How much does the average doctor visit cost?

OCCOM BILL wrote:

kickycan wrote:
OCCOM BILL wrote:
kickycan wrote:
Osso, I have a question about this. How can they just decide that something is too high, if it's all in writing? I don't understand how that's legal.
Price tag for service needs to fit their guidelines for "reasonable and customary" or the overage is on you.

I guess I can see them doing that. It's a scumbag move, but it is insurance companies we're talking about here after all, so I guess it shouldn't surprise me.

Thanks for the article Osso. I haven't read it yet, but I will.
Not really. This provision prevents patients from seeking treatment at inordinately expensive facilities and driving up the price of everyone's policies. Most well run facilities will lower their stated prices to fit this requirement as a matter of policy, anyway... though the best of the best will charge according what the market will bear. A practice in a crazy high-rent building can't be expected to match the price of one in the hood, and your fellow policy holders shouldn't be expected to foot the bill for another's expensive tastes. Nothing scumbagish at all from my perspective.

We disagree. What a surprise.

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By the way, I picked a plan that has $30 office visit copays, and pretty crappy coverage for hospital stays. If I have to stay in a hospital, I'll be shelling out the first thirteen grand myself, but after that, I'm all set. Isn't that great?

I think I can still change my choice to the best plan they had if I want, but that one is just a bit more than what I think I can afford right now. I know it's not the best coverage, but I needed to pick one now, since I'm not covered at all at the moment.

I'm definitely going to have to look into other options, cuz this one kind of sucks.

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Since you enjoy free lancing, is this something that you'll aways have to face?

Or, do you envision yourself working FT for a company someday?

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Have you investigated New York State's health coverage program? It's called Healthy New York. The amount you pay is based on earnings. The coverage is not bad. Low co-pays. Don't have the info at hand at the moment.

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I wouldn't rule out a permanent job, Chai, but I'm sort of trying to move away from that and into a good freelance position. If I could get a freelance job without having to go through the middleman of an employment agency, then I would easily be abel to afford good health coverage. That's what I want.

Roberta, thank you, I will look into that.

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Here's the info. Roberta is talking about. As a self-employed individual you can't make more than $23,000 per year. They were talking about changing that, but I'm not sure they did.

Healthy New York

I've been without insurance for almost 15 years. I've put money away in an account I think of as my health savings plan. I've been healthy, so I haven't needed it so far. I recently helped a sick friend fight with her insurance company over tests her doctor recommended and the agency felt were unnecessary. I came away feeling I was better off dealing directly with doctors and hospital finance departments than with greedy, heartless insurance agencies.

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Green Witch wrote:

Here's the info. Roberta is talking about. As a self-employed individual you can't make more than $23,000 per year. They were talking about changing that, but I'm not sure they did.

Thanks, GW.

According to the site, it's a little more than that now, but still, I'm way over that, so I guess I'm out.

I don't have the guts to do it on my own. I need the security of having coverage.

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Kicky, It just occurred to me that you qualify as a NYC freelance commercial artist. You can join the Graphics Artist Guild (GAG) of NY and get their group insurance rates. Check it out:

GAG Insurance

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I make more than $23,000 a year too. I spoke with someone at Healthy NY. I was told that one low-income month would qualify me. The problem I had was that my low-income month wasn't the most recent month. You have to submit your most recent monthly income.

My contact was a few years ago. Things might have changed. Couldn't hurt to look into it.

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OCCOM BILL wrote:

kickycan wrote:
OCCOM BILL wrote:
kickycan wrote:
Osso, I have a question about this. How can they just decide that something is too high, if it's all in writing? I don't understand how that's legal.
Price tag for service needs to fit their guidelines for "reasonable and customary" or the overage is on you.

I guess I can see them doing that. It's a scumbag move, but it is insurance companies we're talking about here after all, so I guess it shouldn't surprise me.

Thanks for the article Osso. I haven't read it yet, but I will.
Not really. This provision prevents patients from seeking treatment at inordinately expensive facilities and driving up the price of everyone's policies. Most well run facilities will lower their stated prices to fit this requirement as a matter of policy, anyway... though the best of the best will charge according what the market will bear. A practice in a crazy high-rent building can't be expected to match the price of one in the hood, and your fellow policy holders shouldn't be expected to foot the bill for another's expensive tastes. Nothing scumbagish at all from my perspective.

I think the answer, well, you two know me, is inbetween. Some is scumbaggy, some isn't, on different sides.

I'll admit to fulgent bias, as I had insurance poor parents in my teens. We had, for some time, well, years, a borderline empty refrigerator while my parents tried to meet the insurance bills. I found myself reliving that not so long ago, despite my not wanting to go there. Close to the end, when they most needed it, they had to give up the insurance, having hardly ever used it.

This experience informs my view, though I don't hate business in general, as such. As I said about the Group Insurance for self employed folk, I can understand the business decision for those companies not to go there. F/ks batches of people up, though.

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Roberta wrote:

I make more than $23,000 a year too. I spoke with someone at Healthy NY. I was told that one low-income month would qualify me. The problem I had was that my low-income month wasn't the most recent month. You have to submit your most recent monthly income.

My contact was a few years ago. Things might have changed. Couldn't hurt to look into it.

I agree it can't hurt to ask. However, when I applied they required a copy of my tax return to see if I qualified. I was below the $23,000 for the year but I was awarded a NYS agricultural grant that technically counted as income. The grant amount put me over the $23,000. They rejected me because of the grant and told me try again next year. The following year my husband had to take more money out of the business which put us over the "per household income limit", so that year were we also refused.

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Green Witch wrote:

Roberta wrote:
I make more than $23,000 a year too. I spoke with someone at Healthy NY. I was told that one low-income month would qualify me. The problem I had was that my low-income month wasn't the most recent month. You have to submit your most recent monthly income.

My contact was a few years ago. Things might have changed. Couldn't hurt to look into it.

I agree it can't hurt to ask. However, when I applied they required a copy of my tax return to see if I qualified. I was below the $23,000 for the year but I was awarded a NYS agricultural grant that technically counted as income. The grant amount put me over the $23,000. They rejected me because of the grant and told me try again next year. The following year my husband had to take more money out of the business which put us over the "per household income limit", so that year were we also refused.

When I applied, all they asked me for was proof of income for one month. This was two years ago. Maybe they've gotten tougher. Or I may not be remembering accurately.

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You know, I think it depends on who answers the phone when you call. I hear so many different things about the program that I don't know what to believe, that's why I think it's worth it for Kicky to at least check it out. I know people who have been on it for years and definitely now make too much money. Other people that I thought would qualify have been rejected. I'm hoping our new Big Man in Albany will get some of this under control and offer some practical solutions. I'm going sacrifice a virgin Barbie doll to the gods and pray for Universal Health Insurance.

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Green Witch wrote:

You know, I think it depends on who answers the phone when you call. I hear so many different things about the program that I don't know what to believe, that's why I think it's worth it for Kicky to at least check it out. I know people who have been on it for years and definitely now make too much money. Other people that I thought would qualify have been rejected. I'm hoping our new Big Man in Albany will get some of this under control and offer some practical solutions. I'm going sacrifice a virgin Barbie doll to the gods and pray for Universal Health Insurance.

You found a Barbie doll who's a virgin?!

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Based on Ken dolls, they all must be virgins.

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Insurance companies suck...I am extremely lucky and have great medical. I can never leave my job. Ever. Seriously. They could beat me daily with a wet reed and still I'd stay on to keep the insurance.

I wish I knew more about freelance insurance so I could help ya out. I work for a giant corporation (national company) so my options are way different from yours.

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Green Witch wrote:

Kicky, It just occurred to me that you qualify as a NYC freelance commercial artist. You can join the Graphics Artist Guild (GAG) of NY and get their group insurance rates. Check it out:

GAG Insurance

This has made my day.
Waiting patiently to find out if Kicky has bought himself some "GAG" Insurance.

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I am licensed in health insurance and used to see all kinds of plans and programs.. both private and corporate coverage.

You need to look at a few things first:

1. Deductible- is it 12 per each 12 months? or per calendar year? upfront or for each visit.. if it is upfront, you could find yourself with a minor ailment and pay $500.
2. Out-of-network coverage (many plans will not cover you if you travel beyond 30 miles from your home. ie vacation, etc.) OR they will cover a small percentage... ie 20% instead of 80%. if you do not travel that often, then it's not a concern for you
3. Co-Payment. Are all doctors the same co-pay or are specialists more?
4. Do you need referrals to see a doctor other than your primary care physician?
5. Are there maximum coverage allowances...ie would a 3 day hospital stay be covered at a certain percentage or in full
6. Monthly payments.. the higher your co-pay and deductible, the less you should pay per month.
7. Are you able to find doctors in your area that accept this coverage? many people buy the cheapest coverage, only the find out that it is too good to be true, since no one in their area accepts it.
8. Have you had a lapse in coverage? If so, many plans will NOT cover you for any preexisting conditions.. ie.. you get diagnosed with diabetes and you are not covered. Any lapse will generally result in a 12 month wait period for any preexisting conditions.
9. Does your employer offer a plan?

The average doctor visit (without any tests or bloodwork) is approximately $200. A specialist can be in any price range, depending on their practice, demand and what city they are located in.

Hope this helps.

if you have more questions, contact me at [email protected]

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That's a good summary, life4me8.

Welcome to Able2Know.

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Roberta and Green Witch, I hope you don't mind my quoting you two for my new signature. Squawk if you do...

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How much does the average doctor visit cost?

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