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Old 10-16-2020, 10:42 PM   #197
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I'm not an insurance expert by any means so I may be all wet on this but let me mention something that's happened to me many years ago. I went in for an annual physical and blood work. The office mistakenly build me directly for the blood work instead of billing the insurance company. The amount was somewhere around $540. I called the office and they apologized and submitted it to Blue Cross Blue Shield. A month or two or three later I get a Reconciliation from Blue Cross and lo and behold, the discounted price was around $45. I asked the doctor's office but I would have had to pay had I not had Insurance. The insurance lady's answer was, the full 500-plus although they would give me 10% for cash payment. I suspect Liberty might put you in the same situation. That is, not paying the discounted rate, but rather you would have to pay the exorbitant non discounted rate.
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Old 10-17-2020, 07:02 AM   #198
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Quote:
Originally Posted by cekkk View Post
I'm not an insurance expert by any means so I may be all wet on this but let me mention something that's happened to me many years ago. I went in for an annual physical and blood work. The office mistakenly build me directly for the blood work instead of billing the insurance company. The amount was somewhere around $540. I called the office and they apologized and submitted it to Blue Cross Blue Shield. A month or two or three later I get a Reconciliation from Blue Cross and lo and behold, the discounted price was around $45. I asked the doctor's office but I would have had to pay had I not had Insurance. The insurance lady's answer was, the full 500-plus although they would give me 10% for cash payment. I suspect Liberty might put you in the same situation. That is, not paying the discounted rate, but rather you would have to pay the exorbitant non discounted rate.

A little off topic but we had the same type experience. Wife sustained an injury while we were camping out west one year ago. Went to ER in DesMoines Iowa and then many doctors back home. Never got a bill from ER visit but we did from surgeons back home and that worried us.

Finally went online to review BCBS explanation of benefits to see if ER in Iowa ever billed BCBS. Yep there it was, $4500+ in ER charges. So what did BCBS pay? Just shy of $500. Yep. [emoji15] We owed nothing. This is how people without good medical insurance go bankrupt from medical bills. Thank goodness for health insurance.
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Old 10-17-2020, 08:15 AM   #199
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Regarding the post from BillJinOR on Liberty HealthShare, I thought I should share some additional perspective. Yes it is true that prices have risen significantly, and I think that this is due to the dramatic increase in people joining the plan, due to fleeing ObamaCare, and the "average health" of the people within the plan has actually gone down.

Price for a married couple recently went up to $499/month, and the "deductible" (they call it "annual unshared amount") is $1700. It's still WAY WAY cheaper than ObamaCare.

The key thing I wanted to counter though with regard to the earlier post is the info on the "process" for submitting expenses and paying/getting reimbursed. First, you can essentially go to any doctor you choose, although the program of course encourages "consumer responsibility" and presumes that you will use good judgement in choosing providers (e.g., if there are two labs in your area that will perform an MRI and one charges $500 but the other charges $1000, they *want* you to choose the cheaper).

Also, it is has been my experience that MOST providers WILL file the bills directly to Liberty HealthShare, so that you do NOT have to pay up front and then get reimbursed. Yet it is true that Liberty HealthShare is not technically "insurance," but rather a "voluntary healthcare expense sharing service," but in my experience just about everything about the process works JUST LIKE INSURANCE. My providers file the bill with Liberty HealthShare, Liberty "negotiates" reduced amounts just like insurance companies, and then Liberty pays the provider directly the negotiated (lower) amount, once the member has satisfied their annual deductible. So the process usually goes exactly like insurance.

For SOME providers though, as the previous poster indicated, they WON'T file with Liberty, so they do require you to pay upfront, usually at a cash-payment/no-insurance "discount" that is nevertheless still far more expensive than "negotiated insurance rates." And then you have to manually submit the bill to Liberty (they make it easy, with online filling), and then Liberty will reimburse you for the full amount you've paid (again, after you satisfy your deductible).

Sometimes the provider will bill Liberty directly, Liberty will negotiate a lower amount, Liberty pays that directly to the provider, and then the provider tries to "balance bill" YOU for the difference. When that happens though, you just notify Liberty of the balance bill and they step in and take care of it. They continue to try to negotiate with the provider to get them to accept the negotiated lower ("insurance-like") rate, but if the provider refuses and demands the balance bill get paid, then Liberty pays that as well. YOU are never responsible (ultimately) to pay any amounts beyond your annual deductible.

As for the timeliness of reimbursement, I've been a member since 2016, and my experience was that the first year or so was very satisfactory, but then Liberty got "overwhelmed" with the flood of new members and also some change in management and they got behind, and we had a number of bills that languished for 6-9 months or more before finally getting resolved (always properly with appropriate reimbursement to us and/or providers). But in the past year it seems that those issues have been corrected, and Liberty is once again handling bills in a very timely manner.

All in all I feel that I can still VERY HIGHLY recommend them as an excellent, much lower cost alternative to ObamaCare.

Tom
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Old 10-17-2020, 10:43 AM   #200
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It’s good to know some drs will bill liberty. The DW has had 3 dr offices in Oregon and all refuse to deal with the billing. Perhaps our bad luck? And I agree liberty have always paid whatever amount we have billed ( above our agreed “deductible ”). I just think people should be aware of the differences and not be surprised if the dr office refuses to bill. Count it as a bonus if they do
ObamaCare was killer for us as we make more than the maximum allowed income for govt paid subsidy so the premium and deductible was mind boggling. Liberty for the DW and Medicare for me has worked well.
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Old 11-23-2020, 12:33 PM   #201
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Did anyone mention the hitting the emergency room and getting a new phone number option? (The only working health plan we've yet to come up with.)
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Old 11-23-2020, 05:09 PM   #202
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Health insurance is the only thing that's keeping millions at their job
Yup. A couple of years ago some of my mid-50's friends said exactly the same thing. They all had enough in savings to retire comfortably but health care costs were keeping them all in their jobs.

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Old 11-24-2020, 08:29 AM   #203
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When my wife and I married in 85 she had a fantastic Health Plan with the state. Great for us as I was self-employed. $180 a month for a family covered prescription, doctor, Hospital, fantastic Dental, and some vision coverage. Annual per person deductible was only $50 , and that's for the whole year. No co-pays. And our maximum out-of-pocket for Doctor/hospital was only $1,000 . That continued through the rest of our working years and into retirement. Oddly, the monthly price never vary more than a couple of dollars even when we went on Medicare. Of course, with Medicare, our medical choices were diminished and our monthly premiums nearly tripled.
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Old 03-09-2021, 05:59 PM   #204
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My Final Answer

Since I started this thread, it is only appropriate that I share how I answered my own problem. I just returned from a brief meeting with my insurance agent to wrap up the paperwork.



I am going with Blue Cross of Idaho, under the Affordable Care Act. For my 18 year old son and I, it will cost me about $37/month. Yes the deductible is $8500 a year BUT, should something happen, I can pay that deductible.



I realize that I do need to be careful to avoid the pitfalls of seeking care outside of the network, but I'm willing to take that chance. I am betting that for the next 24 months, my health will remain good and I won't need to see my doctor at a rate any more than I have for the past 20 years.


I do have to watch my taxable income so that I remain within 18% to 400% of the Federal poverty rate. But that is easy. To make this even better, I expect my 18 year old son to either enlist or take a full time job with his own benefits, soon. I worked with the same local insurance agent that handles my employer's plan.



On April 1st I loose my employer's plan because I will officially retire. We have started planning a couple of weeks on the Washington and Oregon coast for some early season camping.


I'm sure this answer isn't for everyone, but it will work for me and my situation.
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Old 03-09-2021, 09:34 PM   #205
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Since I started this thread, it is only appropriate that I share how I answered my own problem. I just returned from a brief meeting with my insurance agent to wrap up the paperwork.

I am going with Blue Cross of Idaho, under the Affordable Care Act. For my 18 year old son and I, it will cost me about $37/month. Yes the deductible is $8500 a year BUT, should something happen, I can pay that deductible.
Thanks for returning with your answer! Stay healthy. Wear your mask. Best of luck to you!
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