On saving $ and health insurance

[Doran]

Beansprouts mentions in another thread that she and her family have decided to drop their insurance policies in order to put the $1000/mo into a savings account from which they pay for medical expenses. Genie mentions using a Humana policy that only requires payments after the large family deductible is met.

 

Our family made a long overdue switch to BCBS CareFirst in March, ditching an expensive, many year policy with Golden Rule. At the time of the switch, we were paying upwards of $700/mo for a family of four. We never met the deductible and there was co-pay arrangement, which meant we paid everything out of pocket. In that time, I became so frustrated with medical bills for well visits that I just stopped going to the doctor altogether. I also stopped taking my kids, except for "sick visits". Bad practice, I know, but the bills just infuriated me so much. As did the health insurance payments which robbed us of that money every month for NOTHING!

 

We just received our second bill from CareFirst, announcing a payment due July 1. Our premiums are less now, so we are saving hundreds per month. But, there was a note on this bill reading as follows:

 

 

 

Effective July 1, your new rate will be reflected in your bill.

 

 

I'm freaked. Does this mean they are already going to raise our rates?!? The last time I called BCBS, I was on hold for 40 minutes (I swear they're trying to make me have a heart attack, these people ;)). So, I wanted to inquire here first to see if anyone has knowledge of what this means.

 

I also would enjoy a discussion among those of us who are are self employed or otherwise self-pay for insurance about ways to manage this costly aspect of living in our country. It really disturbs me, but I feel very stuck.

 

 

[sandellie4]

I can't say much more than you've already said, much of it reflecting my own sentiments for years. We were self-employed for years but couldn't get insurance, or could only get it at exorbitant rates, because we have children with special needs. I have a friend of mine who could afford it because she didn't have any previous health needs in her family at all; but after her husband had a pancreatic attack, which was originally mistaken for a heart attack, she was unable to get insurance again except at really high rates. We've just had to go without the coverage in our family. If we get into a car accident, God forbid, we'll be on the dole, I guess. Not what I would have chosen, but really, what are regular working people to do? We're not poor and don't qualify for help in any area of our lives. We're just plain old middle class and we can't afford health insurance. That's just all there is to it. I wonder what other people are doing....

 

Sandy

[Anne]

We have a Premera Blue Cross HSA policy, and they have raised our rates every year.

 

:glare:

 

Anne

[genie]

When I was with BCBS they raised rates every July, it was 20-30 $ a year increase. I was in my early 20's and this policy covered me and the kids. So yes, they are raising your rates. Sorry.

 

When I had BCBS, would you believe it? They actually LOWERED our bill one year by $12 per month!! I was so completely shocked!

 

It was in FL, and it was a major medical coverage only. We started out at $82 per month for the three of us, and it actually went to $70 per month! I just wish they offered the same program here in CO!

[beansprouts]

Our big problem with insurance was that we couldn't afford the health care we wanted and needed. We had to pay for our two boys' midwife because our plan would not cover homebirths. We had to pay for all dental and eye care. DH was prescribed physical therapy but we could not afford the $50 co-pay per visit. If we had some of our own money which was given to the insurance company we could have just covered these bills ourselves.

 

DH and I were unable to find an HSA which would meet our needs without costing *almost* as much as our health plan cost us. We ditched insurance completely and will be using a plain old checking account for all health, dental , eye care, band-aids, aspirin, etc., I plan to keep reciepts for everything and will write off what I can. We usually get most of our taxes back anyways, but even if we do incur some penalties I think we will still save money.

 

Because our company still carries a group health plan for other employees, it is a simple phone call to get us back on the policy if something catastrophic should occur. A few years ago we had an employee who discovered she had cancer. dh was able to get insurance for her within a day or so.

[beansprouts]

If we get into a car accident, God forbid, we'll be on the dole, I guess.

 

But isn't that what auto insurance is for???

[genie]

I also would enjoy a discussion among those of us who are are self employed or otherwise self-pay for insurance about ways to manage this costly aspect of living in our country. It really disturbs me, but I feel very stuck.

 

 

 

When we moved, I used ehealthinsurance.com to find the lowest possible insurance program. Once you get your online quote (and you don't have to give any personal identifying info) you can sort it by price to find the lowest ones. Then I compared some of the cheapest and picked from there. Like I said in the other thread, even self-paying for doctor visits comes out cheaper than paying for insurance policies with "better" coverage.

[beansprouts]

Like I said in the other thread, even self-paying for doctor visits comes out cheaper than paying for insurance policies with "better" coverage.

 

She's right. I believe strongly that if the U.S. government wants to solve the health care crisis, they should stop putting their faith in crooked insurance companies and enpower people to pay for their own health care (through better HSA's for example...) And allow good old fashioned capitalism to be its regulator. This is the one business where the consumer never looks at the bill.

[snickelfritz]

Because our company still carries a group health plan for other employees, it is a simple phone call to get us back on the policy if something catastrophic should occur. A few years ago we had an employee who discovered she had cancer. dh was able to get insurance for her within a day or so.

 

This could vary by state. I know for certain in our state that you can only change insurance at your job (sign up, drop, change plan choices, etc...) at the yearly enrollment OR in the case of a qualifying event. Qualifying events are things like job loss for either spouse, birth of a child, etc... An illness would not be a qualifying event and a person wouldn't be able to get back on company insurance until the next plan change time.

 

I just wanted to clarify that for any that read this thread and think that's an alternative. Check with human resources before you make a change.

[sandellie4]

But isn't that what auto insurance is for???

 

You're right, of course. I just meant something catastrophic.

 

Sandy

[RoughCollie]

We pay $1600 a month for our BCBS insurance, which has copays. It is actually $200 a month cheaper than our former BCBS insurance, which program was canceled by the insurer.

 

I researched insurance plans to death, and this was the best I could come up with in our circumstances.

 

We are stuck. My medication costs $600 a month and I have heart problems, so we can't afford to have just any insurance plan.

 

Our insurance company has paid out more than we have paid in, what with major surgeries for a couple of kids, my bypass surgery, and the boys having been in the NICU for 3 months. We could have never in a million years paid for all that, so I am grateful for the insurance, even though it costs a small fortune.

 

I don't know of any way to manage this cost, other than suck it up. I'm grateful we have the coverage. It's a big hit every month, though.

 

RC

 

I also would enjoy a discussion among those of us who are are self employed or otherwise self-pay for insurance about ways to manage this costly aspect of living in our country. It really disturbs me, but I feel very stuck.

 

 

[/color]

[beansprouts]

You're right, of course. I just meant something catastrophic.

 

 

 

Well that was part of it for us also. The most likely scenario for us at our age in excellent health is that our catastrophic event would involve a car accident. We're insured for that.

[TraceyS/FL]

Because our company still carries a group health plan for other employees, it is a simple phone call to get us back on the policy if something catastrophic should occur. A few years ago we had an employee who discovered she had cancer. dh was able to get insurance for her within a day or so.

 

This actually hasn't been our experience in Group Health plans (both in employer role as just as an employee). We've also had individual coverage.

 

Group Plans are still subject to pre-existing conditions if you have a lapse in coverage more than 60~ days.

 

Legally, they can only allow you on during Open Enrollment, or at a qualifying event. The Government has their hands in all of this.

 

A good agent can work miracles, but i'd (personally) not be counting on getting back on with coverage without some wrangling (especially in the case of something like cancer, i'd say that person was very lucky). Once you see a doctor - that becomes pre-existing.

 

Sounds like you have a good agent - so keep them happy and hopefully you won't need to find out if you can just get on or not.

 

I hate insurance - DH's last employer made us pay everything. $1300 a month..... we didn't even have enough to eat on after that deduction. Now we have issues with the kids.... sigh.... next week, i'll deal with that next week.

[RoughCollie]

We have requested detailed bills from hospitals so we can make sure that we and Blue Cross have not been charged for things we did not receive.

 

The hospitals refused to give us the invoices. We didn't have the time or inclination to sue them for that information, which surely we are entitled to.

 

 

This is the one business where the consumer never looks at the bill.

[beansprouts]

This could vary by state. I know for certain in our state that you can only change insurance at your job (sign up, drop, change plan choices, etc...) at the yearly enrollment OR in the case of a qualifying event. Qualifying events are things like job loss for either spouse, birth of a child, etc... An illness would not be a qualifying event and a person wouldn't be able to get back on company insurance until the next plan change time.

 

I just wanted to clarify that for any that read this thread and think that's an alternative. Check with human resources before you make a change.

 

Good point, of course. I think most of us are either self-employed or own our companies. Therefore we make these rules, and we can change them as we need ;)

[genie]

 

We are stuck. My medication costs $600 a month and I have heart problems, so we can't afford to have just any insurance plan.

 

 

 

Ugh! I feel for you. I meant to qualify my post with what I said in the other one, which is that we are mostly healthy, and don't have specific medical issues. I really can't imagine being in your position.

 

 

And I can certainly understand how such a large percentage of bankruptcies occur due to medical expenses. The system really is messed up, and I have a hard time believing the government is the entity to fix it. :confused1:

[RoughCollie]

That's not how it works here. If you pay cash for any medical treatment, including dental, you pay a lot more than insured people do.

 

I don't know what costs are elsewhere, but here in Mass, those doctor and dental visits (for physicals and teeth cleaning) are very expensive. Our former $1850 a month health insurance policy did not cover physicals for kids over age 5, and did not include dental coverage. Our new $1600 a month policy covers one physical a year, but still no dental coverage.

 

 

Like I said in the other thread, even self-paying for doctor visits comes out cheaper than paying for insurance policies with "better" coverage.

[beansprouts]

I don't know what costs are elsewhere, but here in Mass, those doctor and dental visits (for physicals and teeth cleaning) are very expensive. Our former $1850 a month health insurance policy did not cover physicals for kids over age 5, and did not include dental coverage. Our new $1600 a month policy covers one physical a year, but still no dental coverage.

 

Is Mass requiring everybody to be insured now? I know they were considering it a few years ago.

 

I know everybody's situation varies, and some simply can not be without insurance. For us normal medical care means the $120 per year well checks for each child and the occasional $500 - 1000 ER visit. We are in excellent health ourselves, and while this is a big step, I feel at peace with our decision.

[beansprouts]

We have requested detailed bills from hospitals so we can make sure that we and Blue Cross have not been charged for things we did not receive.

 

The hospitals refused to give us the invoices. We didn't have the time or inclination to sue them for that information, which surely we are entitled to.

 

I wasn't trying to suggest that the consumer was at fault for not inspecting the bill. This information should be readily available.

[NicksMama-Zack's Mama Too]

This could vary by state. I know for certain in our state that you can only change insurance at your job (sign up, drop, change plan choices, etc...) at the yearly enrollment OR in the case of a qualifying event. Qualifying events are things like job loss for either spouse, birth of a child, etc... An illness would not be a qualifying event and a person wouldn't be able to get back on company insurance until the next plan change time.

 

I just wanted to clarify that for any that read this thread and think that's an alternative. Check with human resources before you make a change.

 

We thought about dropping family coverage, but found out getting reinstated into the company's group plan would be next to impossible. I wish my dh's employer would offer HSA's, but they have a business interest in the health insurance company.:confused:

[genie]

That's not how it works here. If you pay cash for any medical treatment, including dental, you pay a lot more than insured people do.

 

 

 

I'm not sure if you are referring to just the copays or what, but here is an example of what I mean. I once took my daughter to a new pediatrician for an initial consultation. When the doctor found out we were self-pay, he "coded" the visit as an exam because it would be cheaper. So instead of something like $120, it was only $85. Now, people with copays may have only paid $10 - $30 for that visit, but they are also paying hundreds more per month for their insurance. So when you add the two together I pay much less.

 

Also, my daughter has had to go to some doctors visits that wouldn't be covered at all under most insurance plans. But even at $200 per visit, since she only goes at most once a month, that's still way less than what full insurance would have cost us for the month, and we still would have had to pay for the visit.

 

I understand all situations are different. My only point in this post is to explain what I meant because I'm not sure if I was being very clear before.

[Mama Lynx]

We have been extremely happy with Aetna. We paid less than $400 a month for a family of six. Our deductible was a bit high - I think something like $2000 per person, or $2000 per family, can't remember which. However, doctor visits were covered with a reasonable copay. Preventive health was covered. Emergency visits were covered. They paid quickly, and had *excellent* customer service.

 

We left them because my dh took a job with a company that has employer-provided insurance; we pay $115 a month for our contribution.

 

FYI: In Texas, we had a high-deductible, catastrophic health policy. Our doctors always gave us the cash discount, because we pretty much had to pay everything out of pocket.

[elegantlion]

We are self-employed and without insurance. We pay out of pocket for necessary expenses. We have found that even on bad years we'd pay less than insurance premiums. We're hoping to have some hospitialization insurance this year, but our budget hasn't allowed it in the last few years.

 

We are fairly healthy outside of a few issues. I'm not even sure I could get insured as I am a cancer survivor (14 years, yeah!). Where we used to live we had a wonderful doctor who gave us a nice discount for self payment. Here we have a no nonsense doctor who has been great for dh.

[Kari C in SC]

Well that was part of it for us also. The most likely scenario for us at our age in excellent health is that our catastrophic event would involve a car accident. We're insured for that.

 

Do your kids play outside? I am not trying to be rude... seriously, my dd has had two injuries just playing, being a kid. Her first was jabbing her scooter handle way up into her chin. Not pretty or fun. Her second was just this year - she crushed her ankle on her cousins' trampolene. She was in the hospital for 4 days and had to have her ankle rebuilt. Then she had numerous xrays and appointments for the next 4 months and finally another surgery to remove the hardware in her ankle. I have no idea what all of this cost. We were lucky enough to have her on Florida Healthy Kids and they have covered it even though we were out of state. Our Healthy Kids insurance was up at the end of May. I put my kids and I on United Health Care with a $2500 deductable. It costs $334 a month for me and 3 kids. My dh has health insurance through his work. His work insurance was too expensive for the rest of us, but his is paid for and he is considered uninsurable if we tried to get our own coverage. Again, I am not trying to mean, rude or condescending in any way. I am just really paranoid that one of my kids will get another injury from just playing. Part of me hates spending that $334 this month, but I keep telling myself it is a good safety net to have.

[beansprouts]

Do your kids play outside? I am not trying to be rude... seriously, my dd has had two injuries just playing, being a kid. Her first was jabbing her scooter handle way up into her chin. Not pretty or fun. Her second was just this year - she crushed her ankle on her cousins' trampolene. She was in the hospital for 4 days and had to have her ankle rebuilt...

 

Fair question. I wish I knew what the bill would be for this kind of event, it would definitely help. I know my daughter's stitches cost about $500. I think the most common ER visits will be in this range. On a quick search it looks like a broken leg can cost $50,000 but I don't know what is included in that bill, nor do I know how much I would have to pay in co-pays. (i.e. the $50 per visit for physical therapy which we couldn't afford with our health plan...) It is possible that we would be worse off with insurance.

 

As I see it we are saving $12,000 a year in an account to cover events like these. In less than five years we could pay the bill outright. Otherwise hospitals will work out payment plans. Even if we end up paying off the bill in increments of $800 - $1000 per month for a while, I don't think it will ruin us. I would rather pay up fair and square as things happen than continue making "fear" payments. (It almost feels like extortion.) Injuries like these do not happen often, and sometimes never - even with active kids like ours ;)

[genie]

 

(It almost feels like extortion.)

 

It does, doesn't it!! :cursing:

[Doran]

Fair question. I wish I knew what the bill would be for this kind of event, it would definitely help. I know my daughter's stitches cost about $500. I think the most common ER visits will be in this range. On a quick search it looks like a broken leg can cost $50,000 but I don't know what is included in that bill, nor do I know how much I would have to pay in co-pays. (i.e. the $50 per visit for physical therapy which we couldn't afford with our health plan...) It is possible that we would be worse off with insurance.

 

As I see it we are saving $12,000 a year in an account to cover events like these. In less than five years we could pay the bill outright. Otherwise hospitals will work out payment plans. Even if we end up paying off the bill in increments of $800 - $1000 per month for a while, I don't think it will ruin us. I would rather pay up fair and square as things happen than continue making "fear" payments. (It almost feels like extortion.) Injuries like these do not happen often, and sometimes never - even with active kids like ours ;)

 

 

While I realize I am not an 83 year old man, I have been witness to some of the bills my parents have to manage after extended hospital stays by my father. The costs are staggering, to the point that I know we would be ruined should we have to pay for something catastrophic. But, like you, the whole system makes me angry (and that's no way to live), because I feel as if I don't really have a choice. Extortion is a good word for it.

 

For your purposes, beansprouts, this site might prove to have some useful links. I think i wish I'd found it before we made our switch.

[Doran]

Was only mis-routed once, and was only on hold for maybe 5 minutes total. Phew! :001_smile:

 

I learned that (1) they are expecting a rate increase at the first of July and that (2) the increase will not affect our policy. I also learned that there is generally an increase annually, in January. When I asked whether there was any target as to what amount the increase might be, the rep. said, "No."

 

So...good news...and bad news.

[beansprouts]

While I realize I am not an 83 year old man, I have been witness to some of the bills my parents have to manage after extended hospital stays by my father.

 

I am 35 and dh is 38, we are a few years from 83 ;) As our health situation changes we will re-evaluate. Perhaps by the time we need insurance we will no longer be covering for a family of five.

[beansprouts]

Excellent link, Doran! I have bookmarked it for future reference.

[Sharon H in IL]

Excellent link, Doran! I have bookmarked it for future reference.

 

You might prefer to save it to a document. Newspapers don't keep their articles on their websites indefinitely. Wouldn't want to lose all this excellent info.