My Health Insurance Rebate

Posted: July 22, 2013 in Uncategorized
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I just received a rebate through my health care provider for the year 2012. The reason is that my provider company did not meet the 80/20 rule set in motion by the Affordable Care Act. What that aspect of the law does is to define how much of your health care premiums must be used for actual patient care in one form or another. 80% must be used in direct service to the patient. If it is less than that the company is enjoying that over 20% margin as more sheer profit. My company didn’t meet that. They had to repay the difference.

As our health care premiums skyrocketed upward the company realized even more profit – money not directed toward patient care.

You know all those limits on hospital stays in which you the patient were pushed out the hospital door before you felt ready to do go? Remember that procedure the insurance company blocked because they said it was too expensive? Do you recall how your doctor had to do fancy footwork just to get payment for you by rescheduling his/her payment? In my health care company all that took place while they still couldn’t designate at least 80% of premiums to direct patient care.

That’s why the Affordable Care Act has that provision, to insure that the patient, the customer, is not exploited. And that’s why I got a rebate – along with all the other clients like myself. That particular provision is long overdue in our system in which roughly 85% of Americans are covered by private insurance. I’m happy for it.

  1. Audie says:

    Let the joyful dance begin!!! This has been so long overdue! Medicare is superb…let all of our people have the security knowing that they will receive the care they need without worrying that they will end in bankruptsy!
    40% of all bankruptsys are caused by medical bills. What a revolting outcome for a sick person. They not only have to recover from a life threatening illness…but then they lose their house!!! What sense does that make????
    This is such a wonderful change in how we view healthcare. God Bless America!

  2. Kirk says:

    So does this mean the government is going to make up for shortfalls in lean years for the investors in this insurance company? Is the government going to provide venture capital to enable them to expand their business? If the people or group that subscribe to this plan decide they are treated poorly they have the right to look for different coverage. That’s called competition in a free market economy. How long before the government mandates how the churches spend their money, or how to believe. This is a country based on freedom. It starts to be eroded now. And most are following like lambs to slaughter in the name of social justice. What a shame!

  3. hartman6712 says:

    Last Sunday at Foundry UMC in Washington , D.C., I listened to one of the most compassionate presentations about the relationship between the teachings of Jesus and social justice in our society I have ever heard. The speaker was Sister Simone Campbell, Executive Director of NETWORK and better known as the leader of “Nuns on the Bus.” Along with others in the congregation I applauded and uttered an audible “Amen” when she said, “It is an unpatriotic lie to say the constitution is about the individual. It begins with “We the people…” and its purpose is to provide for the “general welfare.” And, as a frequent writer of letters to my congresswoman and senators (who pay absolutely no attention, of course) and of letters to the editor, I resonated, too, with her assurance that “Advocacy in behalf of the marginalized and poor is the ministry of Jesus and the church….”

    I have no fear of going like “a lamb to the slaughter” following the path of the Jesus I know who made that very same choice.

    • Kirk says:

      I believe Jesus said something like give a man a fish and he will eat for a day. Teach a man to fish and he will eat for a lifetime. There is no shame in helping the needy. In fact it’s a virtue. I’m blessed that I too can help others and enjoy doing so. Why does the government need to be the one to help. The real beef I have is for those who choose to live off the largess of others. Living a life not helping their fellow man but rather taking and taking not giving back to the collective good. There are truly needy people but unfortunately our system of help has become flawed. The government needs to reform. Also more people like us need to step forward to give what we can for a better world. Larger and larger government with more and more money leads to more corruption. I mean this for democrats, republicans, liberal and conservative.

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