So mad - our health insurance copays are doubling next year!

[ccgirl]

This. Germany has a system in place as well. My husband has a bunch of friends who live over there. 7-8% out of each paycheck is taken out to cover each persons care head to toe. So you could work what is their version of a minimum wage job and be covered for brain surgery.

Even the Bahamas has a system in place, my husband and I talked with a local while we were there a couple weeks ago on a cruise.

Now here in the states however, you start qualifying for Medicare at 65, or have to have little to no money to qualify for Medicaid. Our healthcare system is pretty low ranking compared to other countries.

The problem with this is....what happens if you don't work? In this case, my insurance would actually go up.

 

[NLD]

I have been administering my companies medical insurance plan over 25 years. The rates were rising substantially every year for monthly premiums long before the Health Care reform act was passed. Something needs to be changed in health insurance and no one - Republican, Democrat, Independent, etc has a clue how to fix the system.

I would for one, like to see them get rid of the TV advertising for prescription drugs. No one should be going to see their doctor to request a specific drug (and heck - with those disclaimers who would?)

Yes and yes.

As for us... dh's company just got bought out, and as a result his insurance company is changing.

It's costing us $300 more per month just in the premiums. The deductible is also higher. I think co-pays are the same but not sure.

And still I'm grateful for what we've got through dh's employer, because even paying $300 more per month in premiums for the family plan, it's heck of a lot better than what I get offered through work.

I'm actually envious of some of the stories and figures on this thread. Working in the nonprofit world, my insurance costs were WAY more six years ago than what some of you are quoting you have now. My first white-collar job in the field that I'm currently employed in did pay a small percentage of the premium for employees, but paid nothing for a spouse.

It would have been cheaper to buy an individual plan for dh, but that wasn't an option because of pre-existing conditions.

By the time you added up what I paid in JUST the premium to cover me, dh, and dd plus childcare and the gas it cost me to get to that job, there was nothing else. (It paid a pittance on top of having poor benefits.) I literally worked full-time solely so we could be insured at that period in our lives.

But I do feel bad for everyone whose premiums and co-pays are going up (despite being somewhat jealous in some cases too! LOL). But more than that, I'm tired and exhausted by it all and really, really worried about what it will be like for my daughter by the time she's an adult.

We need single-payer. I simply see no other way.

 

[PrincessSuzanne]

My DH is active duty. My family opts to be on Tricare Standard (PPO style that we pay for) verse Tricare Prime. My insurance is 100X cheaper than most peoples. No monthly premiums, $300 year family deductible, $1000 catastrophic cap which is when Tricare covers everything else in full. I paid less than $1000 (never met the cap) the year I had DD and had cancer, chemo, multiple tests and surgeries. Pretty crazy. I'm definitely thankful. We'd be bankrupt without it I'm sure.

My DH was Active Duty when we met, but his contract was up before we married, so he fulfilled his Reserve Duty for 5 years, was out for 5 years and just went back a years ago, I didn't even know this was an option for us until a few months ago and I am so glad I did, Our other insurance was eating me alive, because it seems both of us has has some issue or another this year.

I don't even mind the premium. I was paying over $300 per month just in premiums and hundreds for the few prescriptions I take and never reaching the deductible. You can't beat $192/mo and $5 for prescriptions.

Our policy is pretty much the same as Tricare Standard and I can still see my doctor. I might opt to go to the Military Hospital when the new one opens, if I needed to.

One of the reasons I am glad to live in MA. We still have uninsured but not as many in other states since it is a requirement. The insurance is asking for medical necessity to cover things. A lot of MD's get referral fees when they refer you to a specialist. Unfortunately, sometimes greed sets in and they refer you when it is not truly medically necessary.

I agree with needing a good rating too. Patients have a choice with healthcare and a lot don't realize that. My closest hospital does not have a very good reputation. I never go there. Cab rides home have been pretty common in every hospital I have worked in.

Oh, I agree with the rating, to an extent. But, you could have a patient you were giving the best treatment to and no matter what you do, they will never be happy, I see it alot. We are one of the best hospitals in this town and that is why alot of people come here. It will be interesting to see how this all plays out.

 

[pintamino]

Just had a general appointment today and my doctor ordered bloodwork as I have PCOS and am insulin resistant -- then I found out my insurance no longer covers bloodwork until the $1500 deductible is met I'm lucky to still be on my parents insurance, but the costs of the tests adds up to over $500! They pay quite a good chunk in premiums too, so I was shocked to learn that bloodwork is no longer covered (I haven't had it done since we switched insurance plans).

Those will be getting put off for a while, unfortunately.

 

[crashbb]

A single payer health system, like in France and Canada, seems the only way to go. Companies and individuals can't afford healthcare, anymore. Let's cut out insurance, completely.

Except, at least here (Canada) we haven't cut out insurance completely. Not everything is covered under provincial healthcare (e.g. dentists and prescription drugs for most people). So, most of us still have insurance.

Mine is through work and I don't, outright, pay anything for it. It covers 80% of most things (e.g. drugs, eye doctor, dentist, physio, massage). Some things have yearly caps (or 24 month caps) after which it doesn't pay anything. Other things, like drugs, have a cap ($1000) after which it pays 100%. My deductible is $25/year (one for drugs/health care and another for dentist - so a total of $50). I also have about $850 in a spending account that I can use to pay the extra 20% or things over the cap.

No, I say that I don't pay anything BUT - it is a taxable benefit (about $17 per month). Also, they way our work does it, we all get $X in credits (the amount depends if you are single, a couple or a family) and you "buy" your options. So, you can choose from 60%, 80% or 100% coverage (one option for dentist and another for healthcare - so you can do 60% in one and 100% in the other). These credits are also used to buy life insurance (above the standard 2 times your salary), LTD (above the standard 50%), and accidental death. Any extra credits can go into an RRSP (retirement savings plan), health care spending account, or be taken as cash. You could also pay in if you end up choosing options that come to more than your credits. So, by taking more than the bare minimum, I am losing money that I could have received; I think my options were about $700 per year - so it "costs" me $700 plus the taxable benefit.

Other companies do things differently (and there are people who don't have company plans and purchase their own insurance). But, the main point is, a single payer health care system does not remove all need for health insurance.

 

[ccgirl]

Except, at least here (Canada) we haven't cut out insurance completely. Not everything is covered under provincial healthcare (e.g. dentists and prescription drugs for most people). So, most of us still have insurance.

Mine is through work and I don't, outright, pay anything for it. It covers 80% of most things (e.g. drugs, eye doctor, dentist, physio, massage). Some things have yearly caps (or 24 month caps) after which it doesn't pay anything. Other things, like drugs, have a cap ($1000) after which it pays 100%. My deductible is $25/year (one for drugs/health care and another for dentist - so a total of $50). I also have about $850 in a spending account that I can use to pay the extra 20% or things over the cap.

No, I say that I don't pay anything BUT - it is a taxable benefit (about $17 per month). Also, they way our work does it, we all get $X in credits (the amount depends if you are single, a couple or a family) and you "buy" your options. So, you can choose from 60%, 80% or 100% coverage (one option for dentist and another for healthcare - so you can do 60% in one and 100% in the other). These credits are also used to buy life insurance (above the standard 2 times your salary), LTD (above the standard 50%), and accidental death. Any extra credits can go into an RRSP (retirement savings plan), health care spending account, or be taken as cash. You could also pay in if you end up choosing options that come to more than your credits. So, by taking more than the bare minimum, I am losing money that I could have received; I think my options were about $700 per year - so it "costs" me $700 plus the taxable benefit.

Other companies do things differently (and there are people who don't have company plans and purchase their own insurance). But, the main point is, a single payer health care system does not remove all need for health insurance.

Thank you for this explanation. I think a lot of people are under the wrong impression that Canadians don't pay a dime. Their taxes just pay the insurance and they see doctors for free. So, your explanation is very helpful.

 

[Piecey]

No sympathy from me, but if you want to feel better about it:

Family coverage thru my work will be over $21,000 for the premium. My employer does pay a small portion.

Primary doctor visits are $40

Specialists are $50

RX ranges from $35 - $70. And 2 of my kids have conditions which require daily meds.

ER visit = $100

We would seriously be broke.

DH pays $90 right now ($97 next year) biweekly in his pay for our family plan. So $2522 next year in premiums.

No well-child copay, no adult routine physical (1x per year) copay. $10 copay for other visits.

$25 for specialists. All maternity- visits, labs, tests, delivery, etc. is 100% covered (handy, as I had a baby in '09, and '10).

85%/15%... $750 family deductible (have a $1k FSA auto deduct from DH's checks) and $5k catastrophic deductible, which we've hit for the second year in a row as our youngest has health issues.

It also pays for an eye exam ($5 copay) every year and 50% of 2 dental cleanings/year and 35% of other dental work.

We would be bankrupt with some of the insurance policies I am reading about here.

 

[jsmith]

Princess Susanne- just so you know-you can not 'opt' to go to an MTF on Reserve Select exactly. You will not be assigned a Primary Care Manager in the Facility and will be a Space A patient only-making getting care nearly impossible. You will want to keep your regular on the economy Doctor. You can use the ER if needed and if there is a pharmacy on your installation and medication you are prescribed is in their fomulary you pay nothing to fill perscriptions. Unforunately, like any thing else in the military , the documentation you are given is not real clear on that but i work on a very large active duty installation and can not be seen by the PCM i had had in the MTF for 5 years since we changed to RS-dont get me wrong-its still a very very good value and i wont change-but having to get a PCM on the economy sucked since my records are all at EACH

 

[GAGirlInVA]

we changed from copays to coinsurance 90/10 so I am very nervous how this will affect us. We get half the deductible ($800 for family- deposited in a HRA or HSA-so confused with these acronyms)so $400 paid by my company and can get $50 ea for the online health survey and $50 ea for annual physicals (unfortunately we had dh do his in august- but I may do an annual mid year for an extra $50) My physical is 1/6. I also get another $50 for mamography. So I will get the deductible paid off pretty quick. But 10% of an unknown amount scares me. I asked the insurance company for office visit contracted amts- they told me to ask the doctor's office who asked me to contact the insurance company. Methinks I see a problem and it does make me nervous.

I've never been able to be told what the contracted rate is for anything. I just have to wait for the EOB's. Frustrating!

 

[crashbb]

Thank you for this explanation. I think a lot of people are under the wrong impression that Canadians don't pay a dime. Their taxes just pay the insurance and they see doctors for free. So, your explanation is very helpful.

A bit more than that - I don't pay out of pocket if I go to the ER or if I need surgery or an MRI, for example.

But, in general, I don't think that most people in the US understand our healthcare system. Not the ones who portray Canada as the Utopia for which the US should aim nor the ones who portray Canada as some Hell hole into which the US would fall should they incorporate a single payer system. This is not a condemnation of Americans - most Canadians couldn't correctly describe the US healthcare system.