Do you pay every time you go to clinic ( general visits)

[anonymous]

Hey all, i was discussing with hubby about costs of medical bills ie: medications, hosp addmisions and clinic visits.

What do you guy's have to pay for, out of pocket and what subsidies do you have.

Just curious!

Our situation is - We are not on any private health covers or insurnaces. when we go to clinic its free, as it is an ongoing condition (medicare) pays, medicine we also have a subsidy for. Olivia has a health care card in her name that entails her to cost price medication, so if it costs the general public $ 28 Aust, it will cost her/us $4.60. Which is a big saving, but only lasts until age 16 and then your on your own.

I don't get why they cut it off at 16, as CF is progressive and will get worse over the years. So at the time where we will need cheaper meds, we will have tp pay full price. I think its bull s***t.

Hospital stay's i 'm sure are free too as well as medications and procedures such as a bronch.

So, i am just curiouse as to how things work in your country. When it comes to $$$, in CF care.

Thanks in advance

Eli ( not logged in) sorry.lol

 

[anonymous]

We pay a $15 co-pay for each office visit, $30 if it's an emergency room visit. Hospitalizations, blood work, x-rays are 100% covered. Meds are a $5 co-pay for generic and $10 co-pay for name brand prescriptions. We are very lucky to have the insurance coverage we do and it's one of the reasons hubby stays at his job when he sometimes would rather find something else.

 

[Abby]

sorry, that was me above, didn't realize I wasn't signed in.

 

[NoExcuses]

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[coltsfan715]

I don't pay anything for dr visits because I have 3 insurances. Two of them are through my dad and 1 is through Medicare. So long as I am classified as a disabled dependent then he can keep me on his insurance as long as he likes.

For prescriptions it ranges depending on the class of the medication - it can be anywhere from less the $10 to $35. We are able to send claims in to my other insurance and get partial reimbursement for those copays though, so it works out to paying much less than 10-35 dollars.


If I were to have to pay a copay everytime I went to the doc it would range from 10 from PCP (Primary Care Physician), 20 for Specialist, 25 for ER visits. I think it is something like that.

Lindsey

 

[anonymous]

hi just thought i would post . i live in england and we have the nhs (national health service) which any one can use, we can go to casualty (ER) the doctors clinics and it will cost nothing. this applies to every person in the uk. i cant imagine what it would be like if i had to pay for all my medications and such like! i did work it out once what i have cost my country when i was 18 and it wasnt far off £1.46 million!
what happens if you dont have insurance in the usa? would you have to pay for everything

 

[wuffles]

I'm sure you know the situation in Australia, Eli, but I thought I'd answer anyway...

I don't pay for my 3-monthly visits as I go to a public hospital but we always did when I was younger because I went to private clinics. Now that I am on my own and paying all my own bills public is the way to go! The only problem is that it is VERY difficult to get appointments and the doctor is always a lot more hurried than I am used to. I go to private hospitals for stays if possible, so that means less waiting times and private rooms. That costs a fair bit.

So I pay $30 for each of my medications (except Nasonex which is $50) , plus my specialist appointments (ENT mainly), plus GP visits ($27 or something after Medicare rebate), vitamins (these are one of my main expenses). We have private health insurance which is about $120/month for both of us.

I know that many of the CF organisations in Australia are campaigning for health care cards to be available to adult CFers. That would REALLY help me. Most people my age go and buy clothes or go out partying with their extra money, I go and stock up on my medications <img src="i/expressions/face-icon-small-tongue.gif" border="0">

 

[anonymous]

I live in tennessee and we have TennCare. Its a very complicated and crazy system however I don't pay for ANYTHING nothing at all... But in a few months Ill be married and hes a army man so ill have TRI-CARE

 

[anonymous]

Well, we're in the US. We pay $25 for dr visit copays (specialist and non-specialist PCP). The pulmo group (Riley Children's) uses a hospital's facility so the hospital bills seperately. The $25 is <b>just to see the dr</b> then we get charged approx $150-900 from the hospital for the use of the room plus any x-rays, PFTs, etc. We have a $500/person deductible so once that's met, we just pay 20%. Drugs are $10, 25, 40. ER is $100 plus 20% of anything over $100. Max out of pocket <b>excluding</b> drugs is $3,500 per person.

Amy what did you mean "because you work"? If you didn't work, wouldn't you NOT have health coverage? Or, do you mean you'd qualify for your parents coverage? Or is COBRA set up that way??? Just confused.
Mel

 

[NoExcuses]

/

 

[Ratatosk]

We have Blue Cross and we pay We pay a $20 co-pay for each office visit, $50 if it's an emergency room visit. Prior to meeting our 250 per person deductible we also have to pay 10%. If we go out of network we pay $20 copay for office visits and 20%. There are also discounts the clinics always provide, too. Once we meet our deductible, then there's another level for coinsurance and once that's paid we get into Maximum out of pocket. Only reached that once and that was shortly after ds was born and had to have surgery for a bowel obstruction, 4 week stay in the NICU and another 2 weeks at the local hospital. And even then we had issues getting insurance to pay for the ambulance to the airport to lifeflight him to the city for emergency surgery.

 

[anonymous]

We pay $20 for all doctor visits/clincic visits (this includes all labwork), $50 for ER visits, and $250 per hospitalization (no matter how long the stay is).

 

[dyza]

Amy is right, in the UK we pay 9% national insurance which pays for the nhs, so the more youearn the more you pay.

Thats not to say that you cant use it if you have never worked because you can, in that respect it is free to everyone.

In the UK there is a list of diseases that are exempt from prescription charges, incidently the charge is £6.50 for all medicines regardless of expense,back to that list, unfortunately CF is not on the list.

The list has various things like diabetes, and to be honest not sure what else, all I know is that the illnesses on the list are life-long illnesses, so why not CF on the list?

When the list was made up in the 50s, the life expectancy for CF was very low, and as all medicines for under 16 are free, then in their ultimate wisdom they did not see the need to include CF. Obviously things have changed somewhat and there is currently a lobby going through parliament for the exemption list to be upgraded to reflect more modern times.

 

[dyza]

<a target=_blank class=ftalternatingbarlinklarge href="http://www.scottishsocialistparty.org/scrap/scrap06.html
">http://www.scottishsocialistpa...rg/scrap/scrap06.html
</a>
here is a link to what I was saying about the presrciptions

 

[princessjdc]

every appointment I only need to pay 15 for my co pay and thats it, and then what ever the insurance doesnt pay then they send me a bill of propbably 30 bucks every so often, not all the time tho.

 

[Dustin82]

I am on Missouri Medcaid and I have to pay $150.00 when I go to the Doc. The insurance companys that my parents have say that I am to old and I am not in school so I cant be covered on there plan which I understand that.

Dustin 24
CFRD
Missouri

 

[Landy]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Dustin82</b></i>

I am on Missouri Medcaid and I have to pay $150.00 when I go to the Doc. The insurance companys that my parents have say that I am to old and I am not in school so I cant be covered on there plan which I understand that.



Dustin 24

CFRD

Missouri</end quote></div>

Dustin
You may want to read Lindsey's reply above re: staying on her dad's insurance because she's disabled. I wonder if your parent's insurance would do the same thing...it would be worth a shot to ask??

 

[Dustin82]

Thanks for the idea but we have tried. I only have to pay that 150.00 when I go to the dr. i dont pay it every month.
Dustin 24
CFRD
Missouri

 

[Allisa35]

As much as I hate HMO's, our insurance as been a blessing. We pay $15.00 per dr. visit for PCP and $40.00 for specialist physician. All labs, x-ray's, etc. are paid at 100%. Our meds are $10, $25 & $40. Thankfully, I haven't been in the hospital, but I believe they pay 100% after payment of $300. We have no deductibles but have a family out-of-pocket of $3,000 per year. The one major thing I dislike about our insurance is that we have to have a PCP who then has to refer you to a specialist (CF dr.) I have a good PCP though who is very familiar with CF, so I have no problems getting the referrals.

 

[eli]

Thanks to all who replied. Its interesting to see the difference in all the countries when it come to $$$$, for medical bills.

I t varies so widley, but like Wuffles said in her post. Here in Australia they are fighting to change the law on over 16 you are not entitled to a health care card which enables you to buy your meds at cost price.

This needs to change, because as i said in my original post. That is when you will need your hcc the most, as CF is progressive and does get worse as you grow older.

Thanks agian for you insight, guy's.