Health Insurance

Sharese,
Get your health insurance squared away before you get here. We looked into it after we got here thinking we might save some money. Boy, were we wrong. There is only one company who writes individual policies in the territory. It was $300 per month per person with a $5000 annual deductible and no prescription coverage. That was a year ago.

that wasn't my experience. i called American Medical Plans of the VI's 340-773-8658 and they told me they could cover me for $95 a month with a $500 deductable-- covers hospital & dr visits, labs, no prescriptions unless hospitalized. i'm in my mid-20s, so that helps it stay cheaper. but try them-- they were really helpful

If you shop on the mainland and are interested in presription coverage, try to make sure that there is a pharmacy on island that will accept that insrance before locking yourself into a plan. If there isn't a pharmacy that accepts your plan, you'll need to pay the actual cost for all of your medications up front and then get reimbursed. With the high cost of prescriptions and the slow moving mail service in the USVI, you could end up being owed quite a bit of money.

HC
(One who knows this all too well)

Thanks! I'll continue to look for a plan here that will also cover us in the VI's, but I'll keep that number Molly gave too. Sounds like my best bet for prescriptions is the by-mail service that we have now, keeping in mind the delay of course. But just in case, are there any "big-name" drug stores, like Rite-Aid or Walgreens?

Sorry, Sharese, no such big name drug stores here on St. Croix. Closest we get is a People's Pharmacy, but they seem to always be out of EVERYTHING you need.

Am not sure about St. Thomas -- if the nice STT'ers who post here don't know the answer, you can always check the phone book at http://www.viphonebook.com (Be sure to log on to that site using Internet Explorer -- the listings will not display properly in Netscape.)

The big name pharmacy on St Thomas is K-Mart. Insurance is regulated through the Lt Governor's office. Very few health insurers and very expensive.

We get our meds via mail. We were using AdvanceRX.com, but our insurance company just switched over to Walgreens. You might look into getting prescriptions that way. Then you may be able to use a stateside company for your health insurance.

Does anyone get scripts from Puerto Rico? If so, is it easier than via mail or in VI?

Bou'ya,

Several of my prescriptions are written in PR, but I haven't tried to get any of them filled there yet. It's worth looking into -- will let you know what I discover.

HC

Good day all,

I have been giving the health insurance question alot of thought lately. I'll be on island within a few weeks, however I am 22, and have 3 months until i'm no longer covered under my parent's policy. I'm not planning on recieving benefits from my future island employer because if I did and did not recieve them, well then i'd be out of luck.

I'm starting to search mainlaind providers that will cover me in the VI, but it's not easy. I've been searching through the VI phonebook also and have a list of providers to call this week. I'm hoping that some of you could steer me towards (or away) from certain providers that are based in the VI in case I cannot find an insurer in the states. Likewise, if you have coverage from the states, do them a favor and advertise here.

Thanks,

Kyle

We all suffer under the weight of too much medical cost. George Bush and the Republican party are in the "pockets" of big medical providers through out the states and in the Virgin Islands as well. My wife and I pay over $10,000.00 a year in medical insurance premiums, (plus deductables)and we have NO major health problems.

It is time for all of us to make our government listen to us... and make the changes that will protect us as we "age". ..yeh...I'm old..pushing 60...but is that really old?

People with severe medical problems are major victims too.

Canada has a system that works.

Why doesn't our government spend "our" money to provide a workable systerm for you and me.??

Maybe they are to busy protecting the very rich and fighting "phantom" wars???

Am I pi##ed off?...You bet....

Get rid of Bush

Agree 100%

But that didn't help me much with finding health insurance now did it? 😉

Kyle

Did our health coverage costs get significantly higher when Clinton left office? Wasn't Bush the one that was trying to get medical malpractice awards limited and the democrats vetoed that? Hmm. I think I'm voting for Kerry, still undecided, but not because of health care.

To help Kyle out I have Cigna Healthcare from Connecticut general life insurance company, and when I called Cigna when I got down here to make sure I could see a doctor and still be in network so I don't have to pay massive deductibles out of pocket. They gave me 5 docotors on St Thomas and the St Thomas hospital is also in network.

GO MEDMAN! I've been advocating for single payer health care since 1992.

Hey Stu, I'd like you to consider looking at the litigation aspect from this angle. If the AMA stepped up to the plate and helped to police its own membership by taking away the licenses the bad doctors that are responsbile for egregious medical errors instead of supporting them and helping to keep malpractice occurances hidden, perhaps there wouldn't be lawsuits that result in compensation for the loss of life, limbs, etc. Did you know that the AMA even protects its members who are currently and actively addicted to drugs and/or alcohol because they consider those addictions a disease? You better bet I'm going to sue if a doctor performs surgery that goes wrong while she/he is drunk or high and the AMA knew lf it and did nothing to alert state medical licensing agencies that this physician was a potentially serious threat to people in need of care.

And for the record, well over 95% of all malpractice lawsuit awards are for less than $1000. Want to ask how much of insurance company overhead goes to administrative costs, which includes salaries?

HC

(Islander -- feel free to delete if you feel this is way too far off topic or inflammatory. HC, the verbose and opinionated, just couldn't let this one highly personal issue pass unremarked upon. *embarrassed grin*)

I knew I'd get a response out of you. Coming from a family of doctors, one of which used to treat a person for chronic pain, which I know you are familiar with. Wouldn't you know it, the person sued him for making him into a drug addict.

1. The doctor never over prescribed meds. Made sure the correct amount of time had lapsed between scrips.

2. Being chronic pain, as you know, is very difficult water to chart because of the varying degrees of pain and basically you are trusting the patient that they are actually experiencing pain. I know I don't need to tell you this.

So tell me when my father was treating him, that he should have said I don't beleive you have pain anymore or I think your pain is stronger than you say. And you wonder why most doctors avoid pain management like the plague? I remember a previous post where you have to fly to PR and you tried a bunch of doctors on the island and they said no way.

Its not the awards that are killers, although some are. And I think you need to double check your facts on average awards. 70% of malpractice claims were dismissed (read frivolous) of the 30% that had payments the MEDIAN award was over 1 million, and the AVERAGE award was 3.9 million in 2002 and 6.2 million in 2003 (see "Jury Verdict Research, Current Award Trends in Personal Injury 43rd Ed. 2004). With those kinds of numbers don't you think more and more people are going to try and sue?

Anyway, its not only the awards that are killers, its the cost of malpractice insurance and the cost of representing these frivolous lawsuits. People think medicine is 100% science and should always be 100% correct. If someone amputates the wrong arm they get a million bucks, but if someone gets a small infection get over it.

Then with the fear of all the lawsuits docotrs are covering their asses by ordering unecessary tests which then adds to the skyrocketing medical care costs. MANY MANY doctors such as the ones you have expereinced will stop treating certain cases or refusing care on certain high risk specialties such as neurosurgery and OBGYN, mainly baby delivery, Right now is a FANTASTIC time to be a midwife because all OBGYNs will soon only be doing pap smears and maybe some routine prenatal care.

Then since some states have implemented caps on punitive damages, their liability insurance premiums are lower, so watch the doctors run for the borders. Jeez let me see I can save $75,000 a year by moving to this state? No brainer. Good luck keeping doctors, and getting an appointment with the ones left.

HOWEVER, I do agree that med companies could lower their prices. Stop taking groups of doctors on cruises to "show" them how good their drug is. However, I also do understand is a free market economy and how much these companies spend on research getting this drug to market as well. Although I think a happy medium should be found on price and profit taking.

Holy cow this was a hot button. But I hope it doesn't get deleted because I think it is an interesting conversation and I'm not taking offense to anything I hope you don't either. This is democracy at its best.

By the way I do agree with you that Docs that are drunk on the job and those unbelievably awful doctors that everyone knows about should lose their licenses. Definitely those quacks that prescribe anything for $50, and do unecessary procedures because they are profitable.

Although I'm on the fence on alcoholic and drug addict docs if they weren't on the job high, and part of me says that even if they were high on the job that there should be some sort of reparation they can make (suspension for 3 years, supervised care, etc) that can get them back in the saddle somehow.

Ok I'm done.

Hi Stu

Actually my medical premium when Clinton was in office was $3200 a year.

I have no problem with controling malpractice awards. My major complaint is with the drug companies and the companies selling medical insurance.

Like HC I have long advocated a single payer program like Canada's. My feeling is the NO person in America (or it's possessions) should go with out full affordable medical coverage. Any thing else is a crime.

"My feeling is the NO person in America (or it's possessions) should go with out full affordable medical coverage. Any thing else is a crime."

My feeling is that YOU are responsible for YOUR health. Health care costs are skyrocketing today (aside from the insane litigation issue) due largely to lifestyle related illnesses. If you're overweight, fail to exercise, smoke, abuse drugs, and/or eat improperly, why should I, the taxpayer, pay your medical bills? To suggest that I, the taxpayer, should, is socialist, and should be recognized as another form of theft.

Interesting rant. I kind of like that. Although me being the debater, now who says "Food Dependency" is a herititary disease as well as "Alcoholism" etc. basically many docs are trying to make people feel better by saying its a heriditary disease and its not their fault they eat twinkies and McDonanlds. Actually lets sue Hostess and McDonalds for making us fat. Jay is right about the "new" diseases that HMOs and docs now have to treat, that are related to illnesses.

I think people need to step up and take responsiblity for their actions. I agree. Peronsally I tihnk each person should be evaluated based on their lifestyle, health, etc and should pay insurance based on that. Good drivers get lower car insurance, drunk smokers who work in construction should have higher insurance rates (damn thats me) over a healthy receptionist.

State governement funded healthcare has many problems associated with it, that I think will make matters worse. I.E. Taxes out of control, more red tape than you have now, and inadequate medical care because all of the good docs would rather take care of the rich private patients because their nice private HMOs reimburse faster than the governments standard 6 months. I could on. But I won't.

Hi Jay,

Let me introduce myself and start by saying I love a good discussion as much as Stu does, and there are just certain things I can't let lay, like the whole personal responsibility concept.. I want you to know that I am writing this with a smile on my face and in the hopes that you feel good that someone was affected enough by your thoughts to dedicate a lot of energy to exploring them.

I am a high end medical user from a malignant spinal cord tumor that likely developed when I born and wasn't diagnosed until I was 14. Needless to say there was nothing that I did as a child to cause this. Keeping me alive has meant hundreds and hundreds of thousand dollars in surgeries, medications, radiation therapy, physical therapy, orthotic devices and other durable medical equipment. Side effects from the management on that cancer earned me two different kinds of lung disease, and it now turns out that what is left of my cervical spinal cord has adhered to the spine and is slowly being stretched, and will eventually result in quadriplegia that is lilely at the same level as Christopher Reeves--maybe even within a year. And with all of these limitations, I am now overweight, too.

I'd like to hear -- over a drink -- just how I am responsible for all this, and why the thousands of tax dollars I've paid in as a professional -- and continue to pay in -- shouldn't provide health care for me when I am no longer able to work. BTW, I will likely hjave to leave work not because I want to or couldn't continue to do my job, but because no private insurance will pay for a personal assistant to help at home or the office, and I won't be able to hire a trustowrthy and dependable one on only income that I paid into SSDI. With no job, I turn from a tax payer into a tax user. How does that make sense?

It's pretty easy to make blanket statements like let all the smokers/fatsos/druggies reap the consequences of their behavior, until someone you love is one of them. Even if I could support treating so-called behavioral health issues, what about the elderly and me? Do we also get cut off because you don't want your tax dollars paying for my health needs? (I have long thought I would like to have a checkbox on my tax forms that let me say that my money can't be spent to invade sovereign countries or to pay for the cadillac of insurance coverage given to members of Congress.)

Your tax dollars go to make sure that every child is afforded the opportunity to receive a free public education -- why aren't you screaming that this is really socialized education and everyone should take care of their own? The answer is because we know the greater good for our society comes from having an educated pool of citizens and workers.. Why shouldn't having a healthy pool of citizens and workers be just as important? The government -- and the rest of the civilized world -- already has declared it a basic right, whch is why Medicaid and Medicare exist.

Medicaid and Medicare, last time I checked, ran with only 3% of their total costs going to admin and overhead. Private insurance company overhead averages between 15-35%. How can it not be more efficient and cost effective to give the money currently going to private insurance to Medicaid and Medicare and let those two programs cover everyone -- not just the poor, elderly, and disabled. -- and use the 12-32% overhead savings for direct care and patient services. After all, the whole concept of insurance is based on spreading out the risk across the largest pool of people. Seems to me that nothing makes more sense than spreading the cost risk across everyone in the US.

Finished, and have no strenth to keep typing this or replies to any rebuttals. Propose that all interested in this terrific debate agree to meet and do it over with true civility: food and beverages!

HC
Flaming lefty and tired one handed typist

HC,

I'll give you the short answer now and expand later when I have more time.

Health care resources, like any other resource, are limited. In a free market economy, the scarcity of a resource influences it's cost. Now let's say that you and I and 498 other people live on an island and we, being civilized people and all, decide to pool a certain portion of our resources to provide a safety net for ourselves should we fall on hard times and/or become ill. Let's choose some arbitrary amount, say 5 percent. Now, as long as most of us remain healthy and productive there is no problem. The few among us who suffer from misfortune will have adequate resources available from the common pool to provide for their care and sustainment. But let's change the scenario a little, let's pretend 40 precent of us are smokers, and let's pretend another 40 percent are so obese and have such poor eating habits that adult onset diabetes is a certainty. Now let's fast forward in time to the point where the smoker's begin developing heart disease and lung disease and require hospitalzation and medication. Ditto the diabetics. Now a much larger number of folks are drawing from the same pool that is used to sustain those unfortunate few who are ill through no fault of their own. To add insult to injury, not only are the "lifestyle disease" sufferer's drawing from the pool, they're no longer contributing to the pool which means the remaining "healthy" folks now need to contribute larger and larger percentages of their production to the pool. And hey, since "health care" is "free", and an "entitlement", there is no free market mechanism in place to encourage people to safeguard their health so that scarce resources can be expended on those who truly need them. Eventually the entire system collapses. The only way such a system might work would be if it were directed by a fascist totalitarian state which dictates it's citizen's lifestyle choices including foods and exercise.

I would love to have a drink with you and Jay about this. I think you will realize we are all on the same page.

I had a wordy answer that got erased when my quality phone line cut me off. So you are spared some meaningless wordiness.

In a nutshell. All of these new diseases like SAD Seasonal Affected Disorder, and everything else seems to be a new disease. Doctors need to tell patients, go home, lose weight stop smoking and drinking and yeah winter sucks and if you get this depressed when it snows then friggin move instead of "treating" them for a "disease" which takes away money from really needy patients.

However, maybe part of that is fear of malpractice suits, "my wife committed suicide when it snowed and now I'm suing the doctor because she had a weatther disease" or maybe its safer to treat and more profitable. Regardless its a shame all of these people are being treated for stuff that they could have avoided and taking money from people that are truly sick.

Anyway, this is coming from a Republican, which is scary, but it seems, amazingly to me, that the Democrats have been the one holding up the medical malpractice legislation.

Ask any Medicaire or Medicaid patient if they would rather be on a private plan. yes it takes more admin costs, but good service costs more. Its a tradeoff. Man we would be an interesting group at lunch one day. I'm up for it, although I know you are over on STX.

Boy... this mole hill has turned into a volcanic mountain. Thanks for the Cigna tip Stu... ok you all go back to ranting now.

Kyle

Kyle,

I'm not on the Islands yet, but here is how I currently handle my insurance needs. I set up a Medical Savings Account (MSA) with a national insurance provider, Fortis Health, and then purchased a high deductible ($5k) catastrophic coverage policy for myself and my daughter. My premium is $180 per month (I'm 42, daughter is 15) and I put another $310 per month into the MSA to cover the deductible should I need to but the amount is my choice. Everything is tax deductible. In addition to the above, I don't smoke, I exercise everyday (running is my "thing") and I try to eat a balanced diet. I don't live like a Monk but I do try to do everything in moderation. You could probably do the same thing for much less. Good Luck!

Jay