So mad - our health insurance copays are doubling next year!

[Pea-n-Me]

Some of our copays will almost triple next year.

Premiums went up 400% this year and another 200% next year.

If that wasn't bad enough, they've begun to deny services as well.

 

[ToddyLu]

Our hospital decided to only continue insurance for retirees-NOT THEIR DEPENDENTS. So if my Dad had worked where I work for 40 years and decided to retire this year he would get coverage until age 65--my Mom nothing...and she is 6 years younger and has always been on his insurance.


Then once you reach 65 and get Medicare you are off the books completely and there is no more hospital secondary or anything.

I will have to work until I am 65 just because the premiums are so high. Once of our secretaries was going to retire this year instead of next year--until she found out the premiums would be $1100 a month. She is working until she gets Medicare next year.

AND I WORK AT A LARGE COMMUNITY OWED HOSPITAL!!!

*and yes, I am thankful for all I have in this economy--but to do that to someone after they worked there 30 years and were looking forward to early retirement.

 

[Anne34]

What happens in 2014?[/QUOTE]

That is when Obamacare goes into effect. Many companies are already talking about dropping their own coverage and having employees use the govenment plan. NOT looking forward to this......

 

[dismichelle]

Not a big change in premiums for us this year. I think we pay around $360/month for medical. $35 sick visits/specialist visits. $50 well visits. This is for a family of 6 and my DH has extensive medical issues.

My daughter is in speech therapy, but I pay 20% copay after the $575 deductible.

Could definitely be worse. If nothing happens, we will not pay anymore than the $1500 I put into our FSA this year. That should be enough to cover the speech therapy deductible, well visits for the entire family, the kids average of one sick visit every other year, meds for DH (about $40/month), and if there's any left it will go towards the braces payments I'm still making for DS.

 

[Arielle22]

I handle the health insurance renewal for my company. This is the way it works.

Your broker gets the renewal numbers a few months before the end of the contract year.

Then the broker comes back with options for lowering the renewal. For instance, if you raise your copayments from a,b,c to x,y,z it will save you 1% of the premiums. Another one is to raise deductibles on emergency room visits and it will save you x%.

Your broker can then try to get bids from other insurance companies. We were in the position this year that due to high claims we had no options other than renew with our current company.

The company makes its decision based on many factors (profiatbility, future predictions and desire to attract good employees to name a few). It is a tough position to be in because if too few employees sign up for insurance it makes renewal tougher the next year. My company pays for 75% of premiums and it is still too expensive for many employees.

We are based in MA which has Romney care which is what Obama care is based on. So we have already had many changes over the past few years. Under certain circumstances a company has to pay into the state fund so much per employee.

My company has a 12.50% increase but with no changes. That is with a $1000 per individual/$2500 per employee deductible and a 25/35/50 perscription copayment.

 

[neatokimmo]

I will have to work until I am 65 just because the premiums are so high..

I think a lot of us are in that boat, having to work until Medicare kicks in. That is, assuming it is available in 28 years. I am not holding my breath.

I had sticker shock for health care three years ago. Our cheap plan tripled and they offered a high deductible plan for the first time. Then they offered discounts for employees who didn't smoke and gave everyone 1K to start their funds.

We are on year 4 of this plan and it really makes you think before you run to the doctor. It is about $60 oop for a doc visit for cold/sinus infection etc without tests. Strep test adds another $20. Luckily Walmart has $4 antibiotics!

The regular plan went up again so I put the money I would have been spending on a regular plan into my HSA. I have about $1200 leftover from previous years, 1K this year then $2200 coming in pretax.

It is like a very stressful game, trying to stay ahead of the costs and balance out your HSA savings account.

 

[Jeff_G]

I wish we would get rid of all insurance for health care both employer and or government paid... The entire thing is a big racket. In the 1960's you paid $5.00 for a Dr Visit ($38 in today's dollars) without insurance! The insurance industry helped to drive the cost of healthcare sky high. Now we have to insure against getting even the most common sickness.

The true costs of our health insurance is hidden from us by our employers, so we cannot comparison shop ourselves to find a better deal.

I think we should go back to paying out of pocket for Office visits, Specialists, ERs and just insure against catastrophic conditions...

 

[ccgirl]

I handle the health insurance renewal for my company. This is the way it works.

Your broker gets the renewal numbers a few months before the end of the contract year.

Then the broker comes back with options for lowering the renewal. For instance, if you raise your copayments from a,b,c to x,y,z it will save you 1% of the premiums. Another one is to raise deductibles on emergency room visits and it will save you x%.

Your broker can then try to get bids from other insurance companies. We were in the position this year that due to high claims we had no options other than renew with our current company.

The company makes its decision based on many factors (profiatbility, future predictions and desire to attract good employees to name a few). It is a tough position to be in because if too few employees sign up for insurance it makes renewal tougher the next year. My company pays for 75% of premiums and it is still too expensive for many employees.

We are based in MA which has Romney care which is what Obama care is based on. So we have already had many changes over the past few years. Under certain circumstances a company has to pay into the state fund so much per employee.

My company has a 12.50% increase but with no changes. That is with a $1000 per individual/$2500 per employee deductible and a 25/35/50 perscription copayment.

Thank you for this description. Just to add, another reason premiums are raised is how much it is utilized. For example, if the company pays $10,000 for the health insurance and the insurers use $20,000 the premium is going to be raised because it is paying out more than it is taking out. That part has nothing to do with Romney, Obama or anyone else. It is just how insurance works.

We used to be on my DH's insurance until my company was acquired by a much larger company with incredible benefits. His company did exactly as you described. They had a benefit fair where the broker came and explained everything and it was so very helpful. They ended up switching insurance carriers and the company absorbed a higher premium. The only thing that went up was the copays. They are trying to implement a wellness program as well. Hoping that if they can keep the employers healthy they won't utilize the insurance as much.

As for the earlier post about how much a doctor's office visit is. I used to work for a doctor's office. It is them you need to get the charge from. The insurance company has no idea how much each doctor charges. If there is a contracted rate, the insurance company will know that but might not give you that over the phone. Depending on the type of insurance, not all doctor's have contracted rates.

 

[scard192]

My company indicated during our open enrollment that they chose to raise co-pays to keep the premiums lower for all employees (and the company as well). By raising the co-pays; those who use the plan more bear more of the cost than those who do not use it very much. Seems more fair to everyone.

 

[DVC-Don]

Not only do we have a co-pay but we also pay the entire premium - we are self employed. I'd love to have just a co-pay. In addition to the $800+ per month premium we have a $500 per person deductable then 10% co-pay if the provider in in the network (20% co-pay if outside).

 

[Marionnette]

Not only do we have a co-pay but we also pay the entire premium - we are self employed. I'd love to have just a co-pay. In addition to the $800+ per month premium we have a $500 per person deductable then 10% co-pay if the provider in in the network (20% co-pay if outside).

I hear you!

Our premiums will go up by another $50/month next year. We own our business and pay entirely for our own insurance. The copays for our primary care are $40/visit and $60/visit for specialists and have been that way for a year now. I had an MRI last year and I had to pay $1200 for it myself.

People who are accustomed to having their employers pay a portion of their health insurance are just beginning to see what those of us who pay OOP for our own health care have known for years. It will get worse as the rest of the health insurance "affordable care" act kicks in. Many businesses will accept the fine for not providing health insurance to their employees because it will be cheaper to pay the fine than to pay for their portion of the insurance. And since everyone will be required by law to carry health insurance, it will fall on the individual to acquire and pay for their own policy.

 

[Pea-n-Me]

Not only do we have a co-pay but we also pay the entire premium - we are self employed. I'd love to have just a co-pay. In addition to the $800+ per month premium we have a $500 per person deductable then 10% co-pay if the provider in in the network (20% co-pay if outside).

If it's any consolation, many people even with employer subsidies are paying in this range now as well.

 

[Andrea from PA]

No sympathy from me, but if you want to feel better about it:

Family coverage thru my work will be over $21,000 for the premium. My employer does pay a small portion.

Primary doctor visits are $40

Specialists are $50

RX ranges from $35 - $70. And 2 of my kids have conditions which require daily meds.

ER visit = $100

 

[stacy347]

Whole new policy this year, and almost everything is more than double what we used to pay.

Office visit went from $20 to $45
Urgent care from $20 to $65
ER co-pay from $0 to $200

Rx went from $10 to $15 for generic and $20 to $50 for name brand.

We will now be spending approx. $400/mo. out of pocket once the $500 family deductible is met. It definitely hurts.

 

[ccgirl]

I hear you!

Our premiums will go up by another $50/month next year. We own our business and pay entirely for our own insurance. The copays for our primary care are $40/visit and $60/visit for specialists and have been that way for a year now. I had an MRI last year and I had to pay $1200 for it myself.

People who are accustomed to having their employers pay a portion of their health insurance are just beginning to see what those of us who pay OOP for our own health care have known for years. It will get worse as the rest of the health insurance "affordable care" act kicks in. Many businesses will accept the fine for not providing health insurance to their employees because it will be cheaper to pay the fine than to pay for their portion of the insurance. And since everyone will be required by law to carry health insurance, it will fall on the individual to acquire and pay for their own policy.

In MA we have had mandatory health insurance for a while now. It is up to the individual to ensure they have insurance or they get whacked on their taxes. State run plans count as insurance. Employers are required to tell us how much premium they are paying toward our health insurance (not sure if that is due to state or federal law - state, I think).

I agree with upping copays rather than the premium. Some people run to the ER with a sniffle while others wait until they truly need it.

Interpretation is a funny thing. I interpret my health insurance as excellent and pay around what some others pay for copays/meds. Well visits have no copay. It is $20 for reg dr's visits, $45 for specialists, and $75 for ER. My Meds are 20/40/75 depending on the formulary tier. Both my son and I have asthma that requires regular meds. Honestly, I am just grateful to have insurance. I am careful when we utilize it and go to the dr's only when necessary and the ER only for an emergency.

 

[Pooh2]

We had fantastic insurance for 20 years then Obamacare was signed on.

Our premium went up some, but instead of $25 co-pays and 0 deductible, we now have a $3,000 out of pocket expense PER FAMILY MEMBER. (caps at $6,000 per family).

The only thing the new legislation does for the middle class is discourage us from seeking treatment when ill.

 

[ttfn3]

I have been administering my companies medical insurance plan over 25 years. The rates were rising substantially every year for monthly premiums long before the Health Care reform act was passed. Something needs to be changed in health insurance and no one - Republican, Democrat, Independent, etc has a clue how to fix the system.

I would for one, like to see them get rid of the TV advertising for prescription drugs. No one should be going to see their doctor to request a specific drug (and heck - with those disclaimers who would?)

 

[PatriciaH]

I am so thankful for our health insurance. DH's job pays for our medical, dental and vision 100%. An ER visit is $100, Office visit $15, RX $10/$30/$50. We also have a fitness benefit of $300/year and his work matches it- so $600 a year towards our gym! The benefits at this job are the reason we moved back from FL.

 

[Arielle22]

Thank you for this description. Just to add, another reason premiums are raised is how much it is utilized. For example, if the company pays $10,000 for the health insurance and the insurers use $20,000 the premium is going to be raised because it is paying out more than it is taking out. That part has nothing to do with Romney, Obama or anyone else. It is just how insurance works.

We used to be on my DH's insurance until my company was acquired by a much larger company with incredible benefits. His company did exactly as you described. They had a benefit fair where the broker came and explained everything and it was so very helpful. They ended up switching insurance carriers and the company absorbed a higher premium. The only thing that went up was the copays. They are trying to implement a wellness program as well. Hoping that if they can keep the employers healthy they won't utilize the insurance as much.

As for the earlier post about how much a doctor's office visit is. I used to work for a doctor's office. It is them you need to get the charge from. The insurance company has no idea how much each doctor charges. If there is a contracted rate, the insurance company will know that but might not give you that over the phone. Depending on the type of insurance, not all doctor's have contracted rates.

You are correct in what you added. We were told our insurance paid out more than it took in on our plan last year which is one reason they are not willing to work with us to try and lower the increase. We are a smaller plan which makes it even more difficult.

 

[ccgirl]

I have been administering my companies medical insurance plan over 25 years. The rates were rising substantially every year for monthly premiums long before the Health Care reform act was passed. Something needs to be changed in health insurance and no one - Republican, Democrat, Independent, etc has a clue how to fix the system.

I would for one, like to see them get rid of the TV advertising for prescription drugs. No one should be going to see their doctor to request a specific drug (and heck - with those disclaimers who would?)

Exactly. I am a registered Independent. Rising premiums are nothing new. PP is right...the way insurance is now; it is forcing people to think before they actually seek medical treatment. Of course, never hesitate if it is an emergency. Other than that, there are relatively few reasons one needs to seek medical care. If you have a cold, there is nothing they can do. Ear infections will usually go away on their own. I have a fairly high copayment plan. When my son had a severe asthma attack and I called 911, I thanked God we had it. All I had to pay was the $75 ER copay. Since it was a true emergency and everything was medically necessary the insurance picked this up. I will say that talking to my coworkers of my division, we are selective as to when we use the insurance. Thankfully, there have been no serious illnesses thus far.

My DH's former company, there were quite a few abusers of the insurance. I would say abusers because they would go to the ER with just a sniffle. They were constantly having their premiums raised and switching insurances due to these people. I am so glad we don't have to deal with that anymore.