Healthcare Increase!

[Octavious]

Wow okay ALL our plans suck now. My company was just early on the trigger. Ours didn't go up this year. It's probably because we shed like half the company.

[Smoove_B]

Figured I'd check - just for added hilarity. There's really two general choices based on what type of prescription drug plan you want, and then under each of those you have your pick of three other plans. For 2012, just randomly picking the cheapest plan (which is only about $50 in savings from the other two) it would be $1,471 per month for family medical; +$382 per month for prescription = $1,853 / month.

For 2013 that same exact plan goes to $1611 per month for family medical; $411 per month for prescription = $2,022 / month. If I was willing to switch plans, I might be able to shave off $50-75 per month, but when you're dropping $500 per week for medical, at that point does it really matter?

Anyway, so glad I don't need insurance through my employer; what you're seeing is 100% of the plan cost, passed directly from the insurer to me (employer pays for nothing).

[LawBeefaroni]

FWIW, we have a total of 3 plan options. I'm in the "custom network" option but we also have basic option that is about half as much per month and a BCBS plan that is about twice as much per month. I haven't reveiwed them all yet.

[Skinypupy]

Figured I'd check - just for added hilarity. There's really two general choices based on what type of prescription drug plan you want, and then under each of those you have your pick of three other plans. For 2012, just randomly picking the cheapest plan (which is only about $50 in savings from the other two) it would be $1,471 per month for family medical; +$382 per month for prescription = $1,853 / month.

For 2013 that same exact plan goes to $1611 per month for family medical; $411 per month for prescription = $2,022 / month. If I was willing to switch plans, I might be able to shave off $50-75 per month, but when you're dropping $500 per week for medical, at that point does it really matter?

Anyway, so glad I don't need insurance through my employer; what you're seeing is 100% of the plan cost, passed directly from the insurer to me (employer pays for nothing).

That's utterly insane.

If it's not too nosy to ask, do you have private insurance or do you just go without?

[stessier]

The difference in what qualifies as a "high deductible" plan is amazing. My deductible is $4,800 (80/20 after) and I'm paying about the same premium as you...assuming that premium is per-paycheck and not per-month.

It is per check, but I get paid once a month, so...

And I could have sworn I had included this bit, but it looks like I edited it out. My employer puts $1200 in my HSA.

Finally, I too have the 3 options. One option is a PPO - it doesn't make sense to use this, though, as far as I can tell. The only case where it comes out cheaper is if one person is on their death bed and incurs massive medical bills while everyone else never sees the doctor. Literally never - even one visit each makes the other option the better choice.

The third option is a different high deductible plan. It has a $5200 deductible and $10,400 out of pocket maximum. The premium is 1/4 though - $47 in my case. I have to look at this a bit more as a co-worker mentioned that each person has a separate limit or something like that - made it sound not quite as scary as I originally thought.

[Skinypupy]

The difference in what qualifies as a "high deductible" plan is amazing. My deductible is $4,800 (80/20 after) and I'm paying about the same premium as you...assuming that premium is per-paycheck and not per-month.

It is per check, but I get paid once a month, so...

And I could have sworn I had included this bit, but it looks like I edited it out. My employer puts $1200 in my HSA.

Yeah, mine is that much every 2 weeks. We do get the $1,200 HSA contribution as well, which offsets some of it, I suppose.

The third option is a different high deductible plan. It has a $5200 deductible and $10,400 out of pocket maximum. The premium is 1/4 though - $47 in my case. I have to look at this a bit more as a co-worker mentioned that each person has a separate limit or something like that - made it sound not quite as scary as I originally thought.

This is pretty close to the plan I'm on (deductible is $4,800, OOP is $9,800), except I pay $350/month for it. And I'm contributing an extra $100/paycheck on top of that to my HSA to cover some dental, vision, etc. Company does have a lower deductible plan available ($2,600, same OOP), but the monthly premiums are nearly triple and they limit your HSA contribution. Didn't really seem worth it.

Of course, insurance doesn't even touch any of our IVF/fertility stuff...that's a whole 'nother story.

[Smoove_B]

If it's not too nosy to ask, do you have private insurance or do you just go without?

We're covered under my wife's employer, though I couldn't tell you what we're currently paying and what we're looking at for 2013. I know we're fortunate in that benefits aren't an issue for me, but I honestly cannot imagine what things would be like if we were put in a position where that was our only choice. I share the data since it represents 100% of the plan cost, passed directly to me. If I used the calculator correctly, I believe my F/T counter parts are paying about $115 a month for medical and prescription coverage.

[stessier]

My company says it is self insured. That means it pays for everything itself and just uses an outside company to administer it, right? So the only costs should be actual expenses and administration, right? Because they claim something like $9k/year in healthcare costs for me, but that has to be a company wide average because I haven't hit my $2400 deductible limit in 2 years, so I'm paying all my costs myself.

[LawBeefaroni]

My company says it is self insured. That means it pays for everything itself and just uses an outside company to administer it, right? So the only costs should be actual expenses and administration, right? Because they claim something like $9k/year in healthcare costs for me, but that has to be a company wide average because I haven't hit my $2400 deductible limit in 2 years, so I'm paying all my costs myself.

Self insurance basically means that they pay into their own pool and pay expenses out of that. So even though your direct costs are covered by your deductible and under $9K, they are still paying into the pool every month for you and most likely they are subsidizing a large part of your monthly premium. [You are paing in the same amount as the guy who had $80K in medical bills, that's your $9K]

"Administration" costs are probably a lot more than you might think, they include medical management programs, claims processing and adjudication, etc. In addition, they may have their own stop loss insurance to cover catastrophic cases or unexpected utilization.

[LordMortis]

The real question is how much your company is paying for your health care coverage. Our company provide us with that information. I don't have it in front me but as a single person with no children in 2012 they will have paid something like $15,000 in 2012 for me. I take no deductions from my check. I pay $50 for approved prescriptions (and they must be approved). $10 for in network office visits. I self refer. $150 for emergency room visits. 50% for medical hardware. My copay deductible for anything the do/provide is 10% to a maximum of $1200 a year.

I am the lucky one. A spouse doubles things $2400. Children take it up to $5000. Also a spouse means the company takes $100 out of your check semi monthly and having a family means they take $400 out of your check semi monthly . I have no idea what the company pays for couples and families.

I do know they can't sustain what they're paying and the huge increase to them (that they have been trying to insulate us from every year until now) is going to be paid forward to us. So "a double digit increase in percentage" to me sounds like they they are going to have come up with nearly another $2000 a year to pay for my coverage, which likely means a good chunk of that $2000 will be on me, unless they continue to insulate me, being single with no children, and pass the costs on to families who probably already get a bigger compensation for coverage than I do.

I don't know how many people actually see the costs of their medical to the company but I think some of you might freak out if you did. Between that and all of the payroll taxes, I can see why a company would rather work one person to death than hire two people to do a job, irrespective of "overtime." We'd riot in the streets if we saw how much they were really taking out of our compensation every check to pay for work mans comp, pay roll taxes, unemployment, and health insurance.

[ImLawBoy]

My company says it is self insured. That means it pays for everything itself and just uses an outside company to administer it, right? So the only costs should be actual expenses and administration, right? Because they claim something like $9k/year in healthcare costs for me, but that has to be a company wide average because I haven't hit my $2400 deductible limit in 2 years, so I'm paying all my costs myself.

We're self-insured, too. People like me offset people like you, since we usually hit our deductible by February (if not January), and have hit our out-of-pocket maximum as early as April. In fact, they probably need a lot of people like you just to offset me.

[LawBeefaroni]

I don't know how many people actually see the costs of their medical to the company but I think some of you might freak out if you did. Between that and all of the payroll taxes, I can see why a company would rather work one person to death than hire two people to do a job, irrespective of "overtime." We'd riot in the streets if we saw how much they were really taking out of our compensation every check to pay for work mans comp, pay roll taxes, unemployment, and health insurance.

We get an individualized "total compensation" breakdown that includes company portion of healthcare, pre-tax savings, etc. It's eye opening and I think it has the desired effect on a lot of employees.

[LordMortis]

We get an individualized "total compensation" breakdown that includes company portion of healthcare, pre-tax savings, etc. It's eye opening and I think it has the desired effect on a lot of employees.

It helps me to appreciate what the companies real cost of employing me is. It also helps me appreciate why contractors are so expensive (though it doesn't help me appreciate why so many of them suck so bad. I hate when they make me cost compare when I've found and am happy with existing value added resources.)

[El Guapo]

I currently work for the state. Premiums didn't really go up last year, at least not materially, and right now it's about ~$350/month to cover my family. Evidently they're now negotiating the relevant agreements for next year; it's something of a mystery at the moment since Massachusetts just passed a big health care cost containment bill, and I'm not sure how that's going to play out.

[Skinypupy]

I don't know how many people actually see the costs of their medical to the company but I think some of you might freak out if you did. Between that and all of the payroll taxes, I can see why a company would rather work one person to death than hire two people to do a job, irrespective of "overtime." We'd riot in the streets if we saw how much they were really taking out of our compensation every check to pay for work mans comp, pay roll taxes, unemployment, and health insurance.

We get an individualized "total compensation" breakdown that includes company portion of healthcare, pre-tax savings, etc. It's eye opening and I think it has the desired effect on a lot of employees.

Yep, we get that too.

[RMC]

Yeah, I work for a hospital and this year we have to get a nurse to help with our medical conditions, and they set goals for us to achieve so we can get a reduced rate for our healthcare.

If you don't meet your goals, then you pay a premium of about 150 dollars a month above what everyone else pays.

It seems fair, but boy when you are a little overweight like me it is tough. I need to lose 50 lbs to get down to 185. I have not weighed 185 since I was in the service 20 years ago. But that's my goal. Too bad I work 60+ hours a week, and if I want to spend time with my family it makes it hard to work out. Just a change in diet has shaved 15 lbs off my weight though.. Just need 35 more pounds.

Anyway, we pay about 185 per pay(only twice a month). Plus vision and dental so around 225 per pay.

[Kraken]

My wife's company hasn't lowered the boom on benefit cost hikes yet, but they have let it be known that there won't be any raises again this year. However much they go up will become a pay cut. Add that to the automatic annual 1% increase in her 401k contribution and the expiration of Obama's Social Security tax cut and we're looking at a rather painful hit. And that's the best case, assuming that the "fiscal cliff" doesn't take another couple hundred bucks a month out of pocket.

[LordMortis]

I am now sitting in front of my compensation breakdown. Medical is $16,200 a year for me and I contribute nothing.

[Kraken]

Word came down today that our cost is staying level, but we're getting a new provider. Goodbye Harvard Pilgrim, hello BCBS. This is a direct result of the latest Mass. healthcare reform laws that just went into effect ("Romneycare Phase 2", although Romney had nothing to do with it). Lots of verbiage follows for anybody who's interested in the nitty gritty, and you might be because it's likely to be the template for Obamacare Phase 2.

What, you thought Obamacare was the end of it? Well, universal coverage is only the first step; cost containment comes later. Romneycare was always up front about that.

Spoiler:

We are continuing to take the approach of spreading the increases more equitably. We are not increasing employee contribution rates or prescription copays, as most companies are being forced to do. There will continue to be no out of pocket cost for routine, preventative services with in-network providers. In fact, you have an opportunity to spend less under the BBA plan - for employees that live in Massachusetts, under the EPO plan your deductible will be $250 less for individuals and $500 less for families this year compared to last year if you use providers in the Preferred Tier network of doctors and hospitals.

We will have two plans with BBA:


* EPO plan - for employees that live in Massachusetts. This plan has two
Tiers - the Preferred Tier and the High Cost Tier. If you use providers in the Preferred Tier, you will pay less this year towards the deductible ($750 individual; $1,500 family deductible) compared to last year ($1,000 individual; $2,000 family deductible). Providers in the Preferred Tier have negotiated competitive rates with Blue Cross/Blue Shield and include most of the hospitals and affiliated physicians in Massachusetts. Hospitals in the Preferred Tier include: Boston Children's Hospital, Dana Farber Cancer Institute, Beth Israel Deaconess, Faulkner Hospital, Lahey Clinic, Mass Eye and Ear, MetroWest Medical Center, Mount Auburn Hospital, New England Baptist, Newton-Wellesley Hospital, Norwood Hospital, Tufts Medical Center, Winchester Hospital and dozens of others. If you use providers associated with these hospitals, you will save money.

If you choose to use providers in the High Cost Tier, you will pay more as those providers charge much more for the same services. Sample hospitals in the High Cost Tier include Brigham and Women's Hospital, Massachusetts General Hospital and UMass Medical Center. You can still go to any doctor that you choose as long as they are in the network, but if you use providers associated with these hospitals, it will cost you more money.

One of the reasons that health care costs are spiraling upwards is that there is very little pricing transparency and incentives that allow people to be good consumers and create competition, which has been effective in so many other industries. This two-tiered plan is a small step in this direction. Here is an example why this is important. If you get a routine procedure like a MRI done at a hospital in the Preferred Provider such as Newton-Wellesley Hospital or Beth Israel Deaconess, it costs approximately $1050. If you get that same routine MRI done at a High Cost Provider like Mass General, it will cost approximately $2100, or almost twice as much. This one example does not seem like much, but when you multiply it by the 850 people who are on our plan, it adds up to hundreds of thousands of dollars for both employees and the company. Under this plan, you can go to any doctor that you choose as long as they are in the network, but if you choose providers in the Preferred Tier you will save money and it will cost you more if you decide to use providers in the High Cost Tier. This is the direction that healthcare is going in this country. It is fundamentally viewed as the fairest way to distribute costs across group plans.

Prescription Coverage
All employees enrolled in the BBA plans (both the EPO and PPO plans) will switch to BBA's prescription providers. You will need to start using your new BBA card when filling prescriptions as of November 1, 2012:


* RESTAT - for prescriptions filled at retail pharmacies. RESTAT has
over 64,000 participating pharmacies. If you have any refills left on your current retail prescriptions, you will not need a new prescription until your refills run out, but you will still need to provide your new insurance card to your pharmacy when filling a refill for the first time beginning on November 1, 2012.
* New England Mail Order Pharmacy (NEMOP) - for prescriptions filled
through mail order. If you are currently using the mail order program through Express Scripts (our pharmacy manager under Health Plans, Inc.) you will need to get a new 90 day prescription from your physician to start mail order with NEMOP. Simply complete the Patient Information Form which arrives with your BBA ID Card and follow the instructions on the form. We are able to keep prescription copays the same for both retail and mail order prescriptions. RESTAT's prescription plan has features like step therapy and prior authorization to help keep costs lower for everyone. We understand that disrupting your prescriptions is burdensome so we have negotiated with them and although our new pharmacy coverage is effective as of November 1, 2012, features like step therapy and prior authorization will not go into effect until March 1, 2013 so you have time to prepare. There will be more information on these features at the info sessions and in your plan materials.

Note that they aren't asking us, they're telling us.

I won't know how unhappy I am about this until I delve into the details. First reaction is that Harvard Pilgrim was the best insurance I've ever had. BCBS isn't as good, but it's not nearly as bad as Cigna. So it looks like crappier insurance for the same money, but it could have been worse.

(The coverage is the same; that's dictated by law. It's the administration that's worse.)

[Archinerd]

Just a change in diet has shaved 15 lbs off my weight though.. Just need 35 more pounds.

Did you give up pop (soda) yet? That could get you another 5 lbs if not. If you can't completely give it up (I can't) you can just limit yourself to one a week.

[RMC]

Just a change in diet has shaved 15 lbs off my weight though.. Just need 35 more pounds.

Did you give up pop (soda) yet? That could get you another 5 lbs if not. If you can't completely give it up (I can't) you can just limit yourself to one a week.

I actually don't drink pop at all. I mean I do every once in a while. But I just don't care for it. I like Ice Tea, and do drink that, but other than the caffeine it is not too bad for you(I drink it with no sugar).

I turned 40 this year, and boy can I feel the difference. <sigh> Getting old sucks.

[stessier]

The difference in what qualifies as a "high deductible" plan is amazing. My deductible is $4,800 (80/20 after) and I'm paying about the same premium as you...assuming that premium is per-paycheck and not per-month.

It is per check, but I get paid once a month, so...

And I could have sworn I had included this bit, but it looks like I edited it out. My employer puts $1200 in my HSA.

Finally, I too have the 3 options. One option is a PPO - it doesn't make sense to use this, though, as far as I can tell. The only case where it comes out cheaper is if one person is on their death bed and incurs massive medical bills while everyone else never sees the doctor. Literally never - even one visit each makes the other option the better choice.

The third option is a different high deductible plan. It has a $5200 deductible and $10,400 out of pocket maximum. The premium is 1/4 though - $47 in my case. I have to look at this a bit more as a co-worker mentioned that each person has a separate limit or something like that - made it sound not quite as scary as I originally thought.

I dug into that third option a bit more. It turns out that the family has a $5200 deductible but if any person that passes $2600 (the deductible for an individual on the plan), the plan will start paying out at the specified rates for that person.

This makes it at least competitive with the other High Deductible Plan. In that plan, the whole family deductible is $2600 with a maximum out of pocket of $5200. So under Option 3, if one person gets relatively sick, you won't be out the whole $5200 before the insurance kicks in. The worst case is if the whole family gets just a little sick so you hit the $5200 with no other insurance help. For a family, the difference in premium is $132/month. If I were to take that premium and put it all in the HSA, that's $1584/year. Take that off the $5200 deductible leaves $3616 to compare to the Option 2 deductible of $2600.

Then it all comes down to how lucky are you feeling? If we have a healthy year, the savings would give me a nice cushion in the HSA so I could use the plan again next year and have zero downside risk. Decisions, decisions...

Also, it turns out the payment table was very unclear and the payout will remain 90/10 for in network services and 65/35 for out of network (versus 65/35 for in network that I was assuming). That makes me feel a lot less stabby than I was a week ago.

[stessier]

Arise!

I got my benefit package information for next year. Looks like at least a 10% increase in premium for the high deductible plan I am on after all the discounts I get (for no tobacco, taking the health assessment, etc.). Without those, it would have been around 25% (they came up with new discounts, so if you didn't do the work, you knew you would be paying more). I have to do a lot more reading, though, as they are substantially changing our vision and dental plans as well as a bunch of life/disability insurance type options. There are some lunch and learns next week so I'll report back after I attend one of those.

[ImLawBoy]

I just did annual enrollment yesterday, and there's really only one change to my plan. I'm in a high deductible plan, and our deductible is staying the same ($2,500), as is our out-of-pocket max ($8,250). Monthly premiums for the family are still $119 (plus some add ons here and there for supplemental insurance, dental, vision, and increases to the standard amounts of life and disability insurance). The one change is that we're going to an 80/20 split once the deductible is paid, from an 85/15 split (two years ago it was 90/10). That just means we hit our out-of-pocket max a little sooner next year, so not a big deal.

[Jeff V]

We were already warned that our "we'll bankrupt you before we pay a dime" plan will somehow get worse next year. I haven't seen the packet yet; I imagine that to accomplish this, the premiums will exceed our salary.

[RMC]

I actually lucked out. My wife got a job as a full time teacher this year. Her benefits are out of this world compared to mine, and I work in a hospital.

Here is the base line: 500 family deductible, 250 per person. 250 per month (125 /pay). No co pay for any physician visit, specialists included. ER visits are like 50 as well. And the one benefit that my hospital helps with, is any service from the hospital I get 25% off the amount owed.

However, currently we are paying for my insurance and hers until January. Why? I already met the deductible on my plan, so it makes no sense to drop it. But come January my 350/month premium will go away and the high deductibles and high co pay for visits goes away.

So while my insurance plan was going to get way worse this year, we lucked out with my wife's insurance, and now have very good insurance. I like being a kept man..Other than I still make a little more than 2x what she makes, but her benefits really do make that gap a lot closer than you would think.

[Scuzz]

My companies insurance renewed in July, however Blue Shield has offered us the option of extending the renewal to next Dec 1, so we took that option.

Our insurance ($5k deductible, co-pays on everything) went up 7%, plus the added 2.9% ACA tax that will be added to every policy.

[Kraken]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

[LawBeefaroni]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

Aetna Aexcel, United Premium Designation/Core, etc.

It's their way of creating additional tiered networks. In this local market, most individual and small business plans only have the option of lower cost networks.


Some of our doctors complain.
"Why am I not in this Super Premium Unicorn and Gumdrop network? I get pass on quality but not efficiency? Get me in."
"Efficiency is just a market euphamism for 'low cost'."
"So?"
"Well, let me put it this way. We can renegotiate our contracts so you get get paid less so their cost goes down and then you will pass on 'efficiency'. Would you like that?"
"Er, no, carry on..."




It's all sales and marketing. The same people who come up with product names like Cofinity, Savility, Aexcel, etc.

[Scuzz]

Cofinity

A little close to coffin isn't is for a health care plan?

[Kraken]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

Aetna Aexcel, United Premium Designation/Core, etc.

It's their way of creating additional tiered networks. In this local market, most individual and small business plans only have the option of lower cost networks.


Some of our doctors complain.
"Why am I not in this Super Premium Unicorn and Gumdrop network? I get pass on quality but not efficiency? Get me in."
"Efficiency is just a market euphamism for 'low cost'."
"So?"
"Well, let me put it this way. We can renegotiate our contracts so you get get paid less so their cost goes down and then you will pass on 'efficiency'. Would you like that?"
"Er, no, carry on..."




It's all sales and marketing. The same people who come up with product names like Cofinity, Savility, Aexcel, etc.

At the beginning of the year my wife's employer announced the "good news" that they were holding the line on premiums, but there were going to be some changes to coverage. We were not given an option of paying higher premiums to keep our existing coverage.

Her doctor wants her to get an upper GI series. He feels strongly enough about it to have called her to follow up. So today she called the insurance company and asked what provider they would recommend and how much her out-of-pocket cost would be.

$750.

Yeah, that's not going to happen.

[LawBeefaroni]

Cofinity

A little close to coffin isn't is for a health care plan?

But the URL was available!

[Scuzz]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

Aetna Aexcel, United Premium Designation/Core, etc.

It's their way of creating additional tiered networks. In this local market, most individual and small business plans only have the option of lower cost networks.


Some of our doctors complain.
"Why am I not in this Super Premium Unicorn and Gumdrop network? I get pass on quality but not efficiency? Get me in."
"Efficiency is just a market euphamism for 'low cost'."
"So?"
"Well, let me put it this way. We can renegotiate our contracts so you get get paid less so their cost goes down and then you will pass on 'efficiency'. Would you like that?"
"Er, no, carry on..."




It's all sales and marketing. The same people who come up with product names like Cofinity, Savility, Aexcel, etc.

At the beginning of the year my wife's employer announced the "good news" that they were holding the line on premiums, but there were going to be some changes to coverage. We were not given an option of paying higher premiums to keep our existing coverage.

Her doctor wants her to get an upper GI series. He feels strongly enough about it to have called her to follow up. So today she called the insurance company and asked what provider they would recommend and how much her out-of-pocket cost would be.

$750.

Yeah, that's not going to happen.

As crappy as my policy is colonoscopies (if you are of the right age) are considered wellcare and are free. Unless, they actually find something wrong with you. If find polyps you have to then pay the cost of that work and the colonoscopy is no longer a freebie.

[gilraen]

Wow...I think I'll stop complaining about the health insurance that I get through my employer. They cut down on choices in recent years (it's basically down to multi-tiered CDHP, HMO or high-deductible), but compared to what folks have been discussing in this thread, my Cigna CDHP is the most awesome thing ever.

[Isgrimnur]

In 76 more days, I'll get a $0/month coverage, no copays, straight 75/25 coverage. I'm not really sure if that's good or not. All I know is that it's the only option short of paying for exchange rates wholly out of pocket, which is no choice at all.

[Kraken]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

Aetna Aexcel, United Premium Designation/Core, etc.

It's their way of creating additional tiered networks. In this local market, most individual and small business plans only have the option of lower cost networks.


Some of our doctors complain.
"Why am I not in this Super Premium Unicorn and Gumdrop network? I get pass on quality but not efficiency? Get me in."
"Efficiency is just a market euphamism for 'low cost'."
"So?"
"Well, let me put it this way. We can renegotiate our contracts so you get get paid less so their cost goes down and then you will pass on 'efficiency'. Would you like that?"
"Er, no, carry on..."




It's all sales and marketing. The same people who come up with product names like Cofinity, Savility, Aexcel, etc.

At the beginning of the year my wife's employer announced the "good news" that they were holding the line on premiums, but there were going to be some changes to coverage. We were not given an option of paying higher premiums to keep our existing coverage.

Her doctor wants her to get an upper GI series. He feels strongly enough about it to have called her to follow up. So today she called the insurance company and asked what provider they would recommend and how much her out-of-pocket cost would be.

$750.

Yeah, that's not going to happen.

As crappy as my policy is colonoscopies (if you are of the right age) are considered wellcare and are free. Unless, they actually find something wrong with you. If find polyps you have to then pay the cost of that work and the colonoscopy is no longer a freebie.

I know. My first (and last) "free" colonoscopy cost me $850.

My strategy is to avoid all medical care until I can get Medicare in 8.5 years. In the meantime I'll still get the preventive care that Obamacare mandates as free, but no diagnostics unless I am highly confident that I'm dying.

Did I mention that we pay $600/mo for insurance?

[Scuzz]

This reminds me that I need to find a new doctor after our insurance company decided that our doc of the past 25 years is suddenly a "high-cost provider" whose services will no longer be covered.

Aetna Aexcel, United Premium Designation/Core, etc.

It's their way of creating additional tiered networks. In this local market, most individual and small business plans only have the option of lower cost networks.


Some of our doctors complain.
"Why am I not in this Super Premium Unicorn and Gumdrop network? I get pass on quality but not efficiency? Get me in."
"Efficiency is just a market euphamism for 'low cost'."
"So?"
"Well, let me put it this way. We can renegotiate our contracts so you get get paid less so their cost goes down and then you will pass on 'efficiency'. Would you like that?"
"Er, no, carry on..."




It's all sales and marketing. The same people who come up with product names like Cofinity, Savility, Aexcel, etc.

At the beginning of the year my wife's employer announced the "good news" that they were holding the line on premiums, but there were going to be some changes to coverage. We were not given an option of paying higher premiums to keep our existing coverage.

Her doctor wants her to get an upper GI series. He feels strongly enough about it to have called her to follow up. So today she called the insurance company and asked what provider they would recommend and how much her out-of-pocket cost would be.

$750.

Yeah, that's not going to happen.

As crappy as my policy is colonoscopies (if you are of the right age) are considered wellcare and are free. Unless, they actually find something wrong with you. If find polyps you have to then pay the cost of that work and the colonoscopy is no longer a freebie.

I know. My first (and last) "free" colonoscopy cost me $850.

My strategy is to avoid all medical care until I can get Medicare in 8.5 years. In the meantime I'll still get the preventive care that Obamacare mandates as free, but no diagnostics unless I am highly confident that I'm dying.

Did I mention that we pay $600/mo for insurance?

That is my current plan. Stay healthy until medicare kicks in.

[Chaz]

Man, it's a good thing our current health care system works so well.

[Octavious]

My plan did go up a bit this year, but the 21% raise kind of made me not care much. It seems like a lot of places are catching up to our crappy plan at this point so complaining about it anymore is kind of pointless. At least we don't have a deductible that has to be met.

[Scuzz]

My plan did go up a bit this year, but the 21% raise kind of made me not care much. It seems like a lot of places are catching up to our crappy plan at this point so complaining about it anymore is kind of pointless. At least we don't have a deductible that has to be met.

No deductible? Can't be that crappy a plan. My deductible is $5k.