Need help deciding if I should get rid of my family's insurance

[gladstoneganderfan]

Hi, I was wondering if I could get some advice on health insurance.

We have recently changed insurance companies due to Dh changing jobs. We had BC/BS with his old job (medical, vision & dental). We now have United Health Care( medical only). We are paying around the same each month that we did before, but the benefits are awful compared to what we had.

Most of the doctors in my town are BC/BS providers. It seems like with United, they only pay around a third of bill.

What I am considering is dropping our insurance & putting the money we are spending each month ( over $500) into a health savings account (not sure if that is what they are called).

I'm just sick about putting out that much money each month when it seems like I am just going to get an extra bill from the doctor anyway because United won't pay for something. I figure we could save over $6000 a year!

Plus, I am scared to go to the doctor because I don't know what kind of bill to expect. The last doctor visit, I asked the receptionist to give me an estimate of what my bill was going to be. She said that they couldn't do that, they have to bill the insurance company first, then see what they cover.

I paid my co-pay ($30) and paid $250 towards the bill. A month later, here come a bill for another $280! And this was over something that wasn't that major. If it was something serious, who knows how much that will be.

Now comes the what if part. I have 2 children, one 2, one 6. What if something major happens to them? The usual parental worries...

So, anyone been through this? Is bad insurance better than no insurance? Any advice would be greatly appreciated.

 

[Hedy]

Hi, I was wondering if I could get some advice on health insurance.

We have recently changed insurance companies due to Dh changing jobs. We had BC/BS with his old job (medical, vision & dental). We now have United Health Care( medical only). We are paying around the same each month that we did before, but the benefits are awful compared to what we had.

Most of the doctors in my town are BC/BS providers. It seems like with United, they only pay around a third of bill.

What I am considering is dropping our insurance & putting the money we are spending each month ( over $500) into a health savings account (not sure if that is what they are called).

I'm just sick about putting out that much money each month when it seems like I am just going to get an extra bill from the doctor anyway because United won't pay for something. I figure we could save over $6000 a year!

Plus, I am scared to go to the doctor because I don't know what kind of bill to expect. The last doctor visit, I asked the receptionist to give me an estimate of what my bill was going to be. She said that they couldn't do that, they have to bill the insurance company first, then see what they cover.

I paid my co-pay ($30) and paid $250 towards the bill. A month later, here come a bill for another $280! And this was over something that wasn't that major. If it was something serious, who knows how much that will be.

Now comes the what if part. I have 2 children, one 2, one 6. What if something major happens to them? The usual parental worries...

So, anyone been through this? Is bad insurance better than no insurance? Any advice would be greatly appreciated.

Short answer-yes.
Long answer: is this the same sort of coverage you had with BCBS (PPO, HMO, CDHP?)? Are you even able to drop coverage at this point in the year, or enroll in a flexible spending account (in order to be in a health savings account, you would need to be enrolled in a high deductible health plan). Does your DH's employer offer other plans? You might want to see if you like another plan they offer, and then switch during open enrollment.

 

[D&D's Mom]

I don't know what type UHC plan you have, but ours is great. Since March our son has accumulated some $160,000.00 in medical bills. Our portion has amounted to less than $2000 for our copay and our percentage. His "active" treatment period will be another 20 months so who knows what the grand total may be.

To answer your question, DO NOT allow your family to be without health insurance. You never know what type of catastrophic injury or illness may occur.

How far would that $6000 you saved in your healthcare account go toward a significant medical bill? Granted, either your plan is very basic or your bills are being submitted incorrectly so that the carrier is not paying the appropriate amount. Have you called to disuss with your carrier? Do you have an HMO, PPO or just basic medical insurance? During his open enrollment period, have you husband examine his options very carefully to be sure you are getting what works best for you. Good luck!!

 

[Nicholfamily5]

I'm not sure where you are from, but is it possible to shop around for private insurance? I would also get all the insurance information and read through it carefully....good times, I'm sure. You should have a good idea of what is covered and what isn't.
Also, try calling United, and ask them if there are other plans available to you through hubby's company. You could also try asking his HR rep.
I would definately NOT recommend dropping your insurance and just saving. All it would take would be one trip to the ER and that 6k would be gonzo..then what??? Also, do you have a job? I work part time and could get great benefits for the family if it were needed. Maybe that could be an option for your family?
Good luck with your decisions...

I don't know what type UHC plan you have, but ours is great. Since March our son has accumulated some $160,000.00 in medical bills. Our portion has amounted to less than $2000 for our copay and our percentage. His "active" treatment period will be another 20 months so who knows what the grand total may be.

To answer your question, DO NOT allow your family to be without health insurance. You never know what type of catastrophic injury or illness may occur.

How far would that $6000 you saved in your healthcare account go toward a significant medical bill? Granted, either your plan is very basic or your bills are being submitted incorrectly so that the carrier is not paying the appropriate amount. Have you called to disuss with your carrier? Do you have an HMO, PPO or just basic medical insurance? During his open enrollment period, have you husband examine his options very carefully to be sure you are getting what works best for you. Good luck!!

 

[Toby'sFriend]

well in order to open up a HSA, you first have to purchase a high deductible Health Insurance Policy (ie pays expenses after the Deductible is met - like $2000 a year or so.) Purchasing that policy will eat up a good portion of that $6000 you plan to put into the savings account. So if you go with an HSA, you will still have very bad insurance, you'll just be paying less money for it in premiums.

Beyond that I really can't tell you the answer. I don't know of many people that are choosing these plans voluntarily. They do seem to be used heavily by the self-employed and very small business owner's, because some insurance coverage is better than none.

 

[Pumbaa_]

Are the doctors you are seeing participating in United's plan? If not, that could be part of the high expense.

I second the fact you do not want to be without healthcare insurance. One inpatient hospitalization could wipe your family out for years to come.

Find out when your DH open enrollment period is. Find out if there are any other options. Is a flexible spending account an option?

If this is the only plan, your DH may want to start looking for another job. An increase in base pay quickly gets wiped out if the benefits are poor. Prior to taking any job, you really want to compare the benefit package and see what it will cost you in OOP expenses for the year.

Good luck!

 

[Kimkimba]

You do not want to be without health insurance.

DH and I both had hospital expenses this past year that were unexpected (one of them being my pregnancy - which cost the insurance company over $85,000).

Repeat, you do not want to be without health insurance. Hospital bills are outrageous.

 

[gladstoneganderfan]

Thanks for all of the advice.


To those who asked, our doctor's are not United providers. I have a hard time finding anyone in my town that is a provider (BC/BS has the lock on our market). Plus, I really don't want to send my DD's to a different Ped than their current one.

You all have definatly echoed my fears, an unexpected emergency. With 2 children, anything can happen, as you know. I will keep looking around. I called BC/BS & could get coverage through them (if we get approved). It's not as good, but we could keep the same doctor's.


I think we got spoiled on hubby's old plan. We were discussing me going back to work now that our little one is getting older. I might try to get a job at his old work (we work in the same field).

Thanks again for all of the advice. My head has been swimming trying to figure this out & I needed to hear some experianced opinions.

 

[Cindy B]

Those high fees are in part because the providers you are choosing are out of UHC's provider list.

Unfortunately, in order to have lower bills you have to follow UHC's provider list. You have seen what you have to pay without UHC funding.

I've had to switch doctors (in mid pregnancy) because of a switch in health plan! Of course, I didn't want to, but the insurance changed and I had to do it. I've switched my kids peds for the same reason.

The doctor's should technically be able to tell you what UHC will pay. They should know the UCR schedule for the doctor's office for this insurance.

 

[bumbershoot]

The doctor's should technically be able to tell you what UHC will pay. They should know the UCR schedule for the doctor's office for this insurance.

I have UHC too (and hate it), and they just WON'T. I've tried. No one will give an estimate. It's a big state secret. I think they just dont' want to be the messenger of the bad news.


Of course should something HUGE happen, the 2K or 4K or whatever paid out of pocket would be NOTHING compared to what they would pay.

But when you just don't go to doctors enough to get to your deductible level year after year, so you're paying out of pocket every year and never "using" the insurance, it gets really HARD to see the benefit.

I really hate our UHC plan, and we're strongly considering going into DH's company's offered high deductible and HSA plan next year, unless they dump UHC.


I'd even go back to Great West (note: NOT Group Health, like the stupid hospital kept thinking), which I also hated, b/c even though providers cringed when I said I had GW, GW did pay much more towards bills than UHC...

 

[bumbershoot]

By the way, if you you don't end up switching, but you do still want to use the same pediatrician, when open enrollment comes, figure out how much deductible and general expenditures you'll be likely to have the coming year, and put that into a Flex Plan, if the job offers that. You're still paying ultimately, but it's not taxed (though it is use-it-or-lose-it, so USE it).

However, if the flex plan company is Wage Works, run far far away and ignore the above advice. They are *this* close to being dumped by DH's HR department for FSAs, because they are messing up everyone's flex account (including ours...it's now July in a January-start use-year and we still can't use our card), and one of their reps is known to visciously rip into people who call for help (including my husband), and if you call another rep once you've recovered from Alex's scorn (he seems to feel that funding an FSA isn't "budgeting" your health care dollars, when it absolutely IS, and not having access to one's money really truly does cause problems when THAT is how one has budgeted), and if you tell the next rep who you talked to, THEY will apologize for his behaviour, he's THAT bad.

Flex plan = good.

Flex plan with Wage Works = awful

If Flex with WW is only option = put money into savings account based on estimated yearly out of pocket expenses so you can keep the kids with their regular doc, but maybe you can switch the adults to save some cash.

 

[tink2dw]

I just Incurred a $15,000.00 bill for hospitalization!! Thankfully we could still sign up for Dh's Cobra[what a flipping joke that is!! If the hospital Ever gets paid it will be a miracle] Rather than pay another $500. to Cobra, they are such a mess, The HMO still says I have NO coverage. I paid out of pocket to get my $700.00 medicine at Walmart for $324.00. with AAA discount. Next month I'll get from a Canadian Pharmacy for $224.00.

I guess some coverage may be better than none, but not according to the documentary movie "SICKO".

 

[Colinsmom]

If there are no doctors close to you in UHC's network, you should bring it up with your DH's employer. And appeal to UHC - they will pay in-network benefits if there are no in-network providers within a certain radius of you.

You say the insurance is awful because of how little they pay out of network. Have you sat down and tried to understand the plan? Understand your deductibles, co-pays, out of pocket limits, etc. (both in and out of network)? I have a UHC plan through work that many may call awful because of the high deductible but once the ded is met, they pay 100% which was wonderful when I had DS1 ($45k in hospital bills).

Yes, you absolutely do need health insurance. Even if you accept that you will just go into debt should one of you get seriously ill, consider that some medical providers (usually the best ones that you WANT to see when seriously ill) may not even accept you as patients without insurance. And it can be difficult to get health insurance after the fact if someone in your family develops a medical condition - something called a pre-existing condition exclusion.

 

[HERSEY]

I work with Health insurance claims, You do not want to be without coverage however crappy it might be.

It is rare to find providers(doctors, hospitals, etc) who only participate with one insurance company.

 

[clh2]

My BIL just started treatment for an oral cancer. He has never smoked, in case you are wondering. He is doing an intense 7 weeks of combined chemo and radiation. His anti-nausea medicine for the chemo is $500 PER PILL, and he needed 4 pills for the first round of chemo.

I can't even imagine what the total cost of his treatment will be.

Insurance - I would never be without it.

That being said - have you looked into just private insurance for just catastrohic events? That might be a lot less than insurance that covers every single cold, KWIM?

 

[ameraumi]

We use to have UHC, so I feel your pain. We had a hard time finding anyone that would accept it, most times those drs were 45 min away. Then we ran into the issue of them not paying claims properly. I was never so thankful to go back to BCBS.

That said, Do not go without ins! My dad is in the hospital at this moment recovering from triple bypass. They have already warned mom that the bills will be over $100,000! Even with her crappy insurance, the most she will have to pay is $2000.

Have you looked into private insurance? I am not sure what state you are in, but BCBS does have private plans available. I'm not sure of the cost or coverage but it might be worth it to look into it.

 

[Tink-aholic]

It also depends upon where you live. If you live in Massachusetts, it is illegal (as of today) to go without health insurance.

 

[Ciao Mickey]

It also depends upon where you live. If you live in Massachusetts, it is illegal (as of today) to go without health insurance.

What does a family do if they can't afford insurance? Can you buy a policy from the state?

I know a couple of families in this situation. They make too much money to qualify for any government-run programs and yet they can't afford to buy insurance on their own.

Before my husband unretired himself we were paying almost $1,000 per month for health insurance. And that wasn't the most expensive policy. If we wanted a full coverage policy it was close to $1600 per month!

Health insurance costs are insane, especially for the middle-class.

 

[srgibbs]

With Medical and dental we pay over $500 a month for a family of 4 to be covered. We still have $35 copays to the doctor and your standard out of pocket expenses. Unfortuntely unless you have a Gov.or state type job that is just how much family coverage is. It is totally out of control and I really don't know how people can continue to pay these increasing rates. Even though you may need to switch doctors or drive further to find doctors that take your Insurance I would suggest that instead of continuing to pay so much of out pocket expenses. Don't consider dropping your Health Insurance as you never know what can happen tomorrow. It is just like life insurance we hate to pay for it but if something ever happens you would be so thankful to know you would be taken care of. I know I had United when my second child was born and the hospital bill was around $26,000 and that was for a normal healthy baby. Just consider it protection for the future.

 

[dis-happy]

There is a HUGE problem with dropping your insurance. You really do not ever want to go more than 63 days without coverage....if someone in your family is diagnosed with something major during that time it will forever be considered a "pre-existing" condition that won't be covered under new policies.

We too are self-insured (dh is a partner in a very small firm), using BC/BS. It costs us a fortune and we are generally healthy. It's our second highest expense each month after our mortgage, so I feel your pain. I would try to switch to BCBS if at all possible, since it seems to work best in your area. Another option is to talk to an insurance broker and see if there are some other possibilities.