Moxie Posted July 23, 2009 Share Posted July 23, 2009 What amount per month would you consider 'fair' for health insurance for a family? Let's say there is a $20 co-pay per doctor visit, $1000 personal deductable per year, $2000 family deductable per year. No maximum coverage amount. Quote Link to comment Share on other sites More sharing options...
PiCO Posted July 23, 2009 Share Posted July 23, 2009 What amount per month would you consider 'fair' for health insurance for a family? Let's say there is a $20 co-pay per doctor visit, $1000 personal deductable per year, $2000 family deductable per year. No maximum coverage amount. I'm not sure what you mean by "fair." You can probably google rates and find out what a plan like that goes for. There will be a huge difference between an individual plan (if you have no pre-existing conditions) and a group plan through an employer. The group plan has to cover pre-existing conditions in my state, so it's a LOT more expensive. Quote Link to comment Share on other sites More sharing options...
Moxie Posted July 23, 2009 Author Share Posted July 23, 2009 I'm not sure what you mean by "fair." You can probably google rates and find out what a plan like that goes for. There will be a huge difference between an individual plan (if you have no pre-existing conditions) and a group plan through an employer. The group plan has to cover pre-existing conditions in my state, so it's a LOT more expensive. By fair I mean, what would you be willing to pay to have your family covered, feel like the cost was worth the coverage and still be enough that the insurance company wasn't going in the hole. I know what one costs in the real world because that is about what we have. I'm just curious what people would be willing to pay without feeling like they were getting ripped off. Quote Link to comment Share on other sites More sharing options...
PiCO Posted July 23, 2009 Share Posted July 23, 2009 By fair I mean, what would you be willing to pay to have your family covered, feel like the cost was worth the coverage and still be enough that the insurance company wasn't going in the hole. I know what one costs in the real world because that is about what we have. I'm just curious what people would be willing to pay without feeling like they were getting ripped off. I pay what it takes- I think it's about $650/month for me and my two dds. I have a higher deductible and a higher co-pay, though. It's not something I think about in terms of what I'm "willing to pay" though. I pay what it costs, I research different plans every year (I own a small business, so I get to shop for health insurance myself.) In my opinion, nobody "needs" health insurance until they have a catastrophic accident or illness. Quote Link to comment Share on other sites More sharing options...
Renee in NC Posted July 23, 2009 Share Posted July 23, 2009 What amount per month would you consider 'fair' for health insurance for a family? Let's say there is a $20 co-pay per doctor visit, $1000 personal deductable per year, $2000 family deductable per year. No maximum coverage amount. For that to be fair, it would have to be fairly expensive. When I ran one small business several years ago, a family policy like that was $1000 a month! There was someone who said they paid $130 a month for a $10K deductible policy - I thought that was fair. My family was quoted $575+ for a policy just like that. I think a better question would be - what is a fair amount for a regular doctor's visit? I was billed $180 for my baby's 2 week well baby and that just seemed insane! Quote Link to comment Share on other sites More sharing options...
joannqn Posted July 23, 2009 Share Posted July 23, 2009 My individual insurance cost $267 a month for me only. It has a $20 copay, $500 deductible, and 20% coinsurance with a $2500 out of pocket max. ER/hospital copay is $100, waived if admitted. Prescriptions were 50% copay. I've had this insurance for years, though it used to be $100-something a month. I just got notice that my premium is going up to $367 a month as of August 1st. My other option is to raise my deductible to $1000 and raise my premium to $275. I'm opting to go uninsured... Quote Link to comment Share on other sites More sharing options...
KidsHappen Posted July 23, 2009 Share Posted July 23, 2009 I just figured my approximate total health costs for this year, barring any catostrophies, it will be $13,000. This is just regular health care for my family with no emergencies or chronic care issues. It includes medical, dental, vision, chiropractic, mental health and prescriptions. One child did get braces this year and three family members got glasses. I think each of my children and my hubby have been to the dr. once this year. This is about average for us. I really don't think in terms of fair. This is what it costs and I can afford to pay it so I do. We also spend a large amount on food but we have never been on vacation. It is just how we chose to spend our money. Quote Link to comment Share on other sites More sharing options...
Tabrett Posted July 23, 2009 Share Posted July 23, 2009 There was someone who said they paid $130 a month for a $10K deductible policy - I thought that was fair. I agree. Doc. Office visits should be around $50 for sick or well visits. If regular visits were affordable, we would only need castrophic insurance. We confuse health insurance with health care. An insurance policy was never designed to provide health care. It was designed for emergencies. Quote Link to comment Share on other sites More sharing options...
Mommyof4ks Posted July 23, 2009 Share Posted July 23, 2009 I have no idea! We could not afford the plans with copays and such. We have a high deductible plan that is $100 a month for the 5 of us with a $5000 out of pocket max. amount. We know on January 1 how much we will spend on health care for the year unlike the copay plan that we had with different deductibles for clinic and hospitals and different out of pocket max amounts for clinics and hospitals. It made my head spin lol. The premiums were twice as high for the other plans too. The HMO plan was even worse. This is through dh's employer too, so I have no idea what anything costs for individual plans. I cannot even make a guess on your scenario. Quote Link to comment Share on other sites More sharing options...
stacim Posted July 23, 2009 Share Posted July 23, 2009 We pay $364 for our high deductible HSA plan. Our deductible is $6000 with 0% coinsurance once the deductible is met. We pay $0 for preventive care, but everything else is 100% our responsibility until the deductible is met. It can be a great plan for the right circumstances. I really wish we had a higher balance in our HSA (Health Savings Account) for those times when we do have a bigger expense (like last weeks ER visit), but overall the plan has been working well for us so far. ~Staci Quote Link to comment Share on other sites More sharing options...
TravelingChris Posted July 23, 2009 Share Posted July 23, 2009 We are active duty military so are our costs are different- 150 individual deductible, 300 family deductible, 20% co pay, $1000 catastrophic cap. WE also pay either 3, 9, or 27 I think for prescriptions if we get them at a commercial pharmacy eagain only to the catastrophic cap. We have been in this plan since 2006 and every year we hit the catastrophic cap. THis year we hit it in 2 1/2 months. Nothing like chronic illnesses, allergies, post surgical PT, and fractures to run up those bills. We could have a lesser cost plan but then we give up freedom and add umpteenth hours of haggling with insurance and going to wasted primary care visits just to get referrals. Now that is a true waste- having to go to primary care to get referrals to specialists. I have always gotten all that we wanted but each required another visit to primary care. Since I get them anyway, what is the point of seeing primary care to get them. We do pay a lot for our dental bills since the military has a very limited dental benefit. This year we will be paying close to 2500 in dental bills. Quote Link to comment Share on other sites More sharing options...
Lovedtodeath Posted July 23, 2009 Share Posted July 23, 2009 You know, we are uninsured yet pay around $250 a month for life insurance. hmmm.... I had insurance through the state and paid $500 a month for it and they denied every claim... so I ended up paying all of my medical bills too. Not fair. I had an individual plan through our small business and they denied claims and caused me a lot of work researching, writing and making calls to get the bills paid. Not fair. We get to count very little off on taxes because only medical expenses over 7.5% of our income count. We also spend around $1000 more than the 7.5% on medical care. My bf has insurance through her employer, so that is deducted from her taxes right off the bat. Not fair. We also spend around $300-400 per month on alternative treatments, and more on alternative visits and those don't count at all because only Medical Doctors and their big business FDA payoff drugs are approved expenses. The drugs have not worked for me, they make me more sick. Not fair. Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted July 23, 2009 Share Posted July 23, 2009 I have no idea because one of my DD's is on meds that run $20-40k a year depending on her dosage. That is currently more than our income.... So i know that no matter WHAT we pay, the insurance company is going to lose money on us. Insurance companies don't "pay claims", they "collect premiums", rates rise when that balance gets out of whack. When they and the doctors don't have to worry about insane settlements in lawsuits... then we can have reform and lower prices. ANYWAY, so what should my family pay? we can't pay 100% of our income for meds for one child can we? Quote Link to comment Share on other sites More sharing options...
whitestavern Posted July 23, 2009 Share Posted July 23, 2009 We pay over $500/mo which gives us one well visit per year; no coverage until we hit $10,000. Basically catastrophic insurance. We are RARELY sick yet I have thousands of dollars of doctors/dentists/lab bills I pay a little on each month. It adds up incredible fast. I don't think it's "fair" but it's my only choice as I can't afford a higher monthly premium. I think fair could look something like $500-$700 a month w/low copays, much like a non-self employed person would receive. Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted July 23, 2009 Share Posted July 23, 2009 We pay over $500/mo which gives us one well visit per year; no coverage until we hit $10,000. Basically catastrophic insurance. We are RARELY sick yet I have thousands of dollars of doctors/dentists/lab bills I pay a little on each month. It adds up incredible fast. I don't think it's "fair" but it's my only choice as I can't afford a higher monthly premium. I think fair could look something like $500-$700 a month w/low copays, much like a non-self employed person would receive. The key being the size of the group. More people to collect premiums from, more money to go around. However, group insurance is NOT cheaper to the employer than individual. Most people on group plans need to know that they are NOT paying the full amount of their premium if they are paying under $1000/mo for family coverage. Ask at work what it is - most people are surprised when they get a COBRA bill at the cost. Group is more expensive because there is no underwriting at the individual level, they have to take you. They might get away with pre-existing exclusions, but that is all they have to cover themselves. So the question is, if we all paid $5-700mo for insurance, would the premiums be enough to cover everyones bills? Quote Link to comment Share on other sites More sharing options...
joannqn Posted July 23, 2009 Share Posted July 23, 2009 Insurance companies don't "pay claims", they "collect premiums", rates rise when that balance gets out of whack. When they and the doctors don't have to worry about insane settlements in lawsuits... then we can have reform and lower prices. I agree. It's the lawsuits and out of control malpractice insurance needs that is doing us in. Quote Link to comment Share on other sites More sharing options...
PiCO Posted July 23, 2009 Share Posted July 23, 2009 ANYWAY, so what should my family pay? we can't pay 100% of our income for meds for one child can we? But who is supposed to pay? (My family was on the net receiving end of health insurance for the years dh was in cancer treatment, so I know how you feel about not being able to pay the full cost of actual healthcare. I don't know the answer to this question myself.) Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted July 23, 2009 Share Posted July 23, 2009 But who is supposed to pay? (My family was on the net receiving end of health insurance for the years dh was in cancer treatment, so I know how you feel about not being able to pay the full cost of actual healthcare. I don't know the answer to this question myself.) I don't know. But i can assure you that i didn't plan to be in this position - having a child with a genetic disorder (and other stuff). There was a time a few years ago when we were paying about 60% of our weekly income for insurance (we were paying 100% of the premium). There wasn't enough to live on weekly - my parents were subsidizing the rest. The biggest thing is to figure out what total costs are, then divide that between the "group". Which means some group members aren't going to pay enough, and some will pay for things they never use. And that later group doesn't like that scenario at all. The point with insurance is that it IS a gamble, you don't need it until you NEED IT. At that point, it's impossible to get. My families biz was a self funded group insurance - even with us paying the claims - we just used "Blue Cross" to process the claims and reduce the fees - our rates went up every year. So how do you cut costs there? They took more in premiums... and we paid the claims. Logical? NOT. And right now, i don't think i have insurance. STBXH changed jobs and i haven't seen COBRA papers. I'm not sure what i'm going to do, i have things that need to be fixed - and now i can't even be seen for them. But i don't have the answer - but the other side of the insurance needs to be fixed first before trying to do universal. Quote Link to comment Share on other sites More sharing options...
Lovedtodeath Posted July 23, 2009 Share Posted July 23, 2009 My state has insurance (which would have paid half of my claims had I kept it longer than 3 months). If you can prove that you have been denied coverage by an insurance company due to pre-existing conditions, you can sign up for the state insurance. In the case of cancer or heart disease it is automatically in place. It was around $500 per month for one person. Anyway, you could look into that.:grouphug: Quote Link to comment Share on other sites More sharing options...
OneRoomSchoolHouse Posted July 23, 2009 Share Posted July 23, 2009 Through dh's work insurance, the kids and I are around $800/month. This is with a $1200 deductible. To save money, I opted for a private policy that does not cover maternity that is $124/month. Now that we are considering another baby, I would have to switch to dh's insurance and pay an extra $300/month. Quote Link to comment Share on other sites More sharing options...
abcinnc Posted July 23, 2009 Share Posted July 23, 2009 We pay a little over a $1000 per month for group insurance with $30 co-pay and $1000 deductible. Quote Link to comment Share on other sites More sharing options...
Sara R Posted July 23, 2009 Share Posted July 23, 2009 (edited) I have no idea because one of my DD's is on meds that run $20-40k a year depending on her dosage. That is currently more than our income.... So i know that no matter WHAT we pay, the insurance company is going to lose money on us. ANYWAY, so what should my family pay? we can't pay 100% of our income for meds for one child can we? Holy cow, Tracey! This is for one child with a genetic disorder? Are there any alternative medications? What did they do for this disorder before the current drug? Talk about an example of health care progressing beyond the limits of affordability! On the one hand, how wonderful it is that she has the tools to be here! On the other hand, the money has to come from somewhere. Who is the worker out there who is providing the means for the medicine? I ask myself the same questions about my cancer treatment. Tough, tough questions. Miraculous but unaffordable treatments are a huge reason why medical costs are going out of sight. Edited July 23, 2009 by Sara R Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted July 23, 2009 Share Posted July 23, 2009 Holy cow, Tracy! This is for one child with a genetic disorder? Are there any alternative medications? What did they do for this disorder before the current drug? Talk about an example of health care progressing beyond the limits of affordability! On the one hand, how wonderful it is that she has the tools to be here! On the other hand, the money has to come from somewhere. Who is the worker out there who is providing the means for the medicine? I ask myself the same questions about my cancer treatment. Tough, tough questions. Miraculous but unaffordable treatments are a huge reason why medical costs are going out of sight. She has Tuner Syndrome - it carries a variety of things that go along with it, but the main one is short stature. With growth hormones, they HOPE to get her to 5 feet tall in order to function in society best. At 10 she is currently 47" tall. She has been off of HGH for about 2 years due to no insurance - while she was on them we saw a increase of over 3" in a year. We are hoping to have not missed our main growth window... on our side is that statistically her chances of having functioning ovaries and going into puberty without drug intervention is SLIM to NONE. That helps buy time for growth..... Again, we aren't after anything more than making it so that she can function in the world easier. She will have enough OTHER things against her, that it's a no brainer for us to try. The downside to HGH is that she also has scolisois. The rapid growth tends to make that worse, so now we have to weigh that into the equation with a ton of monitoring. When we took her to the doctor at almost 7 it was because she finally dropped enough on the ped's chart to warrant a visit to the Endo. This was NOT what we expected to hear..... So really, i don't know the answer - do i feel guilty that i have no means to provide my child with the care she needs? You bet. Daily. But in order for her to stand a chance to be a self-sufficient member of society, she needs all the treatment she is getting. Catch-22. This isn't even a "miracle cure" in the terms i bet you were thinking it would be.... but to us it is. Quote Link to comment Share on other sites More sharing options...
Lovedtodeath Posted July 23, 2009 Share Posted July 23, 2009 I could be really stupid... but HGH is available without a prescription from antiaging-systems.com. DHEA also gives your body all precursors to produce hormones and often raises HGH. Just FYI for a desperate interim half-solution, from someone who knows nothing about your daughter's condition. :o Quote Link to comment Share on other sites More sharing options...
Sara R Posted July 23, 2009 Share Posted July 23, 2009 So really, i don't know the answer - do i feel guilty that i have no means to provide my child with the care she needs? You bet. Daily. But in order for her to stand a chance to be a self-sufficient member of society, she needs all the treatment she is getting. Catch-22. This isn't even a "miracle cure" in the terms i bet you were thinking it would be.... but to us it is. I apologize for addressing a very personal issue as an example of a far larger situation. I hope I didn't make you feel defensive. Thanks so much for sharing. I hope there are other ways of providing this safely providing this medicine outside of the mainstream system for an affordable cost. If so--hey, it's the free market at work! :001_smile: Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted July 23, 2009 Share Posted July 23, 2009 I could be really stupid... but HGH is available without a prescription from antiaging-systems.com. DHEA also gives your body all precursors to produce hormones and often raises HGH. Just FYI for a desperate interim half-solution, from someone who knows nothing about your daughter's condition. :o She actually produces more than enough HGH, her body lacks the ability to USE what she produces, so she gets super dosed to get a small amount of growth. "We" (2 endo's & myself) actually think she should be on a special form of HGH, IGF-1, that is used for resistant patients. BUT, there have been no trials on TS girls, so it can't happen. It's new to be approved for the one condition it's used for, so at some point in the future - it will probably be used for TS girls. Just not now (you can read more about that here, it's interesting! LOL!!). I apologize for addressing a very personal issue as an example of a far larger situation. I hope I didn't make you feel defensive. Thanks so much for sharing. I hope there are other ways of providing this safely providing this medicine outside of the mainstream system for an affordable cost. If so--hey, it's the free market at work! :001_smile: Oh no - i wasn't bothered at all. I think "we" (family wise) are a good example of the unexpected. I don't mind sharing - i'm sensitive to the whole issue because i worked closely in insurance in my families business. I know what a twist of fate can do to the bottom line in a year (a $100,000 premmie in a self-funded plan means no one gets bonuses that year!) Until 3 years ago, we were a normal family with ear infection issues. Then it all turned upside down and we are an insurance company nightmare! The point is, what DO you do with families like us? We are real, there are a bunch out there like us. For now, the kids have insurance thru the State of FL Healthy Kids program, with the oldest 2 kicked out and into the Special Needs program. For the middle one, i'm pretty sure she will be on it (or some other government program) until she is 18/21. Hopefully we will have enough reform by that time that will allow her to go on a regular plan... not that we know what that looks like. She is in the approval process for getting back on the HGH - the papers are sitting in the Capital waiting for the one person in the state that goes thru them to approve it. It should be a "rubber stamp" approval, but i can't take anything for granted until it does. If it doesn't, the drug companies have programs we can get into based on income (not much). Quote Link to comment Share on other sites More sharing options...
PiCO Posted July 24, 2009 Share Posted July 24, 2009 Tough, tough questions. Miraculous but unaffordable treatments are a huge reason why medical costs are going out of sight. And some of those "miracle" treatments really aren't much more than science experiments that are paid for through insurance. But we need to try new cancer treatments (for example) if what we have now isn't working. I think this is the issue with medical care these days- there are so many expensive drug protocols out there that are so expensive. But some of these protocols are working. I'm not comfortable saying some people can have the treatment and some people can't, based on any criteria. But we need to figure out what to do. Quote Link to comment Share on other sites More sharing options...
Lovedtodeath Posted July 24, 2009 Share Posted July 24, 2009 And some of those "miracle" treatments really aren't much more than science experiments that are paid for through insurance. But we need to try new cancer treatments (for example) if what we have now isn't working. I think this is the issue with medical care these days- there are so many expensive drug protocols out there that are so expensive. But some of these protocols are working. I'm not comfortable saying some people can have the treatment and some people can't, based on any criteria. But we need to figure out what to do. Well, if they are in experimental stage then why are the consumers paying for them? I have people testing my curriculum and they got it free of monetary charge. They are rendering a service by testing it. Quote Link to comment Share on other sites More sharing options...
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