vent + ? - how terrible is our health insurance?

[makingithappen]

This year, my employer dropped our decent health insurance for 1 not so great option since it was "lower cost". We just found out that next year, we have the same insuance but it will now cost more.

Family is $389/month with $1200 PP deductible then 80% coinsurance up to 3k per year.
Employee+spouse is $274/month plus the same as above.

No copays, we pay 100% of everything (except preventative) up to our deductible. We do have the option to earn incentive money to put towards OOP expenses. This is a LARGE business.

Is this to the point where an individual plan would be better? ($136/month PP with $30 copays, $750 deductible for large items and $2500 max OOP but doesn't cover anything seen in last 2 years)

[pamela]

Does that qualify as a high deductible plan where you can have a HSA? If so the premium is high, but deductible and out of pocket max are good.

[makingithappen]

Oct 1, 2012 9:40:43 GMT -5 pamela said:

Does that qualify as a high deductible plan where you can have a HSA? If so the premium is high, but deductible and out of pocket max are good.

We don't qualify for an HSA since we have an HRA that we can earn employer paid incentives in.

[ijack]

So how much will it cost you total per year? It would depend on how many rx and dr's visits you have a year.
$4668 + $3000 = $7668
indiv plan would cost $1632 + 2500 = $4132

[Deleted]

How much are the incentives? I've seen a lot of businesses go to this sort of plan and if they give you a huge chunk in your HRA by satisfying certain requirements, I don't see it as a "terrible plan." The pre-ex for the last 2 years on an individual plan would deter me from switching.
What about your H's company? Do they have a different plan option you can compare to?

[LoveTrains]

How much is your employer putting into your HRA? For example, at my job, the deductible is $1500 and then my employer puts $1500 into the HRA.

[agnes]

Really...I don't see this as a bad plan. My employer provided insurance plans have always been more.

I personally have not been able to find an individual plan any better.

Have you had any issues in the last 2 years? I think that would be the deciding factor for me. If you've just gone for regular check ups with everything checking out as normal with no issues, I would go with the indiviual plan.

[makingithappen]

H has been laid off, but we didn't have his plan because they only subsidized his portion. It was ~$800/month for the two of us.
I have not been to the dr in the last 2 years except for prenatal stuff, but the baby is on a different plan now and will continue to be. H has been to the ER for seizures 3 times, but we now know they were cause from ambien withdrawals and that is under cotnrol so we don't expect anymore seizures. He doesn't have anything else pre-existing that he can't go to a VA dr for.
We can earn up to $800 each.

[Deleted]

thru my work our family plan (medical only, not dental) is $1095.50 per family per month. We have 3000.00 deductable. AFter that everything is covered in full except prescriptions which are 10/30/50.
Dental is an additional 142.46 per family and they only cover 1000.00 per person per year

[makingithappen]

Oct 1, 2012 13:06:25 GMT -5 @susan3589 said:

thru my work our family plan (medical only, not dental) is $1095.50 per family per month. We have 3000.00 deductable. AFter that everything is covered in full except prescriptions which are 10/30/50.
Dental is an additional 142.46 per family and they only cover 1000.00 per person per year

Oh my! I take everything back ha. It sounds like they don't pay a penny towards yall's premiums....

[Deleted]

I am very envious of your plan. The one time I had insurance through work, they covered my premium and then I had to pay $600 for each additional person. We have individual insurance now and pay around $600 per month total for the premium, but it's crap insurance.

[Becca]

I would be happy with that plan at those premiums.

I would pay 800-900/month for family coverage for a similar plan

[Deleted]

That's a pretty good plan these days. My company is similar, a little lower/month cost and I can use the HSA but our deductible and OOP max are higher.

[kershnic]

I'm confused about what you're doing for insurance for the baby. But I'd lean towards the employer plan. Your H's seizure history would scare me (and anything else that would count as a preexisting condition) and you could easily come out ahead with either plan depending on how much you use it.

Also, it's really interesting to see people talk about this... so few people know what others have for health insurance and it really hurts the national conversation on health care reform. I am surprised that so many in this thread find your insurance good and would instead agree with your assessment that it's not so great. But you work with what you've got.