ScoutTN Posted November 17, 2015 Share Posted November 17, 2015 Ours only went up a very small amount this year, but we had a large increase last year. We have good coverage through Dh's work. Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted November 17, 2015 Share Posted November 17, 2015 Ours changed but not because of ACA. The company that had the contract since I met dh in 1992, lost it to another company* this year. He works for a civilian contractor on a U.S. Air Force base. We had a decent Aetna PPO plan. Though the premium was on the high side, it was affordable, and we had straight co-pays (no deductible) and quite a few providers available. The union negotiated each year to keep the same plan and kept the costs fairly low. There was also an HMO option with a local (and hated by many) insurance provider. We stayed with Aetna. The company that now has the contract also offers the hated local provider, but the PPO they offer is through Cigna. We chose a Cigna "buy-up" plan that has a higher premium than the basic plan but better coverage and still no deductible. Dh and ds both have regular monthly prescriptions and I see a pain management specialist for my back, so we do use our insurance regularly. Ds, with his adhd is required to have regular re-evals in order to keep getting his prescription for adhd meds. The premium is a bit lower than it was with Aetna, the co-pays are higher, and the coverage is a mix. Some things that were covered by Aetna are not covered by our Cigna plan and vice versa. What concerns me is dh's plan to retire in 2 years. He'll be eligible for Medicare but I won't, so I'll need some sort of gap years coverage. Also, ds will need to find something. As long as dh is working ds can stay on our insurance until he turns 26 thanks to ACA. Hopefully ds will qualify for a low cost plan. I expect he'll still have 1-2 years of college left at that time, so he likely won't be working full time or working for a company that provides insurance to part time employees. *They laid off nearly 80% of the old company's people and we were concerned that dh would be forced into early retirement. We're fortunate he wasn't so I try not to complain about what is actually decent insurance coverage. Quote Link to comment Share on other sites More sharing options...
Spryte Posted November 17, 2015 Share Posted November 17, 2015 I posted that we only had a 6% increase this year. Maybe I should have elaborated, as last year's increase was 26%. We, and CFO, are happy with the 6% as we feared higher. ATM, DH's company pays for all premiums, and fully funds HSAs to meet the deductibles. After the deductible is met, very few, if any, co-pays. So we are fortunate, but every year it's a nerve wracking time because of course the company could change its mind on providing what they do. I'm sorry this is so stressful for so many. We need a better system. 2 Quote Link to comment Share on other sites More sharing options...
LMV Posted November 17, 2015 Share Posted November 17, 2015 The insurance I have through work is fully funded (i.e.. I don't have to pay a percentage of the premium) and there is not a co-pay for in-network services. There is a $100/individual and $250/family deductible for in network services. The only pitfall is that out of network services are really essentially not covered. So if our family needs anything that can be done at the hospital I work at then it is essentially free. IF we need something done at another hospital there really isn't any coverage. To be fair our hospital has most services, is a trauma center, has a cath lab, stroke center, NICU, PICU etc. They are not a Children's Hospital (but our kids' awesome pediatrician does admit there and they have had what our kids needed when they have needed admission over the past few years) and they are a little low volume on the CV surgery side so if I or DH needed cardiac revascularization then I would want it done elsewhere. There is also the issue that their PCP network is limited to a hospital sponsored FM group about thirty minutes away from the hospital and where we live. So we cover the whole family on my plan because why not? We cover the whole family on DH's insurance as well in case there is a major issue. DH's insurance is a pretty standard commercial PPO plan. There are co-pays and we have a individual/family deductible and a max OOP clause. The plan has a reasonable network (with the exception of our kids' pediatrician we haven't found a physician who won't take this insurance)and also reimburses reasonably for out of network even if one goes out of network purely by choice (i.e. we use a pediatrician who doesn't accept any commercial insurance for our kids). The one really good feature is that they don't subcontract out their prescription coverage and no prior authorization is needed for prescriptions as long as they are written by a MD/DO. Our prescription co-pay is non-tiered as well. Of course, to an extent you pay for what you get and some of this is what DH negotiated for when he set up the insurance in the first place. Quote Link to comment Share on other sites More sharing options...
applethyme Posted November 17, 2015 Share Posted November 17, 2015 Our insurance has pretty much reached the point of being awful and almost useless. I work in healthcare and have worse insurance than most of the patients I see. I pay $280 per month for the privilege of having a high deductible plan with a $5600 deductible, after I reach $5600 out of pocket I then have to pay 20% of all costs until an out of pocket max of $10,000. While that doesn't sound too terrible, the problem we are having is that our insurance company is telling all of our providers to collect 20% at each visit, even though we have met the $10,000 out of pocket max. When called they will only say that they are behind in processing claims. Because I have a medically needy child, I have had to budget and have spent $1000 per month for health expenses. Then my work has decided that they will no long give raises, only every other year market adjustments. At this point I'm not sure I can afford to work anymore at the job that I love. Quote Link to comment Share on other sites More sharing options...
KrissiK Posted November 17, 2015 Share Posted November 17, 2015 Well, dh did change companies (within the same parent company). So, I really can't compare too closely, but the new benefits package tripled our premium, still with a moderately high deductible. We switched to Medi-Share Quote Link to comment Share on other sites More sharing options...
Carrie12345 Posted November 18, 2015 Share Posted November 18, 2015 Our platinum plan upped our deductible and premium last year, but it didn't feel terribly drastic. *This year, it's a bigger increase on both. I'm less than thrilled. (Well, technically our plans "went away" and we had to pick another.) Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted November 18, 2015 Share Posted November 18, 2015 I work in healthcare and have worse insurance than most of the patients I see. My daughter-in-law is a nurse in a hospital and has said pretty much the same thing. Of course the hospital is run by that local company that offers the hated insurance plans I mentioned in my previous post, so it's not surprising. She and the boys are on dss' insurance. Quote Link to comment Share on other sites More sharing options...
madteaparty Posted November 18, 2015 Share Posted November 18, 2015 I don't know what is due to Obamacare or what, but I was very pleased this year at the high deductible plan which has a HSA associated with it. and now HSA $ carries year to year? Good news. Quote Link to comment Share on other sites More sharing options...
madteaparty Posted November 18, 2015 Share Posted November 18, 2015 Our insurance has pretty much reached the point of being awful and almost useless. I work in healthcare and have worse insurance than most of the patients I see. I pay $280 per month for the privilege of having a high deductible plan with a $5600 deductible, after I reach $5600 out of pocket I then have to pay 20% of all costs until an out of pocket max of $10,000. While that doesn't sound too terrible, the problem we are having is that our insurance company is telling all of our providers to collect 20% at each visit, even though we have met the $10,000 out of pocket max. When called they will only say that they are behind in processing claims. Because I have a medically needy child, I have had to budget and have spent $1000 per month for health expenses. Then my work has decided that they will no long give raises, only every other year market adjustments. At this point I'm not sure I can afford to work anymore at the job that I love.My sister and her DH are also in healthcare and their plan is awful, awful. Between that and the high cost of childcare, I dont know how they manage :(Eta that your plan sounds like our high deductible plan (we pay slightly more per month) but because we are fairly healthy knock something, and because of the pretax HSA, I think it's a great deal. I can't believ they continue to take the coinsurance after the out-of-pocket has been met! :( Quote Link to comment Share on other sites More sharing options...
ikslo Posted November 18, 2015 Share Posted November 18, 2015 My company got bought by a UK based company a few years ago, and DH switched over to my insurance. Is going up a bit this year, but great coverage compared to his company's, which gets worse every year. ACA only made things worse for his coworkers. I also get vacation time similar to most European companies. Quote Link to comment Share on other sites More sharing options...
Guest Posted November 18, 2015 Share Posted November 18, 2015 We were priced out of the market such that a Christian health share plan was our best (and only affordable) option. My kids lost their pediatrician due to this move, as we switched to a family doctor who would accept cash pay and give discounts. Being self-employed with a family is not for the faint of heart. This. When our premiums went from $440 a month to upwards of $1700 and actually covered less, with the same deductible? We ditched it flat out. Even thinking about the topic makes me furious. Quote Link to comment Share on other sites More sharing options...
AimeeM Posted November 18, 2015 Share Posted November 18, 2015 A couple years ago we paid nothing out of pocket, premium-wise. Because my husband's company's costs went up, regarding insuring their employees, our costs went up - now we pay about $80/monthly for premiums, for the family. Our deductibles haven't changed at all; we have a family deductible of $400/yearly/medical; max out of pocket for the family is $6,000/yearly/medical; co-insurance after deductibles are met, not "co-pays". Dental deductibles are $75 per person. I hesitated to post this at all because I'm well aware that we are very blessed regarding our healthcare. DH's company is excellent regarding benefits. However, my husband suggested it may be prudent to post even though our numbers are low, it does show the massive increase, percentage-wise, in healthcare costs across the board. Quote Link to comment Share on other sites More sharing options...
Artichoke Posted November 18, 2015 Share Posted November 18, 2015 We have employer provided insurance. Our premiums, co-pays, and deductibles continue to rise each year. Some benefits are also gradually being phased out as well. Quote Link to comment Share on other sites More sharing options...
Word Nerd Posted November 18, 2015 Share Posted November 18, 2015 My first real job had an excellent insurance plan. The employer covered the entire premium cost, and the deductible was only $100 IIRC. They also offered a health club membership to the club across the parking lot, so a lot of employees went there over lunch or after work. Those were the days. Quote Link to comment Share on other sites More sharing options...
QueenCat Posted November 18, 2015 Share Posted November 18, 2015 2016 premiums will be the same for us as 2015. Prescription coverage is better. Deductible went down by 50%. Originally were told it was going up. No out of pockets other than the deductible and premiums, which is the same as 2015. Overall coverage is better now than it was five years ago. Part of that is due to a change in employer, from a large company to a smaller company (I had expected it to get worse with a small company but it got better). Quote Link to comment Share on other sites More sharing options...
Lanny Posted November 20, 2015 Share Posted November 20, 2015 There was a segment on the 6 P.M. (E.S.T.) news tonight that UnitedHealthcare, one of the largest insurers, may leave the market (Exchanges I think) starting in 2017. Their financial data are not favorable. The Actuaries are the ones who work with the actual data about what their costs and risks are. After that, I think the government guarantees them a profit, or that they will not take a loss, but I'm not sure how that works. UnitedHealthcare is in for 2016, but not sure about 2017. If a large player like that leaves the market, there will be less competition. Quote Link to comment Share on other sites More sharing options...
Frances Posted November 20, 2015 Share Posted November 20, 2015 Our costs will basically stay the same. We pay less than $100 per month for health, dental, and vision coverage, my employer pays the rest. And $50 of our cost is due to my husband declining his employer's insurance. But I pay more in union due per month, even though I'm not a member, than I do for insurance. Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 20, 2015 Share Posted November 20, 2015 Our medical, dental and vision coverage is staying the same. Our prescription drug benefit has changed slightly. The maximum copayment for brand name, on formulary drugs has risen from $120 for a three month supply to $250 for a three month supply. Unfortunately, we do have a family member with an expensive prescription, so we will see our out of pocket costs go up. We did decide to try the HSA with the high deductible insurance plan this year (we have the deductible in the bank already, so we are prepared for that). We think between the savings in income tax and the lower premium cost we will come out slightly ahead of where we would be if we did an HCFA again. We will see! Quote Link to comment Share on other sites More sharing options...
shinyhappypeople Posted November 20, 2015 Share Posted November 20, 2015 I had to stop using our doctor unless I wanted to pay 100%. Now we have to go to the HMO headquarters (much farther away) and get whichever doctors happen to be around. It isn't worth it most of the time, so we go to a chiropractor instead. When we went to buy my kid a new pair of glasses, we were looking at all the frames on the wall, like we always do. But they told us none of those frames were available to us. Per Obamacare there is a box they pull out with 6 choices of plastic kids' frames. I did not even have the option of paying out of pocket for different frames. My older daughter will forever keep popping her lens back in when it falls out rather than get new ugly glasses. Not much else to report since we just don't go to the doctor unless I think we need medicine or a cast or stitches. My costs have not gone down btw. My overall out of pocket costs have gone up. My husband gets insurance through his work and it's gone up a couple hundred dollars a month or so, just for him. I was (and technically AM) still without insurance. Don't qualify for a federal subsidy because DH's plan is considered affordable for one person, therefore it's affordable for a family. <---- government logic I've since signed up with Christian Healthcare Ministries and I love-love-love it. My kids used to be on Healthy Families (great state program, lots of dr. options) but that went away and they were put on Medicare (Medi-Cal). Just... yuck. Very few options for doctors and just generally quite suckish and ghetto. I hate it. Younger DD got very sick last winter, so I drove her to the nearest urgent care. Receptionist took one look at our "insurance" card and told me that they couldn't see my daughter because our PCP wasn't part of their (the clinic's) network (or something like that?) They told me I'd have to drive all the way across town to a different clinic. I offered to pay out of pocket (DD was SO sick!) and they said they weren't allowed to accept payment, per Medi-Cal's rules... and they still wouldn't (couldn't) see DD. So, I ended up calling the company that manages the Medi-Cal plan they're on and throwing a Holy Fit until they changed her PCP on the spot (all the while listening to a lecture about how they'll only do this ONCE for me, blah, blah, blah...) So, um... yeah. Not a fan. Quote Link to comment Share on other sites More sharing options...
rocassie Posted November 20, 2015 Share Posted November 20, 2015 Our rates have gone up, deductibles up, co-pays up, and coverage has gone down. We still have good coverage and and DH's employer still pays a good portion of the cost. Thankfully we are generally healthy but it's hard to pay more when his income has flat lined since about 2009. 1 Quote Link to comment Share on other sites More sharing options...
DawnM Posted November 20, 2015 Author Share Posted November 20, 2015 My husband gets insurance through his work and it's gone up a couple hundred dollars a month or so, just for him. I was (and technically AM) still without insurance. Don't qualify for a federal subsidy because DH's plan is considered affordable for one person, therefore it's affordable for a family. <---- government logic I've since signed up with Christian Healthcare Ministries and I love-love-love it. My kids used to be on Healthy Families (great state program, lots of dr. options) but that went away and they were put on Medicare (Medi-Cal). Just... yuck. Very few options for doctors and just generally quite suckish and ghetto. I hate it. Younger DD got very sick last winter, so I drove her to the nearest urgent care. Receptionist took one look at our "insurance" card and told me that they couldn't see my daughter because our PCP wasn't part of their (the clinic's) network (or something like that?) They told me I'd have to drive all the way across town to a different clinic. I offered to pay out of pocket (DD was SO sick!) and they said they weren't allowed to accept payment, per Medi-Cal's rules... and they still wouldn't (couldn't) see DD. So, I ended up calling the company that manages the Medi-Cal plan they're on and throwing a Holy Fit until they changed her PCP on the spot (all the while listening to a lecture about how they'll only do this ONCE for me, blah, blah, blah...) So, um... yeah. Not a fan. I guess I don't fully understand these programs. I am looking at the website. The premium plan is $150 per person per month? Looks like it doesn't cover all that much either. No mental health? Quote Link to comment Share on other sites More sharing options...
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