In Reply to: Re: Insurance hits a new low!!! Long story. posted by steveVa on May 11, 2018 at 17:47:04:
In his case he is a retired US Civil Service annuitant eligible for continuation of his FEHB benefits (BCBS) as well as Medicare Part B and IMO would be best off with both. Personally, when my wife and I turned 65 we opted to sign up for Medicare Part B along with continuation of my BCBS coverage (Federal Employee Health Benefit group plan). Our Medicare Part B premium is $134/month each and is our primary medical insurance. My Self+1 BCBS premium costs us another $600/month and is secondary insurance paying what Medicare does not. We have not paid a penny out of pocket since we turned 65. Medicare makes the initial determinationa nd sets the allowable rate the provider can charge. It typically pays the first 80% and BCBS picks up the rest along with co-pays and deductibles.
The US health care system is a corrupt conspiracy between service providers and the health insurance industry and and has been for decades. I am looking at a Medicare Benefits Payment Summary right now for treatment services I received in just the last two months - a simple ankle fracture that required a small surgical plate and 4 screws on the right fibula. Some notable highlights from a much longer list:
ER visit to stabilize broken ankle - provider billed $946, insurance allowed and paid $103
Operating Room facility charges - provider billed $23,917, insurance allowed and payed $2,742
Surgeon services - provider billed $2,607, insurance allowed and paid $819
Anesthesia services - provider billed $900, insurance allowed and paid $187
Application of cast - provider billed $309, insurance allowed and payed $92
The actual surgery took less than an hour - I left my house for the trip to the surgical center at 5:30 AM and was back home on the couch with my leg up by 8:30. This is a perfect example of the risk young people take when they decide they don't need good insurance. Without insurance I would be looking at close to $40K in out of pocket health expenses for nothing more the kind of minor fall that could happen to anybody at any time. I can't even imagine what the potential costs would be for something serious.