Pulling an Avitable*
Saturday, September 15, 2007
I wanted to write a post on the book I am reading right now.
It's a fiction by Michael Palmer called The Society. It's about a serial killer who is stalking head honcho's at various HMO companies and blah blah blah.
I wanted to know if the stuff Mr.Palmer writes about HMO's and the Hoops - that are seemingly moving and on fire - that people must jump through just to get the medical care they are paying out their asses every month for, is true.
It's OK. I had to re-read that sentence again to understand it too.
But I am too tired to write up that post, becuase I just spent the last three hours jumping through little html hoops of my own.
*sorry Avi, I'm also too tired to come up with a good title.
Labels: I'm Important Too
posted by Bluepaintred @ 11:59:00 PM
10 Comments:
I don't know about all HMOs but Kaiser Permanente is pretty good about treating your illnesses and ailments without jumping through hoops. At least that I've found. I even had a minor cosmetic procedure done at the $10 co-pay which should have cost me $450 since it is cosmetic but ANYway.
What I have found with Kaiser is that the wait times are ridiculous. I mean I was quoted a 2 month wait for my gynecologist appointment? Dumb. Of course, if you have a medical emergency or you're ill, you can get in on the same day appointments, but still. That annoyed me.
The other HMO that I had before my move to California was with Aetna. And they too were very efficient in treating me and getting me into the surgeries and so on when I had my neck surgery. I saw my regular doctor, then he sent me to the x-rays on the same day. The MRI was scheduled the next day and a day later the results were in for my neurosurgeon and I saw him. After I saw him, the surgery was scheduled for the next week. It was all a whirlwind and I never had any wait time or trouble getting them to pay for any of it.
I dunno what sort of hoops that they write about in the book, maybe you could list some of them and people could answer if they've had that sort of issue? I've not had problems with them, and I don't pay a monthly fee because it is covered by the taxpayers of California through Doug's work (he's a teacher.) The only thing I have to pay is $10 for a visit and $5 for a prescription.
I think it depends on the insurance. Ours is very good. We have a $200 per person deductible each year, but no co-pay in the office. We can see specialists without a referral. In-network doctors are paid at 90% and out-of-network is 80%. There are caps on how many charges you can incur (especially on diagnostic tests and x-rays) but we've never gone over those limits.
We also have decent dental coverage, good optical coverage (they even pay Lasik at 100%) and pretty good chiropractic coverage. Those are set up differently in that there is no deductible. The insurance either pays a set amount toward a specific procedure, or it pays X number of dollars a year, then you're on your own after that.
So, I guess for us, the hoops are huge and on the ground...we just walk right through them.
AAAHHH!!!!Insurance and HMOs and doctors and co-pays!!!!AAAHHHH..*aak*
Note to whoever Metalmom was typing to....I think you made her head explode...there's gray matter on the keyboard.
WTF! Pulling an Avitable? Because I was too tired to write a real post?
Ooh, you fucker.
And I think it's an exaggeration of the problem, but there is still definitely a very large problem.
Try being retired US military, with the promise of medical care after retirement. Then try living in Florida, where all the retirees move...No way can you get into any of the bases as a retiree, 3 months out for a sick call.
Employees I work with pay $350 every two weeks for family medical coverage. I work for a non-profit, we don't pay that well. We do cover the employee.
Florida has a major medical insurance crisis.
medical care in the US sucks. thats all I can say about it. co pays are a joke..
I've pulled on parts of Avitable before.
If you ever need html help, who do you go to?! ME. I am your girl.
Thanks for all the birthday comments on my blog! I have been *stalking* all your blogs tonight. I love the photos of your kitty and your sons are adorable in pictures. I say in pictures cuz I have a son and I know sons are not always adorable LOL. My son called me today for my birthday, miracles do happen!
Also I work for a billing office for a group of radiologists. I know all about HMOS and all that crap.
For myself I have double coverage and still owe every doctor in town for all my fun medical issues. Last week, the scan to find out if I have kidney stones? $900 for a 20 minute procedure. I was actually glad I do have kidney stones, I would hate to waste that kind of money!
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