Something has got to give.

I am fortunate to split the cost of my health insurance 50% with my employer. For a family plan, it is still not an insignificant amount of money, around 15-20% of my gross income is spent on dental/health coverage for my family coverage. Plus copays/deductibles, as my ex-wife takes the kids to urgent care/ER bi-weekly and I had the wisdom to agree to cover all medical bills at 100%.

I know there are many that do not have this employer-subsidized benefit.

EVERY year my premiums go up, my deductible goes up, and my out of pocket max goes up. Without fail. And this coming year, if I want to keep a plan most similar to my current one, I will have to pay an ADDITIONAL $5,500 a year...and the deductible, etc., is still higher than my current plan.

The push is clearly to get everyone to high deductible plans around the $12,000-$15,000 mark before the city kicks any money in (the city is self-insured, contracts with BCBS to handled the details). But damned if their high deductible plans aren't the SAME COST as their PPO plans.

I know this is the same thing for every other person in the country trying to figure out health insurance. How much worse can it get before something drastically changes? Someone was posting the other day about wanting to move to TX, but looking at paying $2,000 a month for health insurance. Nuts.

I will be decreasing my family's coverage. I cannot justify the increase in cost, and have ran all the numbers every way I can think to (pulled all the year's explanation of benefits and entered the info into spreadsheets) and think I will be close to my current if I choose the lower of the two PPOs.

If it was just me, or just me and the wife, I could see doing a high deductible plan. But with 2 kids at 10 or under, the buggers get sick, or do dumb things that land them in the ED.

I truly feel for the millions of people that are even more screwed than I am when it comes to health insurance. But how can it get worse EVERY YEAR, and still be more expensive!?!

quote:

If it was just me, or just me and the wife, I could see doing a high deductible plan. But with 2 kids at 10 or under, the buggers get sick, or do dumb things that land them in the ED.

Yes, but the odds are they won't. Not much of our health insurance money goes for care for kids. Besides, if the requirement to insure people with pre-existing conditions stays, you can switch if a kid develops some awful thing (God forbid).

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Originally posted by sjtill:

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If it was just me, or just me and the wife, I could see doing a high deductible plan. But with 2 kids at 10 or under, the buggers get sick, or do dumb things that land them in the ED.

Yes, but the odds are they won't. Not much of our health insurance money goes for care for kids. Besides, if the requirement to insure people with pre-existing conditions stays, you can switch if a kid develops some awful thing (God forbid).

Under the new plan, my kids' one visit each to the emergency departments will set me back a $500 copay a pop, plus 100% of the bill until the $6,000 individual out of pocket. (10 year old with suspected-but xray showed not-broken foot and 6 year old with what, after several tests, was assumed to have been a kidney stone).

It doesn't take too many of those statistical anomalies to really screw up the Christmas fund...


I realize that's nothing compared to a $250,000 heart surgery bill, but there has to be a way to do this better. My daughter's ED bill was over $4,000 before the insurance got it...the current plan being significantly better than the coming plan, I'm on the hook for around $1,200. No meds given, no surgery, nothing other than a few tests and specialists interpreting them, and all of them looking at each other saying they had no clue what it was, so maybe it was a kidney stone (we feared it was appendicitis, but the pain subsided at around 3am after 4 hours of screaming).


If they want us to have what is effectively a high deductible plan, then let us (Americans) pay $50 a week for family coverage. It's insane to reduce the benefits, but charge more money.

As long as BIG Gov is paying the bill nothing will change, same goes for the cost of higher education. Everyone wants the “free” Gov money train.

Until there’s a massive overhaul of the medical/insurance system, I think we’re f’d. It’s such a racket. I’d comment more but it just pisses me off.

my insurance went up to about $150 a paycheck for my wife and 3 kids this year. its only about a $7 increase over last year, and the plan didn't change. but the deductible is huge. out of pocket max is huge. i'm on the middle of three plans. the next step up with the lowest deductible and lower max-out-of-pocket would've cost me $290 per paycheck.

And then the one time last year when I went to urgent care, they sent me next door (part of the same hospital) to the ER for tests. They admitted me for a 3-day hospitalization. For some reason, the insurance labeled it a "routine healthcare" instead of an emergency and refused to pay a cent of the $9500 bill. it was a mess that didn't get sorted out for about 10 months.

It's all a joke.

Open enrollment is next week. We have been on the high deductible plan for a few years now and I pay 75$ a paycheck and I think we get 1 free health checkup a year. After that I'm on the hook for up to 6k per person and 12k per year not a bad gamble. To switch to a PPO that covers a lot more would be 380$ a paycheck. Can't afford that.

We're using terms like 'paycheck'. The new plan closest to what I have now is $250 a week, 52 weeks a year (plus $25 a week for family dental). This is working for the largest city government system on the east coast from Jacksonville, FL or maybe Atlanta, up to DC.

Jesus Christ, these numbers are staggering to me.

I really feel for everyone paying these absurd prices. I really couldn't imagine.

It's all about who is in the pool.

ER's cannot turn anyone away for medical treatment - to at least stabilize them. Hospitals eat this huge loss annually, and many hospitals have had to close due to no pay/slow pay on the part of the government when it came to reimbursement.

The larger problem is that we have a large pool of people who pay nothing, yet incur the largest part of the bill. Insurers have to make this up somewhere. And where that is done is the paying customer.

Another factor today is, Trump has just ended the illegal Obamacare subsidies paid to insurers. This huge pool of free money has driven their stock prices up 700%. Obama took 900 billion from Medicare/Medicaid for Obamacare. Then he tossed in subsidies. The latter is going away. Obamacare premiums are expected to go up 38% over the next year. They are already double what the average family paid before Obamacare. And with far less coverage.

No-one wants to kick the freeloaders off the tit. And Obamacare drew them in like flies. Unfortunately, all those healthy people didn't share his enthusiasm in paying higher premiums for what they had yesterday, to get less coverage, higher deductibles and to have to pay for many types of coverage they did not need.

If you were in a car dealership and noticed a charge for whitewalls, and you hadn't ordered any, and the salesman explained it was a built in cost for that couple over there...you'd walk out. And that is the story of Obamacare.

We'll see what comes next. Obamacare is about to majorly implode as insurance companies have their porridge bowl emptied.

I will also echo, those rates are a bit shocking.

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Originally posted by Balzé Halzé:
Jesus Christ, these numbers are staggering to me.

I really feel for everyone paying these absurd prices. I really couldn't imagine.

I was sick at my stomach. And I know people pay much more than what I do. It's scary as hell.

If I was insuring at a single rate, it wouldn't be a big deal. The family plans are a kick in the nuts.

The damned aggravating thing is they all seem to be in cahoots. My city plainly states they offer "Middle of the Road" benefits. Well, if every other GD city inches their rates up every year, while increasing the deductibles, out of pocket max, etc., to lessen the burden on the city, that means that every year the "Middle of the Road" is in a hell of a wider road every year

But what is sad...scary...infuriating...someone will probably pop in here and say that they have to pay $2,500 a month for a married adult couple a month. How is that manageable? Where's the money for food? Gas? How can one retire, when their health insurance is going to cost them half of their retirement income? Something's got to give.

I feel your pain. I just finished paying my son's ER bill from 2 years ago. Our deductible was $6,000. Until that is satisfied, we are responsible for the entire ER bill. I cannot afford to pay the bill with one payment. I made monthly payment arrangement with the hospital until it is paid off.

My premiums are about to be $500 per month, for me only. $7,500 deductible. The rest of the family (four people) is about $2,500 per quarter.

I still don't know what was wrong with the old system. Sorry 32 million without insurance, you still got taken care of somehow and my premium was $135 per month and $2,500 deductible.

It seems like "healthcare" became a participation trophy. Like the holy grail of citizenship.

The burden will be pushing me off the system as we just can't afford it. I hope I don't get sick.

It's insane how costly it is. People used to say you have a city job you'll have great coverage. It couldn't be further from the truth. My family plan is $600 per paycheck with a $6,000 deductible. It's mind numbing when I consider the costs. Couple that with the fact I have no prescription benefits until the deductible is met and you are talking about real money.

It doesn't get any better after retirement.
My insurance went up about 15% and the out of pocket is higher too.

Possibly to look into the price of something like an Aflac plan to cover the cost of your out of pocket deductible? 6k before they pay sucks! Maybe the cost per month would outweigh it. Dunno.

Almost makes more sense to surrender to the State and go on the dole....

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Originally posted by dry-fly:
Until there’s a massive overhaul of the medical/insurance system, I think we’re f’d. It’s such a racket.

This ^^^^^

The system was already artificially broken by corporate- and government-subsidized health care, and by government regulation. Zerocare just made it worse.

Remove all regulations that don't relate directly to ensuring what's sold is what's delivered and remove all direct interaction between insurers and providers and watch prices drop like a rock.

Of course: Nobody in the health "care" system wants to see that. They're living high off the hog with the current disaster.

When a hospital presents you with a statement there will be many add ons that the vast majority of people will not be able to decipher nor will the hospital explain adequately. You are paying for everyone that comes to that hospital without insurance that the hospital is Federally obligated to treat. That coupled with runaway costs. Obama Care did not address drug or hospital costs in the formula. The powerful drug and hospital lobby spends God knows how much in a concerted effort to not control costs. Go to the various Canadian on line drug companies and compare their drug costs vs those in the USA.

What is the latest with Healthcare savings accounts?

The idea is tax free deposits to the account, from which health care costs are paid, covered by a low cost catastrophic policy for really large events, like surgeries, etc.

I was very keen on these years ago, but was forced into medicare, and have lost track of the numbers.

We have this under our health insurance. You decide on how much you want to be taken out of your check, depending on what is allowed for your plan (pre-tax for the entire plan year). Then, they divide it for 26 pay period. Your company deducts that from your salary and deposits it into an HSA debit card, each pay cycle. (It is not a lump sum annual amount). You use that to pay your co-pay for doctor's visit, prescription, hospital visit co-pay, etc. For us, we elected 5K per plan year. We get around $195 deposited to our card each pay period (again, this is our own money). We use that for any medical/dental/prescription expenses.

Another thing happening this coming year with my insurance carrier, they are FORCING me to change my insulin to another brand. Have been using (effective) Lantus. They wanted me to change to some other manufacturer, of which I am not sure if it will be as effective or will have any side effects. Lantus was giving patients a break by offering a $10 co-pay each fill. Not sure about this new manufacturer. (Sorry for the thread drift).

quote:

Originally posted by JALLEN:
What is the latest with Healthcare savings accounts?

The idea is tax free deposits to the account, from which health care costs are paid, covered by a low cost catastrophic policy for really large events, like surgeries, etc.

I was very keen on these years ago, but was forced into medicare, and have lost track of the numbers.