Anes wrote,<<<<I was wondering if the very rich carry health insurance or if they are "self-insurred."Whats your idea of rich? I can't tell you how many times I have been stiffed or they have argued about my fee. I am talking about the mega rich.>>>>>What kind of fee were you charging? Was it "reasonable and customary?" Was it anything close to the discounted fees many doctors offer HMOs and other managed care firms?My opinion is that most people should carry a high deductable policy ($2500) and pay for most things out of pocket. If you can look into a Medical Savings Account. I actually looked into an MSA account and decided against it. (There's a reason these things aren't selling as well as the Republicans had hoped.) With an MSA, you end up paying "retail" for your medical needs rather than the discounted "wholesale" costs that a HMO pays. Unless you are willing to negotiate with your doctor to obtain a discounted fee, an MSA may actually cost you more. (Who knows, maybe the reason Anes mega rich patients were arguing about the fee was BECAUSE they were in an MSA. <grin>)For instance, I had some non-cosmetic plastic surgery done on my eye two years ago. It was about a 30 minute procedure done under local anesthetic. The plastic surgeon billed $2,650 for his time. The insurance company paid him $635 under their PPO (preferred provider plan) contract. Under the terms of the insurance company contract, the doctor can't come after me for any of the $2,015 difference. If I was in an MSA, I would have ended up paying the $2,650 myself, unless I was as skillful as the insurance company negotiators in securing a big discount.intercst
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