Anyone Else Worried About Health Premiums Going UP?

[Colleen27]

Perhaps you missed the first sentence of my post.

I saw that you quoted costs from KFF. But the idea that half of people buying coverage won't qualify for subsidies simply doesn't track with the income cutoffs for those subsidies. Nearly half of American households have an annual income below the uppermost limit for single individual subsidies (around 41K; median household income is 50K). And it especially doesn't track if you're looking specifically at the costs and likelihood of younger adults buying coverage, because younger, less experienced workers as a whole tend to be on the lower end of the earnings scale.

 

[crisi]

Interesting. My DS had an option of an employer based "regular" health care plan or an HSA. When he & I looked over the coverage, the HSA didn't cover much. But sounds like yours covers everything except 2,000 per year & you can take that out of your HSA savings.

Sounds like a great deal as long as the coverage after your $2,000 takes care of everything else - does it?

Its a high deductible health care plan...

I pay 100% of the first $1200 per person. I pay 20% and the insurance company pays 80% of everything else, until my out of pocket is $6000 for the entire family, at that point, the insurance pays 100%. No yearly or lifetime maximum (thank you ACA). Rates are the negotiated insurance company rates - no matter if I'm paying or they are or we are sharing.

With the exception of the amounts, this is not much different than how health insurance worked for my parents in the 1970s and until the 1990s, when my dad's company finally went with an HMO. (I think back in the 70s it was more along the lines of the first $800). Before HMOs, this was the way health insurance worked.

The other thing that has changed since back then is that I can put $6000 a year into a savings account pre-tax - as long as we use it for health expenses, its never taxed. We've been doing this three years and have about $14000 in the account - which means that we've only spent $4k out of pocket - all in non-taxed dollars - on health care - other than premiums.

Some items are automatically covered regardless of the deductible - my mammogram. Vaccinations. Bi annual physicals (at our age - babies and once you reach a certain age its annual).

And my premiums are half what they were with the HMO. And I'm not nickle and dimed on post tax dollars for co-pays (you can do a Health Care Spending Account with an HMO - but its use it or lose it - we didn't use it because it was hard to estimate).

We are a fairly healthy family, but my husband has a serious slipped disk problem requiring regular treatment and medications, I've been on medication for a chronic condition for years, and my son had a year of therapy during that time (we did start paying the 80% with him).

 

[mom2my3kids]

Just because I was able to support myself doesn't mean I had a crappy life.

Never meant to imply you did, I am one of those parents who would do without health insurance to make sure my offspring are covered.. I know quite a few parents who when there child turns 18 and graduates they tell them they have to move out..I am not one of those parents, my daughter goes to college will take her six years for her degree..She works part time at a bank, I told her she is always welcome at home, I dont care if she is fifty she will always have a free place to live if she needs one..

 

[anniemck]

Here I sit, reading this as a 46 yo mom with multiple pre-ex conditions. I am an independent contractor where I work because with my conditions I never know if I am going to have a good day or bad, and who wants to hire someone based on that information. I could wake up feeling great and an hour later be back in bed with a head splitting migraine, or falling down due to the stenosis and other issues with my spine.
I just spent 12 nights in the hospital due to neck/back issues and need to have surgery to take care of it, without insurance of any type that is a bit hard to do. Heck I have over $100k in hospital bills for the past 3 months. Waiting for SS to decide if I am a bad enough case for SSDI, in the mean time the ACA is going to be a blessing due to the fact that I will at least have some kind of coverage.

 

[TwoAtDisney]

I never said I was over 55. Think you have me confused with somebody else. I am 41 and I am a nurse.

I will say this. The college degree that my generation was expected to get, no longer promises the pathway to success that it once did. This country needs less MBA's and more plumbers, HVAC techs, and other trades people. People with a trade have a better chance of finding a decent job right now. My father was a tradesman and I was expected to go to college to do better than him. At this point, I would rather my child be a plumber than a CPA.

I thnketh you speaketh before knowing facts! - People with a trade have a better chance of finding a decent job right now. My DH always advised our children - "Put brain in gear before opening mouth!"

You also seem to base your "facts" on the past - My father was a tradesman.

Have 2 plumber sons - read on - these are facts, not ranting.

Wages - I suppose if they were plumbers in NYC they would make wheelbarrows of money (?), but then they would spend it on living expenses. However, they, we the family, all live in the Midwest. $18 an hour. Now that is a lot better than a lot of people, but not CPA wages.

Jobs, Wages, & Fake Plumbers - Before immigrants came across our southern border, plumbers could demand their own deal! They were in the top of the trade job market. Our sons did very well & could, if they wanted, but they didn't, move from employer to employer. Well.....the companies started hiring those immigrants that could or could not speak English, who were & were not legal, & were usually not treated well - paid a whole lot less (like minimum wage) than the real plumbers, who were told to train them. Now, as required by law, there is one plumber on a housing project at $18 or less - although not really always a plumber there. The remaining "plumbers" are not licensed & are making very low wages & are not treated well because most of them can't complain & get reported & sent back to whence they came.

So, not only have licensed plumbers suffered in the work force, so have the immigrants. I feel sorry for both (is that helicoptering?). Luckily, 1 son is the plumber for a hospital at $18 hour (imagine! the whole hospital!), but he has a job. The other does remodels on his own - no employer, therefore, no employer health insurance! That great job in the sky that you described!

Note - I explained their situation, but it is not unique. They still know the plumber employment market & other plumbers.

 

[TwoAtDisney]

Its a high deductible health care plan...

I pay 100% of the first $1200 per person. I pay 20% and the insurance company pays 80% of everything else, until my out of pocket is $6000 for the entire family, at that point, the insurance pays 100%. No yearly or lifetime maximum (thank you ACA). Rates are the negotiated insurance company rates - no matter if I'm paying or they are or we are sharing.

With the exception of the amounts, this is not much different than how health insurance worked for my parents in the 1970s and until the 1990s, when my dad's company finally went with an HMO. (I think back in the 70s it was more along the lines of the first $800). Before HMOs, this was the way health insurance worked.

The other thing that has changed since back then is that I can put $6000 a year into a savings account pre-tax - as long as we use it for health expenses, its never taxed. We've been doing this three years and have about $14000 in the account - which means that we've only spent $4k out of pocket - all in non-taxed dollars - on health care - other than premiums.

Some items are automatically covered regardless of the deductible - my mammogram. Vaccinations. Bi annual physicals (at our age - babies and once you reach a certain age its annual).

And my premiums are half what they were with the HMO. And I'm not nickle and dimed on post tax dollars for co-pays (you can do a Health Care Spending Account with an HMO - but its use it or lose it - we didn't use it because it was hard to estimate).

We are a fairly healthy family, but my husband has a serious slipped disk problem requiring regular treatment and medications, I've been on medication for a chronic condition for years, and my son had a year of therapy during that time (we did start paying the 80% with him).

Thank you so much for taking the time to share that info with me. Your HSA sounds like a coin with a good & bad side! But I'm glad it is working for you - based on what else you can get.

My brother had back problems for years with extreme pain. Rather than having surgery, he found an anesthesiologist who used a laser to kill the nerves that were causing the pain. He had that done several years ago & has not had problems since. It was new then - little more commonly used now, but lots of people don't know about it. DB had a friend who went to his dr & had the same thing done! It's an out-pt procedure. We have 1 dr here who does it & my DB's dr moved to FL to set up a practice. Your DH might want to look into it, although his possible back surgeon/dr will probably not like it! Good luck to him.

 

[crisi]

Thank you so much for taking the time to share that info with me. Your HSA sounds like a coin with a good & bad side! But I'm glad it is working for you - based on what else you can get.

My brother had back problems for years with extreme pain. Rather than having surgery, he found an anesthesiologist who used a laser to kill the nerves that were causing the pain. He had that done several years ago & has not had problems since. It was new then - little more commonly used now, but lots of people don't know about it. DB had a friend who went to his dr & had the same thing done! It's an out-pt procedure. We have 1 dr here who does it & my DB's dr moved to FL to set up a practice. Your DH might want to look into it, although his possible back surgeon/dr will probably not like it! Good luck to him.

Thanks, but his issue is a herniated disk that is herniated because he has a congenital narrowing of the spinal column that narrows further as he ages - eventually he'll need surgery to have his spine cracked open or his cord will be pinched enough to paralyze him. Cutting nerves isn't going to do any good - in fact that is what we are trying to prevent

 

[crisi]

Thank you so much for taking the time to share that info with me. Your HSA sounds like a coin with a good & bad side! But I'm glad it is working for you - based on what else you can get.

Oh, and we qualify for an HMO that would pay everything with a $20 copay - but that is three times as expensive in terms of premiums. Although by the time we put our $6k a year into a savings account, we are a little behind on take home, less than $100 a month - but after we pay what used to be co-pays out, we aren't at all behind in terms of how much money is available to us for things other than health care each year - plus we have the savings account. Frankly, I don't see a bad side to this coin.

 

[TwoAtDisney]

Ok, I originally signed on to here to reveal what I heard on the news today about the health care exchanges, & to give some great links....but instead I got tied up with multiple responses.

NOTE - The commentator said her research showed that "most" examples below received the tax credit price.

For INDIANA - I do not know how much of the following applies to every state, but this at least gives an idea of how things will go.
Levels of Coverage on Medical Costs -
Bronze Plan = 60%
Silver Plan - 70%
Gold Plan = 80%
Platinum Plan = 90%

EXAMPLES - $ premium amounts are monthly
27yo, less than $25,000 gross income - Bronze = $200 before credit; $80 after credit.

Family of 4, less than $50,000 gross income - Silver = $961 before credit; $282 after credit. Bronze is $46 after credit.

Here is the main link - https://www.healthcare.gov/

Explanation of the "Marketplace" - https://www.healthcare.gov/what-is-the-health-insurance-marketplace/

NOTE on the above link, in the bottom right corner is a chat button (24/7). I used it & got a response almost immediately.

Phone # - 24/7 - 800-318-2596

I guess it's best to get the answers from the trained reps than from us on here.

Good health care insurance luck everyone.

 

[nunzia]

You aren't understanding it. The exchange essentially functions as a means of giving individuals access to group-type pricing. The plans are offered by insurance companies and the reimbursement rates will bet set by those companies. The only government involvement is in the subsidies which are paid based on private insurer premiums - it isn't medicaid, though there is an expansion of that in the works in some states to address the very low income, and the government isn't directly involved in setting prices.

I think that's what bothers me the most about the whole discussion on this issue - not the disagreement, there's plenty of room for that, but rather the poor understanding all around. Even the name... Asking people about "Obamacare" evokes an entirely different reaction than asking about the Affordable Care Act (seriously, a 20 point difference in approval figures according to some polls ), and many of the people strongly opposed to it don't understand what it will do. Our media and so-called leadership has been more interested in sowing conflict and currying favor with their viewers/supporters than in informing anyone, and as a consequence much of the debate centers around half-truths and misconceptions.

I do understand that..but..it also sets it up for millions more to be added to Medicaid. Yes..Insurance sucks and needs reforming. but it is INSURANCE that needs reforming not a takeover by the goverment. I will qualify for subsidies...if one of the plans is worth having..oh goodie..I get to add even more to the debt that has no hope of ever being paid off. Whatever. It is all out of our control, we the people do not run this country, we are creeping up on socialism and see how well that works. But it is what it is.

 

[Judyat]

Nunzia you are not adding to the debt. It is paid for. It is not adding anything to the debt. Savings in certain areas and it will actually save over the next 10 years. Doing nothing adds to the debt. There are those who would like you to believe their lies but that's all they have. Check it out and get the facts.

 

[TwoAtDisney]

I do understand that..but..it also sets it up for millions more to be added to Medicaid. Yes..Insurance sucks and needs reforming. but it is INSURANCE that needs reforming not a takeover by the goverment. I will qualify for subsidies...if one of the plans is worth having..oh goodie..I get to add even more to the debt that has no hope of ever being paid off. Whatever. It is all out of our control, we the people do not run this country, we are creeping up on socialism and see how well that works. But it is what it is.

"we are creeping up on socialism" & "it is INSURANCE that needs reforming" - Those are conflicting statements - In your 1st statement, you don't agree on the government stepping in - being "socialism. In the 2nd statement you think a private, not public, business should be "reformed" & obviously that means the government doing the reforming because in our capitalistic country (not saying that is good or bad), insurance companies will not reform themselves & decrease their bottom line.

Why are you worried about the burden a law "for" the American people will place on the national debt (if it does - facts are not in yet). Why wouldn't you say, "Americans deserve a return on their tax dollars" - take the money from what we spend on other countries' wars, nation building other countries, lining pockets of despots & corporations...on & on. There's plenty of tax dollars for us - it's just not spent on us!

 

[dansamy]

Nunzia you are not adding to the debt. It is paid for. It is not adding anything to the debt. Savings in certain areas and it will actually save over the next 10 years. Doing nothing adds to the debt. There are those who would like you to believe their lies but that's all they have. Check it out and get the facts.

I want to know where you get this idea that it's "paid for". Our tax dollars only go so far. Then, our government borrows the rest of what it's spending. Our national debt is in the trillions & ballooning rapidly. The expansion of Medicaid is "paid for", sure. With borrowed money.

 

[Colleen27]

I do understand that..but..it also sets it up for millions more to be added to Medicaid. Yes..Insurance sucks and needs reforming. but it is INSURANCE that needs reforming not a takeover by the goverment. I will qualify for subsidies...if one of the plans is worth having..oh goodie..I get to add even more to the debt that has no hope of ever being paid off. Whatever. It is all out of our control, we the people do not run this country, we are creeping up on socialism and see how well that works. But it is what it is.

I agree that insurance needs reforming, but to me this is a step in the right direction. There's a reason every single developed nation in the world except ours has some for of universal, single-payer health care... Because for-profit health insurance is a broken model from the ground up. It adds an additional layer of cost (profit and operating expenses for the insurance company), a massive amount of complexity for health-care providers (compliance with a different billing system for each insurance company they accept), and can only detract from the quality of patient care (because paid claims erode profits).

As far as the Medicaid expansion, it only covers people up to 133% of the poverty level. Those people should have been eligible all along. Call it socialism if you like, but one of the hallmarks of a developed society is some measure of protection for its most marginal, and proper medical coverage has the potential to save a great deal of money on other programs (ie disability, which many people pursue as a way to get medical care).

And when it comes to the national debt, I don't think it should be balanced on the backs of the poor, elderly, and children. We can afford billions upon billions in aid to countries around the world and lifetime benefits for so-called leaders who are wealthy before they take office and serve only a fraction of the time it would take to earn retirement and health care in any other job, and perpetual war on multiple fronts, but we should eliminate programs that give our poor access to health care and food? That is a priorities issue, not a debt issue.

 

[pryncess527]

I want to know where you get this idea that it's "paid for". Our tax dollars only go so far. Then, our government borrows the rest of what it's spending. Our national debt is in the trillions & ballooning rapidly. The expansion of Medicaid is "paid for", sure. With borrowed money.

No, it isn't.
The ACA was paid for by spending cuts and tax increases. None of it was borrowed. That was a huge sticking point during the debate.

If anyone wants to point to something to blame as the cause of our debt, starting with the two wars we are fighting might be a better place to look. They cost way more than ACA.

 

[Poohbear5]

Nunzia you are not adding to the debt. It is paid for. It is not adding anything to the debt. Savings in certain areas and it will actually save over the next 10 years. Doing nothing adds to the debt. There are those who would like you to believe their lies but that's all they have. Check it out and get the facts.

One of many reports estimating that obamacare will add 6.2 trillion to the federal deficit:

http://www.nationalreview.com/corne...s-62-trillion-long-term-deficit-andrew-stiles

It is paid for by a huge tax on the American people and drastically increased premiums and deductibles on the middle class. And no, most of us are not making over 6 figures but have 2 full time parents working and struggling to make ends meet, pay for kids college, etc.

Many companies are burdened by this 2700 page tax bill and are cutting hours to their employees and laying off. That is nice that a small portion of the population is benefiting from this law, most of us are not. Our deductible went from $1,200 per family to $6,000.

 

[manning]

One of many reports estimating that obamacare will add 6.2 trillion to the federal deficit:

http://www.nationalreview.com/corne...s-62-trillion-long-term-deficit-andrew-stiles

It is paid for by a huge tax on the American people and drastically increased premiums and deductibles on the middle class. And no, most of us are not making over 6 figures but have 2 full time parents working and struggling to make ends meet, pay for kids college, etc.

Many companies are burdened by this 2700 page tax bill and are cutting hours to their employees and laying off. That is nice that a small portion of the population is benefiting from this law, most of us are not. Our deductible went from $1,200 per family to $6,000.

And don't forget the increases in co-pays.

There's more there than premiums.

 

[dansamy]

I agree that our spending needs to be reigned in & not on the backs of the poor & disabled & elderly. But to say that the ACA will not add to our national debt is delusional. It doesn't matter if they cut program A to fund ACA & then borrow money to continue funding program A or if they just borrow money to fund ACA. In the end, the effect is still the same. A bloated, entitled government spending pell mell & unchecked until our nation's economy collapses under the burden of our debt.

 

[Jennabeth]

Bummer! I typed up my response & it got lost in space; hope this isn't a duplicate.

Didn't know HSAs had insurance coverage. I thought the HSA had to pay for all of the health care costs. Sounds like a good deal.

So, why do you try not to use it - does it not cover anything until you reach the deductible, such as, office visits, RXs, out-pt tests, hospital stays, etc. - nothing?

Does your employer contribute?

Crisi answered some of the questions, but I'll answer with what my employer does. I believe to have an HSA you have to have a High Deductible Health Plan (HDHP). The deductible on our plan is $1500 per person or $3000 per family. Once we reach our deductible, the insurance covers everything 100%, including prescription drugs. So, in a year the most we would have to pay is $3000, that is the minimum we try to keep in our HSA.

My HDHP is a PPO that covers routine appointments 100% (I don't have a copay). When I go to the Dr. I show my insurance card. They bill the visit through insurance and then I get a bill. If it's a routine appointment, I get a bill for $0. If it's something else, the bill is discounted per the agreement with the insurance company, I get billed for the remaining amount. If it's a smallish amount, I usually pay it with our checking account, not the HSA (but it still gets applied to the deductible). That's what I mean when I say we try not to use it. And yes, most things are not covered until we reach the deductible. Prescriptions are the worst, but I shop around to find the best deal. You'd be amazing at how much drug prices vary at different stores. Most pharmacies have prices online so it's fairly easy to compare.

I work for a wonderful company that decided to pay 100% of the premium for anyone electing the HDHP instead of the 'standard' insurance plan. This allows me to take the money I would normally spend on premiums and put it into my HSA. This year, someone (with a family) electing to use our regular plan would pay $4,152/year in premiums and still have to pay a co-pay for visits and prescriptions. On top of that, they would have a $500 deductible, then the insurance would cover 90% until the family paid $2000 (not including co-pays), after that 100% would be covered. So, worst case scenario with the regular plan would cost a family $6,152 (not including co-pays). Worst case scenario with the HDHP/HSA would cost a family $3000.

The other thing my employer did to entice people to sign up for the HDHP was offer a one time deposit into their HSAs. In January they put $1,300 into my HSA ($750 for single) to help fund the account. This was to cover any expenses that might occur before the funds were able to build up. This year they've reduced the amount quite a bit because they figure those of us who've had the account for a few years should (hopefully) have a cushion built up.

These incentives worked, in 2013, 80% of the benefit eligible employees at my company were enrolled in the HDHP/HSA. This is saving the company a lot of money because they no longer have to pay 80% of the premiums for the regular plan (employees paid 20%) and employees are becoming smart shoppers (since they have more skin in the game).

Sorry for the book, I think HDHP w/HSAs are the future and I wish more people knew more about them. I really see more and more companies going with this.

 

[Poohbear5]

And don't forget the increases in co-pays.

There's more there than premiums.

Instead of $25 co-pays, my plan now has a $6,000 deductible. So no more copays for me!