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All in the all the healthcare system in the US is complete racket. The idea that the ACA was going to "fix the problem" was always a total joke. Healthcare costs is the problem, health insurance was the scape goat. I'm a fairly strong conservative but I believe healthcare should be socialized.
"The Canadian Institute for Health Information has been tracking doctors’ destinations since 1992. Since then, 60 percent to 70 percent of the physicians who emigrate have headed south of the border. In the mid-1990s, the number of Canadian doctors leaving for the United States spiked at about 400 to 500 a year. But in recent years this number has declined, with only 169 physicians leaving for the States in 2003, 138 in 2004 and 122 both in 2005 and 2006. These numbers represent less than 0.5 percent of all doctors working in Canada.
So when emigration “spiked,” 400 to 500 doctors were leaving Canada for the United States. There are more than 800,000 physicians in the United States right now, so I’m skeptical that every doctor knows one of those émigrés.
In 2004, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out."
https://www.aarp.org/politics-society/government-elections/info-03-2012…
The dam is gonna burst at some point
The Shop
Got on insurance, had the surgery no problem
Thats why in the states, many doctors dont accept medicaid. (Welfare/Social Medicine)
Basically the Govt says, we arent paying 9,000 dollars for a band aid.. 30,000 dollars for 2 stitches. 700,000 for a 15 minute doctor visit.
I am sure you can tell us all the same stories..
However, Canada's highest federal tax rate is 33%, and that is for incomes over $205,000 (for an individual). In United States, our tax rate is 35% for $200,000-$500,000.
Motocross racing is considered a hazardous sport and ANY insurance company will not take on that risk. Whether it is for health coverage, life, or for disability. You can still qualify for these products, but there will be an exclusion if something happened while racing.
What makes no sense at all is that they only go after "RACERS". If you are a random Joe Blow and DONT RACE, but just ride locally they will take you on without exclusions. I haven't worked on a claim yet where that was the case, but I could see that still getting messy.
Basically, if you don't work for a company that has group benefits like long-term care and disability you are screwed finding a product that will cover you on a bike. When you're on a group plan they aren't allowed to ask about medications and activities, because they are not allowed to "anti-select" who gets put on the plan.
I'm from Canada and we have nothing here. I see in the States this guy specializes in this stuff, but I know absolutely nothing about. I've reached out to him before but he couldn't help me since I'm in Canada.
https://www.ridersurance.com
When I purchased my own health/life/disability/sickness policy I had to include how many times I raced (so per moto not race day) the previous year, the current year, and the planned upcoming year.
ANYONE who says to LIE either on an application or claim is causing a whole lot of trouble for themselves. Never never never do that.
In your case I would suggest talking to your work, someone in the insurance business, and/or a lawyer/legal body. I'm not familiar with the USA health system, but if I can help you out just send me a PM.
Pit Row
If EVERYBODY would opt out of insurance the major problems would fix themselves very quickly. Sadly the massive fear-mongering campaign that has gripped our culture over the past few decades has made this an unthinkable action for most.
It would quickly pull expenses into check with reality, and it would put a stop to a lot of abuse of the insurance policy from both sides (hospitals and patients).
Put yourself in the place of an entrepreneur. If you are billing someone for a job and they are well off would you be inclined to "cut them a break". What about someone who is poor? We all (the medical field and the patients view the insurance company as the wealthy customer) This is an over generalization and the problems run far deeper.
Insurance would seem to be a good thought, if not for the heart of man. The fact that we feel we need insurance highlights that we might not always be willing to help each other out, at least not when its gonna "cost us to much".
If not a universal single-payer system, I think we should at least stop having our employers provide health insurance, health savings accounts should be recommended (or even required), individuals should pay more out of pocket. These things would help create more of a market system.
Health savings accounts should be recommended absolutely, but never required; you know freedom and stuff
One of the problems is that we, as a society, are not just going to let somebody bleed to death in the emergency room because they can't pay the bill. We treat them, and then find a way to collect. Not everybody can pay their bill. When that happens, the hospital absorbs the cost. And when the hospital absorbs costs, they really just pass that on to the people who can afford to pay. That's why some form of insurance and savings should be mandatory, and that's why health insurance, in general, should not be thought of the same way as most other consumer goods/services.
While i understand your reasoning, anyone who enters the medical industry should do so with a full understanding of this reality. Also anyone who receives such treatment and abuses it: (can not and will not compensate the hospital to the best of their ability in a gracious way that does not further harm their livelihood), should also be dealt with by society going forward.
Again put yourself in the place of an entrepreneur. Someone comes in looking for charity, sure help them out. Then they misuse/abuse what was given, will you continue to help them out?
We work with every "A" rated carrier in these 3 states, so we have direct contacts with them as well. We have claims specialists that deal with these things all day long and I have no problem guiding you thru what to look for and or what questions to ask.
Based on what you said, but not knowing anything about your plan, 2 things come to mind.
1. Do you have a policy that only covers the ACA (Affordable Care Act) minimum amount of coverage that is required by law to be compliant with the health care reform laws and not have to pay the fines associated with not having healthcare? These plans only cover the 10 mandatory minimum essential healthcare benefit required by law and are what a lot of companies with over 50 employees offer to skirt the employer mandate penalties for not offering ACA complaint coverage to their employees as of 1/1/14. For the most part they would only cover preventive care testing as well as a few other things depending on what bells and whistles are added onto the plan. The will not cover with out a doubt any hospital charges. That is for sure.
2. Have you checked to make sure that the provider that is saying you owe the $70k has the correct insurance information for you and/or are they billing to correct insurance? This happens a lot when the doctor has the old insurance on file and they are billing for services that are no longer covered since you are no longer active on the policy and you will indeed be seeing a bill for $70k since the old carrier doesn't show you in their system.
Also, have you cross referenced the EOB (explanation of benefits) for the specific date of service/claim to make sure that the billing/diagnostic codes that the insurance company has on file for your claim matches what the invoice from the providers are showing. If they don't match they will just deny the claim and kick it back to the provider and then they kick it back to you.
Are you being billing for in-network or out of network services or possibly both?
Never pay a claim until the EOB says it has been finalized and that EOB matches the bill from the provider. The provider has no clue what you have paid into or towards your yearly deductible. They just send everyone invoices until they get paid. They also use 3rd party billers a lot of time as well so things do get messed up, and claims issues happen more than you know. Its usually someone eating bons bons sitting on their couch all day plugging numbers into a keyboard and when the chocolate hits the wrong key you have an issue LOL
Again, without knowing anything about your policy I am just rattling off the first few things that popped into my head as I am reading all of these replies shaking my head.....
Like I said, send me a PM and I can call you or you can call me at my office and I am more than happy to help you out. This is something that your agent or the place you work at, their agent, gets paid to do directly from the insurance carrier for. If they are not willing to help you out then its time to find an agent that will.
I am not saying I will have all the answers or even the answers you want to hear but one way or another I know I can help you get down to the bottom of it. You cant beat free help!!!
Sorry for the long post!
T.J.
As of today, i recieved another packet in the mail. They went on to deny ALL of the claims sent to them. So i can easily up that bill to over $100,000. What a mess.
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