MMR - Health insurance and reality

[Deleted]

We have a HDHP as well. We hit the deductible this year because I had a baby.

Anyway, I wasn't sure at first but I really like it because of the HSA. The money goes in tax free, grows tax free, and comes out tax free. You can invest it if you want and use it for retirement. Assuming you don't hit your deductible every year, you're money ahead and if you do, you're neutral.

[kadams767]

We have had an HDHP for 4 years and it's worked out well for us. We are young, healthy and do not have significant medical costs each year. We've never hit the deductible. My employer pays the premium in full.

[jackpackage]

It's awful! We have a HDHP, which I always thought meant low premiums. We paid over $10k in premiums this past year, plus we hit our our $4500 OOP max for my csection (deductible is $2400). Our insurance totally sucks with reimbursements, so a lot of local providers have dropped them as carriers. We only have one option for an OBGYN, pediatrician, and Dermatologist in our city now.

[evans]

Sept 7, 2012 10:32:31 GMT -5 kadams767 said:

We have had an HDHP for 4 years and it's worked out well for us. We are young, healthy and do not have significant medical costs each year. We've never hit the deductible. My employer pays the premium in full.

This is the way I feel about it too. Our premium is only $10 a month and my employer contributes $2400 a year to our HSA. This is a much better plan for me than having high premiums and low copays and/or deductible.

[jaylea]

Sept 7, 2012 10:45:14 GMT -5 evans said:

Sept 7, 2012 10:32:31 GMT -5 kadams767 said:

We have had an HDHP for 4 years and it's worked out well for us. We are young, healthy and do not have significant medical costs each year. We've never hit the deductible. My employer pays the premium in full.

This is the way I feel about it too. Our premium is only $10 a month and my employer contributes $2400 a year to our HSA. This is a much better plan for me than having high premiums and low copays and/or deductible.

This is great, when it works that way.

But some plans (like the one we had for over a year) cost the employee $400 a month, not $10.

So $4800 a year in premiums plus a $3,000 personal or $6,000 family deductible isn't so great. Especially when the employer contributes nothing to the HSA.

[evans]

Sept 7, 2012 11:01:38 GMT -5 jaylea said:

Sept 7, 2012 10:45:14 GMT -5 evans said:

This is the way I feel about it too. Our premium is only $10 a month and my employer contributes $2400 a year to our HSA. This is a much better plan for me than having high premiums and low copays and/or deductible.

This is great, when it works that way.

But some plans (like the one we had for over a year) cost the employee $400 a month, not $10.

So $4800 a year in premiums plus a $3,000 personal or $6,000 family deductible isn't so great. Especially when the employer contributes nothing to the HSA.

Right. I know I am extremely lucky to have the plan I do have.

[definitelyO]

I agree people have NO idea. we are on DH's HDHP and his OOP Max is $5800 - which we had to pay in Feb of this year (after paying over the deductible in November of last year). but my HDHP has an $11K OOP Max for a family - so his plan is way way better.

but we are repricing our benefits for 2013 now and our HDHP continues to keep really low monthly premiums - because you pay most of the cost oop. but our PPO plan is so expensive! to me anyway. but then again you just pay co-pays with no deductible to meet.

it's a balancing and budget act. pay out of paycheck or pay out of pocket.

[Deleted]

Sept 7, 2012 11:07:34 GMT -5 @msstarry said:

Another reason I am convinced Obamacare or similar would be good for the economy is it would allow for the workforce to be much more dynamic. As many responses on this thread indicate, people stay at jobs they wouldn't otherwise just to stay insured. I feel like having more options on health care would lead to a lot more innovation / small businesses.

I disagree. There are certain parts of the reform which I think are great for individuals, but you need to also look at it from the overall perspective. The rates charged for group insurance are determined by "pooling" claims-this is still going to be the case whether its 1 or 1M plans. Richer benefit plans are steadily decreasing benefits because of the increased costs of claims. The cost of healthCARE would need to be overhauled too otherwise it will continue as is indefintely. Its like trying to fix 1 crack out of many and expecting the pot to still hold all the water.

[anasara]

I'm on DH's health insurance because what my job offers is crap & costs way more. His co-share is about $400/mo with no deductables & hardly any requirements for pre-auths, referrals, etc. He complains about his job being crappily paid but the bennies more than make up for it, especially when it comes to infertility stuff. His insurance covers 80% of meds & procedures. In real life, that means my last failed IVF cost me $4k OOP instead of $20k which never in a million years would we be able to afford.

[vanillacourage]

We have a HDHP, max OOP is $5k which we easily met this year. Sad trombone.

The flip side is this finally got my DH off his butt to go have a painful shoulder looked at. He's been complaining about it for literally years and I had to shriek at him - "THIS YEAR IT IS FREE. GO GET IT LOOKED AT!!!!". Turns out he needed 8w of physical therapy - all free b/c we'd met our max OOP. I am also going to go to a dermatologist for the first time ever to have some weird semi-freckles looked at - might as well, it will never be free again.

[Deleted]

Sept 7, 2012 11:31:33 GMT -5 @msstarry said:

Sept 7, 2012 11:26:20 GMT -5 flygirl said:

I disagree. There are certain parts of the reform which I think are great for individuals, but you need to also look at it from the overall perspective. The rates charged for group insurance are determined by "pooling" claims-this is still going to be the case whether its 1 or 1M plans. Richer benefit plans are steadily decreasing benefits because of the increased costs of claims. The cost of healthCARE would need to be overhauled too otherwise it will continue as is indefintely. Its like trying to fix 1 crack out of many and expecting the pot to still hold all the water.

Well I also agree with decreasing the cost of health care drastically too. In that I would agree to share a room when having this baby, allow my languishing 90 year old grandma to go in front of a "death panel", etc., if that was what was determined to be a good cost/benefit for the country.

I can't tell if you are being serious or not. But I wasn't referring to letting anyone die to save money. I'm talking about the actual charges of the hospitals.

[Deleted]

Sept 7, 2012 12:07:15 GMT -5 @msstarry said:

I was being somewhat serious. My grandmother has been in a lot of pain the past year and is not a good candidate for the interventions they keeping pushing upon her. But since they are available and "free" she isn't turning them down. I wouldn't either.

I get what you are saying. I see a lot of cases where people don't opt for a certain treatment also because its "scary" or more painful (but sometimes more effective) and they do something else that can cost 100x as much.

ETA--oh, and by the way, back to your original post-I work for an insurance company and my insurance SUCKS

[glynn2009]

DH is retired military and I love it. I went several years with no insurance until we married with 2 small children. I happily pay my premium for the year as soon as I get the bill. I tell people I pay it before thay change their mind and make it more. We are lucky and DH did put a lot of time in for the benfit. I have been on both sides of the issue and we are blessed.

[aurora]

Sept 7, 2012 11:26:20 GMT -5 flygirl said:

Sept 7, 2012 11:07:34 GMT -5 @msstarry said:

Another reason I am convinced Obamacare or similar would be good for the economy is it would allow for the workforce to be much more dynamic. As many responses on this thread indicate, people stay at jobs they wouldn't otherwise just to stay insured. I feel like having more options on health care would lead to a lot more innovation / small businesses.

I disagree. There are certain parts of the reform which I think are great for individuals, but you need to also look at it from the overall perspective. The rates charged for group insurance are determined by "pooling" claims-this is still going to be the case whether its 1 or 1M plans. Richer benefit plans are steadily decreasing benefits because of the increased costs of claims. The cost of healthCARE would need to be overhauled too otherwise it will continue as is indefintely. Its like trying to fix 1 crack out of many and expecting the pot to still hold all the water.

Right, but your analysis doesn't change the fact that there are people out there who are not starting small businesses because they cannot get health insurance at any cost. The ACA will allow those people to get insurance, which may prompt some of them to start businesses that will help the economy.

I do agree that there also needs to be health care reform, not just insurance, but I think privatized insurance with few regulations has been a huge part of the problem.

[Deleted]

Sept 7, 2012 13:33:42 GMT -5 aurora said:

Sept 7, 2012 11:26:20 GMT -5 flygirl said:

I disagree. There are certain parts of the reform which I think are great for individuals, but you need to also look at it from the overall perspective. The rates charged for group insurance are determined by "pooling" claims-this is still going to be the case whether its 1 or 1M plans. Richer benefit plans are steadily decreasing benefits because of the increased costs of claims. The cost of healthCARE would need to be overhauled too otherwise it will continue as is indefintely. Its like trying to fix 1 crack out of many and expecting the pot to still hold all the water.

Right, but your analysis doesn't change the fact that there are people out there who are not starting small businesses because they cannot get health insurance at any cost. The ACA will allow those people to get insurance, which may prompt some of them to start businesses that will help the economy.

I do agree that there also needs to be health care reform, not just insurance, but I think privatized insurance with few regulations has been a huge part of the problem.

Not to be a smart a$$, but how does the ACA help them get insurance right now?

[aurora]

Sept 7, 2012 13:49:58 GMT -5 flygirl said:

Sept 7, 2012 13:33:42 GMT -5 aurora said:

Right, but your analysis doesn't change the fact that there are people out there who are not starting small businesses because they cannot get health insurance at any cost. The ACA will allow those people to get insurance, which may prompt some of them to start businesses that will help the economy.

I do agree that there also needs to be health care reform, not just insurance, but I think privatized insurance with few regulations has been a huge part of the problem.

Not to be a smart a$$, but how does the ACA help them get insurance right now?

I'm specifically referring to the no pre-existing condition exclusions part of the law.

I have a pre-existing condition. Therefore, I had to take a job with health insurance benefits. Without ACA, I could not quit my job to start my own company and have health insurance. That's a pretty significant disincentive not to start my own company, no?