Is this what health insurance has become?

[ORMom2Four]

$1500 per person deductible, you pay full bill if sick until deductible is met (but well visits are covered at 80%), no Rx at all until the deductible has been met, etc., Once you do pay the $1500 per person, you continue to pay 20% of bills and insurance covers the rest.

Dh lost his job the first week of September and was just presented an offer (that he accepted) from a big company. His last company, where he worked for 11 years, had less than 60 people. This new one has thousands of employees.....but far worse medical insurance! We hoped that a bigger company might mean better insurance.

Just curious if this is becoming the norm. This job is a 25% pay cut from what he was making before, and now the terrible insurance adds to the financial stress.....but at least he will be employeed.

 

[bored]

Yep, what it's become. I work for publically traded company with 6000+ employees. We had blue cross with copays, your normal health plan last year. This year we have the High Deductible plan that has a $3500 family deductible and 80/20 after that. The cost is a whopping $5 less per week than the good PPO plan we used to have. CEO got a $1.5 million bonus a couple weeks ago, gotta pay for it somehow!

 

[Kellydelly]

Sounds pretty standard, and could be even worse!

 

[mhsjax]

$1500 per person deductible, you pay full bill if sick until deductible is met (but well visits are covered at 80%), no Rx at all until the deductible has been met, etc., Once you do pay the $1500 per person, you continue to pay 20% of bills and insurance covers the rest.

Dh lost his job the first week of September and was just presented an offer (that he accepted) from a big company. His last company, where he worked for 11 years, had less than 60 people. This new one has thousands of employees.....but far worse medical insurance! We hoped that a bigger company might mean better insurance.

Just curious if this is becoming the norm. This job is a 25% pay cut from what he was making before, and now the terrible insurance adds to the financial stress.....but at least he will be employeed.

Sounds like my DSIL and her DH insurance plan and they are on a lot of medications. It kills them.

 

[crjack]

I went from a small company to a very large one as well and the benefits are awful...always have been, even in a good economy. I only work P/T and we have always used DH's.

I think the high number of employees works against you with benefits because the overall cost is just so high. What is offered to one typically has to be offered to all.

Also, not being political at all but many companies are anticipating the added cost of the new healthcare bill for the next fiscal year. No matter what it ends up being, healthcare costs continue to rise so companies continue to scale back on offerings.

Congrats on the job for DH. I know the pay cut is hard to swallow but he must feel good to get the job offer. Best of luck.

 

[bfeller]

Yes, it sounds like DH company, plus they just cut his bonus and gave many employees a 35% paycut..but at least we have a job. Trying to stay positive.

 

[dakcp2001]

The prescription coverage may have its own dediuctible which is less than 1500. Mine has a 150 for rx, then 800 for everything else.

 

[mamacatnv]

Yes, for many cash strapped companies the rising cost of benefits have had to be addressed and the rising costs are being foisted onto the employees. Health care is very expensive. I work for a small company (25 emp) and we pay over $600 per employee per month for a basic HMO. Then add dental, vision & life insurance in and its a big portion of our operating budget.

Last year, what my employer did was we kept the cost to the employee dependents the same and our costs the same but we had to up the deductibles. The reasoning was that the employees that use the plan the most, which contributed to the 23% rate increase we were looking at, need to share in the burden of the rate increases.

ie the employees who are sicklier and are the reason behind our increases will now pay more out of pocket. Many of our sicklier employees (not all) have health complications due to factors they can control; weight, smoking and lack of exercise. We had to either pass along the costs increase to all the employees and offer the same exact plan we had been offering or up the deductibles and co-pays for office visits, major medical and RX coverage and keep our contribution the same.

The employee that complained the most was the one who is wayyyyy overweight, smokes like a chimney, eats non stop junk food and has all sorts of lifestyle related issues, oh and that employee has their spouse on the plan. The spouse has the same issues as the employee.

 

[BelleRocks]

Yes, could be worse. As a self-employed couple, our policy has a $7500 deductible with no coverage at all until deductible is met. So basically it is only going to be for catastrophic events. Dr, lab, RX, all out of pocket. This costs us about $400/month for a family of 3. And we are all healthy with no pre-existings.

 

[Christine]

Yes, could be worse. As a self-employed couple, our policy has a $7500 deductible with no coverage at all until deductible is met. So basically it is only going to be for catastrophic events. Dr, lab, RX, all out of pocket. This costs us about $400/month for a family of 3. And we are all healthy with no pre-existings.

That's awful. But the hear some people tell it, it's easy to go out on your own and get private insurance that's decent. I wonder if this varies from state to state?

 

[merekc]

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[RadioNate]

Yep we moved companies this year. Insurance costs us more out of pocket each paycheck then we have an $1500 deductible, they only cover one "well child" visit per year, to get prescription coverage at all we have to go through Medco, they also only pay 80/20 for most things, it's awful. The salt in the wound is that my DH now works for a company who is primarily an insurance company.

Last month we took my DD to urgent care after she fell down the stairs and hurt her ankle. Under our old insurance we would have paid a $50 co-pay and that would be the end of that. With this insurance they covered the "visit" less the $30 co-pay but we had to pay out of pocket for all her xrays and the air cast, etc.

 

[SereneOne]

My DH's company has two plans, one is a PPO which we have now and an HRA. We are switching to the HRA, it is 75 bucks less a pay period, we are responsible for the first 3100 but the company puts in 1000 in an account that I understand is to be used for copays on doc visits and meds. Once we meet the 3100, the insurance covers 90 percent and we pay 10 percent. There is no copay for well-child check ups, mammograms, OBGYN. Medicine is 15/25/40. Seems like a good deal to us. DH and I rarely go to the doctor, maybe twice a year and my meds I get from Walmart.

We were concerned with our DD7, bc she has a feeding tube and has a feeding pump which runs around 1500 a month for all the supplies and Pediasure. Thankfully, because she gets a small amount of Disability SSI, Medicaid is her secondary insurance and covers the difference.

It is BC/BS, we used to have Aetna a few years ago and they were AWESOME. BC/BS is good, but not as good as Aetna.

Sorry to hear of the job loss and congratulations on the job. My husband did not lose his job, but his pay was cut 18,000 a year, along with some benefits and it has been tight.

 

[LindaG4458]

A couple years back DH's co raised the rates and copays/deductibles for the Blue Cross PPO significantly. We decided to take a risk and took the EPO instead. So far we have only had one doctor that did not accept it (he was in the process of applying) and the copays and such are reasonable. If anything really serious happens to me (he is now on Medicare but I still have the co policy) we'll just have to eat the cost of anyone who does not participate.

 

[mickeyboat]

Yup. Insurance premiums are getting so high that employers have to make the tough choice to reduce benefits / require employees to contribute more in order to provide benefits to their employees.

I switched jobs in March, and went from paying $0 for my health and dental benefits to paying $96 per week for them. We went from a very small deductible and co-pay to a much larger one. It has made a big difference in our family's budget!

 

[dicar123]

Thanks for reminding me that I need to go thru all the paperwork to decide whether to switch from our current PPO or go with the high-deductible.

Just curious, do high deductible plans usually have a cap? We don't typically use doctors much, so we'd probably never reach our deductible limit, but I'm concerned about a catastrophe that could 20% me into the poorhouse...

 

[golfgal]

My DH's company has two plans, one is a PPO which we have now and an HRA. We are switching to the HRA, it is 75 bucks less a pay period, we are responsible for the first 3100 but the company puts in 1000 in an account that I understand is to be used for copays on doc visits and meds. Once we meet the 3100, the insurance covers 90 percent and we pay 10 percent. There is no copay for well-child check ups, mammograms, OBGYN. Medicine is 15/25/40. Seems like a good deal to us. DH and I rarely go to the doctor, maybe twice a year and my meds I get from Walmart.

We were concerned with our DD7, bc she has a feeding tube and has a feeding pump which runs around 1500 a month for all the supplies and Pediasure. Thankfully, because she gets a small amount of Disability SSI, Medicaid is her secondary insurance and covers the difference.

It is BC/BS, we used to have Aetna a few years ago and they were AWESOME. BC/BS is good, but not as good as Aetna.

Sorry to hear of the job loss and congratulations on the job. My husband did not lose his job, but his pay was cut 18,000 a year, along with some benefits and it has been tight.

If you can, don't touch the $1000-put it in your Health Savings Account and let it grow. When you retire, you will have a nice nest egg to pay for health insurance, assisted living costs, etc. High Deductible plans, from a long term financial standpoint, are REALLY nice plans.

Also, for those that have 80/20, 90/10 plans, often there is a cap on how much you pay on those. Look over your benefit page and if you see something like "deductible" $1500, out of pocket max $5000, the most you will pay is $5000. If you meet that everything is covered at 100% after that.

Insurance plans vary from company to company, state to state. We had nothing but MAJOR HEADACHES with Aetna and have had no problems what so ever with our various BC/BS plans. Keep in mind it is NOT the insurance company that selects your coverage, it is your EMPLOYER so if you have issues with your coverage, talk to them.

In MN for years, all preventative care has been, by law, covered at 100% no matter what plan you have. The health reform has the same clause (not sure when that takes effect, 2012 maybe??).

 

[golfgal]

Thanks for reminding me that I need to go thru all the paperwork to decide whether to switch from our current PPO or go with the high-deductible.

Just curious, do high deductible plans usually have a cap? We don't typically use doctors much, so we'd probably never reach our deductible limit, but I'm concerned about a catastrophe that could 20% me into the poorhouse...

Usually with a high deductible plan you pay your deductible and have 100% coverage after that. High Deductible is a bit of a misnomer too, many plans have $1500 for the deductible and everything after that is covered at 100%. Often the savings for the plan (premiums) makes up for most of that deductible AND if it is a qualified HD plan you can put that $1500 (more actually) into a Heath Savings Account tax free (write off on your taxes) so you SAVE money in the long run with a plan like this if you contribute to your HSA. That money goes in tax free, grows tax free and can be USED tax free. They are beautiful plans, especially if you don't go to the doctor often.

 

[SereneOne]

If you can, don't touch the $1000-put it in your Health Savings Account and let it grow. When you retire, you will have a nice nest egg to pay for health insurance, assisted living costs, etc. High Deductible plans, from a long term financial standpoint, are REALLY nice plans.

Also, for those that have 80/20, 90/10 plans, often there is a cap on how much you pay on those. Look over your benefit page and if you see something like "deductible" $1500, out of pocket max $5000, the most you will pay is $5000. If you meet that everything is covered at 100% after that.

Insurance plans vary from company to company, state to state. We had nothing but MAJOR HEADACHES with Aetna and have had no problems what so ever with our various BC/BS plans. Keep in mind it is NOT the insurance company that selects your coverage, it is your EMPLOYER so if you have issues with your coverage, talk to them.

In MN for years, all preventative care has been, by law, covered at 100% no matter what plan you have. The health reform has the same clause (not sure when that takes effect, 2012 maybe??).

Thanks that is good to know!

We were told our deductible we have to meet is for 3100 and the thousand the company puts in the account goes towards the deductible, making it 2100. Once that is met is is 90/10.

The way I understand it, we use the 1000 for co-pays, meds, otc meds, etc. We can also put money in an HSA? To use towards medical expenses too. I don't see us using the grand though.

We have had a PPO for many years so the HRA and HSA are new to us.

 

[golfgal]

Thanks that is good to know!

We were told our deductible we have to meet is for 3100 and the thousand the company puts in the account goes towards the deductible, making it 2100. Once that is met is is 90/10.

The way I understand it, we use the 1000 for co-pays, meds, otc meds, etc. We can also put money in an HSA? To use towards medical expenses too. I don't see us using the grand though.

We have had a PPO for many years so the HRA and HSA are new to us.

Yes, the $1000 is earmarked for deductibles, etc but if you don't really need to use it, don't. What you could do is as you incur medical expenses, add that money into your HSA, then pay out of your HSA when the bill comes--say you go to the dr and your portion is going to be $110. Put that $110 into your HSA, then write the check for the dr bill out of your HSA account--often you have a debit card so you can just write that in on the bill if your Dr does that. You can then write that off on your taxes-up to $6150/year if you are married. You don't HAVE to use the $1000 for anything. When you turn 65, you can use the money in your HSA to pay for your Medicare supplement insurance plan-basically your company can pre-pay your insurance in retirement this way. Now, obviously if you NEED the money, use it but you don't lose it every year like you do with a flex spend plan. Some HSA's allow you to invest that money into mutual funds after you have $1000 or whatever in the account. I would be VERY conservative with this if you go this route though.