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Freaking health insurance costs


Moxie
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We got the numbers for 2015 today. I could buy a second house for less, literally. So, with 3 weeks left in the year, how do I make an informed decision and switch?? Effing insurance.

 

Yikes!  We got an amazing deal on our second home (like DH and I seriously prayed for the sellers because we figured they must have something really bad in their lives to be selling at about a quarter of market value) but it was still a little over $200,000.  I can't imagine paying that for insurance! 

 

I presume that you have already checked out the insurance exchange for your state but if for some reason you haven't you could start there.  Some on the forum have reported amazing rates and deals so it is worth looking at if you haven't.  I checked last year just so we would have all the information to make an informed decision.  In our case, continuing with covering the family through the plan DH carries for his employees was definitely cheaper than going through the exchange but DH has worked a bit with the carrier to carve out a good plan.  We also cover the whole family on my insurance through the hospital I work for because it is essentially free coverage. It is also good coverage in some senses with a very low deductible and no coinsurance or copay. Unfortunately it is also a plan with a very limited network and essentially no out of network coverage so it is great for routine things but it doesn't cover some of the specialists our kids see.  That is where we depend on DH's plan which also reimburses us the majority of the costs for the pediatrician who no longer takes any commercial plans.

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Are you asking where to look or what kind of coverage you should be looking for?

 

We discovered that our state's health insurance exchange had little information; better rates were available through contacting different insurance groups directly. I'm not sure *why* that is true, but it is.

 

Some of the weird loops we've discovered in comparing plans:

*having a co-insurance amount on top of co-pays (ie $500 copay for ER visits + 40% total cost of trip up to max out

*very high maximum limits

*weird limits to coverage (OT only for injury or certain conditions diagnosable from birth injury)

*small networks

*odd rules as to when labs fall into an office visit versus when they hit the co-insurance

*very differing amounts for co-pays for drugs, convoluted rules for when you must use mail order medicines, co-pays for meds higher than cash cost at pharmacy

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Yikes!  We got an amazing deal on our second home (like DH and I seriously prayed for the sellers because we figured they must have something really bad in their lives to be selling at about a quarter of market value) but it was still a little over $200,000.  I can't imagine paying that for insurance! 

 

 

 

I think Moxie is in the midwest. House prices are probably a little subdued there compared to...

 

1. Keep a higher deductible and see if you can sign up for FHSA to cover smaller bills like doctor visits

2. Check out one of those community pool organizations like Samaritan's.   http://samaritanministries.org/

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We just had to switch insurance very unexpectedly.  I found the best policy for us was to go to the company directly and purchase an off market plan.  We know as a family that we are going to go to X doctors and X specialists each year up front.  DD2 and myself have high medical needs, and DD2 in particular has an out of state provider with a specific recurring charge once or twice a year.  Therefore we know that for our family, a high deductible, HSA plan works well for us and we just have to budget for it.  Of course, we had to make sure the plan we picked met our needs, and included the specific providers and covered her specialty charges which are often not spelled out.   

 

Reality is that insurance companies would not insure us if they had a choice.  

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Yeah, which is why this totally sucks. I'm supposed to research all our options in 12 hours?!?

 

:grouphug:  That's so little time! I'd focus on the high deductible plans. Even though we have high medical costs, it's still less expensive than traditional plans. We budget assuming we're going to hit the maximum out of pockets. The traditional plans are priced to be unaffordable in my experience.

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What does your state offer? Is state insurance available for your kids? What about you and your husband? You may qualify for the government subsidies too.

Luckily? Sadly? we're evil rich people (ha!!) so we just get to pay for it.

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If you currently have an ObamaCare policy on the exchange in your state, they suggest NOT just clicking to renew the policy. There may be a better plan available for you on the exchange, at the same price or lower. So, check on the exchange to see if something better is available to you now.

 

Also, if I was in your shoes, with the time pressure, I would call an Independent Insurance Broker and ask for his/her ideas.

 

Depending on the decision of the U.S. Supreme Court during June 2015, this issue may go away, but, then again, it may not. It will depend upon their decision.

 

 GL!

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I am so sorry, Moxie. Insurance is a dreadful thing - so expensive, yet not to have coverage can be devastating. We have watched ours creep up over the years. It's part of dh's compensation package and they have crazy formulas for coverage combinations. Every year of the last five he's had to sell vacation days for increased cost to not cut into take-home pay. Now he sells a whole week. 😣

 

I hope you are able to get some good advice and get choices made by the deadline.

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I am having a meltdown here over insurance. Cobra is $1300 a month. We are running out of our 60 days and our application has been rejected due to changes in the cobra company. we have mounting bills and if we don't get coverage we may end up with preexisting clauses. I have heard of terrible networks for Covered CA so don't want to use that. We have that Dec 15 date looming. If we miss it we are uninsured until February 1. Covered CA is also $1300 with better coverage but that is useless if we can't see any local Drs.

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We got the numbers for 2015 today. I could buy a second house for less, literally. So, with 3 weeks left in the year, how do I make an informed decision and switch?? Effing insurance.

 

We spend roughly double what our house payment is on insurance. And it's really crappy insurance. :(

 

ETA: But our house payment is pretty low. Low cost of living area. But still.

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If you live in VA you need to try to resolve this tomorrow. I just finished watching the 6 P.M. news. 300-400K people in VA are having their coverage cancelled. Or, is it 300-400K families? The deadline is next Monday night at Midnight. Again, I suggest contacting an Independent Insurance Agent, Friday morning.   GL

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We are on the exchange, hired a broker to analyze plans for us, and still ended up with a 2 hour wrestling match with the website and a monthly bill of $1000 for "bronze" (bare bones) coverage.

 

Hooray for "affordable care" (<--- sarcasm)

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We are on the exchange, hired a broker to analyze plans for us, and still ended up with a 2 hour wrestling match with the website and a monthly bill of $1000 for "bronze" (bare bones) coverage.

 

Hooray for "affordable care" (<--- sarcasm)

 

Even with bare-bones coverage you still pay for medical care in addition to monthly premiums. No, health care is not affordable. 

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Get a catastrophic plan and a health savings account?

 

A lot of these plans went away with the ACA for not meeting specific criteria. That's been a real problem because a lot of people purchased these at low premium and the budgeted heavily for medical costs. For those that could afford to meet a $10,000 bill, this worked well.

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A lot of these plans went away with the ACA for not meeting specific criteria. That's been a real problem because a lot of people purchased these at low premium and the budgeted heavily for medical costs. For those that could afford to meet a $10,000 bill, this worked well.

Oh yeah, dh's HSA went away with the ACA. Thank goodness we got three out of four kids through braces with before then.

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:grouphug:  For many of you.  I wish there were better options as reading this thread makes my head spin - or for the visual -  :banghead: .

 

I still have to recommend having something vs nothing based upon our experience and that of some close friends.  I wish there were more good non-profit options that worked for everyone.

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It's part of dh's compensation package and they have crazy formulas for coverage combinations. Every year of the last five he's had to sell vacation days for increased cost to not cut into take-home pay. Now he sells a whole week. 😣

Man, I wish my DH's company did this. He has tons of vacation that they don't want him to take, anyhow.

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I don't understand why you had such little notice of open enrollment. In my area there was heavy advertising that open enrollment started on Nov 15th. I just logged on to the website and reviewed all my current options. I did spend a week or two going over those options and ended up dropping down a level to keep more money in my pocket. Dh sees specialists who do not take insurance. After numerous phone calls to confirm that prescriptions and lab work would be covered regardless of who orders as long as the service is filled at a participating vendor I was able to choose something.

The reality for us is that without the aca we would not be able to get any kind of insurance. It is less expensive then cobra

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