Patrick Elliott wrote:
> Tom Austin wrote:
>> So, this makes the situation even worse - the uninsured have to make 
>> up for the insured.
> 
> rating the costs. I.e. An X-Ray really costs $500, so they would say it 
> only cost $400, then only pay 75% of that, so you would end up paying 
> $100 for the premium, and $100 for the "non-covered" cost, and they 
> would then only pay the other $300, when they **should have** been 
> correctly reporting the average cost as $500 in the first place, and 
> paying out $375.
> 

It is a big game.

I remember a company self-run insurance program that I was a part of 
once.  A 'traditional' plan - I pay out of pocket and they reimburse me 
80%.  Not too bad... until you get a bill.

I submit a $500 bill for a procedure to the insurance.  That should take 
care of my deductible.....  but wait.  The UCR for the procedure is only 
$200, so only 80% of $200 is applied to my deductible ONLY $160!!!  So 
now I still have $340 on the deductible, yet I am already out $500.

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