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Old 11-15-2010, 10:17 AM   #1
leadfootlevi
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Health Care

We have what most would consider good health care. It's company-provided, so the company pays for some and we pay for some. However, it's still very expensive! We don't go to the doctor except for our annual checkups (which are $0). Yet, we pay $112 per paycheck for 3 (me, DH, and DS) and we get the lowest possible health care plan ($25 physician co pay, plan pays 80% for hospitalizations after deductible of $1500, $8000 out of pocket max ) , basic dental (cleanings are covered, but anything beyond that isn't - it's basically a discounted rate), eye insurance for me only (again, this is not really insurance, but a discount), and low-levels of life insurance.

I've considered going without health insurance and dealing with the financial consequences after the fact in the event that something did happen, but I just can't make myself do it. If you're willing to share, what do you pay for health care, and more importantly, are there any tips for getting these costs down?

Thanks!
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Old 11-15-2010, 10:42 AM   #2
MissAndrea
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I was paying almost $400/mo for only DD and me!! That was through my employer and didn't include vision...just medical and dental. I got married in June and switched to DH's plan and it's $100/mo and includes vision!! The copays are lower on DH's plan too. I can't say apple for apple if we have identical coverage or deductibles, but DD and I have both went to the dr since having it and I can say I'm much happier with his! It is saving us over $3000 a year. I worked at a local bank, he works for a nation wide company so I'm assuming that's why his is better. IMHO, I do not think $112/paycheck is that bad for the 3 of you for medical, dental, and vision. Maybe it's just because I've had much worse! Wait..unless you are paid weekly so it's $400/mo, and in that case...blech. Oh, the $8000 family out of pocket kind of sucks!! I do know ours is much less than that.
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Old 11-15-2010, 10:50 AM   #3
leadfootlevi
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Quote:
Originally Posted by MissAndrea View Post
I was paying almost $400/mo for only DD and me!! That was through my employer and didn't include vision...just medical and dental. I got married in June and switched to DH's plan and it's $100/mo and includes vision!! The copays are lower on DH's plan too. I can't say apple for apple if we have identical coverage or deductibles, but DD and I have both went to the dr since having it and I can say I'm much happier with his! It is saving us over $3000 a year. I worked at a local bank, he works for a nation wide company so I'm assuming that's why his is better. IMHO, I do not think $112/paycheck is that bad for the 3 of you for medical, dental, and vision. Maybe it's just because I've had much worse! Wait..unless you are paid weekly so it's $400/mo, and in that case...blech. Oh, the $8000 family out of pocket kind of sucks!! I do know ours is much less than that.
I'm paid bi-weekly so it's roughly $240/month. But, we never go to the doctor. Of course, with my luck, as soon as I declined coverage one of us would have a major medical deal and then we would be out thousands!
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Old 11-15-2010, 10:56 AM   #4
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We have a premium PPO Anthem Blue Cross/Blue Shield plan through my dads company. He pays about $215/paycheck for 4 of us (he gets paid bi-weekly). Our plan is (per person):
$250 deductable
$8,000 OOP max
$20 copay for internist
$40 copay for specialist

Not including what we pay for the actually health insurance, we spent more than$11,000 on my medical bills alone last year.
For me alone we spent:
$250 deductable
$8,000 OOP
about $1,700 for copays
about $1,000 on prescriptions
about $500 on parking (included in medical expenses on taxes b/c its hospital parking)
so that is about $11,450 and I know that there were some more misc. expenses as well and we do still have 3 other people in the family who had expenses as well!!!!

We always say that with the amount we have spent in medical bills in the past 5 years, it could have paid for about 3 years of college for me...absolutely ridiculous
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Old 11-15-2010, 10:59 AM   #5
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Exactly. I really don't think you should cancel your insurance. Totally just my opinion, but you really might regret it later. And even if you guys don't ever really "use" it, you mentioned going for regualr check ups (which is great!!) and you guys might stop doing that if you didn't have insurance. I hate talking about health insurance though. They are crooks. The whole system is totally messed up. I'm going to back out of this convo now before I start getting angry.
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Old 11-15-2010, 11:05 AM   #6
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I had also at one time debated cutting our medical insurance, but with 2 daughters, I didn't want to take the chance that we'd have something huge medical-wise come up.

We pay about $300 per month through my dh's employer, with $25 copays, $20 drugs, etc.

I'm glad we have the insurance though because even though we've all been fairly healthy this year... my older dd for the first time ever had an ear infection so bad that the fluid just wouldn't go away. Ended up getting tubes put in few wks ago...

Just got the claim forms in the mail on Friday and her surgery was covered 100%. That little 15 minute surgery alone would've cost us approx. $2200. So 7 months of our insurance premiums were just used, lol.

I just wouldn't chance it.. you never know what's going to happen.
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Old 11-15-2010, 11:14 AM   #7
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Quote:
Originally Posted by leadfootlevi View Post
We have what most would consider good health care. It's company-provided, so the company pays for some and we pay for some. However, it's still very expensive! We don't go to the doctor except for our annual checkups (which are $0). Yet, we pay $112 per paycheck for 3 (me, DH, and DS) and we get the lowest possible health care plan ($25 physician co pay, plan pays 80% for hospitalizations after deductible of $1500, $8000 out of pocket max ) , basic dental (cleanings are covered, but anything beyond that isn't - it's basically a discounted rate), eye insurance for me only (again, this is not really insurance, but a discount), and low-levels of life insurance.

I've considered going without health insurance and dealing with the financial consequences after the fact in the event that something did happen, but I just can't make myself do it. If you're willing to share, what do you pay for health care, and more importantly, are there any tips for getting these costs down?

Thanks!
I think that you are in great shape compared to us. Health insurance for myself and the kids runs nearly seven hundred per month. We are self insured. My husband is on his own policy due to a pre existing condition. The cost is another three hundred per month just for him! Visits to the primary care doctor are twenty dollars. A specialist (after visiting the primary and getting a referral) is another fifty dollars. An mri recently cost me two hundred and fifty dollars for the copay. The sling Im wearing will be billed to me separately as a medical device. When I start physical therapy it will be fifty dollars per visit out of my pocket. And I may need as many as three visits per week for six weeks. My deductible for hospital stays is five hundred dollars. So is outpatient surgery. I have no idea what our limit of liability is since they cant seem to send me the correct schedule of services. No dental. No eye insurance. No life insurance included in the policy. Rumor has it that our insurance rates will be rising by forty per cent next year. So if you think you have it bad, then think again. Its alot worse if you have to obtain insurance on your own.
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Old 11-15-2010, 11:20 AM   #8
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Here is my little thought on going without insurance and paying out of pocket:

I had surgery a year ago for a reconstruction on my knee. The surgery was billed at over $20K but the insurance paid 90% of the negotiated rate of $6K. So the hospital adjusted the $14K. If I had no insurance, I would not have had to pay 6K, I would have had to pay 20K...
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Old 11-15-2010, 11:21 AM   #9
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My god, how do you people live like that? It sounds crazy!

You have my sympathies, up to a point.
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Old 11-15-2010, 11:24 AM   #10
leadfootlevi
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Quote:
Originally Posted by KadysMom View Post
Here is my little thought on going without insurance and paying out of pocket:

I had surgery a year ago for a reconstruction on my knee. The surgery was billed at over $20K but the insurance paid 90% of the negotiated rate of $6K. So the hospital adjusted the $14K. If I had no insurance, I would not have had to pay 6K, I would have had to pay 20K...
Probably not. Usually there are rates for people with insurance and (typically lower) rates for people without insurance.
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Old 11-15-2010, 12:56 PM   #11
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We pay nothing but co-pays ($15-$25) for Blue Cross, Delta Dental and vision- thank God! One of the reasons we up and moved from FL back to MA was this job. It has awesome benefits, 401k (matching 100% soon) life and disability insurance and pension. In FL we were always contract and temp. At DH's last temp job in FL, they paid his insurance but I cost $800/month (healthy!) Crazy! Thank God we had insurance when DH slipped in flip flops in the garage and broke his elbow! Freak accidents can happen even if you are healthy! I also got my Irish citizenship so we can live, work and own land in any EU country in case we are in need of better jobs/medical care in the future!
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Old 11-15-2010, 01:19 PM   #12
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Quote:
Originally Posted by leadfootlevi View Post
We have what most would consider good health care. It's company-provided, so the company pays for some and we pay for some. However, it's still very expensive! We don't go to the doctor except for our annual checkups (which are $0). Yet, we pay $112 per paycheck for 3 (me, DH, and DS) and we get the lowest possible health care plan ($25 physician co pay, plan pays 80% for hospitalizations after deductible of $1500, $8000 out of pocket max ) , basic dental (cleanings are covered, but anything beyond that isn't - it's basically a discounted rate), eye insurance for me only (again, this is not really insurance, but a discount), and low-levels of life insurance.

I've considered going without health insurance and dealing with the financial consequences after the fact in the event that something did happen, but I just can't make myself do it. If you're willing to share, what do you pay for health care, and more importantly, are there any tips for getting these costs down?

Thanks!
I don't have any tips for lowering the costs, but don't try to go without insurance. All it would take is one major event and you are in hot water. Years ago our son was sick and hospitalized for three weeks. The total bill was well over $40,000. We payed our $5,000 max. Lucky for us, this all happened in Jan/Feb, so for the rest of that year, we had no more medical bills to contend with. The $5,000 was enough.

This year we chose to downgrade to the lower plan offered at DH's work. We are all healthy and rarely go to the doctor. The second tier plan was half the cost ($400 vs. $800 a month), had a higher deductible and max out of pocket. The payout was 70/30 instead of 80/20. We're going to pay dearly for "saving" that $400 a month. Our daughter was diagnosed with a rare eye condition and had surgery last week. No idea what the final bill is going to be yet, but I'm pretty sure I didn't save a penny by downgrading our insurance this year.

Sorry I couldn't be more help. You could shop around for a less expensive option, but personally I think the plan you have sounds pretty good.
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Old 11-15-2010, 01:30 PM   #13
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Quote:
Originally Posted by leadfootlevi View Post
We have what most would consider good health care. It's company-provided, so the company pays for some and we pay for some. However, it's still very expensive! We don't go to the doctor except for our annual checkups (which are $0). Yet, we pay $112 per paycheck for 3 (me, DH, and DS) and we get the lowest possible health care plan ($25 physician co pay, plan pays 80% for hospitalizations after deductible of $1500, $8000 out of pocket max ) , basic dental (cleanings are covered, but anything beyond that isn't - it's basically a discounted rate), eye insurance for me only (again, this is not really insurance, but a discount), and low-levels of life insurance.

I've considered going without health insurance and dealing with the financial consequences after the fact in the event that something did happen, but I just can't make myself do it. If you're willing to share, what do you pay for health care, and more importantly, are there any tips for getting these costs down?

Thanks!
I am assuming this is bi weekly so $224 per month but even at $448 per month if it is weekly for 3 people is dirt cheap and you plan is a good one and not low line. You would be lucky to cover your family for triple the $448 with $5000 deductable and no co pay meaning you pay the cost of all dr's visits till over the $5000 and they they will pay 80%. Keep it and be thankful that you have innexpensive health insurance.
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Old 11-15-2010, 01:33 PM   #14
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Probably not. Usually there are rates for people with insurance and (typically lower) rates for people without insurance.
Were does this exhist? That is not true where I live.
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Old 11-15-2010, 02:13 PM   #15
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I wouldn't go without...

Health insurance is one of those things that I wouldn't even lapse for one day. Of course, I have a brother who was in a catastrophic accident and was hospitalized for six months. My parents had insurance where they were responsible for 20% (an 80/20 plan). That 20% put them so far in the red, and just about totally bankrupt. Thankfully their house was still paid for or they would have been foreclosed on (even with their $65/month mortgage payment). Their responsibility for medical bills was over $100,000.

Of course, during this time they had to miss work. My brother was in a hospital 2 hours from home & my mom stayed in a home they had for family members on the premise. So no paycheck for her. My dad was going down a few times a week (missing work of course).

Because of this scenario, I am AFRAID to even go without health insurance for even one day. I'll give up cable, cell phones, internet, cars, etc. before I gave up health insurance.

Having said that, it doesn't mean I don't complain about health insurance premiums going up, with coverage going down. I was just looking at the change in my policy that will be effective on 1/1/11. I'm going to be paying $222 (up from $208 per pay period - every two weeks) and ALL the co-pays have gone up signficantly! All except if I'm addicted to drugs or need to quit smoking -- there is no copays for those services, which I find really strange. There's also no copayment if I want to be screened for gonorheaa or cyphilis, or other STDs. I must say that there are no co-pays for preventive care checkups (but there was no copay before either). This year, an MRI costs me nothing; next year it will cost me $175.. ridiculous. The first statement of the changes says, "Several provisions of the Affordable Care Act (ACA) affect eligibility and benefits under the **** Program"

Alright, sorry to get off topic

Bottom line, IMHO, is to keep the insurance and give up other luxuries...
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