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Old 10-05-2012, 10:14 PM   #76
tvguy
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Originally Posted by spacemountainmom View Post
My dh is self employed and we pay very high premiums for high deductible health insurance. During the last policy year dh went to the doctor twice, dd once and ds did not go at all. We got a letter saying that there would not be a refund. I don't think they even paid out enough to equal one month's worth of premium. I don't get it.
Well, I think you hit on another part of the problem. What did your Doctor bill the insurance, and what did they pay? I went to see a specialist, and he billed my insurance $800.......mine you he spent 5 minutes with me. Now, the contracted amount he finally was paid was reduced to $500......but, $500 for 5 minutes for a specialist........for a condition that 20 years ago my primary care Doctor would have handled himself for no additonal fee.
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Old 10-05-2012, 10:26 PM   #77
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Yup, that's what a lot of people seem to be ignoring. Public sector jobs have generally been lower paid than in the private sector. It was the benefits that made these jobs attractive. As benefits are being erroded they are becoming more in line with the private sector but not the salaries are still lower.

Generally speaking of course.
Yep. And the way they've rationalized it is by moving the bar... Instead of looking at comparable educational attainment, they focus on specific majors. Never mind that a major in education or social work or anything along those lines applies primarily to the public sector, and that the students choosing those fields are spending just as much on their education as the ones getting degrees in accounting and computer science.
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Old 10-05-2012, 11:32 PM   #78
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Yup, that's what a lot of people seem to be ignoring. Public sector jobs have generally been lower paid than in the private sector. It was the benefits that made these jobs attractive. As benefits are being erroded they are becoming more in line with the private sector but not the salaries are still lower.

Generally speaking of course.
Exactly, my mom decided to work at an inner city school with rough kids because of the benefits. She could breezed through the years but stuck it out! These kids don't even call her Mrs (last name)
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Old 10-06-2012, 09:48 AM   #79
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Yep, and DH is a state empoyee and has our states "teacher's" insurance.

Stinks--lots of premium increases and high deductibles with Dr visits of $150 out of pocket. There have been many years where the insurance increased and pay didn't.

We are not "sickly" people and do not go to the dr. unless it is very serious for these reasons.

Hopefully, something will change in our healthcare system soon.
We had an overview of our new health insurance at work. It starts at a $500 deductable per individual across the board (but it goes as high as $10,000 out of pocket max for a family) and it all depends on which doc you see and where.
Anyway, DH and I see doc once a year for our physical, we stay in network. So we pay about $600 a month for insurance and still pay for our dr visit completely because all we do is get a checkup.
I know I shouldn't complain. We are healthy, knock on wood. Insurance is for "just in case", like our auto , life and homeowners insurace. We pay it but don't have claims.

Insurance deductables should work the other way. Pay claims up to $500 (or even a lower amount) a year in full and THEN have out of pocket kick in up to whatever amount deductable before it pays out again. That way the light users get some benefit.

re: bolded. many non state employees deal with wage freezes and hour/pay cuts along with rising costs of everything and yes, it rots. our home budget has had many redos as of late..adjusting to make it work.
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Old 10-06-2012, 09:54 AM   #80
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Hmmm, Vancouver must be the exception then. My sister in law paid $500 out of pocket to get her MRI so she didn't have to wait a year. And I wonder why my father in law would tell me to call up my President and tell him we don't want Canadian medical. Strange, really strange.
I think it is wonderful that your sister in law had the option of paying $500 and having the MRI immediately. To put it in perspective, it might have cost her 10 times that amount in insurance premiums to have that in the US.

The issue on this thread is not American vs Canadian health care. It's that the OP's mother has less coverage and higher deductibles than she had before, and it's costing her more for the privilege. What somebody else has or pays is irrelevant to the OP...her mother now has a smaller budget to work with than she had before and she is venting.
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Old 10-06-2012, 09:56 AM   #81
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Yup, that's what a lot of people seem to be ignoring. Public sector jobs have generally been lower paid than in the private sector. It was the benefits that made these jobs attractive. As benefits are being erroded they are becoming more in line with the private sector but not the salaries are still lower.

Generally speaking of course.
Where I live, the average teacher salary is at least equal to the average private sector salary. Now, back in the 70's, this was not the case, so things like free health insurance and pension packages were used to entice good teachers to work here.

Now, we have a problem. Our state can't afford to pay all of these public pensions. Teachers are balking at having to pay any money towards their health benefits, because they never had to. There was automatic salary increases every single year (something the private sector hasn't seen in a while).

My mom worked for the state for peanuts, and it was worth it for her pension package and lifelong insurance benefits. She will enjoy her $5 co-pays during retirement.
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Old 10-06-2012, 10:15 AM   #82
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Last year we got a $16 refund. This year we were recently informed that our insurance is going up 12% for family insurance effective January 1st. We get a free yearly physical but otherwise we have to pay a $400 dectible per person then we pay 20% of the additional cost until we get to $2200. Three of the 4 of us have to meet our full deductibles or maximum costs. I would love to have set copays over this type of plan as we always did before dh got this job 2 years ago.
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Old 10-06-2012, 02:41 PM   #83
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No refunds for a lot of folks who work for major corporations, because you have health coverage, not health insurance. Your employer may hire an insurance company to administer the plan, so you have a Cigna or United Healthcare card, but in reality the employer is self insuring.
All the employees premiums go into a pool, the employer uses that money, and their own money to pay your actual medical bills. Companies are gambling that the actual cost of all the health care services their employees use will add up to less than what insurance premiums would cost them. Which of course, is almost always going to happen because insurance companies would got bankrupt if they paid out more in claims than they collected in premiums.
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Old 10-06-2012, 05:07 PM   #84
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I haven't read the other posts, so forgive me if this has already been said.

I'm sorry that the changes are difficult to swallow- but the new insurance plan you describe is the type of plan we have had for YEARS. We also pay almost $600 a month (family of 4) for it. While I understand that it is a lot of money, I think most people are in this type of situation.

Oh, and overworked and underpaid- yeah- my DH works in a tech field, got laid off, hired back, and is making $3 an hour less than what he was hired at five years ago. I totally get it....
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Old 10-06-2012, 06:20 PM   #85
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Insurance deductables should work the other way. Pay claims up to $500 (or even a lower amount) a year in full and THEN have out of pocket kick in up to whatever amount deductable before it pays out again. That way the light users get some benefit.
Our plan works sort of like you describe. It's a health reimbursement account medical plan. We pay a monthly premium that pays our 100% of our costs up to $2250 for our family. Then our $1500 deductible kicks in. After that, it's an 80/20 PPO plan.

Annual physicals are covered 100% no matter if you've met your deductible or not.

If we don't spend the $2250, the balance rolls to the next year and we have more money available before the deductible kicks in.

It makes us accountable for our health care costs, i.e., do we really need to go to the doctor for a cold? and it's so much better than the plan we had before. The maternity benefits were especially terrible on that one.

We can also use a Flexible Savings Account for extra things like dental and our deductible.
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Old 10-06-2012, 07:29 PM   #86
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Not all states have those great teachers benefit plans. I live in the south and just discovered a visit to the ER, to have my dd's ankle x-rayed, comes with a $125 co-pay. I know we've met the family deductible, my ds had same day surgery in June and I still owe the hospital $700, the anesthesiologist $80, and the GP who signed a paper saying ds was healthy enough to have the procedure $125. I also owe Urgent Care $150 because same ds stuck his thumb in a fan and needed 3 stitches, a month after the 20 minute same day procedure. A doctor visit is only covered 80% after the deductible is met, which usually comes out to at least $80, more if there's lab work involved. The ONLY group in town that takes our state BC/BS charges over $250 just to walk in the door. They were kind enough to post a sign over the check-out desk telling us that. Dental coverage is even worse. For this wonderful insurance I pay over $1200 a month and it's going up again in Jan. Prescriptions aren't any better, I beg doctors to write generics that I can get at Walmart for $4 because it's cheaper then what my plan covers. Oh, and our pay has been frozen for 5 years now. I have a Master's and make $40,000 a year. The classified staff (teacher assistants) hasn't had a raise in almost 10 years. I don't know how my assistants pay for rent or food. Their pay, after 15 and 19 years, is so low their kids still qualify for medicaid.
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Old 10-06-2012, 08:12 PM   #87
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In my town (CT) teachers pay 16 percent of their salary for insurance (for the family plan - I don't know what individuals pay.) For reference (and because I think it's fascinating), a step 1 teacher with a BA starts at $49,073. With an MA, $53,870. After 8 years, with a BA, $66,560; with MA, $71,000. After 15 years with the MA it's $90,577, with big jumps up for additional credits (e.g., MA at 15 years with 75 credits, $102,819.) Enough to pay for medical care and have a good bit left over.
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Old 10-06-2012, 08:18 PM   #88
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In my town (CT) teachers pay 16 percent of their salary for insurance (for the family plan - I don't know what individuals pay.) For reference (and because I think it's fascinating), a step 1 teacher with a BA starts at $49,073. With an MA, $53,870. After 8 years, with a BA, $66,560; with MA, $71,000. After 15 years with the MA it's $90,577, with big jumps up for additional credits (e.g., MA at 15 years with 75 credits, $102,819.) Enough to pay for medical care and have a good bit left over.
Just for comparison, I'm a Step 14 and make $35,690. If we ever earn another step (we've been frozen for 4 years), I'll never make more than $50,000. While my insurance premium isn't horrible for an individual, a family plan is over $600 a month.
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Old 10-06-2012, 09:54 PM   #89
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Just for comparison, I'm a Step 14 and make $35,690. If we ever earn another step (we've been frozen for 4 years), I'll never make more than $50,000. While my insurance premium isn't horrible for an individual, a family plan is over $600 a month.
My mom hasn't had a pay raise in five years either. But props to you for working so hard and not getting the salary you deserve. If that amount is pre-tax then I don't know how any teacher could survive. I know my mom makes a decent living. I think her extra stress right now is paying for not only my college, but covering my sisters grad school since my sister can't get any loans.
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Old 10-06-2012, 10:29 PM   #90
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Just for comparison, I'm a Step 14 and make $35,690. If we ever earn another step (we've been frozen for 4 years), I'll never make more than $50,000. While my insurance premium isn't horrible for an individual, a family plan is over $600 a month.
Starting here is $43,000. Top out after 7 years at $70,000 for a 9 month contract.
Got your Masters, add $5,000 a year. Coach a sport, direct the band, lead the choir, add $5,000. Teach summer school, add $3,000 a session.
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