Health Insurance Changes

[Georgiana Daniels]

Today we got the benefits package for our health insurance and now I'm concerned and a little upset.

 

We've always had the low-cost/high-deductible plan, which was fine because once the out-of-pocket max was reached the plan would cover at 100%. But now they've done away with it.

 

The new plans offer NOTHING in the way of 100% coverage in the event of a catastrophe. Our premiums stay about the same, but the deductible and out-of-pocket max both went way up. For our family, the insurance won't kick in until $8000, and then will only cover 80%, not 100%.

 

Is anyone else experiencing a crappy surprise with their coverage changes this October? :confused:

[QueenCat]

Today we got the benefits package for our health insurance and now I'm concerned and a little upset.

 

We've always had the low-cost/high-deductible plan, which was fine because once the out-of-pocket max was reached the plan would cover at 100%. But now they've done away with it.

 

The new plans offer NOTHING in the way of 100% coverage in the event of a catastrophe. Our premiums stay about the same, but the deductible and out-of-pocket max both went way up. For our family, the insurance won't kick in until $8000, and then will only cover 80%, not 100%.

 

Is anyone else experiencing a crappy surprise with their coverage changes this October? :confused:

 

That isn't fun at all. We just got ours, no changes in premiums or with deductibles/coverage. Well, some of the female stuff is no longer part of the deductible but that's good. Federal law requires those things to be covered at 100%, so at least you'll be able to meet those things without worry. Included are annual well woman exams, pap, contraception and mammogram.

[littlebug42]

Ours hasn't changed but I expect it to change any time. I predict that those of us with good insurance are going to be on the losing end of the Affordable Health Care Act. The money to pay for all of it has to come from somewhere and the insurance companies are not going to want to lose their profits either.

[tabrizia]

We just changed insurance since DH recently switched jobs. We were going to go for the high deductible plan again since the one we had through DH's old huge company was fairly good. Yeah we are back on a regular PPO plan, because the high deductible plan at DH's new office is not a viable option for anyone on the family plan. We know that we have a ton of medical appointments for DS in the upcoming year, so that adds into it, but even if we didn't it is not a good choice, which is annoying since the monthly cost is significantly less then the option we chose, though not when deductible and total out of pocket costs are added in.

[QueenCat]

Ours hasn't changed but I expect it to change any time. I predict that those of us with good insurance are going to be on the losing end of the Affordable Health Care Act. The money to pay for all of it has to come from somewhere and the insurance companies are not going to want to lose their profits either.

 

We have excellent insurance. We are not having any changes in premiums, deductibles, coverage for 2013. Except the few things added outside of the deductible, at 100% coverage, due to the AHCA.

[Joker]

Ours is changing as well. I don't want to get political, but the first line said it was due to the Affordable Health Care Act. Dh has had this job for 13 years and we've always had great insurance, until now. One dd's asthma and allergy meds will go from costing us $20/month to $80/month. They also won't be paying 100% even after deductibles are met, and the deductibles are going up considerably. It's gonna hurt us a lot.

[Paula in MS]

Everyone I have spoken to over the past couple of weeks has told me their deductibles are doubling (no matter where they started.). Ours is also doubling. The amount we paid for prescriptions is also doubling, although we have a good prescription plan. (Going from $5 per prescription to $10 is better than most). I really hate this considering we have to pay dental completely out of pocket due to the outrageous dental insurance premiums.

 

I broke my wrist last month and had to have outpatient surgery to set with pins and plates. I could not believe how much the Non-discounted charges were. (We are up to $50,000 so far.). Really, it was laughable. A broken wrist and a one hour out- patient surgery. Of course, the insurance "writes off" most of that before they pay, but still....$2500 for an ER visit and temporary set? Really?

 

Sorry, ranting. When you have a family full of healthy people, it is a shocker when you have a real accident. Glad we had the insurance. Even though we are rarely sick, it really comes in handy for those broken wrists.:D. I really feel for those families with $1000 deductibles and lots of health problems. Sad.

[Lisbeth]

Ours is changing as well. I don't want to get political, but the first line said it was due to the Affordable Health Care Act. Dh has had this job for 13 years and we've always had great insurance, until now. One dd's asthma and allergy meds will go from costing us $20/month to $80/month. They also won't be paying 100% even after deductibles are met, and the deductibles are going up considerably. It's gonna hurt us a lot.

 

Yes, I have heard this from so many friends. Expect it to get much worse unless the "Affordable HC Act" is killed. It was so frustratingly predictable. :(

[Pawz4me]

Our insurance costs have been steadily (and sometimes dramatically) rising every year for a decade or more. We haven't found out yet about this year's increase, but we certainly expect one. And because of the history of rising insurance costs, we certainly won't be blaming it on the Affordable Health Care Act.

Edited October 16, 2012 by Pawz4me

[Georgiana Daniels]

We have excellent insurance. We are not having any changes in premiums, deductibles, coverage for 2013. Except the few things added outside of the deductible, at 100% coverage, due to the AHCA.

 

 

Count yourself lucky. :)

 

I desperately wish ours stayed as it was.

[Georgiana Daniels]

Yes, I have heard this from so many friends. Expect it to get much worse unless the "Affordable HC Act" is killed. It was so frustratingly predictable. :(

 

The sad thing is, even if it is killed I don't see prices going back down. Once they rise, that's it.

[QueenCat]

Count yourself lucky. :)

 

I desperately wish ours stayed as it was.

 

I do... but outside of people I meet here, I see many people who are not experiencing huge negative changes. Most people seem to be happier with their coverage, in my neck of the woods... but I know a lot of people who have young adults who are benefiting, so that may be a big part of it.

[NoPlaceLikeHome]

Our insurance costs have been steadily (and sometimes dramatically) rising every year for a decade or more. We haven't found out yet about this year's increase, but we certainly expect one. And because of the history of rising insurance costs, we certainly won't be blaming it on the Affordable Health Care Act.

 

:iagree:Totally. Our family has until recently experienced big increases in premiums and less coverage for health care going back over the past 20 years. I recall the CEO of the hospital telling us employees that the hospital's employee health insurance premiums were going up 20 to 50% every year, which why our premiums and plans got worse every year in the 1990s.

 

This sort of thing is not new at all and why we need the Affordable Healthcare Act.

[Joker]

If our premiums and costs had been steadily rising over the past several years, I also wouldn't blame the ACHA. That hasn't been our experience, though. Maybe it's because dh has been with the same employer for more than 13 years, but our premiums haven't ever risen that much and our copays have gone from $25 to $35~but that's over the past 13 years. Our Rx have remained rather steady until this next year.

 

FTR, there are many things I like about the ACHA. I especially am glad for the pre-existing condition changes since both of my dds would have trouble. I'm still upset at the cost increases happening this next year that dh's employer says is in response to the ACHA, though. I have no reason to doubt their claims since they've always offered great coverage until now.

[MSNative]

We just got our insurance info. Very similar to your experience, OP. Premiums doubled, deductible almost doubled, etc. I had expected this. I was surprised that our allowed FSA contributions were cut in half. Our paperwork said this was because of the affordable care act. That was a big bummer for us. We usually pick the low premium/high deductible option and sock as much as possible in our FSA. We use it all each year. So, this year we will pay much more and will have much less in our tax free account. :(

[NoPlaceLikeHome]

If our premiums and costs had been steadily rising over the past several years, I also wouldn't blame the ACHA. That hasn't been our experience, though. Maybe it's because dh has been with the same employer for more than 13 years, but our premiums haven't ever risen that much and our copays have gone from $25 to $35~but that's over the past 13 years. Our Rx have remained rather steady until this next year.

 

FTR, there are many things I like about the ACHA. I especially am glad for the pre-existing condition changes since both of my dds would have trouble. I'm still upset at the cost increases happening this next year that dh's employer says is in response to the ACHA, though. I have no reason to doubt their claims since they've always offered great coverage until now.

 

Yes, it is possible that the premiums you paid as an employee did not go up but I am willing to bet that the employer's share of the same health care premiums went up every year and that these costs were not passed on to employees in your case.

[TranquilMind]

Today we got the benefits package for our health insurance and now I'm concerned and a little upset.

 

We've always had the low-cost/high-deductible plan, which was fine because once the out-of-pocket max was reached the plan would cover at 100%. But now they've done away with it.

 

The new plans offer NOTHING in the way of 100% coverage in the event of a catastrophe. Our premiums stay about the same, but the deductible and out-of-pocket max both went way up. For our family, the insurance won't kick in until $8000, and then will only cover 80%, not 100%.

 

Is anyone else experiencing a crappy surprise with their coverage changes this October? :confused:

 

We had our crappy surprise in April. All insurance is now is a discount up front if you have a known name, like Anthem. After that, you had better not have anything serious or you'd better have loads of cash.

 

Thanks, Obamacare! They set this in motion in anticipation of this, but perhaps it would have happened anyway. It's really a travesty. We need to close insurance companies.

[Joker]

Yes, it is possible that the premiums you paid as an employee did not go up but I am willing to bet that the employer paid increases every year that were not passed on to employees.

 

We receive a detailed statement every year before open enrollment that states what the employer paid out. I'm also aware of that cost when signing up because it's all online and available for employees to view. The costs have never risen as much as they are this year, and they're rising for a plan that's worse than any offered in the last 13 years.

[Georgiana Daniels]

My dh has been with the same employer for 7 years and out cvg has been nearly idetical year to year. Our premiums are almost identical this year, but the coverage is so much worse. I'm particularly worried about losing that 100% coverage after meeting the deductible. That's what saved our hides when I had my appendix out a few years ago.

 

I'm frightened. A small operation like that would bury is in 2013.

[mellifera33]

Our premiums "only" went up about 15%, but our deductible doubled--it is now $3000 per person. We found this out a week after we found that that we're expecting. :glare:

[TranquilMind]

The sad thing is, even if it is killed I don't see prices going back down. Once they rise, that's it.

 

Absolutely. Nothing ever goes down, only up.

 

(Except my rental amounts and property values....what's up with that?:confused:)

[Mommyof4ks]

We still have our high deductible plan this year, but The Affordable Care Act is doing away with those, so 2013 might be our last year with it. That plan kept us from bankruptcy when my son got cancer, so I seriously hope we do not get sick after next year. Sigh.

[stripe]

I have no idea why decent health care is considered some sort of luxury. It is unbelievable expensive and incredibly important.

 

I really feel for those families with $1000 deductibles and lots of health problems. Sad.

I don't. I wish I had a $1000 deductible.

 

Lots of uninsured and underinsured members of this forum wish they had the healthcare plans many people on here are complaining about, and THAT is what the Affordable Health Care Act was designed to address. The millions of Americans with nothing. Big fat nothing.

[justamouse]

It's a nightmare. :grouphug:

[staceyobu]

Why does the AHCA drive up costs?

[TranquilMind]

:iagree:Totally. Our family has until recently experienced big increases in premiums and less coverage for health care going back over the past 20 years. I recall the CEO of the hospital telling us employees that the hospital's employee health insurance premiums were going up 20 to 50% every year, which why our premiums and plans got worse every year in the 1990s.

 

This sort of thing is not new at all and why we need the Affordable Healthcare Act.

 

We had the same insurance through all that time. Our premiums did not rise appreciably during this time, nor were our coverages slashed.

 

This is simply not in the same league as what is going on now.

[QueenCat]

Why does the AHCA drive up costs?

 

From everything I've read, it'll drive up in the short run, out of fear among other factors, and then stabilize & go down some as more are covered. I'll try to find the articles I'd read on this a while back. Probably not tonight though.

[Momof3littles]

At a former employer of Dh's, we had a cadillac plan, essentially. Dh left that position years ago, but we still have friends there. They now pay a lot OOP for their premiums, and that started waaaay before the ACA went into effect. The employee contribution has been steadily rising for years...about a decade, and was high pre-ACA.

 

We pay OOP for a high deductible plan as DH's employer plan is rather expensive. They are a small business. FWIW, the premiums at his employer dropped and are more manageable now than they have been the last few years. We are still sticking with our private higher deductible plan (6k deductible for the whole family, not per person). The cost went up a minimal amount this year as compared to last year.

 

These changes have been going on long before the enactment of the ACA, IMO. Some employers didn't pass all of the increases on to employees, but as the costs have risen each year, eventually many companies have come to expect a greater contribution from employees.

 

We did get a 600 refund from our insurer as part of the ACA.

Edited October 16, 2012 by Momof3littles

[Karen in CO]

Our insurance costs have been steadily (and sometimes dramatically) rising every year for a decade or more. We haven't found out yet about this year's increase, but we certainly expect one. And because of the history of rising insurance costs, we certainly won't be blaming it on the Affordable Health Care Act.

 

Indeed. Over the past decade to cut costs, our insurance switched prescription coverage to a different system. The medicines we use monthly have changed from a $5 or $10 copay to a $40 copay because they weren't on the preferred list. My dd's epi pens are a $50 copay. That is crazy. My migraine medicine is a $40 copay every month this year but was only $20 last year. Generics are $5, but that doesn't help me at all. I'm expecting more of the same, but we don't get to see our changes until Oct 19th. It is always a fun time of year when I have two weeks to compare my and dh's medical plans and see which is better and which covers what and who snuck in excessive costs for us somewhere we didn't expect.

[NicksMama-Zack's Mama Too]

I wonder how an insurance company can absorb the costs of all these 19 to 26 year old "children" who are on their parents insurance without some sort of increase in premiums? Does anyone know?

 

IRL I know business owners who's insurance has gone up by 30% every year for the last two or three years. They've had to switch to affordable plans (higher co-pays, higher deductibles) and have decided to have their employees that want to keep the old, expensive insurance to pay the increases. Business is slow and they can't afford to keep absorbing the increases as they had in year's past.

[QueenCat]

I wonder how an insurance company can absorb the costs of all these 19 to 26 year old "children" who are on their parents insurance without some sort of increase in premiums? Does anyone know?

 

Many of those were already covered, as they were in school. Most insurances cover students until 22/23. From what I understand, the employer can charge extra for the non-student but it is still likely to be cheaper for the young adult than trying to get their own plan (they are at the highest risk for not having an employer based plan available, which is why this was included in the AHCA). Thankfully, dh's company won't charge extra for the young adults.

[Pawz4me]

I wonder how an insurance company can absorb the costs of all these 19 to 26 year old "children" who are on their parents insurance without some sort of increase in premiums? Does anyone know?

 

They aren't on their parents' insurance for free. The parents (or their employers) will be paying for family coverage, just as they did when those kids were younger. The ACA just raises the age limit for kids remaining on their parents' coverage.

 

And in theory those young people will bring down the cost of insurance for everyone. They're generally a healthy group that doesn't require a lot of medical services. They're exactly the sort of people insurance companies want to insure, because that age demographic helps them make money. And since the ACA sets limits on the percentage of premiums that must go to patient care (or, in other words, it caps the amount of profit an insurance company can make), having more insured healthy young people should reduce costs for all because a good chunk of the premiums paid for them will go to cover the cost of care for older and/or less healthy people. Or that's my very simplified understanding of how it works.

Edited October 16, 2012 by Pawz4me

[Renee in NC]

We still have our high deductible plan this year, but The Affordable Care Act is doing away with those, so 2013 might be our last year with it. That plan kept us from bankruptcy when my son got cancer, so I seriously hope we do not get sick after next year. Sigh.

 

Do you have a source for this? From what I have read, the only difference is that NEW (after 2010) high deductible plans will be required to cover preventative care at 100% with no deductible. Mine does that already.

[creekland]

:grouphug: Reading through this thread makes me feel really, really glad that we switched to a health sharing program (not insurance) many, many moons ago. Otherwise, we'd be in the same position. Even teachers at school are having to pay more for less coverage than before - for some of them - amazingly more depending upon their circumstances.

 

I wish someone would truly fix healthcare. What it's been "fixed" with now is not it IMO.

[happyhomemaker25]

My mom is retired from an insurance company. She still has a year before she can go on Medicaid. She just found out her premiums went up almost $100 and her deductible is sky high now. She's on a fixed income so this is a real kick in the seat for her. She also has a lot of health problems.

[Night Elf]

Oh my. I'm so glad our health insurance isn't increasing. DH works for HP and they announced they were going to absorb the increases. They must be doing that anyway because our plan has been the same for as many years as I can think about. He doesn't think our plan is changing but they only released the information yesterday and he hasn't yet spent time online looking at the coverage. He says we do pay what he considers alot for premiums, but our coverage has always been top notch. I'll admit though that we are very happy that we can keep dd20 on our policy even without her being in school.

[NicksMama-Zack's Mama Too]

They aren't on their parents' insurance for free. The parents (or their employers) will be paying for family coverage, just as they did when those kids were younger. The ACA just raises the age limit for kids remaining on their parents' coverage.

 

And in theory those young people will bring down the cost of insurance for everyone. They're generally a healthy group that doesn't require a lot of medical services. They're exactly the sort of people insurance companies want to insure, because that age demographic helps them make money. And since the ACA sets limits on the percentage of premiums that must go to patient care (or, in other words, it caps the amount of profit an insurance company can make), having more insured healthy young people should reduce costs for all because a good chunk of the premiums paid for them will go to cover the cost of care for older and/or less healthy people. Or that's my very simplified understanding of how it works.

 

This is something I've never understood. Families with 2 children pay the same premium as families with ten children. If adding 19-26 years costs nothing extra to those already paying "family" premiums, then where are the "premiums paid for them" coming from?

[Pawz4me]

This is something I've never understood. Families with 2 children pay the same premium as families with ten children. If adding 19-26 years costs nothing extra to those already paying "family" premiums' date=' then where are the "premiums paid for them" coming from?[/quote']

 

That's not how it's done through DH's employer. There are tiers based on total family size. So a family of ten pays considerably more than a family of four. They're self-insured, though, so that might make a difference.

[Jenny in GA]

I haven't read the other replies, but in June we had a craptastic change.

 

Our monthly premium went up to $1,400. Oh, and our co-pay went up to $75. Co-pays don't count toward the deductible.

 

I have a serious chronic illness, so it is literally impossible for us to shop for other health insurance options. Plus we sometimes have as many as three doctor visits a week. A $75 co-pay on top of $1400/month is really killing us.

 

It makes me so angry. We can't save for kids' college, can't take vacations, can't hire a babysitter, are driving cars that are over ten years old ... just because our routine health care is so expensive.

 

And there's nothing we can do about it.

[Leav97]

This is something I've never understood. Families with 2 children pay the same premium as families with ten children. If adding 19-26 years costs nothing extra to those already paying "family" premiums' date=' then where are the "premiums paid for them" coming from?[/quote']

 

The average family has ~2.5 kids. Imagine paying for a family plan for an extra 7 years. That's the difference. At my work the family plan cost about twice as much as the employee + spouse plan.

[Kathryn]

Our premiums are increasing almost 20%. Deductibles and out-of-pocket maximums are doubling. We used to be able to "earn" money off of our pre-tax premiums by having physicals and filling out health progress reports and stuff online. Now, doing those same things will get us a taxable gift card.

[QueenCat]

That's not how it's done through DH's employer. There are tiers based on total family size. So a family of ten pays considerably more than a family of four. They're self-insured, though, so that might make a difference.

 

I would imagine being self-insured does make a difference with that. Every company dh has worked for has either "employee only", employee/spouse, or employee/spouse/all children or employee/all children. Same cost for one kid as for 10.

[ktgrok]

Our insurance costs have been steadily (and sometimes dramatically) rising every year for a decade or more. We haven't found out yet about this year's increase, but we certainly expect one. And because of the history of rising insurance costs, we certainly won't be blaming it on the Affordable Health Care Act.

 

:iagree:

[QueenCat]

The average family has ~2.5 kids. Imagine paying for a family plan for an extra 7 years. That's the difference. At my work the family plan cost about twice as much as the employee + spouse plan.

 

Wow, the worst difference I ever saw with anyone dh worked for was about 25%. But you don't have to choose to keep the kids on your plan when they are young adults. It is merely an option for you. We will choose to do it as it in the best interest of our young adult children to have insurance.

[ktgrok]

They aren't on their parents' insurance for free. The parents (or their employers) will be paying for family coverage, just as they did when those kids were younger. The ACA just raises the age limit for kids remaining on their parents' coverage.

 

And in theory those young people will bring down the cost of insurance for everyone. They're generally a healthy group that doesn't require a lot of medical services. They're exactly the sort of people insurance companies want to insure, because that age demographic helps them make money. And since the ACA sets limits on the percentage of premiums that must go to patient care (or, in other words, it caps the amount of profit an insurance company can make), having more insured healthy young people should reduce costs for all because a good chunk of the premiums paid for them will go to cover the cost of care for older and/or less healthy people. Or that's my very simplified understanding of how it works.

 

:iagree:

[Leav97]

Wow, the worst difference I ever saw with anyone dh worked for was about 25%. But you don't have to choose to keep the kids on your plan when they are young adults. It is merely an option for you. We will choose to do it as it in the best interest of our young adult children to have insurance.

 

Well, my plan at work is heavily subsidized by my employer. Small amounts of money can make a large percentage.

[QueenCat]

Well, my plan at work is heavily subsidized by my employer. Small amounts of money can make a large percentage.

 

True but then you are not normally looking at large amounts of money.

[Leav97]

True but then you are not normally looking at large amounts of money.

 

It's still payed by someone. The insurance plans offered end up costing about $20,000/employee. Even if a lot of the cost isn't handed down to the employee the cost remain. And then you start thinking about deductibles, out of pocket maximums, co-pays, HSA, FSA. Yeah the costs never end even if the employer is picking up a huge chunk.

[DianeW88]

Yes, I have heard this from so many friends. Expect it to get much worse unless the "Affordable HC Act" is killed. It was so frustratingly predictable. :(

 

:iagree: Many of the employees at my husband's company are hourly workers. Their hours will now be reduced to less than 30 per week so that the company does not have to pay for their health coverage. It is SERIOUSLY going to hurt these families. And many other companies will do the exact same thing.

[southcarolinamom]

My BCBS personal health insurance coverage for myself and 2 children went up 10% starting this month to $373. I can't do anything else to tweak my coverage, i.e. raise the deductible or raise the out of pocket limit. I'm already at the top of that tier -- $5000 out of pocket deductible per person. It totally stinks.