Jump to content

Menu

What is your health insurance deductible?


Recommended Posts

Mine is $3500 for the family. Our insurance doesn't have an individual deductible, just family. We pay 100% of deductible up front then we are covered 100% after deductible is met as long as our provider is listed in our PPO. Our deductible includes prescriptions.

Link to comment
Share on other sites

We have a private insurance for the kids and me. We just changed to a high deductible HSA which has a $10,000 deductible. After we reach that (which I pray NEVER happens), then everything is covered 100%. Until then, well-child visits (including immunizations) and annual adult well visits are covered 100%. For sick visits, visits to specialists, and hospitalization, we pay the "negotiated lower insurance rate" for all services. The plan has its risk factors, but I feel comfortable with it for our family. We are never sick (except for colds and things that don't require doctors), hardly ever go see specialists, and have not been to the hospital. Our monthly premium for the 4 of us (1 adult, 3 kids) is just over $200.

Link to comment
Share on other sites

My husband has worked for the same company for 11 years. When he first started, our deductible was $100/year per person. This year it is $300/person; $600/family. Two people have to meet the $300 deductible. Next year, it is going up to $450/person. Thanks to Obama Care (as the company says in so many words). I don't know all the details of the Obama Care. One big reason I am assuming it is going up is there is no max for lifetime insurance coverage. It was usually $2 million/person, now it is unlimited. There are some very sick people who have a lot of medical expenses, so I am assuming this is one big reason.

 

Anyways, we will pay $160ish for medical and dental coverage a month.

 

We get our money's worth, sadly, because our middle son gets Occupational Therapy services every week.

 

We have a $25 copay. And I recently discovered that it's better to go to Walmart to get some prescriptions. We paid $30 for an antibiotic that was normally $2 before at CVS. It would be $4 at Wally World. So now we will go to Wally World for all our scripts. Insured or not, there are lots of scripts they have available for $4/script. Look it up online before getting something filled.

 

Vicki

Link to comment
Share on other sites

Ours is $8000 per person, I think the family max is $24K, but I'm not sure about that one. It used to be $5000, but Bud just raised it to the $8k option last year.

 

We chose this insurance - we could go with lower premiums, but prefer to save the premium and self-insure the high deductible. So far, so good.

 

ETA: This is the same insurance we've had since 2002.

Link to comment
Share on other sites

$0, no deductible.... Dh's new company, where he's been for almost 2 years, has awesome health insurance. No premiums, no deductibles, no co-pays, for anything, including prescriptions. We do pay some for dental and most of our vision. They have excellent benefits because it is hard to find enough well trained people to do the jobs. Not enough people are willing to get the Computer Science and Engineering degrees to fill the positions, which are most of the positions at his company. They don't want other companies to "steal" their employees.

Link to comment
Share on other sites

We meet our family deductible (it is high compared to most people's plans, but I don't know how much) early in the year - usually by Feb!, then pay 20% after that. We meet our family out of pocket maximum every single year - last year in the spring, this year in the fall. Then, we pay nothing after that. The out of pocket maximum is very high though - something like $8000. We just have to plan that into our budget each year:001_smile:.

Link to comment
Share on other sites

We had to change insurance companies last year to avoid ours going up to $10,000 per person (which is the plan we could afford). It's at $5,000 per person, with absolutely no coverage for anything before that (the other plan had some minor coverage for office visits and prescriptions).

Link to comment
Share on other sites

We are so fortunate. I'm a University employee and our insurance rocks! We pay $220.00 per month, then $20.00 per visit. $100 per hospital admissions. That's it.

 

We have decent dental and vision, as well.

 

 

This is great, but these wonderful plans are also why health care costs so much across the board and we're in a so-called "crisis," right now.

 

We have $6500 in deductibles and and HSA. Our medical expenses, with 1 diabetic child and the rest of us relatively healthy, run about $7000 out of pocket, annually.

 

Where insurance helps us most is in the negotiated service rates. For the uninsured, the system sucks.

Edited by Gooblink
Link to comment
Share on other sites

OUr deductible is 150 individual/300 family. After that we have a co-pay of either 15 or 20% depending if the doctor is network or not. We pay either 3, 6, or 21? per prescription per month's supply. Our catastrophic limit is 1000 and we never go past March meeting that.

 

Except that we have a supplement that pays the 20% after the deductable is met. We choose this over Prime coverage where 100% is covered with no supplement necessary, but most/ all care is at a MTF (Military Treatment Facility) with military or contract doctors. After 14 years of government health care, we opted to get out of the Prime system and pay some out of pocket so we could choose our own doctors. Free isn't always best, and the way it looks, we pay much less out of pocket than most of you all.

Link to comment
Share on other sites

We are self employed and our health insurance costs us $650. per month. We have a family deductible of $2,500. per year-then we are covered 100% on all visits/prescriptions. Some years we barely meet our ded.--this year we met it early on in the year. I have had a lot of neurologist/pt/pain clinic appts and husband is having a hard time with his back and will be having back surgery next month--so this year there are no complaints of the $650. per month premiums!

Link to comment
Share on other sites

Hubby's work policy that we refused is now $750 a month for a family, 3500 deductible with a cap of 2 (meaning two people have to reach it), $5,000 out of pocket max at 80/20 split and then 100% coverage after that. Drugs, dr visits, and specialists do not apply to the deductible. Procedures and labs do. So we would have to rack up 7,000 in labs and procedures to get to a 80/20 split and then rack up 5,000 to get to 100%. So it's basically catastrophic insurance with co pay dr visits since we are basically a healthy lot with few if any issues outside of allergies. we couldn't afford it a couple of years ago when it was a little lower and after this hike, several of the employees dropped it. We're just a waiting on the Obama gov care to take effect because we will be busted to 1099 contract workers and won't have any access to work insurance. we might be able to get insurance under the new health bill.

Link to comment
Share on other sites

This is great, but these wonderful plans are also why health care costs so much across the board and we're in a so-called "crisis," right now.

 

We have $6500 in deductibles and and HSA. Our medical expenses, with 1 diabetic child and the rest of us relatively healthy, run about $7000 out of pocket, annually.

 

Where insurance helps us most is in the negotiated service rates. For the uninsured, the system sucks.

 

:grouphug:

 

I do disagree that wonderful healthcare plans have a major impact on the sky rocketing health care costs that has been occurring for the past several decades. I suspect that the excessive charges for medical services and drugs have more to do with sky rocketing costs as well as funding the uninsured treatment costs. I understand that if you have to pay then you will use medical services less but this does not help those who have chronic diseases or catastrophes and cannot afford to pay out of pocket for life-saving treatments. The problem with high deductible plans in my opinion is that many cannot afford to pay the excessive deductibles and therefore will forgo medical care and probably end up costing the system even more in the end:(

Link to comment
Share on other sites

Our deductible is $800 per person in-network (PPO), times 8 people in our family. There is a separate deductible out-of-network, which I think is another $800 per person. We have a $30 co-pay; which, as it turns out, is about half the cost of a sick visit at our ped. Our deductible basically doubled for 2010 from what it was. Some things are covered without regard to the deductible - certain kinds of well-visits, I think.

 

Our annual premium totals $34,000, group insurance (we pay the entire premium). We have 6 kids. The coverage we get is usually excellent, though it does not include therapy for developmental delays. One of the kids has a pre-existing condition (long story) so at this time we can only stick with the group plan.

 

If I had a choice, I'd rather have a high-deductible/low-premium policy for catastrophic coverage only, and pay out of pocket for more regular visits. $34,000 would buy a whole lot of health care out of pocket; even if half of it went to a catastrophic-only policy, we'd still come out ahead except for the infrequent years where something really big happened (and we're no strangers to odd medical things happening), in which case we'd be prepared to deal with the high deductible. But at the moment we're still dealing with the pre-existing condition, so that's not an option.

 

Plus, as far as I know, "high deductible/low premium" plans will NOT qualify under the new health law for people over age 30 (or some similar age).

Link to comment
Share on other sites

:grouphug:

 

I do disagree that wonderful healthcare plans have a major impact on the sky rocketing health care costs that has been occurring for the past several decades. I suspect that the excessive charges for medical services and drugs have more to do with sky rocketing costs as well as funding the uninsured treatment costs. I understand that if you have to pay then you will use medical services less but this does not help those who have chronic diseases or catastrophes and cannot afford to pay out of pocket for life-saving treatments. The problem with high deductible plans in my opinion is that many cannot afford to pay the excessive deductibles and therefore will forgo medical care and probably end up costing the system even more in the end:(

 

I disagree with this. I believe that if medical insurance was more like other kinds of insurance (auto, homeowner's, etc.) and only covered the unexpected big costs rather than routine ones folks would have a greater incentive to have a healthy lifestyle (eat right, exercise, quit smoking, etc.) Something like >90% of diabetes, >85% of cardiovascular disease, and >80% of cancer is attributable to poor lifestyle. So long as the cost of treating the consequences of poor lifestyle is spread out over the entire pool, there's little incentive for the individual to change.

Link to comment
Share on other sites

Guest Cheryl in SoCal
I disagree with this. I believe that if medical insurance was more like other kinds of insurance (auto, homeowner's, etc.) and only covered the unexpected big costs rather than routine ones folks would have a greater incentive to have a healthy lifestyle (eat right, exercise, quit smoking, etc.) Something like >90% of diabetes, >85% of cardiovascular disease, and >80% of cancer is attributable to poor lifestyle. So long as the cost of treating the consequences of poor lifestyle is spread out over the entire pool, there's little incentive for the individual to change.

That would be penalizing those who aren't responsible for their medical diseases/disorders. My children are not responsible for their medical issues (cleft lip/palate and cataracts/glaucoma), and there are MANY more like them. If we didn't have the excellent medical insurance we have we would be BROKE, and none of what our medical insurance pays for is due to anyone's chosen lifestyle.

 

ETA that your plan also doesn't address health maintenance that helps reduce medical costs by catching health issues before they are severe (and expensive). How many women would end up with cervical cancer because they don't get regular pap smears, how many would end up in the ER with pneumonia instead because they didn't treat a less serious respiratory infection earlier, etc? Many such "routine" services help keep overall medical costs down.

Edited by Cheryl in SoCal
Link to comment
Share on other sites

Our deductible is $800 per person in-network (PPO), times 8 people in our family. There is a separate deductible out-of-network, which I think is another $800 per person. We have a $30 co-pay; which, as it turns out, is about half the cost of a sick visit at our ped. Our deductible basically doubled for 2010 from what it was. Some things are covered without regard to the deductible - certain kinds of well-visits, I think.

 

Our annual premium totals $34,000, group insurance (we pay the entire premium). We have 6 kids. The coverage we get is usually excellent, though it does not include therapy for developmental delays. One of the kids has a pre-existing condition (long story) so at this time we can only stick with the group plan.

 

If I had a choice, I'd rather have a high-deductible/low-premium policy for catastrophic coverage only, and pay out of pocket for more regular visits. $34,000 would buy a whole lot of health care out of pocket; even if half of it went to a catastrophic-only policy, we'd still come out ahead except for the infrequent years where something really big happened (and we're no strangers to odd medical things happening), in which case we'd be prepared to deal with the high deductible. But at the moment we're still dealing with the pre-existing condition, so that's not an option.

 

Plus, as far as I know, "high deductible/low premium" plans will NOT qualify under the new health law for people over age 30 (or some similar age).

:blink: $34,000 a year for health insurance? Am I understanding you correctly? Are you having to stay with a company because of pre-existing conditions and your annual medical bills are more than $34,000 a year?

Link to comment
Share on other sites

:blink: $34,000 a year for health insurance? Am I understanding you correctly? Are you having to stay with a company because of pre-existing conditions and your annual medical bills are more than $34,000 a year?

 

Our actual medical expenses, for services rendered (whether out of pocket or paid by insurance), are surely under 10k for this year, though DH did have an MRI of his shoulder the other day, which I assume is over 1k. I've never really added it all up, so I could be off. Maybe our actual expenses could be as high as 15k. But DH's little old-man-mid-life-crisis-athlete issues I think are our biggest expense this year. Garden variety sick visits, a couple of chest x-rays for the baby, I had broken ribs in January, DH had stitches. So I still think under or around 10k. The ds with the pre-existing condition - congenital thrombocytopenia (low platelets) - will have one specialist visit and a few blood tests, probably totalling less than $400. But we must keep in the back of our mind that his condition is also a symptom of leukemia (let me be clear, this is not something that's on our radar screen - not suspected - knock on lots of wood!!!), but we can't go without catastrophic coverage at a minimum, except that we can't buy catastrophic coverage on the individual market due to this condition. We would be able to afford a significantly high deductible if such a policy were available to us in exchange for a lower premium, but as I noted, it's not, though I admit I haven't looked very hard; our friends have done the looking (chalk me up as another person who'd like to see a national market for individual health insurance - somewhere there is, or could be in the future, an insurance company that could make money off of us and we'd likewise be happy to do business with them).

 

However, we DO pay an annual premium of $34,000 - you read that correctly - plus the deductible of $800 per person for in-network visits (x8, though most of us won't reach that this year), plus the $30 co-pay per visit. That's for decent coverage, but not outrageous coverage. The pre-existing condition does not figure into the premium directly, though it might be that a number of individuals in the group have such conditions. Most of the people at the firm who pay the whole premium (the lower level employees do NOT pay the whole thing) have left the coverage pool except the ones that have pre-existing conditions. I sure don't consider it a "cadillac plan" but obviously it will be taxed as such when the surcharge kicks in, though that's not planned until close to the end of this decade (yep, we'd be close to $50k in today's dollars).

 

We pay the whole premium due to DH's position at his firm. I think it would be very instructive if more companies were clear about the portion of the premiums that the company pays on behalf of the employee, in addition to the amounts the employee pays. When I was working, I had the SAME EXACT plan and insurance company as DH's firm, and my out-of-paycheck premium was nothing compared to what we pay now (I was also single then with no kids ;) so it is hard to compare but it was only a very, very small fraction of what we pay now - so small I never even noticed it - my firm was paying a portion and yet I don't even know how much that was).

 

I vaguely recall reading that coverage became connected with employment when there were wage controls (maybe during WWII? can't remember) as a way for employers to compete. Personally, I would like to see insurance de-coupled from employment income, in that the whole amount goes into the paycheck total, including any premium payed by the employer in addition to that paid by the employee, and then a separate form allow the cost as an income tax deduction, and most of all I'd like to see the same deduction allowed for individual non-employer health insurance. Group insurance obtained through an employer vs individual insurance is an apples/oranges comparison because of a frequent lack of transparency about what the employer is paying, combined with the different tax treatment. Not only does this lack of transparency cause distortions in the insurance market, but also in the employment market as compensation is less transparent. When compensation is less transparent, it's harder to compare jobs - different jobs can appear to have similar compensation but really have quite different compensation due to different levels of benefits - and markets function less efficiently.

Link to comment
Share on other sites

We have a private insurance for the kids and me. We just changed to a high deductible HSA which has a $10,000 deductible. After we reach that (which I pray NEVER happens), then everything is covered 100%. Until then, well-child visits (including immunizations) and annual adult well visits are covered 100%. For sick visits, visits to specialists, and hospitalization, we pay the "negotiated lower insurance rate" for all services. The plan has its risk factors, but I feel comfortable with it for our family. We are never sick (except for colds and things that don't require doctors), hardly ever go see specialists, and have not been to the hospital. Our monthly premium for the 4 of us (1 adult, 3 kids) is just over $200.

 

This is exactly us, except that we pay $524 per month for 2 adults/2 children.

Link to comment
Share on other sites

Crimson wife said:I believe that if medical insurance was more like other kinds of insurance (auto, homeowner's, etc.) and only covered the unexpected big costs rather than routine ones folks would have a greater incentive to have a healthy lifestyle (eat right, exercise, quit smoking, etc.) Something like >90% of diabetes, >85% of cardiovascular disease, and >80% of cancer is attributable to poor lifestyle. So long as the cost of treating the consequences of poor lifestyle is spread out over the entire pool, there's little incentive for the individual to change.

 

This isn't true in my family where we have constant medical bills. Major Depression, ADHD, PMDD, Rheumatoid Arthritis, Migraines, Asthma, Blood clots, Antibiotic infections, broken bones, torn ligaments, eye problems, etc, etc, are not from poor lifestyle. We don't have a single illness that is caused by lifestyle issues. We do have a lot of problems though and they cost a lot. One reason my dh decided to stay in the military was because of medical costs. It turned out to be a very wise decision. One of my blood thinners cost over $2000. My dd's medicine to prevent non stop migraines and also prevent PMDD issues cost 900 for a three month prescription. NOw my father had heart disease and he had low cholesterol, no high blood pressure, and wasn't overweight. THere are many people like that. There are also people who are skinny and have high blood pressure or high cholestrol. I had a neighbor like that when I was little. He exercised hard five days a week and he still had high risk of heart disease. Why? Heridity. That was my father's issue too. Nothing else.

 

It certainly isn't true that most cancers are caused by lifestyle choices. We have no idea what causes most cancers. Only a very few we do and even there, like lung cancer, only 75% is in smokers or former smokers. Others we know a cause but the cause is something like a virus. Oh and if you want to tell me how that is a lifestyle choice, I can tell you about a friend of mine whose first husband cheated and essentially gave her the virus which caused cervical cancer. One more thing, I may have very well survived my recent blood clots because I was overweight. The survival rate for blood clots is much better in overweight people. Why? They don;t know but do know its true.

Link to comment
Share on other sites

We pay $1,638 a month for 7 people. Hubby's work covers $1,000 of that (the union negotiates that since there is no cafeteria, they get $500 every two weeks. If you are single, that covers all of your premium plus extra.). We are responsible for the first $2000 in co-pays, after that, everything is covered. Well baby visits, yearly physical, maternity visits, admission to the hospital are all completely covered. We just pay for prescription co-pays ($5 generic, $15 name brand), sick appointments, and a $100 co-pay for emergency room visits (unless you are admitted-then its covered).

Link to comment
Share on other sites

$600 deductible and then it kicks in at 90/10. Up to $1800 I think and then it's covered at 100%. We tried really hard to hit that 100% point, but it looks like we just missed it despite 3 ER visits, 1 hospitalization, and home health care with IV meds and a PICC line for a week. Plus regular medical issues. Office visits are $25 which has really killed us this year. Last month we spent $150 in OV copays. And DH has 15 more visits scheduled to get PT at $25/time. We only put $1000 into our FSA and that was gone by early summer. We are putting in $1500 for 2011 and we'll see how long that lasts.

Link to comment
Share on other sites

Our current plan does not require a deductible if we use an in-network provider but we do have a limit on certain kinds of care (my chiro, physical and message therapy is already used up and I am in a lot of pain) and we have to pay a co-pay for all visits (different amounts for different kinds of care). Our monthly deduction for health care is $500. Our total health care expenses last year was $13,000 and they will be about the same this year and next providing we don't have any major problems. This includes eye care, dental care, chiro care, therapy, medical and prescriptions and everyone except for me is pretty healthy. Our health care provider seems to change every year even though my hubby is with the same company.

Link to comment
Share on other sites

I pay $260 a month and that includes dental. We have a $5000 family deductible that must be met before anything is covered, even prescriptions, (not including dental, that is a little different) We have a $10,000 max out of pocket for the family and then things will be covered at 100%, otherwise it is 80/20 for preferred providers Tier 1, 70/30 for sort of preferred Tier 2, and they don't pay at all for Tier 3 unless you have permission. It sucks but it is the only option we have since DH is self employed.

Link to comment
Share on other sites

Mine is $3500 for the family. Our insurance doesn't have an individual deductible, just family. We pay 100% of deductible up front then we are covered 100% after deductible is met as long as our provider is listed in our PPO. Our deductible includes prescriptions.

 

No deductable. Full coverage for free (except for adult eye care, we pay $65 per adult optom. appt. and glasses are paid) and we pay 35 cents per prescription.

Link to comment
Share on other sites

ISomething like >90% of diabetes, >85% of cardiovascular disease, and >80% of cancer is attributable to poor lifestyle. So long as the cost of treating the consequences of poor lifestyle is spread out over the entire pool, there's little incentive for the individual to change.

 

Where do these numbers come from?

 

The 2010 World Cancer Congress had far different numbers. The Union for International Cancer Control (UICC) attracted more than 3,000 delegates from 94 countries and regions all over the world.

 

"Experts at the meeting said one-third of global cancer cases were preventable. Urgent actions by governments, individuals and medical communities are required to stop the rise in cancer deaths, they said.

 

Hao Xishan, president of the 2010 World Cancer Congress, said among cancer-causing lifestyle factors, smoking is the world's largest single preventable carcinogenic factor. Hao said 80 percent to 90 percent of lung cancer deaths in the world were attributed to smoking.

 

On the other hand, in the area of prevention, only 9 percent of nations globally prohibited smoking in bars and restaurants and 65 countries were reported having no national smoke-free policy.

 

David Hill, president of the UICC, said about 40 percent of cancer was caused by three main factors: lifestyle, infectious diseases and occupational or environmental factors.

 

"I can not tell you which kind of foods can cause cancer from regular consumption," Hill said. "But one thing is certain. Overeating can cause obesity, which is one of the main factors that lead to cancer.""

 

Two of my daughter's close friends are fighting cancer (or complications) right now, and I know they had healthy lifestyles when they were diagnosed as children. Actually, they both have had cancer for more than 10 years.

Link to comment
Share on other sites

Maybe people should be required to sign when they buy cigarettes saying they will pay out of pocket for lung cancer treatment/oxygen tanks, etc. :glare:

 

Hao Xishan, president of the 2010 World Cancer Congress, said among cancer-causing lifestyle factors, smoking is the world's largest single preventable carcinogenic factor. Hao said 80 percent to 90 percent of lung cancer deaths in the world were attributed to smoking.

 

 

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...