I hate health insurance changes

[mjkacmom]

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.

 

[clori]

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.

 

[tvguy]

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.

 

[marcyinPA]

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....

 

[HamTown]

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.

 

[stm61]

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.

 

[Janepod]

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.

 

[teacherforhi]

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.

 

[Callie]

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.

 

[tvguy]

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.

 

[sunshine1178]

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.

My company offers an HRA with high deductible plan. We have a $2000 individual deductible ($4000 out of network,) and the company funds an HRA account with $1500.

So, my first $1500 of in-network costs are paid automatically by the HRA. I pay $500 out of pocket for expenses above that, and then the insurance company pays any bills once I have incurred more than $2000 in a year.

As long as we stay in-network, my out of pocket expenses are essentially capped at $500 per person, which makes it easy to budget for. I don't visit doctors frivolously, but it is a relief not to worry about costs when we do need medical intervention.

 

[HelenaB]

I've read through this thread. I know I'm a foreigner and so it's probably none of my business but still... it seems normal for families to have to pay out $600 a month for healthcare plus possibly more if they actually have to see a doctor or get treatment.

How the heck do you manage?

 

[Swan4Me]

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.

Sorry-but no parent is obligated to pay for college OR grad school.

We helped with college and combined with scholarships, our kids finished debt free. But no way I'd pay for grad school.Your sister needs to help with those costs, esp with these changes, IMO

 

[MIGrandma]

I've read through this thread. I know I'm a foreigner and so it's probably none of my business but still... it seems normal for families to have to pay out $600 a month for healthcare plus possibly more if they actually have to see a doctor or get treatment.

How the heck do you manage?

For us, health insurance is something we just will not do without. We're both 55 now, so our insurance did go up about $50/month so we're paying $750/month just for the two of us and it isn't "great" insurance either. But God forbid something horrible happens and one of us develops a life-threatening disease or something we want to have that coverage.

We would give up traveling and other luxuries before we would give up our health insurance.

 

[marcyinPA]

I've read through this thread. I know I'm a foreigner and so it's probably none of my business but still... it seems normal for families to have to pay out $600 a month for healthcare plus possibly more if they actually have to see a doctor or get treatment.

How the heck do you manage?

It isn't easy, but you do what you have to do. My DH works two jobs and I work one- plus a weekly babysitting gig- just to afford the basics. We pay a little less than a quarter of his monthly income towards health insurance premiums for our family. Obviously, that money is taken out of his paycheck so we never see it- so we just budget accordingly. It stinks- and I don't see it getting any better any time soon. But, we are happy, and healthy, and our NEEDS are met. We are doing pretty well.

 

[Colleen27]

I've read through this thread. I know I'm a foreigner and so it's probably none of my business but still... it seems normal for families to have to pay out $600 a month for healthcare plus possibly more if they actually have to see a doctor or get treatment.

How the heck do you manage?

A lot of people don't (it is more acceptable in the US to ration based on ability to pay than upon medical need - long waits for elective and non-emergent procedures are unacceptable, tens of thousands of working poor having little or no access to medical care is fine), and many of those that do have to make hard decisions to do it. No one talks much about the economic costs of our flawed system but it STRONGLY discourages entrepreneurial ventures as well as restricting consumer spending more and more with each successive year. In other words it is a drag on the two primary drivers of our economy.

 

[Coconut36]

My mom is a public school teacher. Aka, she is under-paid and overworked. What kept her going was the health insurance. Due to the new laws, they had to change their plans.
All our prescriptions have tripled in price. Some have gone up times 12!
A visit to a urgent care clinic is now $40, when it was free after the deductibles.
Regular doctor is $20 co-pay. Same as above, free after deductible.
Our deductible also got MASSIVE!
Not to mention this new plan costs about 21% more than the old one.
She hasn't seen a pay raise in 5 years either.
But this really fits my family hard. I personally have a ton of health issues. Mental Health is going to be a killer, but I can't not seek the treatment.

Sorry had to vent.

I sincerely doubt the increases have anything to do with Healthcare Reform..my DH's plans through his district have been ridiculous for years. For the last 8 years his pay has done nothing but DECREASE..no raises and increased health and retirement costs. In his district the plan runs about $1,000 a month (for a district with an average pay for teachers of $2,000 a month and has been at that rate for close to 5 years now) and that is $50 for a specialist, $100 for ER or Urgent Care visit and $35 for regular visit co pay. Tiered costs for meds..one of his meds for cholesterol runs about $50 a month. It sucks.

We are not insured through his district and have private health insurance directly with the insurance company for a fraction of the costs (although a high deductible).

 

[npmommie]

Without getting political, I will say healthcare costs for massachusetts have increased, and it is due to the mandates and the reform here.
the idea was to reduce costs, yes, but it didn't work out that way.

 

[Callie]

Sorry-but no parent is obligated to pay for college OR grad school.

We helped with college and combined with scholarships, our kids finished debt free. But no way I'd pay for grad school.Your sister needs to help with those costs, esp with these changes, IMO

My sister will be repaying her. But they cannot seem to get loans because my mom makes too much money. Same with my college.
Also she has quite a bit of money tied up in investments for retirement that she refuses to touch

 

[Coconut36]

I've read through this thread. I know I'm a foreigner and so it's probably none of my business but still... it seems normal for families to have to pay out $600 a month for healthcare plus possibly more if they actually have to see a doctor or get treatment.

How the heck do you manage?

Millions of Americans don't manage. They forgo health insurance because they can't afford to carry it and thus put off care/visits because of the cost or they manage to pay the premiums but many end up "insurance poor" because they then can't afford to actually use it because of the high co pays, Rx drug costs and deductibles. It's not good for a lot of people...you read stories of people having to choose between paying their rent or taking their child to the Dr or people who have to choose between paying for insulin or buying food for the month.