2014 Healthcare a Vent!

[akcire]

First let me say up until this time I have been fortunate to have excellent health insurance. My husband works for a fortune 50 company. Our family insurance costs were just about $3000 annually for medical. We had a 20% co insurance. With an out of pocket maximum of $4000 for our family. As someone who has ongoing yet random medical issues this has been a blessing.

I just received the documentation for our 2014 insurance. There is a premium increase to $4000 for the family which is something we can absorb. However our new out of pocket in network maximum is $12,500. If I had to go out of network it is now $25,000. Yet my maximum FSA is now $2500!!

I literally don't think I can afford to have a second child. I had a very easy pregnancy (despite my issues) and was monitored regularly. I ended up with a semi-emergency c section but was discharged 32 hours later. We have just begun thinking about putting in extra effort for a second child. I know with my third trimester twice weekly visits I would hit that out of pocket maximum.

Seriously, I'd be better off getting divorced and going on public aid if I become pregnant. How is that a plan for the country?

Called HR when I saw what was going on, just to ask some questions. Had the company left the 2013 insurance in place they could not afford the fines. So my husband's company which took great care of us, now has been penalized? Gotta love this country. This will effectively ensure the educated middle class who understand their policies will not be having additional children. Yet the judgment proof masses can reproduce without consequences. Of course the highest wage earners and those with family fortunes will be marginally effected, if at all.

Told my husband to start considering some of those international job offers he gets, since our life is certainly going to be changing dramatically her in USA.

Vent over, carry on with your day!

 

[marius97]

Can you educate me? I thought that an out of pocket maximum was where you pay your deductibles/co-pays and once that total hits your max, then everything is covered at 100% after that. Is that not the case? DW works for the state so she has always had great insurance...a little less great these days though. It only cost us $150 for DS8's $200,000 birth.

 

[Marionnette]

Can you educate me? I thought that an out of pocket maximum was where you pay your deductibles/co-pays and once that total hits your max, then everything is covered at 100% after that. Is that not the case? DW works for the state so she has always had great insurance...a little less great these days though. It only cost us $150 for DS8's $200,000 birth.

Policies differ. We have an HMO. When we meet our deductible, everything above that amount is 100% covered. However, my sister's policy has her paying 20% of any amount over her deductible while her insurance pays the other 80%. It all depends on how your policy is written . There are also out- of-pocket maximums that will be different for each policy. That's why it's very important to go over these exchange insurance policies carefully.

 

[bethy]

Our annual family deductible is $8000 and we meet it every year with fairly normal health issues and expenses. Plus there are the monthly premiums.

I took my DD8 in two days ago for a suspected broken toe. She was in a ton of pain and it was hugely swollen and she could barely walk. Even then, I briefly hesitated about taking her in. When checking in the front desk person made a point to make sure I knew I had a high deductible plan. My response was that yes, I knew I was going to have a good sized bill at the end of the visit (off the top of my head I'm going to guess a minimum $1800 - which we will pay for later this month by writing a check directly out of our regular checking account.)

She then handed me a pamphlet and chirped that our family could make an income up to $100,000 and still apply for Financial Aid there and get the whole thing paid for. I had to decline and it was all I could do not to say that my bill will likely be significantly larger just in order to help pay for that program. Plus there are the guilds and private fundraising to thank as well.

All that said, I just see insurance now as something that's there for catastrophes only. For us, we expect to spend $15,000 at least for healthcare every year. And I do navigate the Healthcare system very carefully and make sure that every expense is truly necessary, etc. For example for my DD's toe - I questioned the doctor as to whether an xray was truly necessary when they maybe couldn't do anything for a broken toe but tape it anyway . . .

 

[JoiseyMom]

All that said, I just see insurance now as something that's there for catastrophes only.

This is how insurance used to be. When I was a kid, we paid OOP for everything (granted back in the 60's doc visits and meds were much cheaper, but then again salaries were much less). The health insurance kicked in for hospitals, and major medicals.

Our insurance has a 3k deductible before we pay 20% for in network. Then we have a 6k max for OOP before we are covered at 100%. We hit the 3k in March and the 6k this summer. I am waiting to see what next year's policy brings us....but from what I have read, DH's company has been getting ACA appliant for the past 2 years..so we might not change much. (fingers crossed).

 

[Pooh2]

I feel your pain, OP.
Ours went up by $6,000 for 2 of us. I really feel for those with children at home who are getting hit with these costs and new parents just starting out.

Our policy was also a "cadillac" policy before being downgraded to avoid the 40
% tax. Employers are being punished for providing top notch coverage. It makes no sense at all. This law is such a huge tax burden on the middle class.

 

[kellia]

Dh and I haven't gotten our enrollment info for 2014 yet, but I've heard from others who have that it went up a LOT!!!

I honestly don't understand why it went up so much for people who already had insurance through their employers. I thought the purpose of Obamacare was to give access to insurance to those who didn't have it. Why did it affect everyone else so much, too?

 

[Chelley00]

Our premium DOUBLED.

Our family deductible went from $1,500 to $4,000.

Our out of pocket max went from $4,000 to $10,000.

Our prescription coverage went from me paying $100/month to $325/month for just my medications.

and the rumor is the company will be eliminating spousal coverage next year which will force me to go to the "affordable" care, which is higher still because I will need the highest tier coverage.

 

[dalmatian7]

can someone enlighten me a little, what is the penalty for having good coverage? or did your companies downgrade because they have to cover everyone now? Just curious because we have good coverage with DH's work and I want to know if I should be looking more closely at things now. we are blessed to be very healthy but OP I feel your pain, I know my cousin had to seriously save during her pregnancy because of what there OOP costs were with the plan they have.

 

[mrsklamc]

I honestly don't understand why it went up so much for people who already had insurance through their employers. I thought the purpose of Obamacare was to give access to insurance to those who didn't have it. Why did it affect everyone else so much, too?

Among other reasons, because more things are covered, because they can't exclude people with pre-exisiting conditions, and because family coverage is now up to 26, which a lot of women are having babies by then.

 

[mrsklamc]

can someone enlighten me a little, what is the penalty for having good coverage?

It's called a 'Cadillac' tax, and I think (but am not really sure) that it's when your coverage costs more than a certain amount of money, it can no longer be paid for with pre-tax dollars.

 

[Marionnette]

can someone enlighten me a little, what is the penalty for having good coverage? or did your companies downgrade because they have to cover everyone now? Just curious because we have good coverage with DH's work and I want to know if I should be looking more closely at things now. we are blessed to be very healthy but OP I feel your pain, I know my cousin had to seriously save during her pregnancy because of what there OOP costs were with the plan they have.

There is a 40% tax on companies that provide their employees with "Cadillac" healthcare plans. In order to avoid paying the tax, companies have had to eliminate those plans from their employee benefits.

If your husband's employer has not notified you that your plan will be changing, it could be because they are willing to pay the tax, OR they are exempt from the tax for now, OR they just haven't put together their healthcare benefits package for next year yet, OR it's possible that while you find that your plan is good for you, it is not what was considered to be a "Cadillac" plan and doesn't need to be eliminated.

 

[nd5056]

I feel your pain, OP.
Ours went up by $6,000 for 2 of us. I really feel for those with children at home who are getting hit with these costs and new parents just starting out.

Our policy was also a "cadillac" policy before being downgraded to avoid the 40
% tax. Employers are being punished for providing top notch coverage. It makes no sense at all. This law is such a huge tax burden on the middle class.

We have asked for CHANGE, haven't we???

.

 

[danygirl]

OP. I would look into an Aflac policy or two. We use the Aflac accident insurance. $520 per year but pays out for any injuries. Not health insurance so not obamacare. They also have hospitalization and didability

 

[travelbug]

My cousin's family is reeling from what they heard from their insurance company. They had been paying $850 per month, with a $5000 deductible. They just got a letter from the insurance company saying that in order to maintain a $5000 deductible, their monthly premium will go up to $2300 per month.

 

[MsDunny]

I posted on another thread, but will post here also.

Our premium through my dh's work, will go up 114%. We already have an HSA with a very high deductible for our family, and our well visits ARE NOT covered as others have stated would be the case. Now, we are a fairly healthy family and work hard to remain healthy by eating right and taking care of ourselves.
I have friends who are extremely overweight and have health issues. She was bragging to me that they could finally get insurance (they had been denied coverage before because of their weight) and that they quality for the subsidy, so their family of 4 is not paying much of a premium at all.

I don't mean to be negative, but that makes me angry.

 

[toystory1130]

Dh and I haven't gotten our enrollment info for 2014 yet, but I've heard from others who have that it went up a LOT!!!

I honestly don't understand why it went up so much for people who already had insurance through their employers. I thought the purpose of Obamacare was to give access to insurance to those who didn't have it. Why did it affect everyone else so much, too?

Who do you think is going to PAY for the millions of uninsured who now will have healthcare?????

 

[wiigirl]

Ours went up too...ughhh

 

[nd5056]

Who do you think is going to PAY for the millions of uninsured who now will have healthcare?????

Yup!

Makes me want to get divorce and quit my job as well, I'll get more money left for food then right now working every day...

.

 

[Claire&TheBoys]

First let me say up until this time I have been fortunate to have excellent health insurance. My husband works for a fortune 50 company. Our family insurance costs were just about $3000 annually for medical. We had a 20% co insurance. With an out of pocket maximum of $4000 for our family. As someone who has ongoing yet random medical issues this has been a blessing.

I just received the documentation for our 2014 insurance. There is a premium increase to $4000 for the family which is something we can absorb. However our new out of pocket in network maximum is $12,500. If I had to go out of network it is now $25,000. Yet my maximum FSA is now $2500!!

I literally don't think I can afford to have a second child. I had a very easy pregnancy (despite my issues) and was monitored regularly. I ended up with a semi-emergency c section but was discharged 32 hours later. We have just begun thinking about putting in extra effort for a second child. I know with my third trimester twice weekly visits I would hit that out of pocket maximum.

Seriously, I'd be better off getting divorced and going on public aid if I become pregnant. How is that a plan for the country?

Called HR when I saw what was going on, just to ask some questions. Had the company left the 2013 insurance in place they could not afford the fines. So my husband's company which took great care of us, now has been penalized? Gotta love this country. This will effectively ensure the educated middle class who understand their policies will not be having additional children. Yet the judgment proof masses can reproduce without consequences. Of course the highest wage earners and those with family fortunes will be marginally effected, if at all.

Told my husband to start considering some of those international job offers he gets, since our life is certainly going to be changing dramatically her in USA.

Vent over, carry on with your day!

Do you have a deductible in addition to the out-of-pocket max of $12,500? I know our plan (BCBS) has us with a certain amount of deductible, and an OOP max, so for example, I wound up paying 100% of the amount to have a wart burned off my son's finger this year, but once we hit the deductible, we were only responsible for a certain % of the allowable charge. Once all of what we paid for that % hit the OOP max, we didn't have to pay any more for the year and everything was covered at 100%.

As for the maternity care, ask your OB/GYN how they bill. When I had my sons, the delivery fee was $2400 and I paid 20% of that, insurance paid the rest. All of my regular pre-natal visits were included in that and each one was not billed separately. The only amounts I had to pay were for the ultrasounds I had to check the thickness of my cervix (it was thinner than my OB was happy about and to make sure it didn't get too thin too early, I was checked every two weeks). So the number of office visits may not directly affect how much you're billed for L&D.

Healthcare is a giant mess and no one has a good solution.