LordMortis wrote:We have an HR Guy they hired two years ago who has finally taken over our health care negotiations. I'm ascared. Accounting always tried to do what was best for everyone within a budget. New HR guy is whacky conservative who sounds as if he's more interested in making a point than making the best of bad situations, sort of like too many of my relatives.
And Lazy ass HR with axe to grind, gets strike one. While the increase in rates hasn't come through, our plan has been tweaked. co-pay, co-insurance, deductible maximum for one person went from $1000 to $6,600.
Part of this is really is Thanx Obama, the other part is Thanx HR idiot.
Just got the bad news. Increase in my premiums went up ~26%, from 193 to 243.55 per pay, so from 386 to 487.10. We use to get a discount of 25% if we used our hospital, that is gone. Our deductible went up by about 25% as well. Plus until you meet the annual out of pocket expense, you pay 10% of all services. So meet the deductible, (3,000 family), then I pay 10% of the services from there, until I meet the 6,000 annual out of pocket maximum. It might be half that depending on the wording, so I am waiting to get that info back. there might be an individual max, but that is not how it reads, but I don't think I should have a higher out of pocket max on an individual than an individual plan. But who knows, these plans are all different. There are also some massive restrictions on what physicians I can see, as the new health system is way to the east of us, and we are the furthers west. So we don't have a lot of existing physicians in the system, other than the ones we have had in our system. So we have to change physicians, but not a huge deal, most plans make you use certain docs.
Also, our prescriptions use to be 10% cheaper if we used our pharmacy(the hospital has a stand alone pharmacy in our medical building), that is gone, and actually is now more expensive than any CVS pharmacy for 90 day supplies(one example I saw showed that our pharmacy would be about 30% more expensive). This is not bad, as I still get at least the same rate, just lose the option to go over to the close pharmacy and actually talk to a pharmacist if I had a question.
However, it is not all bad. We use to have separate deductibles for Drugs and Medical. They are now the same, so there is that.
The system is pushing the high deductible plan. The premiums are lower, 290/month, or 145.10/pay. But the deductibles are through the roof. And while I will run the numbers, there is not really an incentive for me to switch, as I have some health issues, and see physicians once a quarter and get lab work done 4-6 times a year, and have tons of prescriptions that I take. So I almost always meet the deductible for myself in the first few months of any plan. And a higher one, just means more bills.
Just FYI, I am quoting the highest rate, family, as I have a wife and three kids. Can't wait for my wife to start teaching again, so that she can get better insurance. But overall, the increase is going to be hard to budget, but we will survive.
Difficulties mastered are opportunities won. - Winston Churchill
Sheesh, this is one small box. Thankfully, everything's packed in nicely this time. Not too tight nor too loose (someone's sig in 3, 2, ...). - Hepcat
Ouch. That's a big jump. And the 10% coninsurance is kind of weird but at least you're still getting relatively decent coverage.
On quirk that I just noticed on ours is that they added a new category, Employee + children, for single parents or those with otherwise-insured spouses/partners.
Previously it was just Employee, Employee + Spouse, and Employee + Family (including single parents). Oddly, although I think it's a good thing, the premium for Employee + Children is lower than that for Employee + Spouse.
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
LawBeefaroni wrote:Ouch. That's a big jump. And the 10% coninsurance is kind of weird but at least you're still getting relatively decent coverage.
On quirk that I just noticed on ours is that they added a new category, Employee + children, for single parents or those with otherwise-insured spouses/partners.
Previously it was just Employee, Employee + Spouse, and Employee + Family (including single parents). Oddly, although I think it's a good thing, the premium for Employee + Children is lower than that for Employee + Spouse.
Yep, we had four levels (But our employee + kids was higher than employee + Spouse).
Employee - Base level
Employee + Spouse(or same sex partner) : 40 more than Employee
Employee + Kids : 80 more than employee
Employee + Family : 100 more than employee
There is no spouse surcharge, and a $ 25 /pay increase if you are a smoker. Again, good an bad. But everyone has the smoker clause now I am guessing.
Difficulties mastered are opportunities won. - Winston Churchill
Sheesh, this is one small box. Thankfully, everything's packed in nicely this time. Not too tight nor too loose (someone's sig in 3, 2, ...). - Hepcat
One change I noted last year was that we had to start paying per child. There was no "Employee + Family" option any more.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
My wife is going into the doctor tomorrow morning. She has 100% of the symptoms of a bad gall bladder. RM9 has me scared.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
Octavious wrote:My wife is going into the doctor tomorrow morning. She has 100% of the symptoms of a bad gall bladder. RM9 has me scared.
Have less fear. Going to your doctor and finding out you have a bum gallbladder is exactly how you want to find out that you have a bum gallbladder. Assuming for the moment that she just had a gall stone attack and the pain has gone away for the time being. That gives you time to find a surgeon that won't rape you, that is in-network or whatever other shenanigans your health insurance requires to avoid fisting you repeatedly.
What you don't want is EMERGENCY gallbladder removal. ELECTIVE gallbladder removal is the way to go. The only real risk at that point is the anesthesiologist and the assistant surgeon that will always be brought in because they can.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
RunningMn9 wrote:What you don't want is EMERGENCY gallbladder removal. ELECTIVE gallbladder removal is the way to go. The only real risk at that point is the anesthesiologist and the assistant surgeon that will always be brought in because they can.
I'm to the point now where I'd be bringing this up before the surgery date as well. If they're bringing in someone in, they'd better be picking them off the same provider lists I found them on. I would make it clear, deliver it in writing, registered mail, and via e-mail that I would hold them responsible for any excess charges incurred by that failure.
Isgrimnur wrote:I'm to the point now where I'd be bringing this up before the surgery date as well. If they're bringing in someone in, they'd better be picking them off the same provider lists I found them on. I would make it clear, deliver it in writing, registered mail, and via e-mail that I would hold them responsible for any excess charges incurred by that failure.
Agreed. This is the last remaining issue that I have in my situation, as I've begged the assistant surgeon to just take what the insurance company gave him (they paid about 30% of his billed charges). It is unreasonable (to me) to be held financially responsible for the surgeon choosing an assistant that is outside of my network - especially when I never consented to an assistant surgeon in the first place (well, I'm sure I generically did on a form somewhere, but it never came up in the conversation I had with the primary surgeon).
My overall advice - do NOT wait for your organs to go critical before addressing these issues. If you have a gall stone attack, go to your doctor and get your gall bladder yanked under your own terms when you control the variables (who, when and where). I can live with what happened to me, because it is in large part my own fault. I never should have ignored the gall stone attacks.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
RunningMn9 wrote:What you don't want is EMERGENCY gallbladder removal. ELECTIVE gallbladder removal is the way to go. The only real risk at that point is the anesthesiologist and the assistant surgeon that will always be brought in because they can.
I'm to the point now where I'd be bringing this up before the surgery date as well. If they're bringing in someone in, they'd better be picking them off the same provider lists I found them on. I would make it clear, deliver it in writing, registered mail, and via e-mail that I would hold them responsible for any excess charges incurred by that failure.
You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
RunningMn9 wrote:What you don't want is EMERGENCY gallbladder removal. ELECTIVE gallbladder removal is the way to go. The only real risk at that point is the anesthesiologist and the assistant surgeon that will always be brought in because they can.
I'm to the point now where I'd be bringing this up before the surgery date as well. If they're bringing in someone in, they'd better be picking them off the same provider lists I found them on. I would make it clear, deliver it in writing, registered mail, and via e-mail that I would hold them responsible for any excess charges incurred by that failure.
You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
In Ohio at my hospital all of our Anesthesiologists are part of the insurance plans that the hospital accepts. We only rarely have a physician that practices here that is not on an insurance plan that we don't accept. And those are specialists that only come here once in a blue moon. So while I can not comment on other states, or hospitals I know that mine tries to ensure we don't have the situation that RM9 has ever occur to our patients.
In an emergency situation, no one ever checks insurance. But I have helped people get the documentation to prove it was an emergency so that they can appeal. RM9's situation sounds bad, and I wish I could say that I have never seen what happened to him happen. But I have, and it sucks.
That's why I always encourage people to know what their plans allow, but hell emergencies happen.
Wish you luck RM9 in getting the physicians and others to do what is right and forgive the excess on those bills.
Difficulties mastered are opportunities won. - Winston Churchill
Sheesh, this is one small box. Thankfully, everything's packed in nicely this time. Not too tight nor too loose (someone's sig in 3, 2, ...). - Hepcat
Isgrimnur wrote:I'm to the point now where I'd be bringing this up before the surgery date as well. If they're bringing in someone in, they'd better be picking them off the same provider lists I found them on. I would make it clear, deliver it in writing, registered mail, and via e-mail that I would hold them responsible for any excess charges incurred by that failure.
Agreed. This is the last remaining issue that I have in my situation, as I've begged the assistant surgeon to just take what the insurance company gave him (they paid about 30% of his billed charges). It is unreasonable (to me) to be held financially responsible for the surgeon choosing an assistant that is outside of my network - especially when I never consented to an assistant surgeon in the first place (well, I'm sure I generically did on a form somewhere, but it never came up in the conversation I had with the primary surgeon).
My overall advice - do NOT wait for your organs to go critical before addressing these issues. If you have a gall stone attack, go to your doctor and get your gall bladder yanked under your own terms when you control the variables (who, when and where). I can live with what happened to me, because it is in large part my own fault. I never should have ignored the gall stone attacks.
I'm worried that if I'm right they will ship her right to the hospital. She's a total mess and I've been begging her to go to the doctor. Hopefully I have no idea what I'm thinking it is.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
RMC wrote:In Ohio at my hospital all of our Anesthesiologists are part of the insurance plans that the hospital accepts.
I really don't understand why this isn't standard operating procedure. It should be a condition of gaining privileges at a hospital.
RMC wrote:I know that mine tries to ensure we don't have the situation that RM9 has ever occur to our patients.
I appreciate their efforts from afar.
RMC wrote:But I have helped people get the documentation to prove it was an emergency so that they can appeal. RM9's situation sounds bad, and I wish I could say that I have never seen what happened to him happen. But I have, and it sucks.
I have that. It didn't help. The problem is that the only way that becomes relevant is if I sue them. In Alabama, from NJ. They seem to know that I am not going to do that, so just keep saying that it wasn't an emergency because they didn't operate on me in the emergency room. And that was good enough for the State Dept of Insurance.
RMC wrote:Wish you luck RM9 in getting the physicians and others to do what is right and forgive the excess on those bills.
The primary surgeon forgave a substantial part of his clearly insane bill (around $17,000 of it). I haven't heard back from the assistant yet, but whether he forgives it or not, I'm not paying him.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
Octavious wrote:I'm worried that if I'm right they will ship her right to the hospital. She's a total mess and I've been begging her to go to the doctor. Hopefully I have no idea what I'm thinking it is.
The amount of agony that is experienced when your gallbladder goes critical is not something you can miss. It is completely incapacitating, and it doesn't go away. It is the only time in my life that the pain was sufficient to cause me to vomit. And after about six hours, I started hallucinating from the pain.
Unfortunately I have an almost legendary ability to tolerate pain, and so I was willing to endure that for 11 hours before suggesting that maybe a trip to the ER was in order. But I don't know that most people would be that stupid. You cannot mistake the symptoms. If you feel the same sort of symptoms (to a lesser degree), and they go away in 30-45 minutes, then you are probably having a gall stone attack, and there is no reason to rush you in for emergency surgery. If we are sitting here today - and she is able to wait until tomorrow to go to the doctor, you should be fine.
I cannot stress enough just how debilitating the pain was.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
Ouch, yeah across state lines is never fun. The only suggestion that I have, is try to call the hospital that they performed the procedure at, and ask for the President/CEO. Ours will actually take a call from patients. Tell him your situation, and ask if you can get a letter from a physician stating that it was an emergency situation, and explain what the insurance company is saying.
If you have done that, then I am out of ideas. Some hospitals are just bad, and don't care. I wish that was not the case, but it is true. Also, since you don't have any relationship with any of the physicians or hospital, it is hard to get any traction.
A long shot would be to take your medical record to your current physician, and ask him if he could review it and write a letter saying it was an emergency. Sometimes peer to peer physicians will allow certain things. But that is a long shot, as your physician would have to actually write a letter on something that someone else documented. So not something that I would guess would work all that well...
Difficulties mastered are opportunities won. - Winston Churchill
Sheesh, this is one small box. Thankfully, everything's packed in nicely this time. Not too tight nor too loose (someone's sig in 3, 2, ...). - Hepcat
coopasonic wrote:You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
This was my MIL's experience for an outpatient colonoscopy. The procedure itself was covered under her insurance. When she arrived for her appointment, as they were prepping her, the anesthesiologist came in, introduced himself and let her know that if she wanted any of his magical potions, she needed to sign some forms and that he didn't accept her insurance. She's a better person than I am because I would have left. Why the F are you working at an outpatient clinic and refusing to accept member insurance? Seriously? F that guy.
Last edited by Smoove_B on Mon Oct 20, 2014 2:22 pm, edited 1 time in total.
Well this is the same person who had shingles for a week before she got it checked out. She said she was in pain, but holy crap shingles usually knocks people on their ass.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
RMC wrote:The only suggestion that I have, is try to call the hospital that they performed the procedure at, and ask for the President/CEO.
We did that back in 2013.
The President contacted my wife directly and put her in touch with the top financial dude at the hospital. Their position is that they have no authority over what the doctors charge (a big part of the problem with the insurance company stems from the fact that the surgeons bill is *insane*). They can charge me eleventy billion dollars, and that's cool with the hospital. They did furnish us with copies of everything, including the 200 pages of OR reports, noting just how grave the situation was. The insurance company couldn't have cared less.
I appreciate the suggestions, but after two years (today is actually the two-year anniversary of the incident), I've given up.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
Octavious wrote:Well this is the same person who had shingles for a week before she got it checked out. She said she was in pain, but holy crap shingles usually knocks people on their ass.
I have no frame of reference for that. Anyone that I know who has had an emergency situation (with either the appendix or gall bladder), there is no mistaking it - and you are simply incapable of waiting a day or two to seek medical assistance.
I should stress that you should really hope that she's not just dealing with the pain. If the gall bladder has become infected and has perished, it can easily become a fatal event. I don't want to scare you more - but you do NOT want to wait around if you are in that kind of pain. You cannot let that organ rupture if it's infected. I was significantly closer to that than I should have allowed (probably within hours). Had they known how bad it was before they went in, I would have an 18-inch scar in my chest, and would have been in the hospital for 2-3 weeks. Don't fuck around with your gallbladder.
Last edited by RunningMn9 on Mon Oct 20, 2014 2:41 pm, edited 1 time in total.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
coopasonic wrote:You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
This was my MIL's experience for an outpatient colonoscopy. The procedure itself was covered under her insurance. When she arrived for her appointment, as they were prepping her, the anesthesiologist came in, introduced himself and let her know that if she wanted any of his magical potions, she needed to sign some forms and that he didn't accept her insurance. She's a better person than I am because I would have left. Why the F are you working at an outpatient clinic and refusing to accept member insurance? Seriously? F that guy.
No shit. That's about fucked up. Why is clinic letting him work there and why is the surgeon working with them? Again, that's about fucked up.
RMC wrote:In Ohio at my hospital all of our Anesthesiologists are part of the insurance plans that the hospital accepts.
I really don't understand why this isn't standard operating procedure. It should be a condition of gaining privileges at a hospital.
It would be a financial, legal, and operational nightmare to require every on-staff physician to have a participation agreement with the same plans/contracts. The way it often works is that the hospital managed care contracts cover facility based "hospital based" services (radiologists, anesthesiologists, pathologists, etc). Then there are usually hospital-employed groups as well and they mirror all the plans the hospital is in. The problem is that the remaining independent providers aren't going to want to be told by the hospital which plans they are and aren't in. Never mind the fact that providers often have priviliges at multiple hospitals.
We have been approached by one large insurer to amend our agreements to include an ER wrap product that would allow out-of-network emergency room and follow-up inpatient services to be paid at a negotiated rate. This would eliminate the RM9 Scenario. We're still hashing out the details though, it's very vague in how it would work.
RunningMn9 wrote:
RMC wrote:I know that mine tries to ensure we don't have the situation that RM9 has ever occur to our patients.
I appreciate their efforts from afar.
It also cuts down on uncollectable receivables. It's a win/win.
There is so much weird stuff going on out there right now. A major national corporation is creating "Centers of Excellence" agreements for joint replacement. Meaning they cut deals with various hospitals around the country to do joint replacements at a fixed price and their employees have to choose one of those locations for their surgery, or else face out-of-network or lower tier coverage. When cover 150,000+ employed individuals plus who knows how many reitrees across the US, many of them are going to be a plane ride away from an in-network facility for joint replacement. But hey, lower cost for the $200B+ market cap company.
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
LordMortis wrote:
No shit. That's about fucked up. Why is clinic letting him work there and why is the surgeon working with them?
That's the real problem. You can't blame the guy for being there if the clinic invited him.
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
Octavious wrote:Well this is the same person who had shingles for a week before she got it checked out. She said she was in pain, but holy crap shingles usually knocks people on their ass.
I have no frame of reference for that. Anyone that I know who has had an emergency situation (with either the appendix or gall bladder), there is no mistaking it - and you are simply incapable of waiting a day or two to seek medical assistance.
I should stress that you should really hope that she's not just dealing with the pain. If the gall bladder has become infected and has perished, it can easily become a fatal event. I don't want to scare you more - but you do NOT want to wait around if you are in that kind of pain. You cannot let that organ rupture if it's infected. I was significantly closer to that than I should have allowed (probably within hours). Had they known how bad it was before they went in, I would have an 18-inch scar in my chest, and would have been in the hospital for 2-3 weeks. Don't fuck around with your gallbladder.
Ya she's the most stubborn person alive so who really knows. She has an appointment at 10AM tomorrow. Generally when I try and guess I problem I'm totally off so we'll see.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
Octavious wrote:Generally when I try and guess I problem I'm totally off so we'll see.
Let's hope that you keep your record intact.
And in banks across the world
Christians, Moslems, Hindus, Jews
And every other race, creed, colour, tint or hue
Get down on their knees and pray
The raccoon and the groundhog neatly
Make up bags of change
But the monkey in the corner
Well he's slowly drifting out of range
coopasonic wrote:You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
This was my MIL's experience for an outpatient colonoscopy. The procedure itself was covered under her insurance. When she arrived for her appointment, as they were prepping her, the anesthesiologist came in, introduced himself and let her know that if she wanted any of his magical potions, she needed to sign some forms and that he didn't accept her insurance. She's a better person than I am because I would have left. Why the F are you working at an outpatient clinic and refusing to accept member insurance? Seriously? F that guy.
I would tell them I didn't need it because I would relieve any pain by clinching the doctors gonads between my fingers.
coopasonic wrote:You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
This was my MIL's experience for an outpatient colonoscopy. The procedure itself was covered under her insurance. When she arrived for her appointment, as they were prepping her, the anesthesiologist came in, introduced himself and let her know that if she wanted any of his magical potions, she needed to sign some forms and that he didn't accept her insurance. She's a better person than I am because I would have left. Why the F are you working at an outpatient clinic and refusing to accept member insurance? Seriously? F that guy.
I would tell them I didn't need it because I would relieve any pain by clinching the doctors gonads between my fingers.
That's a non-covered service.
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
coopasonic wrote:You may not get anesthesia (or surgery) then. I am not sure any anesthesiologist is on a plan.
This was my MIL's experience for an outpatient colonoscopy. The procedure itself was covered under her insurance. When she arrived for her appointment, as they were prepping her, the anesthesiologist came in, introduced himself and let her know that if she wanted any of his magical potions, she needed to sign some forms and that he didn't accept her insurance. She's a better person than I am because I would have left. Why the F are you working at an outpatient clinic and refusing to accept member insurance? Seriously? F that guy.
I would have asked for a pint of whisky and a bullet to bite.
LawBeefaroni wrote:Ouch. That's a big jump. And the 10% coninsurance is kind of weird but at least you're still getting relatively decent coverage.
On quirk that I just noticed on ours is that they added a new category, Employee + children, for single parents or those with otherwise-insured spouses/partners.
Previously it was just Employee, Employee + Spouse, and Employee + Family (including single parents). Oddly, although I think it's a good thing, the premium for Employee + Children is lower than that for Employee + Spouse.
I noticed this too. The rate for Employee+Spouse is the same as Employee+child. I should probably take another look at my wife's option; it could be cheaper to spin her off to her own plan than to pay for the family option.
Octavious wrote:Generally when I try and guess I problem I'm totally off so we'll see.
Let's hope that you keep your record intact.
If my FF record is any indication she should be fine.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
LawBeefaroni wrote:Ouch. That's a big jump. And the 10% coninsurance is kind of weird but at least you're still getting relatively decent coverage.
On quirk that I just noticed on ours is that they added a new category, Employee + children, for single parents or those with otherwise-insured spouses/partners.
Previously it was just Employee, Employee + Spouse, and Employee + Family (including single parents). Oddly, although I think it's a good thing, the premium for Employee + Children is lower than that for Employee + Spouse.
I noticed this too. The rate for Employee+Spouse is the same as Employee+child. I should probably take another look at my wife's option; it could be cheaper to spin her off to her own plan than to pay for the family option.
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
LawBeefaroni wrote:Ouch. That's a big jump. And the 10% coninsurance is kind of weird but at least you're still getting relatively decent coverage.
On quirk that I just noticed on ours is that they added a new category, Employee + children, for single parents or those with otherwise-insured spouses/partners.
Previously it was just Employee, Employee + Spouse, and Employee + Family (including single parents). Oddly, although I think it's a good thing, the premium for Employee + Children is lower than that for Employee + Spouse.
I noticed this too. The rate for Employee+Spouse is the same as Employee+child. I should probably take another look at my wife's option; it could be cheaper to spin her off to her own plan than to pay for the family option.
Our individual insurance actually is pretty good. It's people with a family that get screwed in my place.
Capitalism tries for a delicate balance: It attempts to work things out so that everyone gets just enough stuff to keep them from getting violent and trying to take other people’s stuff.
Octavious wrote:Our individual insurance actually is pretty good. It's people with a family that get screwed in my place.
I personally feel like it's the other way around (in my place). My benefits are compared poorly because I don't have a family for the company to take care of. A company of 45 people pays to insure somewhere between 150 and 200 people and they are only insuring 1 person on account of me. No spouse. No children.
We just added a monthly fee ($100, I think) if your spouse has insurance available through another job, but still gets insurance through the employee. That's on top of the increase for adding spouse and family in the general monthly contribution. Fortunately (?), my wife doesn't work at the moment.
Enrolled today. Benefits improved slightly if you are looking for reproductive assistance. We also got the option to change our Dental elections every year instead of every 2 years. There was no change to the Deductibles or out of pocket expenses.
But the premiums went way up - 25% for my plan.
Also, found out I've been living the high life this year and didn't realize it. I meant to put $225/month in my HSA during this year and have only been putting in $22.50/month. Now not only is my HSA low, but it's going to be painful to replenish. BLECH!
We should start hearing rumblings in the next couple weeks. And given how much the companies are asking for, I'm not thrilled about the prospect of it being a pleasant surprise.
None of this sounds good. My initial costs didn't go up by much last. Year instead they jacked my copay/con-insure/deductible maximum from $1100 to $8500, I think.
If they are looking to recoup a 20% cost increase, I have no idea where it's coming from this coming year. So when does the ACA stop the bleeding again?
Those increases are just for the ACA State Exchange products, unless I'm mistaken. And here's a pretty good guide about how to read those numbers.
Those in non-exchange plans will probably see increases more in line with what we've been seeing annually the last 4 or 5 years. But I expect there will be a lot of cost cutting measures beyond premiums. I'm seeing a lot more activity in the narrow networks where you are limited to a small subset of providers and hospitals (selected based on how much they get paid).
" Hey OP, listen to my advice alright." -Tha General "No scientific discovery is named after its original discoverer." -Stigler's Law of Eponymy, discovered by Robert K. Merton MYT
My company has been notified by Blue Shield that the insurance plan they were nice enough to let us keep the last two years is disappearing with the next renewal. I expect we will be asked to move into something more expensive. It can't have fewer perks as we are pretty much at that limitation already.
The renewal date is 12-1, so I should be finding out the bad news soon.
