[breezeonby]

I live in the USA :usa2: I have private health insurance. I don't need a referral and my plan covers everything except dental and vision.
I have dentures and only need new dentures every 5-6 years. I go once a year to have my gums and tongue checked out, just don't want to get cancer or something. My dentist only charges me $20 to check me out. Had cataract surgery in May 2010 and I just need to get a dilated exam once per year. My prescription drug plan changed somewhat. They dropped a lot of meds off of the formulary which I wasn't happy about that. If I find that my current rx plan is too strict, I can change to a different rx plan, but it will cost me about $60 more each month. It is still early in the year and I am going to start asking for samples of new medications. Ask your doctor to give you a tour of their sample closet, my doctor has 2 closets and he has a lot of samples. :focus: Anyway, if you live outside of the USA, I am really interested as to how your health care system works.

 

[onaughmae]

well..I am in the US....but I have a PPO, I can go to anyone but going to someone in network is obviously cheaper for me. I have medical, vision and dental coverage. I pay 30.00 for dr visits, including any labs, xrays, whatever they order. If I have to go for something like an MRI or CT scan, my deductible for the year is 500 dollars, then I am covered 100% after that. I have drug coverage, the cost depends on if it is generic or not but I never pay over 90 dollars for a 3 month supply of anything. My testing supplies are covered 100%. My pump supplies are mostly covered, I pay 90.00 for a 3 month supply. I have to say...I cant complain. I pay a lot for my coverage, about 4200.00/year, but its worth it.

 

[onlymep]

I live in Australia and my health cover is a mixed bag. Part of my health is covered by a govt funded system called Medicare (you have to pay a levy for it through the tax system). My usual docs visit is $68, but I get $21 back (my doc registered different... the usual rebate is $34). If I go for xrays, ct scans, ultrasounds, specialists, etc... I pay upfront and then get partial rebate from Medicare (private health fund doesn't cover this). eg. I paid $190 for last ultrasound and got approx $110 back. My medication is covered mostly by govt funded Pharmaceutical Benefit Scheme, although on average I pay between $20-$35 per script. My lancets/needles/test strips is partially covered under National Diabetes Services Scheme. I get the needles fully covered, but have to partially pay for strips & fully pay for lancets. I have my own private health cover which covers incidentals (covered for 80% of cost mostly) such as ambulance, dental, physio, chiropractic, etc. I also have basic hospital cover with that policy. I probably spend minimum of $75 everytime I visit a pharmacy on average. So I reckon I spend a lot of money on my health.. I'd hate to think what it would cost if all of family was diabetic, or some other chronic condition.

 

[jwags]

We are self employed and both 60, so we have to buy our insurance on the open market. Since we both have diabetes and my husband has high BP we may through the nose for a policy. Each year it goes up $100-$200 per month. We went to the highest deductible allowed ($6,000) but we still have to pay over $1000 per month in premiums. We have to go to a doctor in our PPO to have it go towards our deductible and get the Anthem discount. In 5 years of this we have never met our deductible so we pay for every doctors visit, Rx, lab test, etc. I would love to be able to get Catastrophic insurance but they don't sell it. I can't wait until I turn 65 then our premiums will be cut by 60-70% with Medicare. Lately we have found buying our expensive meds from Canada saves us 60%.

 

[breezeonby]

So far the 3 posts are very interesting. I don't believe there is free lunch when it comes to paying for health care.

 

[Shanny]

So far the 3 posts are very interesting. I don't believe there is free lunch when it comes to paying for health care.

Not even America's favorite whipping boy, Medicare. By the time I pay the premiums on my basic Medicare policy, my Medicare supplement, and my Part D coverage, I'm out over $300 a month. And for the household, that's over $600 a month. Hardly a "handout", as many would have you believe.

 

[beefy]

I'm in Alberta, Canada. In Canada you can see your family physican or be referred for lab tests/most specialists/MRI's etc. for no cost under your provinces health care plans. Most provinces do deduct from your paycheque to help cover the cost of this (Alberta does NOT), as well Canada has fairly high income taxes to cover the costs. Prescription drugs are not covered unless you collect some kind of social assistance.

The downside is, especially in Alberta, the system is swamped. In Calgary you can wait 6-12 months for an MRI. I waited 3 full weeks for an 'urgent' MRI. There are usually at least one or two people a year that make the news because they DIE waiting in the Emergency room because the system is overcrowded, over-worked and under-served.

Other downsides: About 1/4 of the people don't have a family doctor, because of the Dr. shortage here. There's long wait times for specialists. Many services not covered, such as: Podiatry (my son had to pay $400 to remove an ingrown toenail), Chiropractic, Dental, Eye Exams (except medically-necessary exams), Psychological services (though psychiatrists are covered).

I have private health insurance through my employer to cover many of the un-insured services - I don't recall how much I pay for that, but it's well worth it. I have a whopping $50 deductible for family member per year, and 80% co-pay on most prescriptions, most dental (not cosmetic), and most un-insured services I mentioned above, including prescription eyewear. But there's a maximum yearly limit on each service (maximum per 2 years for eyewear).

That's all I can think of at the moment.

 

[Chesney]

I am very lucky... The only thing I pay for is prescriptions and that is only a copay....which can be $3-$44. It is one of the main reasons why we decided 5 years ago to stay in then military. I do have coverage through work too. The tribe pays the premiums but I would have to pay copays so I doubt I will ever use it.

 

[onlymep]

a good topic to bring up - thanks Breeze.
It's been an interesting read so far.
One thing I noticed we all have in common.... we spend too much money on our health. It's expensive being diabetic.
I guess it's all worth it though.
@beefy... our public system here (covered by Medicare) is overcrowded too and really long waiting lists. We have a doc shortage and some that bulk bill to Medicare (so costs you nothing) and others that don't (which is most of them nowdays) They force people here now to have private health cover (they never used to) once you are aged 30+. The reality though is that a lot of people can't afford to pay the premiums here and they are dropping out of private health. Cost of living has increased a lot, etc. We are now being told that they are introducing a flood levy in our tax to help pay for the big clean up in QLD (but we have 5 states in total that had floods recently... not sure what happens to the other 4... but we're only paying for 1 apparently).... this is after they have done huge fundraising across the country already... majority of people not happy with the idea. I'm not sure if it's true, but I've heard we are one of the most heavily taxed countries in the world (with income tax and goods & sales tax combined... plus all the other taxes/levy). :loco:

 

[breezeonby]

I always thought that those living in England & Canada had it made when it came to health insurance. I guess we often imagine these things. I wanted to know, so that is why I asked. If it is not high premiums, then it is higher taxes to cover the cost. You know even in the USA, Medicaid doesn't pay for everything and in order to qualify you can't own a penny over $2,000.

 

[jwags]

I think a lot of people think Medicare is free healthcare. As Shanny said there is a basic premium per person and that only covers 80%, so most people have to buy a supplement and prescription insurance which can add another couple of hundered dollars per person. Half of people's SS checks go to healthcare. I think this is what has to change. Those Medicare Advantage plans looked like a good option but I think they are planning on downsizing or getting rid of many of those plans. Since we have a high deductible insurance plan we are allowed to have a HSA ( Health Saving Account) . We put in the maximum each year but don't touch it. We are trying to accumulate enough to pay for extra medical bills during retirment. I read somewhere that the average couple in retirement even with SS and Medicare needed another $200,000 on the average especially if you don't have supplemental insurance.

 

[Shanny]

When I reached the age to enroll in Medicare, I had no intention of also applying for the old-age benefit at that time - if I could wait a few more years the amount per month would increase a bit. But when things got rolling, it became alarmingly apparent that the premiums for my three Medicare-related policies was far more than I could pinch out of our already-strained budget. I was forced to apply for the old-age benefits just in order to pay the premiums for my Medicare policies, and of course now I'm stuck receiving the lower benefit as long as I live. Because of the increase this year in the Medicare premium, my total benefit is about $25 LESS this year than it was last year. Dunno yet how THAT'S gonna play out . . .

Ever hear the old saying that they get you, coming AND going?! Mercy Sakes!