I like talking to the health insurance company here

[lapsedmodernist]

me: I am looking for a therapist in my area.

insurance phone lady: I can help you with that (pulls up a list of names and phone numbers, reads them off to me)

me: and how many sessions do you cover?

insurance phone lady: that depends on your therapist. Basically, the therapist decides. If he says he needs to see you every day, or every week, or once a month--whatever he decides, we cover that.

me: so do I pay him and then send in a claim form?

insurance phone lady: no, you just show them your insurance card, and they bill us directly. You don't get any bills from them.

me: and do I have a copay?

insurance phone lady: what do you mean?

me: like, I pay a fixed part of the bill?

insurance phone lady: I am sorry, I don't understand. What do you mean?

Comments

[dcart.livejournal.com]

How retro. I used to have insurance like that in the U.S. It was in the early 90s and provided through my dad's union. The first time I had a co-pay for something was a very WTF kind of moment.

[lapsedmodernist.livejournal.com]

they do have a deductible here. But it's sane, comparatively.

[uberconfused.livejournal.com]

Ha ha ha ha ha ha.
See, it doesn't *have* to be like it is in the US!

[lapsedmodernist.livejournal.com]

oh, I know...

[twotoedsloth.livejournal.com]

That is so sweet!

[lapsedmodernist.livejournal.com]

innit?

[congogirl.livejournal.com]

My boss is Belgian and goes home for all her healthcare if possible. They had a thing on the local public radio a while back about a woman that had an odd joint condition in which her joints constantly dislocated themselves. Nobody in the US could help her. She had been married to a Belgian and was therefore a citizen, so she and her current husband up and moved, for the healthcare. As soon as she arrived, she got an appt with a specialist that knew all about her condition. And all her care is covered, of course.

[lapsedmodernist.livejournal.com]

that was pretty much my logic in wanting to have Fionn in canada...

[miekec]

Sigh. Yeah, it's one of the things I remember, and miss. Enjoy it!

[lapsedmodernist.livejournal.com]

omg. How were you brave enough to trade that health care system for the US one?

[miekec]

By trying to not think about it? (image of me with hands over ears going "lalalaICantHearYou") Then again, I am making pretty sure to keep my NL citizenship up-to-date, so at some point I can just return. It is definitely one of my major gripes about living here...

[lapsedmodernist.livejournal.com]

no, but I didn't tell her that she was a profoundly morally bankrupt person who should be ashamed of herself either, which was how 80% of my conversations with Aetna ended.

[imlad.livejournal.com]

Very curious to know your opinion on the quality of service provided, especially over time, and especially in different areas. But yea, it certainly feels more right when the focus is on what is the service that needs to be provided rather on the process of paying for it...

[lapsedmodernist.livejournal.com]

The experience I've had so far here, I've been pleased with. I have a "huisdoctor" which is like my PCP/GP, and he is nice, listens to me, and does research when necessary. I had to have an ultrasound done, which was a far superior experience to everything I'd had in the US, because here they have a large screen angled down from the ceiling, so that the patient can see everything and the ultrasound tech provides a running commentary and explains everything. theophile had to go to the ER for a bad cut and reported a fine and friendly experience, and we've been taking Fionn for his vaccinations, but that's handled separately, through an office of child wellness, who have separate non-medical offices w/their own doctor on staff. I am sure there are crappy doctors here, too, but so far it's been fine.

[birds-hum.livejournal.com]

haha. wow, that rocks it and socks it.

[lapsedmodernist.livejournal.com]

I know, right?

[never-the-less.livejournal.com]

Haha, this is exactly like a conversation I had over New Years with a friend of a friend who lived in Berlin for several years:

her: "I'm having this back pain, and I can't figure out what to do about it?"
dr: "well, have you considered massage therapy? i think it would really help in your case"
her: "uh, i'm here in on an artist's fellowship, I'm not sure I can afford to go"
dr: "oh no, you can just go. your insurance will cover as much as you need. just let me know if it doesn't work and we'll try something else."

i have to say that my MIT health care is pretty close to this, amazingly. but one of my friends recently told me he has a FORTY DOLLAR co-pay these days. ridic!

[lapsedmodernist.livejournal.com]

40 dollar copay! for just GP visits? Which HMOnster manages MIT insurance?

[never-the-less.livejournal.com]

oh sorry, I wasn't clear. I've never paid anything through MIT -- even for my off campus therapy. It's close to the european model. My friend who pays $40, to yes, see a GP, has Oxford and is in NY.

[lolaraincoat.livejournal.com]

I have had experiences like this over and over again dealing with benefits in Canada. When basic health care is nationalized, employers are able to offer much better packages of added benefits. Therapy and massage for all! Yay!

[lapsedmodernist.livejournal.com]

What are you talking about? You don't even realize you live in a system where you cannot choose your doctor, you are deprived of needed services, and Big Brother controls all your medical decisions. Sheesh, how can you expect decent healthcare if there is no private-sector competition to stimulate the motivation to provide good service?

[smschrader.livejournal.com]

I am SO. FUCKING. JEALOUS. Today I called insurance to see if they covered bloodwork if I requested it. I need to have screening done for bloodborne pathogens so I can donate my breastmilk to someone in need. My stupid insurance (which I'm glad to have compared to none) covers no bloodwork unless it's associated with a medical diagnosis so if I just want to know if I have Hepatitis? Sorry, no luck, pay out of pocket. Jerks.

[paracelsus.livejournal.com]

It's a socialist miracle! *wipes tear*

[lapsedmodernist.livejournal.com]

the funny thing is, healthcare here is privatized. They just regulate the hell out of it.

[apropos.livejournal.com]

I had never heard the word "copay" until I moved to the US... they call it a deductible in Canada. "Copay" has always struck me as very American-Newspeakish.

[apropos.livejournal.com]

oh and from the sounds of it you are getting better coverage than you would in Canada. we definitely have fixed maximums, even if you have employee supplemental insurance.

[lapsedmodernist.livejournal.com]

deductibles in America are something else, which actually I don't think you have to deal with with Our University's plan--it's the amount you have to pay out of pocket per year before the insurance starts covering your treatment. The problem for people who are not on employers' plans and thus can only afford cheap insurance is those plans usually have insanely high deductibles, like over $5000. For "regular" insurances it can be $1000-$1500/year. Here it's 150EU per year, unless you are poor, in which case that gets refunded to you.

[akozorez.livejournal.com]

oh. my.

[boobirdsfly.livejournal.com]

Ha. Yes. Copay ? What ?
France is the same way .

[lapsedmodernist.livejournal.com]

yeah, this is what I can't wrap my brain around with you migrants TO the US. I could never give up European health care system for the American horror freakshow.

[boobirdsfly.livejournal.com]

not to mention that this makes mental health, a normal thing, rather than a luxury !

[isolt.livejournal.com]

Oh my jealousy is profound. I've been trying to figure out how I'll cover therapy under the Japanese national health insurance (in which I'm enrolled). Here of course it's a cultural problem insofar as mental health care is NOT a priority in Japan. Still, I am ever so envious.

[pazonada.livejournal.com]

bwaaaaa haa! awesome.

[olamina.livejournal.com]

The first time I came to the hospital here it was the "dežurni doktor" which is like going to the emergency room but not really. When I told them that I'd been having the pain for months they were baffled as to why I'd waited so long. I explained to them that in America people who don't have insurance just have to bare the pain. They couldn't understand the concept of not having at least basic insurance through the government, it just didn't compute.

I just had a conversation with a British friend of mine who lives here, she is very intelligent but had no idea that America had no basic health care arrangement, she also couldn't believe it.

We need more incredulous-ness before the problem will finally be solved in America.