Health insurance doesn't make sense to me

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My 5y/o just had to have some major stuff done to her teeth. Since we don't have (or want) "dental insurance", we found a specialist in children's dentistry, put the 2800 on a credit card, and got a 20% "cash discount". Of that 2800, 900 was for 45 minutes of an anesthesiologist's time and skills.

If we had the military dental insurance (Tricare, underwritten by Delta Dental and Metlife) it would be 96/mo. Amazingly enough, the cap it at $1300/yr (and another lifetime 1750 cap on orthodontics), and the cost shares range from 0% (diagnostics) to 20% (consultation) to 40% (anesthesia) to 50% (periodontal and other stuff). So in my daughter's case, even if we had insurance, we would have hit the cap and ended up paying more (and not having the cash discount) than just putting it on the card and getting miles for our next vacation. And that wouldn't have included the 5 years we've been paying without anyone going to the dentist for more than a checkup/cleaning.
 
So....kids are expensive is what you are saying?
 
BrianFromWA said:
More expensive if you're forced to pay for insurance.
Click to expand...

My son has dental insurance and we teach him to brush and floss regularly. Because of his insurance he has regular checkups and regular cleanings. He is now 9 and has never had a cavity. Please don't get defensive about this, but what are you feeding your daughter? Why does she need so much dental work?

Edit: also, his insurance doesn't have a cap. I've never even heard of a cap on dental insurance. What's that all about? You should be able to shop and get better insurance.
 
dviss1 said:
My son has dental insurance and we teach him to brush and floss regularly. Because of his insurance he has regular checkups and regular cleanings. He is now 9 and has never had a cavity. Please don't get defensive about this, but what are you feeding your daughter? Why does she need so much dental work?

Edit: also, his insurance doesn't have a cap. I've never even heard of a cap on dental insurance. What's that all about? You should be able to shop and get better insurance.
Click to expand...

Not defensive at all....she was born 5 weeks premature and (from what I've been told) enamel is one of the later things "developed" in the womb. Many of the roots on her front teeth were abscessed and had not been found until this batch of x-rays. She had to have 5 baby teeth pulled. So, technically, she's never had a cavity, either.

Checkups and cleanings are a minimal cost (I think we pay $60/yr for the kids). So for a 5yr old and 4yr old we've paid (up to now) about $350 in dental costs for the kids, and maybe that again for my wife. I get free checkups and cleanings from the Navy as part of having to stay deployable. So even with this "big item" we've paid $3500 in 5 years for family dentistry (it would've been about $700 with your child's/family's dental record). Which would've cost me $6000 had I been paying insurance premiums, which obtw would not have covered all of the 3100 of work that I "bought".

Cost shares here....premiums are on a link at the top of that page. Since we're asking, how much do you pay for your family dentistry premiums? Your son can have regular checkups and cleanings without insurance, for about $100/yr--or 1 month's premiums.
 
BrianFromWA said:
My 5y/o just had to have some major stuff done to her teeth. Since we don't have (or want) "dental insurance", we found a specialist in children's dentistry, put the 2800 on a credit card, and got a 20% "cash discount". Of that 2800, 900 was for 45 minutes of an anesthesiologist's time and skills.

If we had the military dental insurance (Tricare, underwritten by Delta Dental and Metlife) it would be 96/mo. Amazingly enough, the cap it at $1300/yr (and another lifetime 1750 cap on orthodontics), and the cost shares range from 0% (diagnostics) to 20% (consultation) to 40% (anesthesia) to 50% (periodontal and other stuff). So in my daughter's case, even if we had insurance, we would have hit the cap and ended up paying more (and not having the cash discount) than just putting it on the card and getting miles for our next vacation. And that wouldn't have included the 5 years we've been paying without anyone going to the dentist for more than a checkup/cleaning.
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thats my problem with all insurance. you are betting against yourself and in most cases it's illegal not to. I have a 1985 toyota pickup truck that cost approx $1300 when i bought it 8 years ago. I've paid it off at least 3 times in insurance payments.

health insurance is a huge scam. they double sometimes triple prices when billing because they know the insurance companies will only pay a % but then you get stuck paying higher prices than if you just paid cash.

health care is a joke. i watch people come to the ER twice daily for pain meds because they sell their prescriptions on the street and now need pain management. every EMS ride to the ER costs as much as my bi monthly pay check and that person doesnt have to pay their bill because legally the ER can't turn someone away. people get ambulance rides because they have a cold rather than eating some chicken noodle soup and going to sleep. not paying your bill doesnt even hurt your credit. credit companies look and see it's for health care and just lol.
 
Use to date a girl that is/was a director of benefits at a certain local company here in the Metro area. You wouldn't believe the type of fraud and boundary breaking that happens in the medical field. Between the health insurance companies, the doctors, AND the employee fraud, it's a complete fucking sham.
 
OK, due to my age, I am on the govt. run Medicare insurance program. I am very fortunate to have a doctor that actually cares more about his patient’s health than making money. He spends as much time as needed with each patient, and never overbooks to make people have long waits.

The hardest part of my doctor's job appears to be interpreting all of the rules and restrictions Medicare places on patient treatment. At my last visit about two weeks ago, he spent more time on the phone trying to understand what was covered, and when it is covered than he did treating me. He had to make three phone calls before he “maybe understood” the answers to his questions.

On one specific procedure, he decided that I probably was not covered for one more year, which we both agreed was crazy. He said he was going ahead with that part of the exam at no charge to me. He wanted to be sure about something and not gamble with my health due to stupid rules made by the Govt..

Not only is understanding what is covered and when very confusing, how you are processed through the system can also affect IF Medicare pays.

Example: Staying overnight in a hospital does not automatically mean Medicare pays the expenses of an overnight hospital stay, even if they are covered. It boils down to if you where formally admitted by the hospital, a bureaucratic procedure. You can spend the night in a hospital and still be considered an outpatient, not an inpatient by how the admission form was worded. You have no way of knowing if you are listed as an inpatient or outpatient, unless you ask. Which is crazy.


The Medicare system does not make sense to me or my doctor. There are way too many loopholes and pit falls.
 
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I liked the way the first health insurance I had was administered. The providers did not know of, or have anything to do with the insurance. I paid the bills and they had no involvement with my insurance or even knowledge that I was covered. The benefits were pay directly to me by my employer, no Insurance company was involved.
Hospital bills were reimbursed 100%. Nothing else was until the medical bills for my family exceed $150 dollars for the year (about $2100 in current money). The excess over the 150 was
reimbursed at 80% with a total out of pocket cap of $500 for a year for the family.

Simple and it worked very well for about 10 years then Government regulations began to erode the benefit until I have none at all except the crappy insurance I can buy.
As I recall, it was about 1980 that Insurance companies like Blue Cross were hired to administer the benefits to keep it inline with government regulation and of course it
began to look like the insurance we know today. It became more and more difficult for employers to comply with government regulations to keep "Medical Insurance"
a non taxable benefit which was always the goal of many Progressives to eliminate. Obama's plan finally wiped mine out with the direct tax on my employer for providing me
insurance. They saw the light, they quit that shit.
 
MarAzul said:
I liked the way the first health insurance I had was administered. The providers did not know of, or have anything to do with the insurance. I paid the bills and they had no involvement with my insurance or even knowledge that I was covered. The benefits were pay directly to me by my employer, no Insurance company was involved.
Hospital bills were reimbursed 100%. Nothing else was until the medical bills for my family exceed $150 dollars for the year (about $2100 in current money). The excess over the 150 was
reimbursed at 80% with a total out of pocket cap of $500 for a year for the family.

Simple and it worked very well for about 10 years then Government regulations began to erode the benefit until I have none at all except the crappy insurance I can buy.
As I recall, it was about 1980 that Insurance companies like Blue Cross were hired to administer the benefits to keep it inline with government regulation and of course it
began to look like the insurance we know today. It became more and more difficult for employers to comply with government regulations to keep "Medical Insurance"
a non taxable benefit which was always the goal of many Progressive to eliminate. Obama's plan finally wiped mine out with the direct tax on my employer for providing me
insurance. They saw the light, they quit that shit.
Click to expand...

So you admit that it was your employer that opted out (Obamacare gave them that option). Are you unwilling to go on the exchange to find a better plan?
 
dviss1 said:
So you admit that it was your employer that opted out (Obamacare gave them that option). Are you unwilling to go on the exchange to find a better plan?
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I can see SlyPokerDog's cognitive ability limits him to being a socialist.

Mod edit, personal insult
 
Last edited by a moderator:
MarAzul said:
I can see SlyPokerDog's cognitive ability limits him to being a socialist.

Mod edit, personal insult
Click to expand...

Asked you a legit question... didn't get an answer... Got a personal insult instead.

In other words, screw you MarAzul...

Queue banning or censorship in 3...2...1
 
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SlyPokerDog is a racist.

Mod edit, personal insult
 
dviss1 said:
Asked you a legit question... didn't get an answer... Got a personal insult instead.

In other words, screw you MarAzul...

Queue banning or censorship in 3...2...1
Click to expand...

Calling someone a socialist might not be an insult. It depends on the person. If you called Bernie Sanders a socialist he would probably say thank you. Since you feel it was a personal insult I will fix it.

This also applies to your offer to screw Marazul. He might not feel this is an insult. He might actually want to take you up on it. Until I find out there would be no reason to ban or censor your post.
 
dviss1 said:
Asked you a legit question... didn't get an answer... Got a personal insult instead.

In other words, screw you MarAzul...

Queue banning or censorship in 3...2...1
Click to expand...
Aw! Come on now, an observation can't be construed into an insult. Besides, I had no idea being called a socialist would be insulting to you.
An then you must realize, dumb ass questions do not deserve answers.
 
MarAzul said:
Aw! Come on now, an observation can't be construed into an insult. Besides, I had no idea being called a socialist would be insulting to you.
An then you must realize, dumb ass questions do not deserve answers.
Click to expand...

Actually you did mean it as an insult.

"limited cognitive abilities" means he's a socialist? It wasn't the socialist part that was the insult.
 
SlyPokerDog said:
Actually you did mean it as an insult.

"limited cognitive abilities" means he's a socialist? It wasn't the socialist part that was the insult.
Click to expand...

I think you need to read it again Sly. I did not say Limited Cognitive ability. I did say his cognitive ability ( the full amount) does limit (the range of conclusions) to socialism.
That sir, is an observation. I suppose it could be refuted, but given the track record, I don't know how.
 
MarAzul said:
I think you need to read it again Sly. I did not say Limited Cognitive ability. I did say his cognitive ability ( the full amount) does limit (the range of conclusions) to socialism.
That sir, is an observation. I suppose it could be refuted, but given the track record, I don't know how.
Click to expand...

My cognitive mod abilities limits me to being a dictator so I edited your post because it's a personal insult.
 
SlyPokerDog said:
My cognitive mod abilities limits me to being a dictator so I edited your post because it's a personal insult.
Click to expand...

Let's see now. I am a racist to be screwed. You are the dictator, and diviss is the Socialist.
OK! I win. I guess that will do for the day.
 
SlyPokerDog has admitted his racism when he said he discriminated against a cat after stalking him in the cat box.
 
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I'm not insulted by being called a socialist. I'm a Democratic Socialist. Though, labeling me is stupid because I have some conservative views as well. I keep sex away from my kid and teach abstinence. Speaking of my cognitive ability and saying it's limited to socialist policies is an insult tho.
 
SlyPokerDog said:
My cognitive mod abilities limits me to being a dictator so I edited your post because it's a personal insult.
Click to expand...
Oh, and by the way, I did not take "screw you MarAzul" as an insult. Because I know he meant MarAzul, Smith and Weston. We never see insults, we always see opportunity.
 
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dviss1 said:
I'm not insulted by being called a socialist. I'm a Democratic Socialist. Though, labeling me is stupid because I have some conservative views as well. I keep sex away from my kid and teach abstinence. Speaking of my cognitive ability and saying it's limited to socialist policies is an insult tho.
Click to expand...

Well then, explain what exactly did make you settle on Socialism if not your cognitive ability?
 
dviss1 said:
MarAzul has admitted his racism when he said he discriminated against a Pakistani guy after stalking him on the shitter.
Click to expand...
i lock the door on my file cabinet when i enter a thread you're in tbh. and i turn my hip hop down.

i also hide my calculator when mags is around

my leaf blower when HCP comes in

my dog treats when sly comes in

and my beer when wookie is in a thread
 
I was hoping for some more insults, I love reading these threads after the fact like everyone is dissing on sly. :)

Here Ill get us back on track.

Slypokerdog has sex with cats.
 
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