Health insurance rant.

[redhen]

Thankfully hubbys union pays our ins benefits monthly... health/scripts/dental/eyeglasses...
but they only pay as long as you are working... if theres no work then they cover you for a few months..then you have to pay out of pocket. And it isnt cheap!
Thankfully SASME(union benefit..) just picked up our ins for a few more months... cause he just got laid of AGAIN...

After that we have to pay COBRA, which for minium coverage i think its going to be like $700+ a month.. not sure how were gonna do THAT if he isnt working??

 

[Southernbelle]

Obamas heath care plan is going to make it so much worse over the next few years.

*Insurance premiums used to come out pre-tax, now they'll come out post-tax
*Limiting how much money we can put in a medical flex plan (because that income isn't taxed)
*Not allowing us to pay for over-the-counter meds with the flex plan (because he wants the taxes)

GRRRRR

I know there's more of his health care bill that will affect us in a negative way, but I can't think of them right now.

 

[redhen]

Quote:
OOh i know! You know about my IVF? I just KNOW that i wont be covered anymore for it when all this passes... (they are going to say that its not a medical necessity..that its "elective"....)
Thats why i am rushing to get it done ASAP.... before my insurance dosent have to pay for it anymore.
Things are going to get real ulgy with this new ins plan...

 

[MoSo]

Quote:
I think we'll get some good and some bad out of it - but keeping things the same as they were was not working for an awful lot of people.

 

[MoSo]

Quote:
Your insurance doesn't "have" to pay for it now, they CHOOSE to offer that benefit. Why are you certain that they won't offer it in the future?

 

[Three Cedars Silkies]

I decided many years ago that I would always work for a company that had decent insurance benefits. I saw too many that were self-employed or worked for mom and pop operations that had little or no insurance. I realize not everyone can do that...it was just always very important for me.

My part of our insurance is about $300 per month and the University pays the other half as part of our benefits. My daughter was very sick for a week about 18 months ago and was at the ER twice in one week...each time they did a CT scan of her abdomen thinking it was appendicitis. My payment was only $50 for each visit and the bills totaled over $15,000. Now understand that the insurance company paid no where near that....they are contracted with BCBS and pay them an agreed upon rate for each procedure/test/exam, etc.

When my daughter saw the bill she freaked out. It made such an impression on her and I don't think she will EVER work anywhere that doesn't provide good insurance benefits. Our premiums and copays just went up too...but it can't compare to $15,000...

 

[redhen]

Quote:
Your insurance doesn't "have" to pay for it now, they CHOOSE to offer that benefit. Why are you certain that they won't offer it in the future?

Yes they DO have to pay for it..i live in a infertility benefit mandated state... (I'm lucky there!

) because MOST states do not have infertility mandated coverage.. but Mass has to pay if the doctor says its needed...

As for the second question..i just have a strong feeling that it wont be covered anymore after this health plan goes through, because like i said, most states now do not have to pay for IVF... so i think that Mass will follow suit when this all becomes federal...
Maybe i'm just paranoid though... we will see..

 

[PineappleMama]

Just like Insurance in Blackjack Health/Car/Life insurance is a gamble.

You (based on scare tactics, news, etc) are betting some huge calamity will strike and you'll get to stick it to the insurance company and get back your payments and then some.

The insurance company is betting on the odds that nothing huge will happen, or if it does they can weasel out of it, and they get to keep your premium payments while giving you nothing in return.

Basic Breakdown for us... last quite for insurance was $400/mo for me and kids, DH is covered... so $4800.00 per year... also known as 17% of our income...

If we don't get sick, to where we need a doctor, then we lose out on $4800.00.
If we do get sick.... we use CareNow and it's 90-350.00* all told x 3 people or visits = $270-1050 = Loss of 3750-4530

The ONLY time insurance would pay for itself is if something horrific happened... Cancer, AIDS, etc that requires multiple and expensive treatments... AND there was no way for them to get out of paying... unlikely. Car insurance has minimum injury payouts per person/wreck so I'm not counting those in this rant.

NOW... HOW TO FIX THAT? SIMPLE.

Offer Health Insurance that is like Car Insurance... IF A DISASTER STRIKES, then you get help. But for basic maintenance you deal with it. With your car, if you have a headlight out you go to the auto store, buy a bulb and put it in. You DON'T make an appointment with your mechanic, wait three weeks to three months... go in, get a scrip then take that to the auto store where it's $5 for their brand or $50 for the name brand bulb and then install it... -or worse have to schedule a 'surgery' with the shop to deal with it.

Same with Home Owners... if your faucet acts up you don't make an appointment with Tim the Toolman, bringing in the defective part for testing, x-rays, etc... then go to Home Despot with your scrip... you go get it yourself.

Offer me disaster insurance at a reasonable rate, because disasters really aren't THAT common, and you'll get my business. Charge me out the nose, 17% of our pay, NOT TO GET ANYTHING and I'm going to tell you where you can stick your fancy card.



*Worst illness I ever had (not counting pregnancy) was Tonsellitus, Upper Resp Infect, Sinus Infect, needing Strep Test (negative), Steroid Shot (tonsils), Antibiotic Shot, Antibiotic Scrip, Novacaine Scrip and all told with scrips was $350, basic visit is $90.

 

[Organics North]

Yep insurance is big business. Big profits, well compensated CEO's. Lots of lobbyists in Washington. Lots of marketing $ to keep the we the sheep calm and paying.

Employer based insurance worked when Companies and workers had a lasting relationship. Know days it is all about the CEO's pocketbook and the stockholders. Employees are disposable. (Yep I worked for nearly 20 years at one company then we got bought out.)

I really really wished our nations discussion on how to fix health coverage could be none political. I am so so sick of that. At least Obama is trying to push the subject. It is my opinion that what start out as good ideas are twisted buy the insurance industries lobbyists, into not spectacular ideas. It is apparent to me we as a nation are not ready to pull our head out of the sand, and see what is going on around us...Until we as a nation stop fearing the word socialized medicine and look to our neighbor to the north, virtually all of Europe, Australia, Japan, and many SE Asian countries for plans that are proven and work, we will continue to pay too much for too little...

ON

 

[Quillgirl]

Ummmm.... can I suggest some of you check into a High Deductible Health Plan along with a Health Savings Account? It may seem like it's more expensive, but in the long run it is not (especially if you are young and healthy.) It makes a lot more sense than the "trading dollars" system of the health maintenance plans most Americans are familiar with.

This may not be popular but: I firmly believe medical insurance is not meant to pay for office visits and small medical expenses. It is to protect your family from catastrophic events. Every household needs to budget for small healthcare expenses just like they would for auto maintenance, or home maintenance. Your home owners policy doesn't pay when you have the AC guy come out to tinker with your heater, and your auto insurance does not pay for your oil changes. Health insurance should not be expected to pay for well visits to your doctor. That's each individual's responsibility to plan for in their yearly budget. Health insurance is expensive because it is used for little things, and because we don't act like consumers. We'll drive farther to pay a little less for gas, we'll cut coupons and shop for generic foods and raise chickens, but won't shop around for the best drug prices? Won't call around to find out the cost of procedures or office visits from one doctor to another? Sorry, but it's not different.

Back to my original suggestion: We are self employed and have never had employer health benefits. Our excellent comprehensive plan is $350 per month ($4200 year) but we have a $3500 deductible (High Deductible Health Plan.) Sounds scary high (you can get lower, but then premiums are higher), but it makes really good sense. Follow me: First, we do get negotiated prices for healthcare/drugs just as you would any other plan. Kids wellvisits and vaccinations, and certain female and male wellness visits each year, are included with nothing out of pocket. (The policy came this way. I don't think it's the best use of my premium dollars.) Our plan has no co-insurance. We pay everything (with the exception of the well visits) until the annual cost hits a family total of $3500, then the insurance pays 100% of everything that follows for the year (or claim) to $5 million.

Back to that big deductible: A health savings account (HSA) allows you to save slightly more than the annual deductible amount TAX FREE. So we budget to save $3500 each year into our HSA using pre-tax dollars (comes off the top of our earned income on tax reports), and it can be spent on anything medical/dental (including glasses,vitamins, bandaids, etc.) If you don't use it all, that's ok. It continues to sit there, tax free and accumulate as any savings account would--but you must spend it on health expenses. Once you reach the deductible amount, you can elect to stop saving until you need to replenish it, or you can continue to save up to the maximum allowed every year TAX FREE. If you have a chunk by the time you reach social security benefits, you can use it to pay for long term health care, still tax free.

We don't often spend our deductible in a year and so get to keep it. With typical plans, we'd be paying that cost in premiums we DIDN'T get to keep at the end of the year. We have become better medical consumers: I shop around the way I would for anything else because it's MY money I'm spending. (I buy one drug through CANADAdrugs.com because it is about 25% of the cost.) The biggest risk our family has is in emergency visits because my sons play sports. I purchased another very inexpensive health plan through the Small Business Owner's Association that is only for ER visits. It has a deductible of $100 then pays 100% with no co-insurance up to $3500. (See how it covers our entire deductible?) It's $25 per month. Not a necessity, but it covers the largest risk we have.

I encourage all of you to look into this more sensible sort of health coverage-- most people don't even know about it. We have the best plan possible at $350 month, but if you get rid of some bells and whistles, you could have a plan for a lot less than ours. And if you are young and single, you are doing yourself a disservice and wasting money not to go with a plan like this. Ours is with Humana, but there are other good plans as well.