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-   The Villages, Florida, Non Villages Discussion (https://www.talkofthevillages.com/forums/villages-florida-non-villages-discussion-93/)
-   -   Recent Health Insurance news (https://www.talkofthevillages.com/forums/villages-florida-non-villages-discussion-93/recent-health-insurance-news-354956/)

Bogie Shooter 12-05-2024 05:24 PM

Quote:

Originally Posted by Bogie Shooter (Post 2390971)
Just wondering what law enforcement could have done to prevent this murder?

Quote:

Originally Posted by kkingston57 (Post 2391031)
To answer your question, Nothing. This was planned now police say he wrote several words on the bullets. including Deny

Was asking OP about the statement...........

mbene 12-05-2024 05:56 PM

Quote:

Originally Posted by CoachKandSportsguy (Post 2390940)

And in other health insurance news recently, Blue Cross Blue Shield of several states said that they will not completely pay for anesthesiologists services during surgery over a certain length of time

Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures

Gotta make those profit numbers for the company's stock option plans!
barf

Just saw that Anthem has gotten so much pushback from professionals in health care that they have recinded this policy.

mbene 12-05-2024 06:14 PM

UHC CEO and other execs unload over $100 million in shares less than two weeks before stock tanks because of DOJ investigation.

OrangeBlossomBaby 12-05-2024 07:02 PM

Quote:

Originally Posted by Aces4 (Post 2391039)
Nothing to do with health care/treatment should be included in the stock market...nothing! How pathetic is it to sit back and take money off those who are ill or in need of treatment?

That being said, I believe personally that the Medicare Advantage for which so many of you have signed up to get the cheap "goodies", good luck. This coverage has been exhaustingly pushed this sign up season because once they get the majority of seniors on this plan, they will do away with original Medicare. And then, we are all back to the same scenario of battling private insurance companies for coverages.

The more we age, how capable are we to fight for healthcare, coverages and medications? Why do you think sales representatives receive greater reimbursement for every Advantage plan they sell vs regular Medicare plan with a supplemental plan?

Many hospitals and physicians won't care for Medicare Advantage patients and have dropped out of the plan now due to "insurance managed health care treatments" that are occurring.

We can't afford regular Medicare, plus a supplemental, or Medigap or whatever. Advantage covers more than regular Medicare, almost always at the same price as regular Medicare (which is deducted from our Social Security checks).

With original Medicare A there's a $1676 deductible, before it starts to pay.

For Part B, there's the $174/month premium out of your social security check, and a $240 deductible before it starts to pay. And then, it'll only pay 80% of costs for covered services, you pay the other 20%.

You also have to pay 20% of *MOST* (not all) approved inpatient hospital doctors services not covered by Medicare A.

You pay co-pays for doctor visits beyond the mandatory preventative coverage (which might or might not still exist next year).

Neither A nor B cover prescription medicines, you'd have to get part D, and pay the premium for that, to get coverage (which is really just reduced cost for most drugs, 0 cost if you can get mail-order).

If you want all those co-pays to be covered, you ALSO have to get Medigap, to pay for the deductibles and co-insurances/co-pays. Medigap has its own premium costs.

So you can pay - double what Social Security checks take out ($174/month) to get the same coverage that Medicare Advantage covers, or you can pay just the $174/month to get that coverage.

The problem isn't with the plan. The problem is with the entire system. Basic medical care should be 100% covered, no premiums, no co-pays, no co-insurance, no deductible, for EVERYONE in this country. Citizens or non-citizens, legal or not legal. Prisoners get better health care than some people in this country right now. That's just not right.

Yearly checkup, vaccines, antibiotics to treat infection, yearly labs/bloodwork, wound care, prostate exam, mammography, colonoscopy, yearly skin check, twice-yearly dental cleaning or perio maintenance and yearly x-rays, a vision and hearing test every year. This should ALL be covered by the taxpayer dollar.

Once you get all THAT covered - then people can be required to decide which ADDITIONAL services they want with insurance (or not). It shouldn't be competitive. Companies shouldn't be profiting off the gamble that someone will be healthy, and the patient betting on being sick. ALL health care should be non-prof. Not charitable - but non-prof. There's a difference between giving something away, and not making bank on profits.

Caymus 12-05-2024 07:13 PM

Quote:

Originally Posted by CoachKandSportsguy (Post 2390956)
so how did you jump from facts on a page to a judgement about my intent with supporting murder?

just because I dislike the conflict inherent in the country's insurance industry, doesn't mean i support murder. . . what it means is that the health insurance situation is getting obviously out of control, which risks ****ing off the wrong person and causing violence and chaos, especially in today's world where law enforcement is much weaker than during other times in history. That is not a good scenario for peace and freedom.

The two items are linked by the financialization and greed within our corporate world, allowed by lax anti trust enforcement, and business school theories and consultant recommendations on how to maximize profits. . as stated, not by murder. . .

Maybe I missed any words of compassion for the victim and his children. All I read was using the event to attack him and the industry. At least wait until after the funeral.

Aces4 12-05-2024 11:05 PM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2391118)
We can't afford regular Medicare, plus a supplemental, or Medigap or whatever. Advantage covers more than regular Medicare, almost always at the same price as regular Medicare (which is deducted from our Social Security checks).

With original Medicare A there's a $1676 deductible, before it starts to pay.

For Part B, there's the $174/month premium out of your social security check, and a $240 deductible before it starts to pay. And then, it'll only pay 80% of costs for covered services, you pay the other 20%.

You also have to pay 20% of *MOST* (not all) approved inpatient hospital doctors services not covered by Medicare A.

You pay co-pays for doctor visits beyond the mandatory preventative coverage (which might or might not still exist next year).

Neither A nor B cover prescription medicines, you'd have to get part D, and pay the premium for that, to get coverage (which is really just reduced cost for most drugs, 0 cost if you can get mail-order).

If you want all those co-pays to be covered, you ALSO have to get Medigap, to pay for the deductibles and co-insurances/co-pays. Medigap has its own premium costs.

So you can pay - double what Social Security checks take out ($174/month) to get the same coverage that Medicare Advantage covers, or you can pay just the $174/month to get that coverage.

The problem isn't with the plan. The problem is with the entire system. Basic medical care should be 100% covered, no premiums, no co-pays, no co-insurance, no deductible, for EVERYONE in this country. Citizens or non-citizens, legal or not legal. Prisoners get better health care than some people in this country right now. That's just not right.

Yearly checkup, vaccines, antibiotics to treat infection, yearly labs/bloodwork, wound care, prostate exam, mammography, colonoscopy, yearly skin check, twice-yearly dental cleaning or perio maintenance and yearly x-rays, a vision and hearing test every year. This should ALL be covered by the taxpayer dollar.

Once you get all THAT covered - then people can be required to decide which ADDITIONAL services they want with insurance (or not). It shouldn't be competitive. Companies shouldn't be profiting off the gamble that someone will be healthy, and the patient betting on being sick. ALL health care should be non-prof. Not charitable - but non-prof. There's a difference between giving something away, and not making bank on profits.


I can't begin to pull apart what you have stated without getting in trouble. I will only say that if every person paid taxes then the taxpayers, as you stated, could cover all medical expenses for everyone. And remove the stock market from all medical care, supplies and RX's. That would be a huge beginning.

mtdjed 12-05-2024 11:32 PM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2391118)
We can't afford regular Medicare, plus a supplemental, or Medigap or whatever. Advantage covers more than regular Medicare, almost always at the same price as regular Medicare (which is deducted from our Social Security checks).

With original Medicare A there's a $1676 deductible, before it starts to pay.

For Part B, there's the $174/month premium out of your social security check, and a $240 deductible before it starts to pay. And then, it'll only pay 80% of costs for covered services, you pay the other 20%.

You also have to pay 20% of *MOST* (not all) approved inpatient hospital doctors services not covered by Medicare A.

You pay co-pays for doctor visits beyond the mandatory preventative coverage (which might or might not still exist next year).

Neither A nor B cover prescription medicines, you'd have to get part D, and pay the premium for that, to get coverage (which is really just reduced cost for most drugs, 0 cost if you can get mail-order).

If you want all those co-pays to be covered, you ALSO have to get Medigap, to pay for the deductibles and co-insurances/co-pays. Medigap has its own premium costs.

So you can pay - double what Social Security checks take out ($174/month) to get the same coverage that Medicare Advantage covers, or you can pay just the $174/month to get that coverage.

The problem isn't with the plan. The problem is with the entire system. Basic medical care should be 100% covered, no premiums, no co-pays, no co-insurance, no deductible, for EVERYONE in this country. Citizens or non-citizens, legal or not legal. Prisoners get better health care than some people in this country right now. That's just not right.

Yearly checkup, vaccines, antibiotics to treat infection, yearly labs/bloodwork, wound care, prostate exam, mammography, colonoscopy, yearly skin check, twice-yearly dental cleaning or perio maintenance and yearly x-rays, a vision and hearing test every year. This should ALL be covered by the taxpayer dollar.

Once you get all THAT covered - then people can be required to decide which ADDITIONAL services they want with insurance (or not). It shouldn't be competitive. Companies shouldn't be profiting off the gamble that someone will be healthy, and the patient betting on being sick. ALL health care should be non-prof. Not charitable - but non-prof. There's a difference between giving something away, and not making bank on profits.

A lot of what you say is correct. But if you step back a moment an recognize that for most of us, the responsibility for our health care is us. There is no universal guarantee to have the government provide any health care other than what you have paid for which may be Part A. And even there, it is not complete.

From that point, the choice is yours. Pay nothing and get nothing more, then face the charges as they occur. Pay the Part B Medicare charge and get the 80% benefit less the annual deductible. Expand coverage by a supplement at your cost or choose a Medicare Advantage option by accepting their conditions.

Your statement that all costs listed by you should be paid for by the government is idealistic and a wonderful wish. However, you have not paid for this service, nor has anyone else.

Based upon your background in the computer world then the "if this, then that" logic should be understood.

Under current laws, you get what is in the law. You understand what is in the law (or Plans).

Your complaint is with the system and your list requirements. Those listed requirements will not likely change in the near future and I wouldn't wait for that to happen before making my choice decisions. Currently have to deal with the present.

jswirs 12-06-2024 05:00 AM

Quote:

Originally Posted by CoachKandSportsguy (Post 2390940)
UHC Insurance CEO got murdered outside his Hilton Hotel this morning. Shot in the back and then several times while on the ground, by a person on a city bike, using a silencer. A video has been released.

His wife said he had been getting threats, and she wasn't clear, but said it might have to do with "lack of coverage."

He was going to his company's investor day

People getting pretty irritated at UHC with the highest denial rate in the industry.
Somebody probably lost a loved one and possibly got bankrupted. .

And in other health insurance news recently, Blue Cross Blue Shield of several states said that they will not completely pay for anesthesiologists services during surgery over a certain length of time

Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures

Gotta make those profit numbers for the company's stock option plans!
barf

You echo my sentiments. While I certainly disagree with murder, I can, however, partially understand the frustration that would lead to this unfortunate situation. Also, it only takes less than one minute to find out what the CEO salary was. Try 10.4 million annually in salary, perks and benefits, which only adds to the frustration of someone who is unhinged. Another thought, I would bet that CEO and his family had better health insurance than what UHC offers to the general public.

CoachKandSportsguy 12-06-2024 06:12 AM

Quote:

Originally Posted by Caymus (Post 2391121)
Maybe I missed any words of compassion for the victim and his children. All I read was using the event to attack him and the industry. At least wait until after the funeral.

thank you for how the assumption can be made. Yes, not stating something positive can be assumed/interpreted/judged to be negative. However, I learned from a person with whom i worked for many years:

assume positive intent until proven otherwise, ie, innocent until proven guilty.
so lack of typed compassion <> condoning the behavior
and yes, I/we don't condone the action, to be clear.

RoseyRed 12-06-2024 06:52 AM

Quote:

Originally Posted by Aces4 (Post 2391039)
Nothing to do with health care/treatment should be included in the stock market...nothing! How pathetic is it to sit back and take money off those who are ill or in need of treatment?

That being said, I believe personally that the Medicare Advantage for which so many of you have signed up to get the cheap "goodies", good luck. This coverage has been exhaustingly pushed this sign up season because once they get the majority of seniors on this plan, they will do away with original Medicare. And then, we are all back to the same scenario of battling private insurance companies for coverages.

The more we age, how capable are we to fight for healthcare, coverages and medications? Why do you think sales representatives receive greater reimbursement for every Advantage plan they sell vs regular Medicare plan with a supplemental plan?

Many hospitals and physicians won't care for Medicare Advantage patients and have dropped out of the plan now due to "insurance managed health care treatments" that are occurring.

We are new to Medicare. Can you provide links to prove where the insurance agents commissions are higher if they get more signups for Advantage plans?

RoseyRed 12-06-2024 07:03 AM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2391118)
We can't afford regular Medicare, plus a supplemental, or Medigap or whatever. Advantage covers more than regular Medicare, almost always at the same price as regular Medicare (which is deducted from our Social Security checks).

With original Medicare A there's a $1676 deductible, before it starts to pay.

For Part B, there's the $174/month premium out of your social security check, and a $240 deductible before it starts to pay. And then, it'll only pay 80% of costs for covered services, you pay the other 20%.

You also have to pay 20% of *MOST* (not all) approved inpatient hospital doctors services not covered by Medicare A.

You pay co-pays for doctor visits beyond the mandatory preventative coverage (which might or might not still exist next year).

Neither A nor B cover prescription medicines, you'd have to get part D, and pay the premium for that, to get coverage (which is really just reduced cost for most drugs, 0 cost if you can get mail-order).

If you want all those co-pays to be covered, you ALSO have to get Medigap, to pay for the deductibles and co-insurances/co-pays. Medigap has its own premium costs.

So you can pay - double what Social Security checks take out ($174/month) to get the same coverage that Medicare Advantage covers, or you can pay just the $174/month to get that coverage.

The problem isn't with the plan. The problem is with the entire system. Basic medical care should be 100% covered, no premiums, no co-pays, no co-insurance, no deductible, for EVERYONE in this country. Citizens or non-citizens, legal or not legal. Prisoners get better health care than some people in this country right now. That's just not right.

Yearly checkup, vaccines, antibiotics to treat infection, yearly labs/bloodwork, wound care, prostate exam, mammography, colonoscopy, yearly skin check, twice-yearly dental cleaning or perio maintenance and yearly x-rays, a vision and hearing test every year. This should ALL be covered by the taxpayer dollar.

Once you get all THAT covered - then people can be required to decide which ADDITIONAL services they want with insurance (or not). It shouldn't be competitive. Companies shouldn't be profiting off the gamble that someone will be healthy, and the patient betting on being sick. ALL health care should be non-prof. Not charitable - but non-prof. There's a difference between giving something away, and not making bank on profits.

The whole system is setup to be so complicated that a person cannot compare apples to apples to make a good decision! Like it is a toss up!

Chamo 12-06-2024 07:13 AM

God I his is more of a therapy session than an informative venue.
Time to get off this sight.

Cuervo 12-06-2024 07:18 AM

This took place just a couple of days ago and there are other plausible reasons why this took place other than his connection with UHC. I'm not saying it is not but why not give it time for the authorities to capture who is responsible and true reason behind it.

PugMom 12-06-2024 07:21 AM

Anthem reversed their decision, announced 1st thing this am

Rainger99 12-06-2024 07:41 AM

Quote:

Originally Posted by PugMom (Post 2391171)
Anthem reversed their decision, announced 1st thing this am

But I would love to know who came up with the idea and the person that approved it!


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