-operation from the other
doctor ... wish me luck