Canadian Health Care We So Envy Lies In Ruins

[Bann (Premo)]

I have had an HSA for 3 years. (I planned ahead. Once my military dependency ended through divorce, I knew I would no longer be covered by the military health care. I had 60 days (I think) to find something or go through COBRA) My first insurance co. was Mega Life and they thoroughly stunk. I paid insurance premiums of 300. a month in addition to having a higher deductible (1,850?) than I do now. (1,700) I didn't have a prescription plan or vision plan through them. I do not recommend Mega life - they also had stinky claims filing procedures, etc., I was really unhappy with them.

Anyhoo - NOW my high deductible insurance plan is thru Carefirst BC/BS and I pay very low monthly premiums. (122. including a vision "discount plan" & a prescription discount plan). My dr. bills Carefirst and they pay an allowed amount (my doctor is in their "network", so they agree to accept that amount) but I can go to whomever I choose) and I pay the balance out of my pocket. It's usually about 1/3 of the total billed. I also pay for my prescriptions out of pocket, after the discount - which is not too much, really. (Or I take it out of my HSA, which is allowed) Another thing I like about BC/BS is a lot of the same stuff I go to the Dr. for is allowed towards my deductible, which was not the case with ML. (don't get that - but it's the difference between the companies)

[cwo_ghwebb]

Originally Posted by Bann

I have had an HSA for 3 years. (I planned ahead. Once my military dependency ended through divorce, I knew I would no longer be covered by the military health care. I had 60 days (I think) to find something or go through COBRA) My first insurance co. was Mega Life and they thoroughly stunk. I paid insurance premiums of 300. a month in addition to having a higher deductible (1,850?) than I do now. (1,700) I didn't have a prescription plan or vision plan through them. I do not recommend Mega life - they also had stinky claims filing procedures, etc., I was really unhappy with them.

Anyhoo - NOW my high deductible insurance plan is thru Carefirst BC/BS and I pay very low monthly premiums. (122. including a vision "discount plan" & a prescription discount plan). My dr. bills Carefirst and they pay an allowed amount (my doctor is in their "network", so they agree to accept that amount) but I can go to whomever I choose) and I pay the balance out of my pocket. It's usually about 1/3 of the total billed. I also pay for my prescriptions out of pocket, after the discount - which is not too much, really. (Or I take it out of my HSA, which is allowed) Another thing I like about BC/BS is a lot of the same stuff I go to the Dr. for is allowed towards my deductible, which was not the case with ML. (don't get that - but it's the difference between the companies)

We got Tricare Prime which is hard to beat. Funny thing is that Medicare (which my wife got after being classified disabled by Social Security), takes precedence over Tricare. Just weird.

[Bann (Premo)]

Originally Posted by cwo_ghwebb

We got Tricare Prime which is hard to beat. Funny thing is that Medicare (which my wife got after being classified disabled by Social Security), takes precedence over Tricare. Just weird.

It's a tangled web, it is.

But the reason is - Tricare is the secondary payer. That's because both programs are essentially "subsidized" by the government, if that's the right word. In other words, Tricare (in your case, Prime) is (for military members, retirees, and their family, etc) is obtained through the federal government and your premiums (460/year for family, last I checked) are a lot less than with private health care insurance companies. Medicare is (for the elderly but sometimes other people who are disabled) through the federal government, also.

When I first got my HSA, one of the regulations were that you couldn't have and HSA if you were under Tricare or Medicare. (because they are essentially subsidized health care insurance plans)

[Bann (Premo)]

Originally Posted by cwo_ghwebb

We got Tricare Prime which is hard to beat. Funny thing is that Medicare (which my wife got after being classified disabled by Social Security), takes precedence over Tricare. Just weird.

My kids are covered through Tricare Prime, which their father pays for. I pay the co-pays. That's by choice, though, because by the time I take off from work to drive to a base 40 mins. away and then the gas, etc. etc. I'd just as soon pay the co-pay to go to a Dr. within 5 miles of my home!

[cwo_ghwebb]

Originally Posted by Bann

It's a tangled web, it is.

But the reason is - Tricare is the secondary payer. That's because both programs are essentially "subsidized" by the government, if that's the right word. In other words, Tricare (in your case, Prime) is (for military members, retirees, and their family, etc) is obtained through the federal government and your premiums (460/year for family, last I checked) are a lot less than with private health care insurance companies. Medicare is (for the elderly but sometimes other people who are disabled) through the federal government, also.

When I first got my HSA, one of the regulations were that you couldn't have and HSA if you were under Tricare or Medicare. (because they are essentially subsidized health care insurance plans)

I never looked into HSAs as we didn't need one. I didn't know that about not being able to get into one of them if you were covered elsewhere. Prime went up to almost $800 last year, still very reasonable. $460 was a steal.

[Bann (Premo)]

Originally Posted by cwo_ghwebb

I never looked into HSAs as we didn't need one. I didn't know that about not being able to get into one of them if you were covered elsewhere. Prime went up to almost $800 last year, still very reasonable. $460 was a steal.

I have to amend my other post. I thought the reason you couldn't get an HSA if you had Tricare was due to it's being subsidized by the gov't. That actually only applies with regard to Medicare. But if you're in another plan (which, at the time I was when I was covered by Tricare) you can't have an HSA unless it's a HD plan.

HSAcenter - Health Savings Accounts - Health Care and Savings for You and Your Family_


I didn't know Tricare Prime went up! Yes, it's still very reasonable.

[wintersprings]

My Grandma in England at the age of 80 needed a new knee. The Nanny State said no, over 80 you don't get anything, here is a wheelchair. So those of us in the Evil USA pooled 10K and she had a new Knee on the open market system (Why does one exist in england?)

Anyway she lived for 10 more years and walked the entire time.

Thanks nanny State, you diverted her knee to someone else.

[This_person]

Originally Posted by Bruzilla

Oh brother are you off! The insurance allowed amount is the only way to keep providers in check, and those rates are negotiated each year with the providers.

I see...the insurance has nothing to do with the costs, just what they'll pay as negotiated with the providers. Makes sense. You're proving my point, BTW.

That is an excellent point! But you know how many people do that? About 2%, and most of those are on Medicare and care more about copays and coinsurance than doctor preference.

And?

You're contradicting yourself. First you say "I have about the best plan I can afford' then you say "I pay for the best plan so that I can get the best service."

That's not a contradiction - I pay for the best plan, I can afford the best plan. Therefore, I pay for the best plan I can afford - the best plan.

If people want optimized healthcare, then pay for it. And if you're not willing to pay for it, don't whine when you don't get it.

I do. I pay for the best plan available, because I want the best insurance available. And, others pay for less, and are willing to take the risk of less. Still others pay for more than what they need, because they can afford it. More don't get what they want, because they can't afford it. Kind of like houses, cars, clothes, plumbers, exterminators, food, etc., etc., etc. And, as I said before, it works. Just because people complain does not mean it doesn't work.