HealthCare / Open Enrollment (1 Viewer)

[bergs]

I think this is the normal healthcare open enrollment period here in the States. Curious what changes people are seeing in their employer provided plans...

I'm covered under my wife's employer's plan, which is solid, but my employer increased all costs on employees across the board, including a 6K deductible that has to be met per family member before the healthcare kicks in. This means a family of 4 has to pay 24K out of pocket before the healthcare applies.

Sadly, I've always thought that this was going to be the result of Obamacare...companies will continually raise the employees' healthcare costs until it makes sense for the employees to use the government-provided programs. Employer-provided healthcare plans become a primarily executive perk like a car allotment in 10 years...

Hopefully other people are seeing a different trend....

 

[atomiktoaster]

We went from a 100% coverage PPO (just co-pays and premiums) to the best plan being a $1500 deductible ($3000 per family) plan with an HSA (with employer contributions). There are also plans down to $250 deductible, but the total cost will be higher. It will be cheaper overall if you're healthy, and not much worse if you hit max out of pocket in-network.

 

[abby99]

The premium for my HMO coverage increased 4.2%, which is actually less than in previous years. Max annual out of pocket is $1500 individual and $3000 family. There is a separate cap of $1500/person for prescription drug copays.

We do have a couple of PPO plans and an HSA plan, but the HMO is best for me.

 

[links_slayer]

The medical plan we choose (we have 8 options) still has no deductible but changed from 100% coverage to 90% coverage for inpatient, outpatient, scans, labwork, etc. Out of pocket max went from $13,200 to $2,500. Our cost/pay period increased ~11%.

Dental coverage also changed from 100% coverage for preventative and basic procedures to 100% for preventative and 80% for basic procedures. No change to cost/pay period.

No change to our vision policy (1 exam/year, basic lenses covered after $25 co-pay, $150 allowance for frames every other calendar year).

 

[Anthony Martino]

What are these benefits you speak of?

 

[catalyzeme]

I was High Deductible/HSA only last year and this year they added a PPO, but the HSA is like $1300 cheaper annually and my employer contributes $1K to the HSA, and the maximum out of pocket is actually lower than the PPO plan so the PPO seems pretty crappy. I'm young single and healthy though so HSA/High Deductible is ideal for me.

 

[kirchhausen]

All of our current plans stayed the same as last year. We did ad a new plan that has a super high deductible (no clue what it is) but has low premiums which keeps us in line with the "affordable" provision of the health care act.

 

[CraigT78]

I pay $3,600 per year for medical for me + family. $150 a pay check. $3,200 annual deductible and everything is out of pocket until the deductible is met. Once met, the plan pays 90% until the $6,000 out of pocket maximum is hit. By selecting this high deductible plan my company give me $1,100 on January 1st into my HSA. Preventative care is 100% free. They also offer 80% and 90% PPO plans, but after crunching numbers for the last few years, I save money with the high deductible plan. Max I will ever spend on healthcare per year is $6000 + the premiums.

Dental is $15 a check and covers all the basic stuff with a $1,500 lifetime kicker for orthodontics per kid.

Vision is $17 a check.

Overall I think it was a ~4% increase over last year. I don't have any complaints with my insurances, and honestly it wasn't until after Obamacare that the higher deductible plan was available and preventative care became free - both positive outcomes in my situation.

 

[BiGGyT]

I am the owner of a small company, our premiums jumped 26.4% this year over last. Coverage for my wife and I is about $1000/month for medical and dental, with a $2500 deductible and $6000 cap. My partner and her kids' coverage is $1200/month. Before the ACA, this same type of coverage was $450, and had a $1000 deductible. I liked my heath plan, but I could not keep my plan, because it was no longer offered, and every year but this one, the prior plan was no longer offered by the healthcare provider. We had BlueCross for 15 years, the first year of the ACA they had to increase our premiums because we were "too low" for the averages of the premiums. Each year after ACA, our premiums would increase 15-25%. Last year we switched to Aetna, not that the premiums were much less, but we got a little better "silver" plan. Now, like I said, renewals are increasing 26.4%, and dental is getting worse. To even try and price the "business exchange", you have to give them SSN and everything ahead of time. Effectively, I will be paying $12,000 just for coverage, and if anything happens, I am out another $6000.

Basically, I am hoping that over the next 10 years, I incur over $120,000+ in health care costs to break even. That is damn sad.

Repeal the ACA, allow health insurance providers to be nation wide rather than limited to each state to establish more economies of scale, and get the gov't out of the doctor office. With non-mandated coverage and broad markets, providers would lower costs and offer competitive products. Many of you who receive your coverage as a benefit only see the part passed onto you, I am sure the overall cost is higher, and the company had to pick a worse policy if they wanted to keep the rates the same.

I gotta go back to work now to pay my damn medical insurance.

BiGGyT

 

[CraigT78]

allow health insurance providers to be nation wide rather than limited to each state to establish more economies of scale

This.

 

[DrStrange]

I've been on self-paid plans for twenty years. There has never been a year when the rates didn't go up and or the benefits cut. If anything my rates aren't rising as fast as they were years ago but it is so hard to compare apples to apples since each year brought a different package of coverage for people of changing ages.

It was common for our plans to be canceled and force me to reapply every year or two. That often wasn't a big deal but when my middle son was found to be a juvenile diabetic we lost coverage within two years and weren't able to ever insure him again through private sector insurance. Same thing with my wife, she was misdiagnosed with cancer and as a result the insurance excluded her for a host of ailments due to the testing she had {which was evidence we thought she was secretly ill}.

Our insurance now isn't cheap - $12,000 deductible costing $1,000/m for my wife and I, but at least we get coverage for the 'break the bank' illnesses where as before my wife had no coverage for cancer or any organ related problems.

DrStrange

 

[trever]

My insurance (company provided) just got quite a bit better. Company pays 100% of the premiums, $3k family deductible.

National coverage won't work as well as people assume. Rates paid to providers are negotiated individually provider by provider and are driven by local market forces more than anything else; absolute size matters much less than the relative size within each hospital's market area.

Each state regulates its own insurance industry, so creating a "nationwide plan" would basically be impossible for an insurer to create.

Buying plans from other states, even if it was allowed, e.g. buy a plan in Indiana when you live in Wyoming would be a terrible mistake as you almost certainly won't have any in-network providers so you practically guarantee yourself the highest out of pocket costs.

 

[Chicken Rob]

Mine went up by 4% this year. Doesn't seem so bad. But the coverage is not that great. I'm not all that thrilled with it. Most of what it covers has not helped me (except emergency life saving surgery). I spend $15k-20k out of pocket on health care that seems to actually improve my health condition that my insurance won't cover, yet, when you look at how I progressed under the normal standard of care by my previous PCP, I was just getting sicker and sicker.

Health care is broken.
For profit health care insurance is bad.
I remain unimpressed with healthcare in general in the US. It's great if you just need emergency acute care, or are naturally healthy, but drift too far from the mean, and you are screwed. Mine is not the only story I know like this.

 

[Tommy]

Through my work, our family plan is $104 bi-weekly with a $1k deductible. Plan pays 90% + 5% (some sort of co-insurance) until the $1k is met, then 100% after that. $20 co-pay for doctor office and $75 for ER (if not admitted). Everything seems to have stayed the same for next year.

 

[bergs]

The only provision of Obamacare that I agree with is preventing people from going immediately busto if something catastrophic happens. Of course, for a lot of people, it seems they're getting bled gradually over the years with premiums and deductibles.

 

[pltrgyst]

Repeal the ACA,...

And just what do you think that will accomplish? There's a reason why *every single* national organization representing chronically ill patients (American Cancer Society, Heart Association, Lung Association, Diabetes Association, and all the other member organizations of the National Health Council) supports the ACA.

... allow health insurance providers to be nation wide rather than limited to each state to establish more economies of scale...

See Trever's lucid and accurate response.

...and get the gov't out of the doctor office.

Without the government, your life expectancy would be significantly shorter, and insurance companies would own you, lock, stock, and barrel, even more than they do now.

I'm a retired Fed worker, one of over 9,000,000 in the Federal Employee's Health Benefits program, which is spectacularly well-run. My wives and I have worked for private sector companies with some of the best benefits programs in the country (Princeton University, MITRE, IBM, Bell Labs, several non-profits), and none of them could touch the Fed program.

Had the democrats had the balls to pass a single-payer system during Obama's first two years in office, you could have had similar choices among competing private sector plans. But no, right wing imbeciles waste their time propagandizing about "death panels " -- which you already have, in the form of insurance companies.

-- Larry

 

[pltrgyst]

The only provision of Obamacare that I agree with is preventing people from going immediately busto if something catastrophic happens....

So you think that people with pre-existing conditions should be unable to get health care insurance at any price? And that children should be forced off their parents healthcare plans at age 18? Wow.

 

[Tommy]

And that children should be forced off their parents healthcare plans at age 18?

Are they still covered up to 24 if they are in college or is that gone now?

 

[bergs]

So you think that people with pre-existing conditions should be unable to get health care insurance at any price? And that children should be forced off their parents healthcare plans at age 18? Wow.

I was treating the pre-existing condition coverage the same as the provisions that stop you from going busto if you get seriously sick - but yeah, if taken separately both are equally important, absolutely. I never paid much attention to the healthcare 18 year old thing - no children (though I vaguely remember being on my mother's healthcare somehow until I was 19 or 20)...

 

[DrStrange]

20 somethings (and their parents ) often don't think much about health insurance until they really need it. P

As many of you have heard, I helped bury one of my Eagle Scouts who contracted a treatable skin cancer but couldn't pay/raise the ~$350,000 for treatment. The local charity hospital would only treat him when the condition because acute - say the last few weeks of his life. I still puke at the idea of letting a 24 year old die of a treatable disease and am more than irritable when I hear folks prattle about how good our medical system is relative to the rest of the world, because it just is not so expect for those who can cover the cost.

DrStrange

 

[BiGGyT]

And just what do you think that will accomplish? There's a reason why *every single* national organization representing chronically ill patients (American Cancer Society, Heart Association, Lung Association, Diabetes Association, and all the other member organizations of the National Health Council) supports the ACA.



See Trever's lucid and accurate response.



Without the government, your life expectancy would be significantly shorter, and insurance companies would own you, lock, stock, and barrel, even more than they do now.

I'm a retired Fed worker, one of over 9,000,000 in the Federal Employee's Health Benefits program, which is spectacularly well-run. My wives and I have worked for private sector companies with some of the best benefits programs in the country (Princeton University, MITRE, IBM, Bell Labs, several non-profits), and none of them could touch the Fed program.

Had the democrats had the balls to pass a single-payer system during Obama's first two years in office, you could have had similar choices among competing private sector plans. But no, right wing imbeciles waste their time propagandizing about "death panels " -- which you already have, in the form of insurance companies.

-- Larry

Government will also give me milk and cookies if I only surrender more of my money and freedom to them. Insurance companies would not own me, because before ACA I was not punished for not having healthcare. Now they truly do own me because they can charge what they want.

Here is a thought, change the laws to allow nationwide coverage and since this is not a "states rights" issue according to the current administration, why should the state regulate insurance in each state any longer. If you are going to break it anyway, break it completely. Also, set national standards for payments like medicare does, not negotiate with in and out of network. If they do not accept medicare, the patient gets paid from medicare what they would pay, but the difference is up to the patient to pay. Every reason it cannot be done can be changed before going to a single payer.

Your Fed program is spectacular because WE pay for it and it is not limited to individual states. If the taxpayers pay for it, it can have as many bells and whistles as you want it to, when a for profit company has to answer to the shareholders and pay it's employees and pay payroll and corporate taxes, they cannot pay for super awesome federal gov't plan. Why not pass a law allowing all us peon taxpayers to join your super awesome government plan? How much would it cost me to be a participant in the fed program? I bet if 100,000,000 of us join, the service and wait times will increase, as will the costs due to staffing requirements to take care of all of us. Why is it the fed program so spectacular and the VA program is having so many problems? Why can't the vets just join your Fed plan? Many simplistic questions from a simple taxpayer that doesn't understand why. Yes, I know, there is some law or code or statute that keeps things segregated, and at some time it may have been logical, but we need to simplify government to make it more efficient, and pull some of these roadblocks out of the way.

Look, I never claimed to be an insurance expert, and I don't know exactly how to fix it or what steps would be necessary to make it more open and fair. What I do know is the lack of competition and options is causing MY insurance for MY company to increase 26.4% in premiums this year over last, and more than double since ACA was enacted. I am looking for a better solution than letting government run it because 1) I believe in the free market 2) I believe that capitalism works better than socialism 3) I believe in less government controlling every part of my life. If government wants to open the doors to insurance companies to offer more options across the country and give us real freedom of choice. Gov't can still regulate it by having basic safety and controls, I am not saying Gov't is evil or bad, in fact I depend on the gov't for many things, I just think that the level of control is excessive and the bureaucracy needs to be reigned in.

Life expectancy is not tied to the government, that is truly cradle-to-grave nanny state thinking. While it can help many of us not die stupidly or protect us from snake-oil salesmen, it is not our savior.

Hopefully, I did not muddle up this too bad as I typed it up while drinking coffee at work, not really focusing on every word and double entandre. I am sure several people will nit-pick my comments to make themselves feel superior, glad that pumps your ego to call me stupid and a fat conservative. Once again, don't care because what you think of me doesn't change my life one bit. I am me, and I am okay with me, and it is still okay for me to have an opinion, you cannot throw me in jail for my thoughts.

Yet.

BiGGyT

 

[jbutler]

If there are two things the committed right and the committed left can agree on they are:

(1) Obamacare sucks balls; and
(2) It is the first step toward a single-payer system.

For the right, the latter is the problem. For the left, it's why Obamacare was and is tolerated.

 

[DrStrange]

I have often wondered at the thinking that subsidiaries of United Health Care would become fierce competitors against each other if only they were allowed to sell across state lines. There really aren't but a handful of large health insurance companies with wholly owned and managed subsidiaries at the state level. There isn't any market pressure to force price reductions to be found by allowing nation wide insurance sales. All we could reasonably hope for is the loss of friction due to dealing with one national set of regulations rather than 50 state level sets of regulations. That isn't nothing, but it isn't the solution to the greater problem.

Jbutler has it right. A single payer system will eventually take over. Based on the experiences in much of the rest of the world, we will find this cheaper and better at keeping us alive though not as profitable for the vendors.

DrStrange

 

[bergs]

Jbutler has it right. A single payer system will eventually take over. Based on the experiences in much of the rest of the world, we will find this cheaper and better at keeping us alive though not as profitable for the vendors.

DrStrange

I have every confidence that our legislators in what is ostensibly still the United States Congress will find a way to make single payer still work to benefit for-profit organizations. Have no fear, the 114th US Congress is here.

 

[DrStrange]

I pinned my hopes on 2022 and new Congressional districts.

DrStrange

 

[pltrgyst]

....Here is a thought, change the laws to allow nationwide coverage and since this is not a "states rights" issue according to the current administration, why should the state regulate insurance in each state any longer.

Mostly because the states also regulate healthcare and medical licensing.

Your Fed program is spectacular because WE pay for it and it is not limited to individual states. If the taxpayers pay for it, it can have as many bells and whistles as you want it to, when a for profit company has to answer to the shareholders and pay it's employees and pay payroll and corporate taxes, they cannot pay for super awesome federal gov't plan.

It is not an extravagant program. What it is is efficient, and run with absolute minimal overhead. It relies on private sector competition to keep prices low.

Why not pass a law allowing all us peon taxpayers to join your super awesome government plan?

That has been suggested frequently, but single-payer paranoia prevents it being considered.

Why is it the fed program so spectacular and the VA program is having so many problems? Why can't the vets just join your Fed plan?

There is only one problem in the VA healthcare system, and that is occasional longer than desirable waits for services (much like the situations in Canada and the UK, for example). But a good majority of vets like their treatment under the present VA system and do not want it changed or privatized.

Many simplistic questions from a simple taxpayer that doesn't understand why. Yes, I know, there is some law or code or statute that keeps things segregated, and at some time it may have been logical, but we need to simplify government to make it more efficient, and pull some of these roadblocks out of the way.

Those are points we all probably agree on.

Life expectancy is not tied to the government, that is truly cradle-to-grave nanny state thinking.

Of course it is connected to the government. Look at all the factors that significantly affect longevity -- nutrition, food quality, medicine, even social engineering, like having a fixed work week with weekends off, and you'll find government is a prime mover in all those institutions.

it is still okay for me to have an opinion, you cannot throw me in jail for my thoughts.

Yet.

Fight the paranoia, Biggy -- eat a Twinkie, have another bourbon, watch a football game. And stop listening to Donald T. Rump.

-- Larry

 

[pltrgyst]

If there are two things the committed right and the committed left can agree on they are:

(1) Obamacare sucks balls; and
(2) It is the first step toward a single-payer system.

Re 1: It's better than what we had before.

And 2: Exactly. Unless you consider Romneycare to have been the first step.

-- Larry

 

[BiGGyT]

I am sure several people will nit-pick my comments to make themselves feel superior, glad that pumps your ego to call me stupid and a fat conservative.

Fight the paranoia, Biggy -- eat a Twinkie, have another bourbon, watch a football game. And stop listening to Donald T. Rump.

-- Larry

sigh

 

[pltrgyst]

sigh

You could note that the comment you quoted was not a nit-pick of your comments. It was specifically in response to your worry about being thrown in jail for your thoughts -- yet.

But if it makes you feel any better, yes, that was stupid.

Myself, I like Twinkies (or, better yet, Butterscotch Krimpets), bourbon, and football. Listening to the Donald's 90 minutes of lunacy earlier today, not so much. The man is insane. I'm pretty sure that right now Ben Carson is telling his friends exactly that.

 

[Mrs Poker Zombie]

I'm covered under my wife's employer's plan, which is solid, but my employer increased all costs on employees across the board, including a 6K deductible that has to be met per family member before the healthcare kicks in. This means a family of 4 has to pay 24K out of pocket before the healthcare applies.

Are you sure that person read the deductible correctly? Usually a family 6k deductible is for the family members as a group, not per person. For example, one of my plans is 4k individual / 6k family; this is 4k if it is just me and 6k for me any everyone else, if I go family plan.

Sadly, I've always thought that this was going to be the result of Obamacare...companies will continually raise the employees' healthcare costs until it makes sense for the employees to use the government-provided programs. Employer-provided healthcare plans become a primarily executive perk like a car allotment in 10 years...

As a worker in healthcare, that is not what I have observed. Yes, costs for employees will go up, however, it is not for the purposes of pushing employees to government plans. It is to meet requirements imposed of not having "Cadillac" plans that are like your last sentence. At the end of the day, more plans will be similar to each other across different companies (which is ultimately a good thing).