The Insanity of the Federal Government

Discussion in 'Politics' started by OldRegular, Nov 26, 2013.

  1. OldRegular

    OldRegular
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    I am starting this thread primarily to see if others have had a similar experience!

    I take a certain medication for a medical problem The medication even in generic form is fairly expensive. Because of unusual circumstances this year I had not required a refill.

    Had a doctors appointment today and needed a new prescription. This medication is not covered by Medicare Part D. Until this year that had not been a problem since the company from which I retired bore most of the cost. Starting in January they eliminated supplemental insurance for all retirees and gave a small stipend instead.

    Knowing the medication was expensive I checked the price with two pharmacies. One pharmacy charged $60.00 for 90 pills; a second charged $75.00 for 90 pills BUT, BUT! An employee at the second pharmacy informed me that if I had a “W” card [Fee of $20.00 per year] I could get the medication for $15.00 and possible discounts on other prescriptions. I did not understand how they did it but I am not one to “look a gift horse in the mouth” whatever that means. I had the doctor’s office call in the prescription to that pharmacy. I checked with the pharmacy when I got home.

    Surprise! Surprise! Because I was on MEDICARE “W” could not sell me a “W” card. It is insanity. Here is a pharmacy willing to cut the cost of my medications for a fee of $20.00 per year and the FEDERALISTAS say no. Why? They don’t pay for the medication anyhow? It is insanity.

    So! Has anyone out there had a similar experience?
     
  2. Deacon

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    Oh let me rant a bit.
    1. Medicare will pay a physician a set price for a cardiac procedure.
    If the doctor orders more than one procedure on a single day, Medicare will only pay the office half of the reimbursement rate for the second procedure… so of course offices don't do two procedures on the same day so they will get full payment from Medicare... a calculated inconveniencing of the patients by Medicare.

    2. Medicare reimbursements for pacemakers are below the cost for the item.
    Cardiologists lose money on every pacemaker they implant.

    3. A cardiologist in the office today saw a patient of his that tried to enroll in ObamaCare. He'd been a patient of the doctor for more than 15 years.
    His patient became frustrated with the broken computer system and he called a special number to speak to a "real person". He said the representative was hard to understand and spoke in broken English. After providing the necessary information he wanted to be reassured that he could keep his doctors.
    They said he could and checked; his primary physician was registered but not his cardiologist. He was told that the cardiologist was either retired or dead because he was not in the system.

    4. We use one-dose vials of a certain medication in stress testing. The vials contain about 50 milligrams of a drug. We are reimbursed by Medicare for each vial used.
    Now we have to send Medicare a record of how many milligrams of drug were used from the single-use vial AND how many were discarded – yet they still reimburse by the vial.

    5. The HIPPA laws were instituted by Congress to assure patients that their health information was safe and protected - and stiff fines were imposed on those that failed to keep information safe.
    Turns out that anything submitted on the ObamaCare website is compromised.

    I could go on.... and on.... and on.... :BangHead:

    Rob
     
  3. exscentric

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    Doc said get the wife from doc's office to emergency room. She stayed 2 1/2 days. Got a bill from hospital. Called and with three phone calls finally found that part d does not pay for meds if you are an out patient. They had not admitted her to the hospital -she was outpatient.

    The little details we don't know about are going to get us big time.
     
  4. OldRegular

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    Had a stress test in September. Cardiologist office called day or so before treadmill and scheduled a second office visit because Medicare would not fully cover stress teat and seeing the cardiologist on same day. Unreal!

    Given how much the cardiologist got for stress test doubt if it much more than covered the technicians salary.

    The "death" panel will soon cut doctors reimbursements so much they can't afford to keep Medicare patients.
     
  5. BobRyan

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    When democrats get in office - everybody suffers because democrats love socialism and the best way to get it - is to make us suffer until we vote it in.
     
  6. saturneptune

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    So Ellen White was a Republican?
     
  7. OldRegular

    OldRegular
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    Is she an old "flame"?
     
  8. OldRegular

    OldRegular
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    Obamacare Will Save You Money

    I had thought about starting a new thread but the following information fits in with the insanity of the reactionary-democrats and the Federal Government. I got on Healthcare.gov and entered the following information:

    Wise County, Virginia

    Family of two, ages 60 and 63

    The results may be a little hard to follow but!

    *****************************************************************
    Anthem HealthKeepers Bronze DirectAccess w/HSA - caas
    HMO | Bronze
    Anthem Blue Cross and Blue Shield

    Monthly premium
    $937/mo
    2 enrollees

    Deductible
    $12,000/yr
    Family total
    $6,000/yr
    Per individual
    Out-of-pocket
    $12,700/yr
    Family maximum
    $6,350/yr
    Per individual maximum
    Copayments/Coinsurance:
    Primary Doctor: 15% Coinsurance after deductible
    Specialist Doctor: 15% Coinsurance after deductible
    Generic Prescription: 15% Coinsurance after deductible
    ER Visit: 15% Coinsurance after deductible

    ****************************************************************************

    Anthem HealthKeepers Bronze DirectAccess w/HSA - caas
    Anthem Blue Cross and Blue Shield
    HMO | Bronze
    More information from the insurance company:
    Summary of Benefits
    Plan Brochure
    Provider Directory
    List of Covered Drugs

    Deductibles (per year):
    Medical deductible (family total)
    $12,000
    Medical deductible (per individual)
    $6,000
    Prescription drug deductible (family total)
    Included in Medical
    Prescription drug deductible (per individual)
    Included in Medical
    Out-of-pocket maximum (per year):
    Health care out-of-pocket maximum (family total)
    $12,700
    Health care out-of-pocket maximum (per individual)
    $6,350
    Prescription drug out-of-pocket maximum (family total)
    Included in Medical
    Prescription drug out-of-pocket maximum (per individual)
    Included in Medical
    Copayments/Coinsurance:
    Primary doctor
    15% Coinsurance after deductible
    Specialist doctor
    15% Coinsurance after deductible
    Inpatient doctor
    15% Coinsurance after deductible
    In-Patient facility
    15% Coinsurance after deductible
    Emergency room
    15% Coinsurance after deductible
    Generic prescription
    15% Coinsurance after deductible
    Preferred brand prescription
    15% Coinsurance after deductible
    Non-preferred brand prescription
    15% Coinsurance after deductible
    Specialty prescription
    15% Coinsurance after deductible​


    So after paying $937x12=$11,244 in premiums and a family deductible of $12,000 or a total of $23,244 I can start collecting on my insurance. But that is not the whole story I apply for a government subsidy, assuming an annual income of $75,000 and get the following:

    Results
    Because your income is more than 400% of the poverty level, you would not qualify for subsidized exchange coverage. The information below is about unsubsidized exchange coverage.
    Household income in 2014:
    484% of poverty level
    Maximum % of income you have to pay for the premium, if eligible for a subsidy:
    None
    Health Insurance premium in 2014 (for a silver plan, before tax credit):
    $14,874 per year
    You could receive a government tax credit subsidy of up to:
    $0 per year
    (which covers 0% of the overall premium)
    Amount you pay for the premium:
    $14,874 per year
    (which equals 19.83% of your household income and covers 100% of the overall premium)

    OTHER LEVELS OF COVERAGE
    The premium amounts above are based on a Silver plan. You could purchase other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).
    For example, you could enroll in a Bronze plan for about $11,248 per year (which is 15% of your household income). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.​
     
  9. thisnumbersdisconnected

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    OldRegular, that is truly depressing. This is the future of healthcare in America? We'll all be bankrupt in the first two years.
     
  10. OldRegular

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    Not to worry! Not to Worry! The liar-in-chief promised to save you $2500 and who are we to question?
     
  11. thisnumbersdisconnected

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    True. Questioning Dear Leader could lead to disappearance.
     

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