Healthcare Increase!

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Jeff V
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Re: Healthcare Increase!

Post by Jeff V »

I went to enroll.healthcaremarketplace.com and went through the questions. I used 2019 AGI (which was well north of $100K); not sure if I can use current state (just my wife's income).
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Re: Healthcare Increase!

Post by Scuzz »

Jeff V wrote: Fri Jun 19, 2020 11:26 pm I went to enroll.healthcaremarketplace.com and went through the questions. I used 2019 AGI (which was well north of $100K); not sure if I can use current state (just my wife's income).
Yea, it is all dependent on income so the more you earned the more it will cost.
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Re: Healthcare Increase!

Post by LawBeefaroni »

Scuzz wrote: Sat Jun 20, 2020 1:20 am
Jeff V wrote: Fri Jun 19, 2020 11:26 pm I went to enroll.healthcaremarketplace.com and went through the questions. I used 2019 AGI (which was well north of $100K); not sure if I can use current state (just my wife's income).
Yea, it is all dependent on income so the more you earned the more it will cost.
Subtle nuance, the less you earn the cheaper it is. There is a ceiling at around $130k (in Illinois) where it caps and doesn't get more expensive. Max rate, you just don't get subsidies.
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Jeff V
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Re: Healthcare Increase!

Post by Jeff V »

I was wrong about COBRA, the amount is actually $1300 per month for family plan, $800 is me + spouse.

Now the form said to use income from your taxes, but with me not working, it's not the current state of things. Using just my wife's salary, a subsidized barely-qualifies-as-insurance plan ($8500 deductible, 60/40 copay) is only about $400 per month. And that would be fine for now. The question is, can we use current income when applying or do I have to use last year's AGI?
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Scuzz
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Re: Healthcare Increase!

Post by Scuzz »

Jeff V wrote: Tue Jun 23, 2020 2:23 pm I was wrong about COBRA, the amount is actually $1300 per month for family plan, $800 is me + spouse.

Now the form said to use income from your taxes, but with me not working, it's not the current state of things. Using just my wife's salary, a subsidized barely-qualifies-as-insurance plan ($8500 deductible, 60/40 copay) is only about $400 per month. And that would be fine for now. The question is, can we use current income when applying or do I have to use last year's AGI?
If I remember right, the California version asks for current or projected annual income. If you guess high you could pay more and in theory could get a little back on your next tax return. If you guess low you would pay less but possibly owe money on your next tax return.
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Re: Healthcare Increase!

Post by Isgrimnur »

Isgrimnur wrote: Tue Sep 11, 2018 10:16 am
Isgrimnur wrote: Tue Sep 19, 2017 5:02 pm
Isgrimnur, Sep 21, 2016 wrote:And for cross reference purposes (pay periods are 2 weeks):

Self $35/period (my selection)
+ kids $177.74
+ spouse $225.83
+ spouse and kids $356.18

And again, spouse coverage is not available if coverage is available through my wife's work, which it is.
Self $35/period (my selection)
+ kids $190.10
+ spouse $241.56
+ spouse and kids $380.90

No increase in OOP maxes ($6k/12k) in network.

Effective November 1st.
This year, they're splitting medical/dental/vision to a la carte. Totalled, the numbers are:

Self $35/period (my selection)
+ kids $203.32
+ spouse $258.39
+ spouse and kids $407.34

No increase in OOP maxes ($6k/12k) in network.

Effective November 1st.
Self $36.80/period (my selection)
+ kids $212.53
+ spouse $270.50
+ spouse and kids $424.96

OOP maxes
- $5/10k Baylor Imagine Health network
- $6.5/13k otherwise

Dental - $1.89/period
Vision - free to me
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Jeff V
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Re: Healthcare Increase!

Post by Jeff V »

Wife finally became eligible and we filled out the forms today.

$210 /biweekly for a $5000 deductible 80/20 plan.
$30 for standard dental that include orthodontics although we won't need it for years. Inexplicably, the plan that did not include ortho was $15 more, with otherwise identical coverage.
Vision is $10 per month. Need it mostly for my wife, my vision problems are diabetes-related and covered under medical. I only need OTC reading glasses.

Over all better than the plan I had at my last job, and cheaper, too.
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Re: Healthcare Increase!

Post by RunningMn9 »

Thank the gods that my current employer pays all of our premiums. Jesus Christ.
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gbasden
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Re: Healthcare Increase!

Post by gbasden »

RunningMn9 wrote: Thu Sep 17, 2020 7:16 pm Thank the gods that my current employer pays all of our premiums. Jesus Christ.
Same!
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Re: Healthcare Increase!

Post by Octavious »

Same here as of last week as my wife's job pays it 100 percent. That's 350 a paycheck I get back now. 9,100 dollars a year for those playing at home. Jesus.... And now you know why I didn't feel too crazy to trade in my 2018 Honda for a 2020... :lol:
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Re: Healthcare Increase!

Post by stessier »

stessier wrote: Mon Oct 15, 2018 2:32 pm
stessier wrote: Fri Oct 06, 2017 10:32 am Got the packet last night.

For the High Deductible plan we are in - () indicate increase/decrease from 2017

Premium - $140/month (+$26 - 23%!)
Individual deductible - $2900 (+100)
Family deductible - $5800 (+200)
Co-insurance after deductible is met - 15% (+5%)
Dental with 2000/year max benefit - $49/month (+$4)

HSA contribution max went up a bit, but I think that limit if federally mandated.

The other plans (another High Dedutible - but less high- and a PPO) also increased, but at a much lower rate.

Not real happy and don't appreciate the notes throughout the packet that while the increases are high, they are still less than the companies we consider competitors for our talent.
Just finished signing up for this year.

Premium - $145/month (+$5 )
Individual deductible - $2900 (+0)
Family deductible - $5800 (+0)
Co-insurance after deductible is met - 20% (+5%)
Dental with 2000/year max benefit - $85/month (+$0 - something must have been off last year because they claim no change for this year)

I also increased my HSA contribution $25/month. With the company contribution, I'm now $1600/year from maxing it out. So another 5 years or so and I will probably be able to max it out.
Looks like I missed last year. This is for spouse+kids and increases are over 2020.

Premium - $230/month (+30)
Individual deductible - $2900 (+0)
Family deductible - $5800 (+0)
Co-insurance after deductible is met - 20% (+0%)
Dental with 2500/year max benefit - $90/month (+$5)
Vision - $20.93/month
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Re: Healthcare Increase!

Post by Octavious »

So you have to spend 5,800 on family before they even pay a dime? :shock: I'm assuming that regular checkups isn't included in that.
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Re: Healthcare Increase!

Post by stessier »

Octavious wrote: Mon Oct 12, 2020 1:51 pm So you have to spend 5,800 on family before they even pay a dime? :shock: I'm assuming that regular checkups isn't included in that.
I have to pay 100% up to any one person hitting $2900 or the combination of our family hitting $5800. Once the single person hits their total or the family hits it's total, it's drops to 80/20 coverage up to $10,800 max out of pocket for the year.
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Re: Healthcare Increase!

Post by LawBeefaroni »

Big changes this year with the acquisition. Going from a 2 PPO option (narrow and national) to a 4 plan option.

My current plan is the full Caddy, about $325 per pay period. Deductible is like $500, have never had out of pocket above my FSA. Usually have a enough FSA at the end of the year to do a group visit to the eye doctor, buy the wife a few pairs of designer frames, and stock up on tourniquets and chest seals.

Now I have to choose from 2 HSA options and 2 PPO options. HSA and PPO each have one narrow and one national network option. Min-maxing this is going to drive me crazy but even the most expensive option will be about $20 less per month after health, vision, dental, and disability insurance. I'm considering going with the national HSA and contributing the difference to the HSA. I could throw $110/period in the HSA and $60 in the FSA and still come in about $75 cheaper per period. With the employer HSA contribution I'd be over the family deductible and near the OOP max. All annuals, preventives, etc are covered at 100% so it's possible to have no out of pocket. Of course the year I drop the Cadillac plan will be the year someone gets sick, right?

But if we can get a few years of HSA accumulation, it would be a nice bonus.
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Re: Healthcare Increase!

Post by LordMortis »

Octavious wrote: Mon Oct 12, 2020 1:51 pm So you have to spend 5,800 on family before they even pay a dime? :shock: I'm assuming that regular checkups isn't included in that.
I can't speak for all insurance but deductible usually is applied for procedures and emergency room and tests but not for doctor's visits which are provided for under copays along prescriptions but I don't see copay listed there, so.... Also with no OOP max when things hit the co-insure, it's hard to tell if the cost is :shock: or not. My work actually refunds my deductible between after $500 until the $2000 mark but they don't kick in on co-insure which is from $2000 to $6500 (double that for family). It' no longer the Cadillac plan we had and has tons of issues but it's better than a kick in the ass. I am weirdly fortunate in that one of my meds does kickbacks. As long as I don't try to double dip against the HRA, my expensive med absorbs deductible and co-insure. It seems like BS to me, but if that's what they do, that's what they do. I hit my OOP of $6500 in around October, so I try to schedule all my testing in November and December.
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Re: Healthcare Increase!

Post by Octavious »

Geez.... I can say that my companies HC and my new HC were way better than that. Neither has a deductible for in network. Of course my companies was 700 a month so unless you go to the doctor a lot the plan mentioned above would probably be cheaper.
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Re: Healthcare Increase!

Post by Jeff V »

Here we go again.

I'm still not gainfully employed, which means I have nothing to offer in terms of affordable health insurance.

Wife just went back to her old job for a 20% increase in salary, but most of that is going to be devoured by the difference in health insurance. Her former company had a good plan, free meds, cost $400/mo. The cheapest plan with this company is $1000/mo, with an unspecified "discount" on meds. I take 5 maintenance meds (perpetual), get labs and see the doc 2x year, wife sees her doc as needed (about 2x a year), is not on maintenance meds yet, but she is borderline diabetic and that could change. Kids are abnormally healthy.

Went to Healthcare.gov. Provisionally they say we qualify for up to a $830 tax credit, which could go down if we make more money this year (ie, I get a job). They do give an option to take a partial credit (full credit if earned would be given at tax time). With a $500 credit, the cheapest plan they have that includes all of our doctors is $560/mo. I touched base with an agent who approached me last year with a "short term" plan (which she said they never kick anyone off) and the best is $530 /mo, but seems to include very little. Wife is not eligible for that $1000/mo plan at work until Aug. 1.

Last year, we let indecision and procrastination carry us through the summer sans insurance. I might still have enough HSA left from my old job to make it through the summer in terms of my meds. None of us have particularly egregious health issues that would cause concern over the next few months -- but that could change in an instant if either of the unvaccinated kids catches Covid. The cheapest option would be that the agent offered, wife would probably then rather keep paying it than take her work coverage (which is about an equivalent level of suck BUT she can then pay more into an HSA, and paying even more does not make her happy). Such a deal might be such a deal though if the cost of meds, labs and office visits go through the roof.
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Re: Healthcare Increase!

Post by Jeff V »

So after confirming our docs all take this short-term policy, we signed up today. Changing the primary to my wife rather than me dropped the rate $50 per month, but the coverages are all the same. We can cancel at any time if better options become available, and the lady we spoke to said there's reason for optimism that come November open enrollment, most plans, government exchange and private insurance, should be a lot less for the coming year.
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Re: Healthcare Increase!

Post by Scuzz »

Jeff V wrote: Thu Jun 17, 2021 10:14 pm So after confirming our docs all take this short-term policy, we signed up today. Changing the primary to my wife rather than me dropped the rate $50 per month, but the coverages are all the same. We can cancel at any time if better options become available, and the lady we spoke to said there's reason for optimism that come November open enrollment, most plans, government exchange and private insurance, should be a lot less for the coming year.
I don't know if it is unique to California or not but the state is running ads here saying how much cheaper health insurance is going to be under the new funding with Covered California. Now it would still all be income based, and I have no idea if all states will do it but it looks like things in California may be getting cheaper. I know several years ago when I priced health insurance thru Covered California I was rather disappointed. But maybe you do have something to look forward to.
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Re: Healthcare Increase!

Post by Octavious »

I get hc free through my wife's job now. That sounds great except it's the most horrible job she's ever had. Insurance claims....Ick...
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Re: Healthcare Increase!

Post by Smoove_B »

My wife's company (our HC provider) changed their plan last fall...during a pandemic and in addition to offering worse, more expensive coverage, so many of our doctors from the prior plan aren't covered anymore. The new specialists and doctors the new HC provider's system are recommending are all 30+ minutes away. But whatever bill of goods was sold to the CEO of her current company so they could have higher profits, I guess that was worth it. My wife has been visiting a number of specialists and every single claim has been denied. Every single one. It's beyond frustrating.
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Re: Healthcare Increase!

Post by Jeff V »

My wife's last job had really good insurance, $400 per month family, meds were 100% covered. She left for a job that pays substantially more, but the insurance is $1100 per month for the cheapest HSA plan, which, of course, does not include contributions to the HSA. This interim plan will be half the price, and can likely be renewed (at possibly a cheaper price) in November if I can't get gainfully employed with a better offer.
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Re: Healthcare Increase!

Post by Isgrimnur »

Isgrimnur wrote: Wed Sep 16, 2020 4:03 pm
Isgrimnur wrote: Tue Sep 11, 2018 10:16 am
Isgrimnur wrote: Tue Sep 19, 2017 5:02 pm
Isgrimnur, Sep 21, 2016 wrote:And for cross reference purposes (pay periods are 2 weeks):

Self $35/period (my selection)
+ kids $177.74
+ spouse $225.83
+ spouse and kids $356.18

And again, spouse coverage is not available if coverage is available through my wife's work, which it is.
Self $35/period (my selection)
+ kids $190.10
+ spouse $241.56
+ spouse and kids $380.90

No increase in OOP maxes ($6k/12k) in network.

Effective November 1st.
This year, they're splitting medical/dental/vision to a la carte. Totalled, the numbers are:

Self $35/period (my selection)
+ kids $203.32
+ spouse $258.39
+ spouse and kids $407.34

No increase in OOP maxes ($6k/12k) in network.

Effective November 1st.
Self $36.80/period (my selection)
+ kids $212.53
+ spouse $270.50
+ spouse and kids $424.96

OOP maxes
- $5/10k Baylor Imagine Health network
- $6.5/13k otherwise

Dental - $1.89/period
Vision - free to me
Dental - $1.95/period

Everything else is the same.
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Re: Healthcare Increase!

Post by Isgrimnur »

The wife is on a marketplace plan for 428.10/month, so we won't be taking the $541 option.
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Re: Healthcare Increase!

Post by Kraken »

Wife signs up for Medicare in November (and I'll be 6 months later). She has an appointment with an HR specialist who will recommend the best blend of Medicare/employer insurance. Whatever the recommendation, I expect our insurance costs to drop considerably next year.
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Re: Healthcare Increase!

Post by Blackhawk »

I have been on Medicare as my primary insurance since I went on disability in 2001, so I haven't seen the market. I find it stunning that basic insurance costs more than my rent.
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Re: Healthcare Increase!

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I left my last "real" job in 93. I was single and it was still free to me.
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Re: Healthcare Increase!

Post by LordMortis »

Kraken wrote: Thu Sep 09, 2021 4:01 pm Wife signs up for Medicare in November (and I'll be 6 months later). She has an appointment with an HR specialist who will recommend the best blend of Medicare/employer insurance. Whatever the recommendation, I expect our insurance costs to drop considerably next year.
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Re: Healthcare Increase!

Post by Jeff V »

So the last couple of years, I've been using an Obamacare broker to find us insurance. She first approached me when we already had decent insurance, I declined at the time but kept her contact info. Despite being in healthcare, only one of my wife's jobs ever had a decent medical plan (and she's seriously thinking about taking a big pay cut to go back there just for the insurance). Last year the kids were approved for Medicaid, but at the end of this month, Federal subsidies that maintained it once qualified expire, and as many as 700,000 IL residents (including, we presume, our kids) will be banished from the ranks of the gainfully insured.

Now, our broker found us an inexpensive policy for this year. She supposedly vetted our docs to ensure they took it, but when my daughter went to her doc a few weeks ago, we found out surprise, this is not the case! Since her Medicaid is still active, they were able to take her anyway. The thing is, next month (after the Medicaid purge), she needs to have her tonsils and adenoids removed.

A PPO plan just for her will equal what we are otherwise paying for the family (which so far might be a wasted effort). But the projected cost of the operation leaves us little choice. My wife doesn't want to wait until we get to the Philippines -- where presumably it was cost no more than $50. She's gonna miss 10 days of school, and the doc said she can't sing for 3 weeks -- she is singing in a stage production with the dress rehearsal 24 days after the operation. Since our son has the same doctor as our daughter, I'm assuming he's out (but also has no need to see a doctor unless something happens). Wife's doctor is part of the same medical group -- she may have some issues, and definitely needs maintenance visits. I asked her to confirm again that my doc takes it...if not, then there's no point continuing with the cheap plan.
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Re: Healthcare Increase!

Post by LordMortis »

You're scaring me. I've been trying to learn about the ACA ahead of time, and I can see plan doctors and coverage and formularies, and it's pretty apparent to me the all BCBSM aren't even close to the same and there are a lot of different versions of it available and none of them were even close to as good as the BCBSM I had when my old employer offered it. Only two versions of it from the huge pool are accepted by my existing PCP and hospital system and of the two versions my most expensive maintenance med is not in formulary.

And of course all of this has either changed or will change by the time I sign up.
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Re: Healthcare Increase!

Post by LawBeefaroni »

Jeff V wrote: Sun Mar 05, 2023 2:16 am So the last couple of years, I've been using an Obamacare broker to find us insurance. She first approached me when we already had decent insurance, I declined at the time but kept her contact info. Despite being in healthcare, only one of my wife's jobs ever had a decent medical plan (and she's seriously thinking about taking a big pay cut to go back there just for the insurance). Last year the kids were approved for Medicaid, but at the end of this month, Federal subsidies that maintained it once qualified expire, and as many as 700,000 IL residents (including, we presume, our kids) will be banished from the ranks of the gainfully insured.

Now, our broker found us an inexpensive policy for this year. She supposedly vetted our docs to ensure they took it, but when my daughter went to her doc a few weeks ago, we found out surprise, this is not the case! Since her Medicaid is still active, they were able to take her anyway. The thing is, next month (after the Medicaid purge), she needs to have her tonsils and adenoids removed.

A PPO plan just for her will equal what we are otherwise paying for the family (which so far might be a wasted effort). But the projected cost of the operation leaves us little choice. My wife doesn't want to wait until we get to the Philippines -- where presumably it was cost no more than $50. She's gonna miss 10 days of school, and the doc said she can't sing for 3 weeks -- she is singing in a stage production with the dress rehearsal 24 days after the operation. Since our son has the same doctor as our daughter, I'm assuming he's out (but also has no need to see a doctor unless something happens). Wife's doctor is part of the same medical group -- she may have some issues, and definitely needs maintenance visits. I asked her to confirm again that my doc takes it...if not, then there's no point continuing with the cheap plan.
There is a lot of confusion around the ACA plans. Offices don't know they're in, the plans directories are wrong, etc.

Some practices even think that ACA plans are medicaid when they're not (AmBetter).

PM me doctor or practice or group, and plan if you want and I can take a look.
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Re: Healthcare Increase!

Post by LordMortis »

LawBeefaroni wrote: Mon Mar 06, 2023 12:17 pm the plans directories are wrong, etc.

Wait. What?!? I've been using those as my upcoming guide. How do you figure out the plans if the plans directories are wrong?
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Re: Healthcare Increase!

Post by LawBeefaroni »

LordMortis wrote: Mon Mar 06, 2023 1:28 pm
LawBeefaroni wrote: Mon Mar 06, 2023 12:17 pm the plans directories are wrong, etc.

Wait. What?!? I've been using those as my upcoming guide. How do you figure out the plans if the plans directories are wrong?
There're notoriously inaccurate. Not saying they are always wrong, but they often are. At least in the Chicago market.

We just joined one effective Jan 1. They even had a banner atop every directory page like "Great news! System XYZ is now in-network!"

But when you looked up our docs or hospitals they all showed up as out of network.
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Re: Healthcare Increase!

Post by Grifman »

It's best to contact your doctor's office directly and get the list of insurance that they accept.
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LordMortis
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Re: Healthcare Increase!

Post by LordMortis »

It would be but my preferred hospital system isn't really a system. It's binding of several systems, a bunch of independent practices, and then a bunch combined medical fields sharing a mega campus. Until being faced with limitations of ACA coverage, every provider I have ever had considered the monstrosity in network. That ACA seems to be its own beast, presumably due to medicaid like reimbursements with gubment complications, I'd guess.
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LawBeefaroni
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Re: Healthcare Increase!

Post by LawBeefaroni »

Grifman wrote: Tue Mar 07, 2023 4:56 pm It's best to contact your doctor's office directly and get the list of insurance that they accept.
I chuckled, seeing sarcasm but it might just be my perspective.

If it's a large group or system and the first few months of the year, they often don't know about new plans, especially ACA plans.

And just as common, they won't know the particular brand name that the patient has on their card ("Open Choice Symplicity Star Plan").

Or they just don't want the patient.
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Jeff V
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Location: Nowhere you want to be.

Re: Healthcare Increase!

Post by Jeff V »

Last year, we had a pretty decent ACA policy. It was priced using my wife's salary at the time (I had no income) and when we asked the agent what happens if my wife makes more, she said, "you'll have to pay a little bit."

Well, wife wound up earning 25% more than we originally stated, plus I added another 30% from driving Uber. Got the punchline from the accountant yesterday...and it's 5 figures. :shock: Was not expecting that much, but part of it was from a part time job my wife had where she generally didn't make enough every week to start collecting tax (her mistake for not specifying an additional amount).
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stessier
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Joined: Tue Dec 21, 2004 12:30 pm
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Re: Healthcare Increase!

Post by stessier »

stessier wrote: Mon Oct 12, 2020 1:37 pm
stessier wrote: Mon Oct 15, 2018 2:32 pm
stessier wrote: Fri Oct 06, 2017 10:32 am Got the packet last night.

For the High Deductible plan we are in - () indicate increase/decrease from 2017

Premium - $140/month (+$26 - 23%!)
Individual deductible - $2900 (+100)
Family deductible - $5800 (+200)
Co-insurance after deductible is met - 15% (+5%)
Dental with 2000/year max benefit - $49/month (+$4)

HSA contribution max went up a bit, but I think that limit if federally mandated.

The other plans (another High Dedutible - but less high- and a PPO) also increased, but at a much lower rate.

Not real happy and don't appreciate the notes throughout the packet that while the increases are high, they are still less than the companies we consider competitors for our talent.
Just finished signing up for this year.

Premium - $145/month (+$5 )
Individual deductible - $2900 (+0)
Family deductible - $5800 (+0)
Co-insurance after deductible is met - 20% (+5%)
Dental with 2000/year max benefit - $85/month (+$0 - something must have been off last year because they claim no change for this year)

I also increased my HSA contribution $25/month. With the company contribution, I'm now $1600/year from maxing it out. So another 5 years or so and I will probably be able to max it out.
Looks like I missed last year. This is for spouse+kids and increases are over 2020.

Premium - $230/month (+30)
Individual deductible - $2900 (+0)
Family deductible - $5800 (+0)
Co-insurance after deductible is met - 20% (+0%)
Dental with 2500/year max benefit - $90/month (+$5)
Vision - $20.93/month
It's been a few years. Premium is going up 2% but the deductible is going up 14% from last year.

Premium - $254/month
Individual deductible - $3200
Family deductible - $6400
Co-insurance after deductible is met - 20%
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coopasonic
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Location: Dallas-ish

Re: Healthcare Increase!

Post by coopasonic »

I'm jealous, not of the plan, but of the history you have been able to maintain. I think it would be interesting to see the progression over the years.
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Skinypupy
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Location: Utah

Re: Healthcare Increase!

Post by Skinypupy »

I got a letter on Friday from my dentist of 25 years. He said that he is dropping the contract with my provider (Cigna) on Jan 1. According to him, they have not increased payouts to providers in over 4 years, and provide the lowest reimbursement (and the most difficult) of all the insurance companies they work with. Funny how my premiums have still raised significantly every year though. :roll:

So now me and the dental catastrophe that is my mouth have to try to find someone new...awesome.
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