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S/o- just how much is your deductible?


Hilltopmom
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S/o of the health insurance thread.

 

How much is your (family's) deductible?

 

We changed this year to the mid level cost choice for dh's insurance & it's a lower premium but still a lot, IMO.

The deductible is $8,000. The more expensive plan had a 6,000 deductible & least expensive was 10,000.

I'm pretty sure after deductible was met, still only 60% was covered.

 

It doesn't qualify for a health savings account but we can set up a health care flex plan.

 

Curious what others have for deductibles.

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Current health share cost (CHM) is $500 for each incident, then everything else is covered for that incident. It resets each time except maternity with is 100% covered.

 

The health plan we will be under with the new company has a 5k deductible, but the company kicks some money toward it and there is an HSA component, so it's very doable if there is a low medical year (fill the HSA). The monthly cost is shockingly low ($230 monthly) and then in network providers 100% covered with a really broad network, and out of network is 70/30. No lifetime max.

 

It's the best insurance I've had in years, not since we were on Aetna about seven years ago. And yes, it was part of the reason we accepted their offer. The job is excellent too ;)

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$750 individual, $2500 family. We are self-employed and it is expensive. It's > $1500/month. Strangely enough, that is down a little bit from the previous year. So, while many people had increasing premiums, ours went down a little bit. That is after having jumped way up from $1200.

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Not even sure I want to admit this...

 

In network, $0. Copays only.

 

No idea about out of network, $300/$600 maybe? We have yet to run into an out of network provider.

Outside the government I haven't seen that in years. Good stuff!

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We choose a lower deductible because we have at least one child who reaches their personal deductible annually rather than the 10000 High Deductible plan offered through DH's work. Those are the only two options available.

 

Ours is 1000/person. 3500/family. After that 80/20 co-insurance. Our co-pays suck though, and those don't count toward the deductible. 

 

ETA: To show just how much our co-pays suck, we have paid just a hair shy of $1000 toward deductible (all for one child), but we have paid out over $1700 in health bills through our insurance. So over $700 in co-pays so far (and only the kids have gone to the doctor this year).

Edited by beckyjo
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My dh is the only one in our family with insurance through his employer right now, and I think his deductible is $2500. I believe it's $5000 per family, but I couldn't swear to that. After that it pays 80% for most things, though prescription coverage kicks in immediately each year and covers all but a $12 copay for each prescription. The prescription coverage alone is worth it for us; he pays $300 a month in premiums and the insurance pays for his $1k a month in prescription meds. (And yes, that does make me wince; there's no way a single month's worth of a generic med should retail for $600, but that's the way it is and he's non-functional without the meds.)

 

I have Medicaid while pregnant and dd has it all the time, so no deductible for us.

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1000 per person.  Max of 3000 per family then all deductibles are met.

 

5500 per person out of pocket max.  Max of 3 per family and then everything is covered 100%

 

My employer offers 3 or 4 plans.  I have the highest level plan which pays the most.

 

 

This is the worst insurance I have ever had. Right now I am laid up in bed with my back in spasms.  I would have gone to the chiro by now, but can't afford it.  I missed work today, trying to see if a day off my feet would help. I have tried everything I can at home so tomorrow I am going to have to just deal with the cost and go anyways.

Edited by Tap
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Not even sure I want to admit this...

 

In network, $0. Copays only.

 

No idea about out of network, $300/$600 maybe? We have yet to run into an out of network provider.

Us, too. Except our deductibles might be $250/$500.

 

Much better than the one I'm offered through my job as a teacher from the state of Georgia.

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We pay for a "gold level" plan, with premiums of around $1100 just for Dh and 1 dc.

I think the deductible is $1000 individual / $2000 family. We always meet it early on.

Copays are $30/$50. My kid has a lot of appointments this year, and we paid about $500 for copays in May.

We also meet the out of pocket maximum most years too.

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The kids and I have a PPO plan.

Deductible:

in network: $350/person, $1050/family

out of network: $700/person, $2,100/family

 

We also have copays from day one (not just after the deductible is reached), so the deductible does not tell the entire story.

The out of pocket limit per year is $3,500/person in network (7k for family) and 10.5k/person out of network (21k/family)

 

 

DH has a high deductible plan with $1,500 in network/$3,000 out of network deductible.

Edited by regentrude
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$10,000 deductible for DH and I. (And we met it, 3 years running.)

However, our coverage is 100% after the deductible, which is comforting since those past years included 41 days in the oncology unit, 2 ICU stays of about 2 weeks, and countless ER visits. (As well as my ACL surgery.)

 

Could be worse.

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$4600 individual

 

$9200 family 

 

That's in-network

 

And we pay $881/month in premiums.  Ouch.  

 

I just had an emergency hospital stay so we'll meet our out of pocket expenses this year ($6500/13,000).  Normally we don't see a doctor unless a limb is falling off because of the high premiums.  It stinks to pay so much for insurance and then avoid the doctor because of the cost.

 

 

Edited by Erica H
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I think it is $2000 for the family ($750 individual) but the vast majority of things are exempt from the deductible.  

 

It's a great plan.  Great enough that my husband has been underemployed to access it.  Because we needed the insurance more than money.  He's making a job change later this year and it's going to be a big adjustment.  

Edited by LucyStoner
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We are paying through the nose this year for $850/person, $1700/family, with 80% coverage after we meet it. 

 

Out of pocket is $9,000 and $2,600 in pharmacy

 

Copays are $15 or $30 depending if it's primary care or specialist. 

 

monthly premium = $1900+ per month

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$6000 per person, $13,000 family, $20,000 out of network.

So yeah...a lot. But my husbands employer does some of the out of pocket expense in an account for us so we don't pay all of that. Sadly we met our deductible last year and are likely to this year too. Although after that it is 100% covered.

Edited by momto3innc
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Insurer axed my old gold plan and switched me to a new, less good gold plan, but it's the best they currently offer.

They call it Omnia -- my guess is that they don't believe anyone is familiar with Latin, because the effect of the Omnia plan is "not all." LOL

 

Network and Is divided into Tiers now, Tier 1 and Tier 2.

 

Tier 1, co-pays only, no deductible

Tier 2, individual $2,500, family $5,000.

Out of network, no coverage (unless life/death emergency)

 

It sounds good, until you start to look at doctors and hospitals. For example, iirc, there are five child psychiatrists for the state -- well, actually, two doctors, with five addresses between them. Many other specialists that we used to see are now in Tier 2. Several well respected hospitals were put in Tier 2, no one knows methodology for this.

 

What irritates me as much as anything is the $500 per day co-pay for Tier 1 hospital stays. The co-pays do not count towards the deductible.

 

ETA

Here are the rates for 2017

Note that the amounts are base rates -- you multiply by age factor and then add up family members.

 

http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates_2017.pdf

Edited by Alessandra
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Not even sure I want to admit this...

 

In network, $0. Copays only.

 

No idea about out of network, $300/$600 maybe? We have yet to run into an out of network provider.

This is us too. We have Regence/blue cross federal employee and it is the best part of my husband's job :)

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We're with health share, so medical issues over $300 are covered at 100% with no deductible.  Anything under $300 and "regular" appts + vaccines, etc, we pay for ourselves.  Our cost is just under $500/month for the whole family.  Considering the last time I priced insurance (when ACA became law) we'd have been paying $900/month with a $2000 deductible and 80% coverage thereafter until $12,500 OOP, I figure we have 5K minimum we can use in "regular" appts ($400 difference x 12 months) before we sort of start breaking even, but then there's still that 100% vs 80% when something goes wrong that comes into play.  I also suspect our cost would have gone up since then, but haven't priced it to be sure.

 

To date, health share has always been better for us - esp when we've had needs.  Then it's saved us thousands, plus covered things insurance wasn't likely to.

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Another no deductible, just copays ($15 office/Rx, $50 Urgent/ER),100% coverage after that, max per year/person is I think $1500. Family max per year is $4500. We pay ~$280/month for all 6 of us. And as far as I recall from last year, our copays count towards max per person OOP.

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$10,000 per year per person. I almost met it the year I broke my arm. However, even in that year, the lower deductible/higher premium would have been a money loser.

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It depends, hubby is on active duty.  Right now we pay nothing (Tricare Prime), when we get back to the States we will go back to Tricare Standard.  Then we will have a 150 per person /300 family deductible, and 25% copay after deductible is met.  Hospitalization is $848 per day or 25% of billed charges plus 25% of separately billed services.  Outpatient surgery is 25% after deductible is met.  Catastrophic cap is $1000 per year.

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$7k family. I'm not sure about individual without looking. We never use it. I pay for everything out of pocket because as a self-pay I have more negotiating power. When my son needed stitches last year we used our insurance card. The bill was huge & we couldn't negotiate it down because we weren't self-pay. So for us, our insurance is just useful if something catastrophic occurs. Everything else we simply budget for (dermatologist, dentist, illnesses, etc).

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$7,150 individual.

$13,600 family, with a $14,300 OOP max.

 

Our premium is in the $1,200 range, but we currently get a decent sized subsidy that we mostly pay back at tax time, depending on dh's bonuses.

He just got a raise, so we'll be paying in its entirety going forward.  If we're extended the privilege of being allowed to.  :toetap05:

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Our deduct is low: $2600/family (odd amount because we can do certain healthy things to reduce it). Out of pocket max for the family for the year is $6000. It's $3000 for the individual. It is an HSA eligible plan. Our portion of the premiums are around $750/month. We could do a lower premium with higher deduct but for our family, this is better, as it spreads some costs out more and we hit the deduct by around March, usually. I will always hit the ind out of pocket.

Edited by QueenCat
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We have no deductibles, only out of pocket maximums. Once family is met everything (including pharmacy) is covered. All co-pays go toward total.

 

$2500 individual

$5000 family

 

Our previous policy was $7500 individual deductible with $15000 family. Very high co-pays and very little went toward deductible. It was a nightmare and one of the reasons dh changed districts (he's a teacher).

Edited by PuddleJumper1
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$1,000 per person/$2,000 max family, but we don't start paying the deductible until the insurance has paid out the first $1,000 per person (my daughter met her deductible February 3rd this year).

 

Pre-ACA we had a $12,500 deductible.  Given all my daughter's health issues we are so thankful we don't have a HDHP anymore.  She'd bankrupt us.  I actually live in fear that they'll change things and make it so she can't be covered through age 26 (full time college is probably not a possibility for her - she'll be going very part time) or one of her many chronic illnesses will become a pre-existing condition screwing her over for life.

 

ETA: We pay something like $500 or so a month for our part which is like 28% of the premium cost.  The federal government (my husband's employer) kicks in the rest.

Edited by Butter
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Pre-ACA we had a $12,500 deductible.  Given all my daughter's health issues we are so thankful we don't have a HDHP anymore.  She'd bankrupt us.  I actually live in fear that they'll change things and make it so she can't be covered through age 26 (full time college is probably not a possibility for her - she'll be going very part time) or one of her many chronic illnesses will become a pre-existing condition screwing her over for life.

 

I completely understand. I have similar fears. Sometimes, it causes me to literally lose sleep.

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I don't remember our deductible but our family max out of pocket is $800, not counting co-pays.  Those are $15 for primary care and $50 for specialists.  We don't pay very much for this insurance, DH's employer covers it, and we know how lucky we are.  DH's job is quite a distance and insurance is the primary reason he hasn't found anything closer.  No one else's insurance comes even close to matching what we have now.  

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