Going to the poor house:2015 Inusrance premiums

[Irin997]

Those with a PPO plan, is an EPO plan an option? We have BCBS EPO (and we have for years) and it provides in network coverage only (with the exception of a true emergency). It's substantially less in premiums for the same care as a PPO plan except all of your doctors need to be in BCBS's network. Just a thought.

 

[danygirl]

Nurse case mgt is part of wellness under aca

 

[eliza61]

Those with a PPO plan, is an EPO plan an option? We have BCBS EPO (and we have for years) and it provides in network coverage only (with the exception of a true emergency). It's substantially less in premiums for the same care as a PPO plan except all of your doctors need to be in BCBS's network. Just a thought.

we have a similar program. You can get a less expensive plan by using in network physicians and also by using nurse practitioners for many routine visits.

For example, every year I had to waste money to take my osns to the doctors to get their sports physicals filled out.
since when my kids were young we were very blessed in that they were very healthy, we moved to a epo and twice a year they went to see a nurse practitioner.

 

[Trixie Belden]

Our rates stayed the same but they introduced a new "wellness plan" with stuff penalties if you don't welcome the intrusion of a nurse case manager who has never met you or your doctor or seen your medical records. Said case manager will now mandate things you must do or you pay . Apparently this wonderful program is part of obamacare and the penalties can be 50% if your premium

On the other hand DH co still pays us not to use his plan. But we might switch to his because their "wellness" plan is more carrot than stick

Ok- just checked on this because I was really curious about it and wondered why it wasn't part of our plan. It is part of the ACA, but it's not mandatory.

I'm not sure how large a company your husband works for danygirl, but the wellness plans are up to individual companies to implement. There are huge premium incentives for companies with less than 100 employees if they have a wellness plan to go along with their health insurance plans. It's not mandated that companies have a wellness plan, but they do get incentives for participating. The company and the health insurance companies decide what incentives they offer and what wellness goals they want to focus on. The penalties and/or incentives have guidelines they have to meet to prevent overly difficult goals or unrealistic outcomes.

The health insurance company should be the one managing the wellness plan, which is why they have nurse case managers calling you. It seems like there's a failure in communication between HR and the health plan if they don't realize flu shots are a company policy and are handled already. Also, if someone is marking your husband as "uncooperative" for following company policy for cell phone use at work, that is something that should be brought to the attention of HR. HR brought the wellness plan into the company so they should be the ones running interference for you-that's not yours or your husband's job, it's what they get paid for.

I would be mad too, if I had those things happening to me. I think sometimes HR and benefits people don't exactly understand the ACA and just throw everything under that umbrella without explaining exactly how it ties in (I worked in HR and benefits and I remember how easily that can happen).

 

[SandyinMonterey]

Everything is out of pocket for us and not covered UNTIL we hit $3000 per person. We have no 80/20 or anything like that anymore. Same goes for prescriptions. If my daughter's inhaler is $100, we pay $100. It all goes toward the $3000. Have no co-pay either, if MD appointment is $300, that's what we pay.

 

[Robinrs]

I'm very happy with my plan, my HSA has paid for all of medications, co-pays and deductibles for the entire year. My company matches our payment 4 times a year and gives us a large contribution at the beginning of the year so it's been a true blessing.

I've paid at LEAST $600 a month to cover myself and my very healthy son until this year when it reduced to about $500 a month. The deductible is high but the HSA card is a blessing.

I have a chronic illness and was nervous for years about pre-existing condition issues but no more. This has been the best part of all of this.

 

[Robinrs]

I am so sorry. Make sure to go and vote although damage has already been done.

I sure will!!

 

[AquaDame]

Nothing has changed for us so far. Same medical coverage and costs since my husband was hired in 2011.

 

[davedmaine]

So our 2015 benefit guide just came out. I have BCBS PPO. I know working PT and needing a family plan is expensive. I am paying $560/month!!!! I am sure to many this is cheap,but health care reform is here to stay. My family deductible is $3,0000. 80/20 max $9,000. Hopefully we will not need to use it this next year. How about everyone else?

That plan actually sounds great to me.. Triple that and then add in a $12k deductible and come talk to me..

 

[JenVi]

We are very blessed with my insurance at work. We have medical, dental and vision for all 5 of us which includes my 23 year old step sons. My employer covers all costs for this coverage and we have a $100 deductible each or $300 deductible for the family and then we pay 10% and they pay 90%.

Very thankful for what we have.

Jen

 

[aclov]

If they dropped his coverage, it would be a qualifying event.

If he goes on his insurance in March he has gained coverage so you should be able to drop him at that point.

 

[aclov]

One thing to keep in mind is also that the employer usually is also paying a portion of the premium. My employer breaks it out for us on our confirmation statement, they also contribute to our HSA. It's a struggle for employers to try to control costs.

 

[Gracie09]

Oh joy we are starting the ACA insurance thing again So far this year thank goodness my insurance has made a nice profit off our family. They haven't paid one penny in claims yet. Hopefully our luck will cont. till renewal in may of 2015. January is physical annual appointment time for us. that should make them pay less then 7% in cost of the premiums paid in, max. Which will give them a nice profit of $26,040 from us. Oh well im hoping for the same crappy insurance I presently have 4k dec HSA, with poilcy under 30k a year.

You do realize how insurance works right. Some years we barely use it, others by march we have been paid back our premiums for the year.

 

[elgerber]

I just got the renewal notice for my decent private plan. It increased almost $600 a month to $1358. So I will take your $560. I can switch to an $859 a month plan with a $13000 deductible if I so choose.

 

[PatMcDuck]

DH and I pay almost $900 a month for our health insurance, just DH and me. Because DH is retired, they kicked DD off the plan at age 22, and she is still a full time student.

We were forced to buy her health insurance. But because her income is very low (she works 2 PT jobs and goes to school) she qualified for the highest subsidy under Obama care. I thank God for it. It is about $110 a month, no deductible. She can no longer be our dependent, of course.

We have yet to receive info on next years premiums. She will finish school in May, and hopefully get a FT job with benefits and no longer need this.

 

[missbrooke06]

How does that work if the spouse has a very different open enrollment period? My husband is on my insurance. Work now charges me over 1000 a year because he could be on another insurance. However I can't move him to his own insurance becasue my open enrollment is in Nov, his is in March. So either we keep him in mine in a few days and then in March he picks up his and we are paying double until next march or we get tax penalties and he has no insurance from Nov. to March. So last year we just got stuck with the dumb fee. However if they said he couldn't be covered at all, yet he isn't in open enrollment at his job and with no qualifying event... It makes no sense at all.

At my place of employment, different enrollment periods is a qualifying event - so if you worked for us, you would enroll your husband and in March, you could drop him. I thought this was a federal requirement but I may be wrong. Talk to your HR person!

 

[missbrooke06]

DH & I each have our own individual plans through our employer (works out cheapest that way). My plan went down $2 a month. I have a HDHP. I am currently paying $37.46 a month. I have a $1500 deductible. However, my employer puts $800 into my HSA at the first of the year so I just have $700 OOP.

DH's insurance went up $20 a month and he now pays $75 a month for his plan with $500 deductible.

DH was just complaining when I redid his insurance rates, he's upset we pay $100 a month for all his insurances. That covers; his medical, vision for us 2, dental for us 2, 3x his annual salary for life insurance and 2x his annual salary for life insurance on me. I told him he really has it made.

Wow! $500 deductible? Does he work in 2005?

 

[Abdul Saleem]

It is all part of the plan people. Make heath care so unaffordable that we will yearn for a single-payer system. Now, to make this non-political, I wonder how much business Disney is missing out on now that people have to spend $6,000 in deductibles instead of on a Disney trip?

 

[Gracie09]

It is all part of the plan people. Make heath care so unaffordable that we will yearn for a single-payer system. Now, to make this non-political, I wonder how much business Disney is missing out on now that people have to spend $6,000 in deductibles instead of on a Disney trip?

My healthcare is pretty affordable. $450 a month for the family plan PPO. It went up $5 whole dollars this year. No deductible unless you go out of network then it $1000 per person/$2500 per family. Some co-pays but under $20 for most doctors. Oh and $5/$10/$25 for prescriptions.

Oh since your asked, they are getting several thousand more of my dollars since instead of 1 trip every other year, I will be taking 3 trips in 12 months.

 

[Ephany]

Thankfully I enroll in my company's benefits plan tomorrow. We just received a letter from our previous insurance company that we were purchasing out of pocket. Not only are they dropping us, our family deductible would increase to 23K/year for in-network care if we decided to go with the plan they're substituting for us. Monthly premiums would increase to $800/month for my family of 3. Instead, I'll be paying $460 a month for the 3 of us with a 6K out of pocket maximum.

I had surgery in May unexpectedly and DH figured out that our paying the insurance premiums for the last 5 years was basically pre-paying for my gall bladder removal. It's insane how much we paid with insurance; I can't even imagine where we'd be if we would have had to pay for it completely out of pocket.