Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I realize more & more that Anthem BSBS is the worst insurance known. I take almost all insurances except Anthem. I don't know how they stay in business. But yes, group plans are somewhat better for a small office, but are still costly. Re: personal health insurance Health insurance has been my biggest nightmare with my low overhead practice. When I started my low overhead practice June 2005, I obtained an individual health insurance policy for my family. (I had always been on group plans prior to this). I signed on with Athem, BCBS (my first mistake). I currently pay $500 per month for a 2K deductible plan for my healthy family of four. (They increased our rate by $100 per month after 6 months on this plan--Sad note accompanying the rate increase notification said their " costs " had increased and they were very sorry to have to pass this along...it brought a tear to my eye...) I signed on in July of 2005 with the following LIFETIME exclusions: my husband's RIGHT elbow is uninsurable and he can not be covered for the diagnosis of depression. (He had received physical therapy for lateral epicondylitis in the last 5 years and one doctor's note mentioned depression, hence the LIFETIME exclusions). In October 2005, I received a letter from Anthem requesting a list of all the physicians I had seen and my 4-year-old son had seen in the last 5 years. Unknown to me, they had put my ENTIRE policy on hold until they received all these records. My son had a couple of claims for well child checks and viral illnesses, and recently broke his wrist. I strained my piriformis when I overdid my rowing. These simple incidents resulted in claims for Anthem, thus triggering a " policy review. " To make a very long horrific story somewhat short, Anthem to this date has not paid ANY claims that have been submitted to them since October. My policy has been " in review " now for over 6 months. I am not allowed to speak to anyone directly regarding my policy and what is under review, and any EOBs for claims submitted are sent back to my providers with " DENY-eligibility under review " . My certified letters sent to Anthem are received, but never to this date acknowledged. I may have to get legal counsel soon, but the next " review " is scheduled for 4/5 and I will wait one last time to see what occurs. I am putting off my older child's well child check until we secure new insurance, which we are currently applying for through my business corporation to obtain a group policy. I will end up paying about $900/month for my family through this plan ($500 deductible), but they can not impose " lifetime exclusions " on any one enrolled, and I will actually have health insurance. My husband and I have just decided this is yet another fixed expense that my business will have to support. I currently see an average of 10-15 patient's/day 4.5 days per week. I have one full time employee who is my receptionist and biller. Her raise this year will be the addition of health insurance for herself and her son ($400/month with new plan). She was uninsurable through an individual plan due to history of migraines. I strongly recommend maintaining some form of group insurance, as the rules behind individual policies seem ever changing and they are too easily able to hold claims hostage for indefinite periods of time. I would have been better off not being insured for the last year than to have this individual policy through Anthem. At least then I would have received cash discounts and my wonderful physicians would have been paid by now. Instead, Anthem has gleefully cashed my monthly check and provided ZERO services. I am now faced with bills that I feel obligated to pay with only small hope of getting reimbursed by Anthem. You are wise to realize this is an serious expense for a solo practicioner. Would I go back to my prior postion? No, but I much wiser to the details of " individual " vs " group " insurance plans. This expense will also make it impossible for me to go to part time hours, as many on this list serve are able to do by having other sources for health insurance. , M.D. Durango, CO n, 27 Mar 2006 09:36:00 -0500 rftulie@... wrote: > So, as I contemplate my future practicing in this model, my wife asks > me, " how are we going to afford health insurance? Isn't it going to be > worse than self-employment tax (which I am complaining about now as I > get paid as a consultant for locum jobs)? > > Is there an archive I could look at regarding how people in this model > (those who aren't liked to someone else's health insurance) pay (or > don't?) for health insurance? > ___________________________________________________ > Try the New Netscape Mail Today! > Virtually Spam-Free | More Storage | Import Your Contact List > http://mail.netscape.com > > > YAHOO! GROUPS LINKS > Visit your group " " on the web. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I realize more & more that Anthem BSBS is the worst insurance known. I take almost all insurances except Anthem. I don't know how they stay in business. But yes, group plans are somewhat better for a small office, but are still costly. Re: personal health insurance Health insurance has been my biggest nightmare with my low overhead practice. When I started my low overhead practice June 2005, I obtained an individual health insurance policy for my family. (I had always been on group plans prior to this). I signed on with Athem, BCBS (my first mistake). I currently pay $500 per month for a 2K deductible plan for my healthy family of four. (They increased our rate by $100 per month after 6 months on this plan--Sad note accompanying the rate increase notification said their " costs " had increased and they were very sorry to have to pass this along...it brought a tear to my eye...) I signed on in July of 2005 with the following LIFETIME exclusions: my husband's RIGHT elbow is uninsurable and he can not be covered for the diagnosis of depression. (He had received physical therapy for lateral epicondylitis in the last 5 years and one doctor's note mentioned depression, hence the LIFETIME exclusions). In October 2005, I received a letter from Anthem requesting a list of all the physicians I had seen and my 4-year-old son had seen in the last 5 years. Unknown to me, they had put my ENTIRE policy on hold until they received all these records. My son had a couple of claims for well child checks and viral illnesses, and recently broke his wrist. I strained my piriformis when I overdid my rowing. These simple incidents resulted in claims for Anthem, thus triggering a " policy review. " To make a very long horrific story somewhat short, Anthem to this date has not paid ANY claims that have been submitted to them since October. My policy has been " in review " now for over 6 months. I am not allowed to speak to anyone directly regarding my policy and what is under review, and any EOBs for claims submitted are sent back to my providers with " DENY-eligibility under review " . My certified letters sent to Anthem are received, but never to this date acknowledged. I may have to get legal counsel soon, but the next " review " is scheduled for 4/5 and I will wait one last time to see what occurs. I am putting off my older child's well child check until we secure new insurance, which we are currently applying for through my business corporation to obtain a group policy. I will end up paying about $900/month for my family through this plan ($500 deductible), but they can not impose " lifetime exclusions " on any one enrolled, and I will actually have health insurance. My husband and I have just decided this is yet another fixed expense that my business will have to support. I currently see an average of 10-15 patient's/day 4.5 days per week. I have one full time employee who is my receptionist and biller. Her raise this year will be the addition of health insurance for herself and her son ($400/month with new plan). She was uninsurable through an individual plan due to history of migraines. I strongly recommend maintaining some form of group insurance, as the rules behind individual policies seem ever changing and they are too easily able to hold claims hostage for indefinite periods of time. I would have been better off not being insured for the last year than to have this individual policy through Anthem. At least then I would have received cash discounts and my wonderful physicians would have been paid by now. Instead, Anthem has gleefully cashed my monthly check and provided ZERO services. I am now faced with bills that I feel obligated to pay with only small hope of getting reimbursed by Anthem. You are wise to realize this is an serious expense for a solo practicioner. Would I go back to my prior postion? No, but I much wiser to the details of " individual " vs " group " insurance plans. This expense will also make it impossible for me to go to part time hours, as many on this list serve are able to do by having other sources for health insurance. , M.D. Durango, CO n, 27 Mar 2006 09:36:00 -0500 rftulie@... wrote: > So, as I contemplate my future practicing in this model, my wife asks > me, " how are we going to afford health insurance? Isn't it going to be > worse than self-employment tax (which I am complaining about now as I > get paid as a consultant for locum jobs)? > > Is there an archive I could look at regarding how people in this model > (those who aren't liked to someone else's health insurance) pay (or > don't?) for health insurance? > ___________________________________________________ > Try the New Netscape Mail Today! > Virtually Spam-Free | More Storage | Import Your Contact List > http://mail.netscape.com > > > YAHOO! GROUPS LINKS > Visit your group " " on the web. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their " costs " had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a " policy review. " > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been " in review " now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with " DENY-eligibility under > review " . > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > " review " is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose " lifetime > exclusions " on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > " individual " vs " group " insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 > rftulie@... wrote: >> So, as I contemplate my future practicing in this model, my wife >> asks >> me, " how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >> YAHOO! GROUPS LINKS >> Visit your group " " on the web. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their " costs " had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a " policy review. " > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been " in review " now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with " DENY-eligibility under > review " . > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > " review " is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose " lifetime > exclusions " on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > " individual " vs " group " insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 > rftulie@... wrote: >> So, as I contemplate my future practicing in this model, my wife >> asks >> me, " how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >> YAHOO! GROUPS LINKS >> Visit your group " " on the web. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I pay 2200 bucks per YEAR (549 quarterly or something like that) for me (38) and my husband (49) on a 5 K deductible plan with Fortis. The ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not even think of calling on them for anything else. It is not worth the hassle to "sweat the small stuff" as they say and I would rather do what I want with whatever doc I want to see and not deal with any insurance> I am willing to pay cash at the time of service, etc... I even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone should try this just for entertainment!). A few quotes from him  "everything looks the same"  " I don't see anything"   until...... "OH, I think I found something..."Anyway it was NORMAL!!! (CIN II years ago)PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...www.idealmedicalpractice.orgOn Mar 29, 2006, at 8:23 AM, Anemaria Lutas wrote: I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their "costs"had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a "policy review." > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been "in review" now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with "DENY-eligibility under > review". > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > "review" is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose "lifetime > exclusions" on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > "individual" vs "group" insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 >  rftulie@... wrote: >>  So, as I contemplate my future practicing in this model, my wife >> asks >> me, "how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >>        YAHOO! GROUPS LINKS >>    Visit your group "" on the web. >>    Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I pay 2200 bucks per YEAR (549 quarterly or something like that) for me (38) and my husband (49) on a 5 K deductible plan with Fortis. The ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not even think of calling on them for anything else. It is not worth the hassle to "sweat the small stuff" as they say and I would rather do what I want with whatever doc I want to see and not deal with any insurance> I am willing to pay cash at the time of service, etc... I even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone should try this just for entertainment!). A few quotes from him  "everything looks the same"  " I don't see anything"   until...... "OH, I think I found something..."Anyway it was NORMAL!!! (CIN II years ago)PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...www.idealmedicalpractice.orgOn Mar 29, 2006, at 8:23 AM, Anemaria Lutas wrote: I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their "costs"had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a "policy review." > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been "in review" now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with "DENY-eligibility under > review". > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > "review" is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose "lifetime > exclusions" on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > "individual" vs "group" insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 >  rftulie@... wrote: >>  So, as I contemplate my future practicing in this model, my wife >> asks >> me, "how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >>        YAHOO! GROUPS LINKS >>    Visit your group "" on the web. >>    Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I pay 2200 bucks per YEAR (549 quarterly or something like that) for me (38) and my husband (49) on a 5 K deductible plan with Fortis. The ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not even think of calling on them for anything else. It is not worth the hassle to "sweat the small stuff" as they say and I would rather do what I want with whatever doc I want to see and not deal with any insurance> I am willing to pay cash at the time of service, etc... I even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone should try this just for entertainment!). A few quotes from him  "everything looks the same"  " I don't see anything"   until...... "OH, I think I found something..."Anyway it was NORMAL!!! (CIN II years ago)PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...www.idealmedicalpractice.orgOn Mar 29, 2006, at 8:23 AM, Anemaria Lutas wrote: I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their "costs"had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a "policy review." > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been "in review" now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with "DENY-eligibility under > review". > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > "review" is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose "lifetime > exclusions" on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > "individual" vs "group" insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 >  rftulie@... wrote: >>  So, as I contemplate my future practicing in this model, my wife >> asks >> me, "how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >>        YAHOO! GROUPS LINKS >>    Visit your group "" on the web. >>    Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 Health insurance has also be a big problem for my little group. We had to have a group of 5. We are using a HSA with a large deductible. Ours has never paid a claim and went up by 35 percent. What BS. This is an important issue for most wanting to do this type of practice. Is there a way to band together? It is also a benefit that is you start for an employee it is hard to take away. It is like a bottomless pit. I can buy an awful lot of health care for the fees these people charge in their fancy suites and high rise office buildings and large bonuses paid to the execs. How do we fight back? Brent > > >> So, as I contemplate my future practicing in this model, my wife > > >> asks > > >> me, " how are we going to afford health insurance? Isn't it going > > to be > > >> worse than self-employment tax (which I am complaining about now > > as I > > >> get paid as a consultant for locum jobs)? > > >> > > >> Is there an archive I could look at regarding how people in this > > model > > >> (those who aren't liked to someone else's health insurance) pay (or > > >> don't?) for health insurance? > > >> ___________________________________________________ > > >> Try the New Netscape Mail Today! > > >> Virtually Spam-Free | More Storage | Import Your Contact List > > >> http://mail.netscape.com > > >> > > >> > > >> YAHOO! GROUPS LINKS > > >> Visit your group " " on the web. > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 Health insurance has also be a big problem for my little group. We had to have a group of 5. We are using a HSA with a large deductible. Ours has never paid a claim and went up by 35 percent. What BS. This is an important issue for most wanting to do this type of practice. Is there a way to band together? It is also a benefit that is you start for an employee it is hard to take away. It is like a bottomless pit. I can buy an awful lot of health care for the fees these people charge in their fancy suites and high rise office buildings and large bonuses paid to the execs. How do we fight back? Brent > > >> So, as I contemplate my future practicing in this model, my wife > > >> asks > > >> me, " how are we going to afford health insurance? Isn't it going > > to be > > >> worse than self-employment tax (which I am complaining about now > > as I > > >> get paid as a consultant for locum jobs)? > > >> > > >> Is there an archive I could look at regarding how people in this > > model > > >> (those who aren't liked to someone else's health insurance) pay (or > > >> don't?) for health insurance? > > >> ___________________________________________________ > > >> Try the New Netscape Mail Today! > > >> Virtually Spam-Free | More Storage | Import Your Contact List > > >> http://mail.netscape.com > > >> > > >> > > >> YAHOO! GROUPS LINKS > > >> Visit your group " " on the web. > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 LOL!!!! Pam, I'm not sure to categorize this as simply " hilarious " or " way too much information " . Either way, it gave me a good laugh. It reminded me of a new patient I had a few years ago from Québec. Her five year-old son who only spoke French at the time joined her for the appointment. She asked that he be there and allowed him to walk about. While I did the Pap he came up behind me and watched from over my shoulder. It was surreal for my nurse and me but the patient was fine with that and her son went back to normal fantasy play of a small child without a pause. In later years her son stayed home or was in the waiting room. Anyway, my nurses and I laughed about it every so often. Tim > I pay 2200 bucks per YEAR (549 quarterly or something like that) for > me (38) and my husband (49) on a 5 K deductible plan with Fortis. The > ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not > even think of calling on them for anything else. It is not worth the > hassle to " sweat the small stuff " as they say and I would rather do > what I want with whatever doc I want to see and not deal with any > insurance> I am willing to pay cash at the time of service, etc... I > even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone > should try this just for entertainment!). A few quotes from him > " everything looks the same " " I don't see anything " until...... > " OH, I think I found something... " > > Anyway it was NORMAL!!! (CIN II years ago) > > > > Pamela > > > Pamela Wible, MD > Family & Community Medicine, LLC > 3575 st. #220 > Eugene, OR 97405 > > roxywible@... > www.idealmedicalpractice.org > > > > > > > > > > > >> I had a hard time with Anthem as well and cancelled my policy after I >> found another insurance through PHCS, by enrolling in a group called >> Alliance for Affordable Services (no interest in the company). My rate >> is now 380 $ month for 2000 deductible (250 for outpatient testing) >> and >> 5 people but excluding ER visits and maternity. It is much better than >> Anthem where my premium was 340 with 5000 deductible and a lot of >> restrictions. Plus their customer service was HORRIBLE. It is a >> horrible company and I hope the market will punish them. >> >> >> >> > >> > Health insurance has been my biggest nightmare with my low overhead >> practice. >> > When I started my low overhead practice June 2005, I obtained an >> individual >> > health insurance policy for my family. (I had always been on group >> plans >> > prior to this). >> > >> > I signed on with Athem, BCBS (my first mistake). I currently pay >> $500 >> > per >> > month for a 2K deductible plan for my healthy family of four. (They >> increased >> > our rate by $100 per month after 6 months on this plan--Sad note >> accompanying >> > the rate increase notification said their " costs " had increased and >> they were >> > very sorry to have to pass this along...it brought a tear to my >> eye...) I >> > signed on in July of 2005 with the following LIFETIME exclusions: my >> husband's >> > RIGHT elbow is uninsurable and he can not be covered for the >> diagnosis >> > of >> > depression. (He had received physical therapy for lateral >> > epicondylitis in >> > the last 5 years and one doctor's note mentioned depression, >> hence the >> > LIFETIME exclusions). >> > >> > In October 2005, I received a letter from Anthem requesting a >> list of >> > all the >> > physicians I had seen and my 4-year-old son had seen in the last 5 >> years. >> > Unknown to me, they had put my ENTIRE policy on hold until they >> > received all >> > these records. My son had a couple of claims for well child checks >> and viral >> > illnesses, and recently broke his wrist. I strained my piriformis >> when I >> > overdid my rowing. These simple incidents resulted in claims for >> Anthem, thus >> > triggering a " policy review. " >> > >> > To make a very long horrific story somewhat short, Anthem to this >> date >> > has not >> > paid ANY claims that have been submitted to them since October. My >> policy has >> > been " in review " now for over 6 months. I am not allowed to >> speak to >> > anyone >> > directly regarding my policy and what is under review, and any EOBs >> for claims >> > submitted are sent back to my providers with " DENY-eligibility under >> review " . >> > My certified letters sent to Anthem are received, but never to this >> date >> > acknowledged. I may have to get legal counsel soon, but the next >> " review " is >> > scheduled for 4/5 and I will wait one last time to see what occurs. >> > >> > I am putting off my older child's well child check until we >> secure new >> > insurance, which we are currently applying for through my business >> corporation >> > to obtain a group policy. I will end up paying about $900/month for >> my family >> > through this plan ($500 deductible), but they can not impose >> " lifetime >> > exclusions " on any one enrolled, and I will actually have health >> insurance. My >> > husband and I have just decided this is yet another fixed expense >> that >> > my >> > business will have to support. >> > >> > I currently see an average of 10-15 patient's/day 4.5 days per >> week. I >> > have >> > one full time employee who is my receptionist and biller. Her raise >> this year >> > will be the addition of health insurance for herself and her son >> ($400/month >> > with new plan). She was uninsurable through an individual plan >> due to >> > history >> > of migraines. >> > >> > I strongly recommend maintaining some form of group insurance, as >> the >> > rules >> > behind individual policies seem ever changing and they are too >> easily >> > able to >> > hold claims hostage for indefinite periods of time. I would have >> been >> > better >> > off not being insured for the last year than to have this individual >> policy >> > through Anthem. At least then I would have received cash discounts >> and my >> > wonderful physicians would have been paid by now. Instead, >> Anthem has >> > gleefully cashed my monthly check and provided ZERO services. I am >> now faced >> > with bills that I feel obligated to pay with only small hope of >> getting >> > reimbursed by Anthem. >> > >> > You are wise to realize this is an serious expense for a solo >> > practicioner. >> > Would I go back to my prior postion? No, but I much wiser to the >> > details of >> > " individual " vs " group " insurance plans. This expense will also >> make >> > it >> > impossible for me to go to part time hours, as many on this list >> serve >> > are >> > able to do by having other sources for health insurance. >> > >> > , M.D. >> > Durango, CO >> > >> > n, 27 Mar 2006 09:36:00 -0500 >> > rftulie@... wrote: >> >> So, as I contemplate my future practicing in this model, my wife >> >> asks >> >> me, " how are we going to afford health insurance? Isn't it going >> to be >> >> worse than self-employment tax (which I am complaining about now >> as I >> >> get paid as a consultant for locum jobs)? >> >> >> >> Is there an archive I could look at regarding how people in this >> model >> >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> >> ___________________________________________________ >> >> Try the New Netscape Mail Today! >> >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >> >> >> >> YAHOO! GROUPS LINKS >> >> Visit your group " " on the web. >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 LOL!!!! Pam, I'm not sure to categorize this as simply " hilarious " or " way too much information " . Either way, it gave me a good laugh. It reminded me of a new patient I had a few years ago from Québec. Her five year-old son who only spoke French at the time joined her for the appointment. She asked that he be there and allowed him to walk about. While I did the Pap he came up behind me and watched from over my shoulder. It was surreal for my nurse and me but the patient was fine with that and her son went back to normal fantasy play of a small child without a pause. In later years her son stayed home or was in the waiting room. Anyway, my nurses and I laughed about it every so often. Tim > I pay 2200 bucks per YEAR (549 quarterly or something like that) for > me (38) and my husband (49) on a 5 K deductible plan with Fortis. The > ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not > even think of calling on them for anything else. It is not worth the > hassle to " sweat the small stuff " as they say and I would rather do > what I want with whatever doc I want to see and not deal with any > insurance> I am willing to pay cash at the time of service, etc... I > even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone > should try this just for entertainment!). A few quotes from him > " everything looks the same " " I don't see anything " until...... > " OH, I think I found something... " > > Anyway it was NORMAL!!! (CIN II years ago) > > > > Pamela > > > Pamela Wible, MD > Family & Community Medicine, LLC > 3575 st. #220 > Eugene, OR 97405 > > roxywible@... > www.idealmedicalpractice.org > > > > > > > > > > > >> I had a hard time with Anthem as well and cancelled my policy after I >> found another insurance through PHCS, by enrolling in a group called >> Alliance for Affordable Services (no interest in the company). My rate >> is now 380 $ month for 2000 deductible (250 for outpatient testing) >> and >> 5 people but excluding ER visits and maternity. It is much better than >> Anthem where my premium was 340 with 5000 deductible and a lot of >> restrictions. Plus their customer service was HORRIBLE. It is a >> horrible company and I hope the market will punish them. >> >> >> >> > >> > Health insurance has been my biggest nightmare with my low overhead >> practice. >> > When I started my low overhead practice June 2005, I obtained an >> individual >> > health insurance policy for my family. (I had always been on group >> plans >> > prior to this). >> > >> > I signed on with Athem, BCBS (my first mistake). I currently pay >> $500 >> > per >> > month for a 2K deductible plan for my healthy family of four. (They >> increased >> > our rate by $100 per month after 6 months on this plan--Sad note >> accompanying >> > the rate increase notification said their " costs " had increased and >> they were >> > very sorry to have to pass this along...it brought a tear to my >> eye...) I >> > signed on in July of 2005 with the following LIFETIME exclusions: my >> husband's >> > RIGHT elbow is uninsurable and he can not be covered for the >> diagnosis >> > of >> > depression. (He had received physical therapy for lateral >> > epicondylitis in >> > the last 5 years and one doctor's note mentioned depression, >> hence the >> > LIFETIME exclusions). >> > >> > In October 2005, I received a letter from Anthem requesting a >> list of >> > all the >> > physicians I had seen and my 4-year-old son had seen in the last 5 >> years. >> > Unknown to me, they had put my ENTIRE policy on hold until they >> > received all >> > these records. My son had a couple of claims for well child checks >> and viral >> > illnesses, and recently broke his wrist. I strained my piriformis >> when I >> > overdid my rowing. These simple incidents resulted in claims for >> Anthem, thus >> > triggering a " policy review. " >> > >> > To make a very long horrific story somewhat short, Anthem to this >> date >> > has not >> > paid ANY claims that have been submitted to them since October. My >> policy has >> > been " in review " now for over 6 months. I am not allowed to >> speak to >> > anyone >> > directly regarding my policy and what is under review, and any EOBs >> for claims >> > submitted are sent back to my providers with " DENY-eligibility under >> review " . >> > My certified letters sent to Anthem are received, but never to this >> date >> > acknowledged. I may have to get legal counsel soon, but the next >> " review " is >> > scheduled for 4/5 and I will wait one last time to see what occurs. >> > >> > I am putting off my older child's well child check until we >> secure new >> > insurance, which we are currently applying for through my business >> corporation >> > to obtain a group policy. I will end up paying about $900/month for >> my family >> > through this plan ($500 deductible), but they can not impose >> " lifetime >> > exclusions " on any one enrolled, and I will actually have health >> insurance. My >> > husband and I have just decided this is yet another fixed expense >> that >> > my >> > business will have to support. >> > >> > I currently see an average of 10-15 patient's/day 4.5 days per >> week. I >> > have >> > one full time employee who is my receptionist and biller. Her raise >> this year >> > will be the addition of health insurance for herself and her son >> ($400/month >> > with new plan). She was uninsurable through an individual plan >> due to >> > history >> > of migraines. >> > >> > I strongly recommend maintaining some form of group insurance, as >> the >> > rules >> > behind individual policies seem ever changing and they are too >> easily >> > able to >> > hold claims hostage for indefinite periods of time. I would have >> been >> > better >> > off not being insured for the last year than to have this individual >> policy >> > through Anthem. At least then I would have received cash discounts >> and my >> > wonderful physicians would have been paid by now. Instead, >> Anthem has >> > gleefully cashed my monthly check and provided ZERO services. I am >> now faced >> > with bills that I feel obligated to pay with only small hope of >> getting >> > reimbursed by Anthem. >> > >> > You are wise to realize this is an serious expense for a solo >> > practicioner. >> > Would I go back to my prior postion? No, but I much wiser to the >> > details of >> > " individual " vs " group " insurance plans. This expense will also >> make >> > it >> > impossible for me to go to part time hours, as many on this list >> serve >> > are >> > able to do by having other sources for health insurance. >> > >> > , M.D. >> > Durango, CO >> > >> > n, 27 Mar 2006 09:36:00 -0500 >> > rftulie@... wrote: >> >> So, as I contemplate my future practicing in this model, my wife >> >> asks >> >> me, " how are we going to afford health insurance? Isn't it going >> to be >> >> worse than self-employment tax (which I am complaining about now >> as I >> >> get paid as a consultant for locum jobs)? >> >> >> >> Is there an archive I could look at regarding how people in this >> model >> >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> >> ___________________________________________________ >> >> Try the New Netscape Mail Today! >> >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >> >> >> >> YAHOO! GROUPS LINKS >> >> Visit your group " " on the web. >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 Brent: I think you have fought back, but i am sure that the insurance industry has written the rules to lower their risk more than they lowered your premiums for the HSA. To truely take them out of the equation there would need to be a two tiered program of insurance one for outpatient primary care and one for hospitalization like Medicare A & B. Call me crazy but I think medicare charges $78/month for part B coverage which should cover out patient care. Perhaps we can provide something similar to remainder of the population. This would decrease the volume of health care dollars the insurance companies could charge premiums on for their profits. The remainder of insurance need would be strickly hospitalization, home care and long term residential care. brenthrabik wrote: Health insurance has also be a big problem for my little group. We had to have a group of 5. We are using a HSA with a large deductible. Ours has never paid a claim and went up by 35 percent. What BS. This is an important issue for most wanting to do this type of practice. Is there a way to band together? It is also a benefit that is you start for an employee it is hard to take away. It is like a bottomless pit. I can buy an awful lot of health care for the fees these people charge in their fancy suites and high rise office buildings and large bonuses paid to the execs. How do we fight back?Brent> > >> So, as I contemplate my future practicing in this model, my wife> > >> asks> > >> me, "how are we going to afford health insurance? Isn't it going > > to be> > >> worse than self-employment tax (which I am complaining about now > > as I> > >> get paid as a consultant for locum jobs)?> > >>> > >> Is there an archive I could look at regarding how people in this > > model> > >> (those who aren't liked to someone else's health insurance) pay (or> > >> don't?) for health insurance?> > >> ___________________________________________________> > >> Try the New Netscape Mail Today!> > >> Virtually Spam-Free | More Storage | Import Your Contact List> > >> http://mail.netscape.com> > >>> > >>> > >> YAHOO! GROUPS LINKS> > >> Visit your group "" on the web.> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2006 Report Share Posted March 29, 2006 I happen to have been dealing with this issue today. i cannot describe without obsceneites the witch I become when I talk to anthem/bl cross. here are thignsi have learned painfully that may help others: 1 .there is nothign you can buy that is afforablde honeest or decent or a good policy There are no understandable consumer frfiendly products Ther are none. do your best. 2.beware of starting n ow- they donot tell you clealry but teh deductible you buy on the may 1 to may1 nexy year policy--well ,the decutible is til the dec 31 calneder year then starts allover. 2 but indiviula policies - can be cheaper-- say, as I do, buy 2 HSAs with a dedeuctilble that the husband will meet but I never do, vs if it is a group or family policy then the deductble is TWICE the individual deductible and the poicy cost is almost twice as much so NOT a good buy. 3. remember that health insurance is leaglaized fraud Try not to say as many bad words as i do. My husband has had a carotid dissection with complication .1 yr later salmonella-->2 wks later Guilloan barre with an ununusal complication. 2 yrs later hit and run 3,ooo miles from home-->helicoptered to a trauma hospital I know a lot about health care and doctors and health insuracne There is little good to say. sadly, jean Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2006 Report Share Posted March 30, 2006 One of the options here, besides a group policy through one of the local IPA's, is to join one of the chamber of commerce's. There are several suburbs that have their own chamber. You can join and be on a group policy with several other small business owners. I have a handful of patients who are small business owners (insurance, antique shop, beauty shop etc...) and they all drive a school bus to and from school. This allows them to get FULL coverage insurance for themselves and their families and work at a really part time job and get summer's off. Just a thought! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2006 Report Share Posted March 30, 2006 Oh I don't think that health plan necessarily sounds " too good to be true " . Par for the course maybe, but not great. A $5,000 deductible is still pretty hefty & $2200/yr on top of that is not extraordinarily high but is still a decent chunk of money to pay considering most everything (other than catastrophic) will be out of pocket. That actually sounds like a pretty good plan: covered for major medical catastrophe & pay out of pocket for the smaller stuff. Re: personal health insurance I pay 2200 bucks per YEAR (549 quarterly or something like that) for me (38) and my husband (49) on a 5 K deductible plan with Fortis. The ONLY reason I have insurance is for a HUGE CATASTROPHE!! I would not even think of calling on them for anything else. It is not worth the hassle to " sweat the small stuff " as they say and I would rather do what I want with whatever doc I want to see and not deal with any insurance> I am willing to pay cash at the time of service, etc... I even taught my hubby to do my pap smear (VERY, VERY FUNNY - everyone should try this just for entertainment!). A few quotes from him " everything looks the same " " I don't see anything " until...... " OH, I think I found something... " Anyway it was NORMAL!!! (CIN II years ago) Pamela Pamela Wible, MD Family & Community Medicine, LLC 3575 st. #220 Eugene, OR 97405 roxywible@... www.idealmedicalpractice.org I had a hard time with Anthem as well and cancelled my policy after I found another insurance through PHCS, by enrolling in a group called Alliance for Affordable Services (no interest in the company). My rate is now 380 $ month for 2000 deductible (250 for outpatient testing) and 5 people but excluding ER visits and maternity. It is much better than Anthem where my premium was 340 with 5000 deductible and a lot of restrictions. Plus their customer service was HORRIBLE. It is a horrible company and I hope the market will punish them. > > Health insurance has been my biggest nightmare with my low overhead > practice. > When I started my low overhead practice June 2005, I obtained an > individual > health insurance policy for my family. (I had always been on group > plans > prior to this). > > I signed on with Athem, BCBS (my first mistake). I currently pay $500 > per > month for a 2K deductible plan for my healthy family of four. (They > increased > our rate by $100 per month after 6 months on this plan--Sad note > accompanying > the rate increase notification said their " costs " had increased and > they were > very sorry to have to pass this along...it brought a tear to my > eye...) I > signed on in July of 2005 with the following LIFETIME exclusions: my > husband's > RIGHT elbow is uninsurable and he can not be covered for the diagnosis > of > depression. (He had received physical therapy for lateral > epicondylitis in > the last 5 years and one doctor's note mentioned depression, hence the > LIFETIME exclusions). > > In October 2005, I received a letter from Anthem requesting a list of > all the > physicians I had seen and my 4-year-old son had seen in the last 5 > years. > Unknown to me, they had put my ENTIRE policy on hold until they > received all > these records. My son had a couple of claims for well child checks > and viral > illnesses, and recently broke his wrist. I strained my piriformis > when I > overdid my rowing. These simple incidents resulted in claims for > Anthem, thus > triggering a " policy review. " > > To make a very long horrific story somewhat short, Anthem to this date > has not > paid ANY claims that have been submitted to them since October. My > policy has > been " in review " now for over 6 months. I am not allowed to speak to > anyone > directly regarding my policy and what is under review, and any EOBs > for claims > submitted are sent back to my providers with " DENY-eligibility under > review " . > My certified letters sent to Anthem are received, but never to this > date > acknowledged. I may have to get legal counsel soon, but the next > " review " is > scheduled for 4/5 and I will wait one last time to see what occurs. > > I am putting off my older child's well child check until we secure new > insurance, which we are currently applying for through my business > corporation > to obtain a group policy. I will end up paying about $900/month for > my family > through this plan ($500 deductible), but they can not impose " lifetime > exclusions " on any one enrolled, and I will actually have health > insurance. My > husband and I have just decided this is yet another fixed expense that > my > business will have to support. > > I currently see an average of 10-15 patient's/day 4.5 days per week. I > have > one full time employee who is my receptionist and biller. Her raise > this year > will be the addition of health insurance for herself and her son > ($400/month > with new plan). She was uninsurable through an individual plan due to > history > of migraines. > > I strongly recommend maintaining some form of group insurance, as the > rules > behind individual policies seem ever changing and they are too easily > able to > hold claims hostage for indefinite periods of time. I would have been > better > off not being insured for the last year than to have this individual > policy > through Anthem. At least then I would have received cash discounts > and my > wonderful physicians would have been paid by now. Instead, Anthem has > gleefully cashed my monthly check and provided ZERO services. I am > now faced > with bills that I feel obligated to pay with only small hope of getting > reimbursed by Anthem. > > You are wise to realize this is an serious expense for a solo > practicioner. > Would I go back to my prior postion? No, but I much wiser to the > details of > " individual " vs " group " insurance plans. This expense will also make > it > impossible for me to go to part time hours, as many on this list serve > are > able to do by having other sources for health insurance. > > , M.D. > Durango, CO > > n, 27 Mar 2006 09:36:00 -0500 > rftulie@... wrote: >> So, as I contemplate my future practicing in this model, my wife >> asks >> me, " how are we going to afford health insurance? Isn't it going to be >> worse than self-employment tax (which I am complaining about now as I >> get paid as a consultant for locum jobs)? >> >> Is there an archive I could look at regarding how people in this model >> (those who aren't liked to someone else's health insurance) pay (or >> don't?) for health insurance? >> ___________________________________________________ >> Try the New Netscape Mail Today! >> Virtually Spam-Free | More Storage | Import Your Contact List >> http://mail.netscape.com >> >> >> YAHOO! 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Guest guest Posted March 30, 2006 Report Share Posted March 30, 2006 LL – Workers comp – my accountant (my brother-in-law) recommended I decline covering myself (as he does for his business) to help keep rates down. Since I don’t have a lot of risk (don’t do injections for needle sticks, etc), I’ve opted to follow his advice. I do have disability and health insurance and business insurance, however. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of lawrence lyon Sent: Wednesday, March 29, 2006 1:36 PM To: practice improvement Subject: personal health insurance i am one of the 45 million uninsured. now approaching 50, i think it's time to have to health insurance. i've called aafp, and they have not had anything to do with personal health insurance for for the past nine years. here in washington state, insurers base rates on age and geographic location. i am waiting for a broker (recommended by the local medical society) for a quote. i've asked for a group rate (for myself and one of my employees; my other employee has her own insurance). i've also asked about vision and dental benefits, so we'll see how much that costs. apparently, benefits are tax-deductible. how do those of us who provide benefits do it? how are they tax deductible? did you go through a broker? did you get " association " rates? did you consult an accountant? if one has group rates based on a group of two, what happens if the other member of the group leaves? how does one prevent rates from increasing? can one prevent rates from increasing? additionally, i'm told that if i provide the opportunity for the benefit, i will have to pay for 75% of the cost for my employee, even though it's tax deductible. i don't think an hsa would be acceptable for my employee because of the high deductible, and am told that an hra is a pain to set up and there would have to be an administrator for it. i was also recommended to pay worker's compensation premiums for myself, and to be an employee of my pllc. is anyone doing that? if i did that, and since i work both at home and at work, would my travel be covered by worker's comp if anything happened to me to/from home/work? thanks in advance. LL Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice. Quote Link to comment Share on other sites More sharing options...
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