Health Insurance is EXPENSIVE!!

[AustinMommyofThree]

Health care is expensive and people want, need, and deserve access to it. Mathematically it stands to reason that health insurance will be correspondingly expensive because they have to pay out those claims plus pay for their own expenses. It stinks, but I don’t know any alternative.

 

[Poohforyou]

Health insurance for my family of four through my husband’s employer is double our mortgage payment. We still owe $5000 on my emergency c-section in March.

Interesting, but it doesn't answer my question. $500-800 a month is very high but if the OP is quoting an annual premium I don't think that's bad at all. If it's quarterly it's pricey but cheaper than even the most basic surgery.

 

[longboard55]

Interesting, but it doesn't answer my question. $500-800 a month is very high but if the OP is quoting an annual premium I don't think that's bad at all. If it's quarterly it's pricey but cheaper than even the most basic surgery.

I assume its monthly

 

[mnrose]

Health care is expensive and people want, need, and deserve access to it. Mathematically it stands to reason that health insurance will be correspondingly expensive because they have to pay out those claims plus pay for their own expenses. It stinks, but I don’t know any alternative.

Really? No alternatives? We could try looking at any of European countries, Canada, Australia, most of Asia, etc, and see if maybe they have any ideas. I can tell you that our German exchange student is dumbfounded at the way our health care system works (or doesn't). Her mother is a pediatrician in Germany, so she's pretty well versed in how that system works.

 

[AustinMommyofThree]

Really? No alternatives? We could try looking at any of European countries, Canada, Australia, most of Asia, etc, and see if maybe they have any ideas. I can tell you that our German exchange student is dumbfounded at the way our health care system works (or doesn't). Her mother is a pediatrician in Germany, so she's pretty well versed in how that system works.

Let me rephrase: no alternatives I can seem to be able to suggest without getting reported by somebody and getting points.

 

[minnie56]

Meanwhile in Canada, my husband was just diagnosed with stomach cancer and our only financial lost are a % of his wage (he had an insurance with his union), the day I miss work for an appointment and parking/gas fee. Everything is covered. No deductible. Same meds for the Chemo that they use in the US and his surgeon is an Harvard graduate, so I'm guessing similar procedures.

We do have "high" taxes. On a total family income of 110 000$ CAD, with two kids, we will pay around 25 000-30 000$ I'd guess? But we get 7$ a day daycare, a free good quality public schools system, low cost colleges, 1 year of parental leave for a new baby, child and family benefits for low to middle class family (we still receive some with our salaries), old age pensions, all services I can think off (road, garbage, parks, ...), + free medical care and procedures, and many other things...

Really why? Salt in the wound ?

 

[nene0182]

These costs are astounding to me especially those quoting what you pay for employer plans. I pay less than $200/month for our family of 3 and that’s for medical, dental and vision. It’s an 80/20 plan with a $2000 deductible. Last year we went with the “expensive” plan that was $300/month and included a $1500 HSA. Even if we had to get insurance through my husband’s employer, the cost for a comparable plan to what we have now would be less than $300/month.

 

[JAMIESMITH]

Interesting, but it doesn't answer my question. $500-800 a month is very high but if the OP is quoting an annual premium I don't think that's bad at all. If it's quarterly it's pricey but cheaper than even the most basic surgery.

It’s probably monthly. We are paying just over $1000 per month for a family plan. Doesn’t matter if you have one kid or ten, the price is the same.

 

[disneychrista]

Is that monthly, quarterly, annual?

Monthly.

 

[sam_gordon]

These costs are astounding to me especially those quoting what you pay for employer plans. I pay less than $200/month for our family of 3 and that’s for medical, dental and vision. It’s an 80/20 plan with a $2000 deductible. Last year we went with the “expensive” plan that was $300/month and included a $1500 HSA. Even if we had to get insurance through my husband’s employer, the cost for a comparable plan to what we have now would be less than $300/month.

I'm paying $260/month for family medical coverage. Employer is paying another $800. Dental is $90/month and Vision is $20. That covers 5 of us. This is a new provider because the old provider elected to stop providing insurance.

It doesn't make sense that prices vary so wildly. FWIW, there's about 150 people in my company.

 

[AlohaNow]

BCBS discontinued our grandfathered health plan this year, which was $1400 for two of us. Our new premium is $38,000/year or $3166 per month.

Yikes! This post scares the crap out of me! We have been on the same BCBS independent plan for 11 years now. With the advent of the ACA we too were grandfathered and are able to keep our non-ACA compliant plan. When we first purchased this plan on the open market friends and family could not believe that the deductible was $5,000/$10,000. Now that just seems to be the norm for almost everyone. The most excellent part of our plan is that it is portable across state lines and as long as we keep paying the premium, no one can take it away from us. (Well…..) We purchased in MD, moved to HI, and now live in CO. Doesn’t matter where we work or even if we work. From our experience I see how little sense it makes to have employer-based health insurance, but that is the norm here in the U.S. Something that was started as a benefit in order to attract servicemen returning from WWII has turned wholly into something else!

Every October I await the letter from BCBS that has our premium increase, and it has been a steady 16.5% increase each and every year. Our pay certainly doesn’t go up that much! I dread the day when we receive the letter that cancels our plan. We will be so up the creek…..

LVSWL – May I ask what state you are in?

 

[LVSWL]

LVSWL – May I ask what state you are in?

Hi! We are in NC. DH has his own business so we have had our own insurance since 1992. We were grandfathered when ACA came about. In 2017 BCBS sent a letter to their grandfathered plan owners that they were ending the plan. They stated that since younger insureds couldn't join the "group", it was not financially feasible for them to continue to insure the 50,000 plan holders. They graciously offered us a plan to replace it...at $38,000/year. We were gutted.

 

[Colleen27]

Mine is $800/mo for an 80/20 family plan... which doesn't sound bad compared to some but it is about half of what I make in a month. And it has a $12,500 deductible, so for it to pay out we'd have already spent more than I earn in a year on it.

 

[AlohaNow]

LVSWL - Very interesting! I fear that our plan may end soon. The thing about younger people not being able to join makes sense. I have no idea how many people are in our 'group'. We are through the National Capital Region, meaning MD/VA/DC. Hopefully our group lasts for at least a few more years! Thanks for the feedback!

 

[SteveH]

Keep in mind that State by State it varies a lot. In my State the Government mandates a whole lot of extras be covered, the carries pass that right along. Those mandates really add up. Very have to compare apples to apples unless you know all the details.

 

[Pea-n-Me]

Sorry if this is a dumb question..

What stops everybody from just not getting insurance and just going to a hospital every time they have a cold or small injury? Would it get to the point where hospitals would stop treating people with no insurance?

I know that hospitals wouldn’t be able to handle the load, but what stops everyone from doing that?

You could, but costs would be high, though I see your point, maybe less than what people are paying now.

Not having insurance, though, is taking a big chance, for if there was a medical catastrophe, hospital bills could cost someone a lot of money, if not bankrupt them.

Even going to an ER if you do have insurance gets costly. The way mine works is that I pay I think it's up to a $200 deductible (way up from much less than that not too long ago) if you go but are not admitted to the hospital from there. If you're admitted, they waive the deductible. This is their way of telling you whether it was appropriate for you to go to the ER or not, since office visits are much less. Basically the large copay is a deterrent for insured people from going to the ER (for issues that probably could've been seen in a doctor's office).

Also, see my next reply...

While I am not an expert in this area (however, my husband is much more well versed in this and we have had extensive discussions) it is only for true emergencies that you cannot be asked financial status before treatment. However, they can ask for proof of insurance before more minor treatment. And if you do not have insurance or the means to pay out of pocket, your quality of care does suffer. I for one hope I never have to see what type of care I would received as an uninsured patient.

This, I'm not sure about - having worked in a major urban ER and a major urban hospital. Caregivers have no idea what's going on with anyone's insurance, tbh; nor do we care much other than for what is best for the patient. What would happen is that, upon admission to the ER or hospital, a non-insured patient would have to sign a waiver saying they were responsible for paying out of pocket. I suppose it might come up when a treatment plan is being discussed, if only to say hey we recommend an MRI or whatever. The uninsured patient would then say, wait, do I really need it, because I am paying out of pocket. So, in other words, recommendations would be what they are, but the treatment plan might be limited unless one's willing to pay the full price for all the treatments recommended. When it comes to inpatient, what happens is if major treatment is necessary, that patient is hooked up with a social worker who then helps the patient apply for Medicaid or disability, whatever they can get. So if quality of care does go down, it is likely because things are so expensive and someone who's paying themselves might want to limit care to the bare minimum until they get some assistance. That's what I see, anyhow. Caregivers know very little about a patient's insurance issues.

We've had Blue Cross health insurance for quite a few years now, premiums were going up, up and up all the time. Our last premium we were paying $1100/month for just my husband and me.

Then we received a letter from them in November saying our policy was being cancelled. We could talk to them and find a different plan that suited our needs, or we could do nothing and they would just put us in a plan themselves and the premium for that policy was going to be about $1293 if I remember correctly.

We knew we had to do something, so DH talked to our auto/home insurance man as they sell health insurance as well. They said to see if we qualified for a subsidy as there had been changes made for this year. So he called. Lo and behold we did qualify (I think they looked at 3 years' worth of our tax returns).

We previously had a Blue Care Network bronze policy, with $6,000/per person deductible.

We now have a silver policy with only $600/per person deductible.

The policy came into effect January 1st, and we pay $158/month. Quite a difference! MUCH easier to afford! We have a $30 co-pay when we go to the doctor, and better prescription coverage too.

So, those of you that had big price jumps in your premiums, you may want to check with your insurance company to see if you qualify for a subsidy.

We are wondering, though, what this will do to our taxes. If we'll have to pay more in taxes because of the subsidy, we're not sure. We have an appointment next month with our accountant so DH will discuss that with him then.

So do you mind if I ask, is the subsidy based on income? Do you happen to know what criteria is used? And when you say this is something new, do you know if this was in the original ACA guidelines? Or how did this make it in there? Thanks

 

[manning]

I understand that not only premiums are going updeductibles are going thru the roof.

Also with drug companies consolidating drug prices are shooting up.

 

[kimblebee]

You could, but costs would be high, though I see your point, maybe less than what people are paying now.

Not having insurance, though, is taking a big chance, for if there was a medical catastrophe, hospital bills could cost someone a lot of money, if not bankrupt them.

Even going to an ER if you do have insurance gets costly. The way mine works is that I pay I think it's up to a $200 deductible (way up from much less than that not too long ago) if you go but are not admitted to the hospital from there. If you're admitted, they waive the deductible. This is their way of telling you whether it was appropriate for you to go to the ER or not, since office visits are much less. Basically the large copay is a deterrent for insured people from going to the ER (for issues that probably could've been seen in a doctor's office).

Also, see my next reply...


This, I'm not sure about - having worked in a major urban ER and a major urban hospital. Caregivers have no idea what's going on with anyone's insurance, tbh; nor do we care much other than for what is best for the patient. What would happen is that, upon admission to the ER or hospital, a non-insured patient would have to sign a waiver saying they were responsible for paying out of pocket. I suppose it might come up when a treatment plan is being discussed, if only to say hey we recommend an MRI or whatever. The uninsured patient would then say, wait, do I really need it, because I am paying out of pocket. So, in other words, recommendations would be what they are, but the treatment plan might be limited unless one's willing to pay the full price for all the treatments recommended. When it comes to inpatient, what happens is if major treatment is necessary, that patient is hooked up with a social worker who then helps the patient apply for Medicaid or disability, whatever they can get. So if quality of care does go down, it is likely because things are so expensive and someone who's paying themselves might want to limit care to the bare minimum until they get some assistance. That's what I see, anyhow. Caregivers know very little about a patient's insurance issues.


So do you mind if I ask, is the subsidy based on income? Do you happen to know what criteria is used? And when you say this is something new, do you know if this was in the original ACA guidelines? Or how did this make it in there? Thanks

Thank you for explaining that. I was under the (false) impression that if you went to a hospital they would treat you for free..no questions asked. I didn’t realize that they would make you sign something saying you would pay out of pocket. That’s why I didn’t understand why people got insurance if they could just go to the hospital for free. I mistook the quote that they had to treat you no matter what.

 

[MillauFr]

Yes, the name has always been misleading.

Just like a Disney Cruise is an affordable vacation...

 

[Pea-n-Me]

Thank you for explaining that. I was under the (false) impression that if you went to a hospital they would treat you for free..no questions asked. I didn’t realize that they would make you sign something saying you would pay out of pocket. That’s why I didn’t understand why people got insurance if they could just go to the hospital for free. I mistook the quote that they had to treat you no matter what.

Exactly how things work in different areas of the country, or even in different hospitals in the same area or region, can vary greatly. I can only speak for what I've seen and experienced. I know where I work there is a certain percentage of the budget is put aside for care for the uninsured. The hospital does eat some costs. (And the rest is probably complex, like perhaps there are tax write offs or something, not really sure.) And I've also read in various places that if people have large bills, they may be able to negotiate what's owed, or at the very least, set up a payment plan. But I do believe that in most hospitals, people have to sign that waiver during the official admission process. It even happens now in doctor's offices when you sign in - you have to attest that if your insurance won't pay for services, that you'll be responsible for it.

Just to add to the discussion, a lot of people blame hospitals for a lot of the high costs of care, and I'm sure there's some truth to that. But everyone wants the best treatment and the best care with the least amount of aggravation, etc. I think many hospitals try to do that for people, but it isn't cheap to provide that. Hospitals know that if they don't pony up, people will go elsewhere, so as businesses, hospitals have to figure out a balance between surviving, staying profitable, and giving patients what they want. Very complex today, and no easy answers to solve the problems.

I will say that patients getting admitted to hospitals today often have complex medical needs, and hospitals are expected to perform to a certain high standard. With the onset of the ACA, Medicare (the government run insurance program for people over age 65 who paid into the system) started implementing very large fines for standards that were not met. Some of these fines are extremely high, like $30K per incident, per patient, say if someone develops a urinary tract infection from a urine catheter (who doesn't?) or a pressure ulcer/bed sore, or if they are readmitted to the hospital within 30 days for certain things, etc. This has been a huge strain on hospitals, because as you can imagine, problems do come up when care is very complex and someone, say, is unconscious for a week or otherwise very sick or debilitated. But very few are talking about that. In addition to fines, for many years, Medicare has lowered reimbursement rates to hospitals for many things, and elderly insured by Medicare comprise a large portion of patient populations, so more and, in essence, better care is being given, yet reimbursements to hospitals are lower and fines are larger and more prevalent.

https://khn.org/news/more-than-half-of-hospitals-to-be-penalized-for-excess-readmissions/

http://www.sandiegouniontribune.com...cquired-penalty-medicare-2015dec26-story.html

https://www.beckershospitalreview.c...o-know-about-medicare-reimbursement-2017.html

So bottom line, these are challenging times for hospitals, too.