an insurance question for the Americans

The deductibles you quoted are pretty high for someone who knows they will be using their health plan. Anything more than a $2k deductible is unreasonable to me - though more reasonable at your monthly rate. Also, what was the second thing you mentioned (that costs double)? I didn't understand it.

FitzyK23 said...
The deductibles you quoted are pretty high for someone who knows they will be using their health plan. Anything more than a $2k deductible is unreasonable to me - though more reasonable at your monthly rate. Also, what was the second thing you mentioned (that costs double)? I didn't understand it.

Yeah, anything over $2K deductible is more like catastrophic insurance. But for healthy people just get an HSA and pay the minimal health expenses with that. Then when they need an appendectomy or something major they won't get hammered.

Group of one insurance is simply a group policy, but for one person. I think it can be expanded to include more people (like spouse and children). It's like group policies at companies in that they can't exclude pre-existing conditions, or have an exemption period. My insurance agent said it'd be about $550/mo and of course rates go up and up as you get older. I don't know if rates also go up as more medical expenses are incurred, like I hear with company group policies.

My insurance is 100% free from my job...however, I have a 250k lifetime limit which is soon approaching.  After my limit runs out I am going straight to government assistance, which I have had in the past as well...and that is also 100% free.

Not many can afford to buy insurance outside of a group.  I have heard of groups of people who are not employers who join together and negotiate group rates with insurance companies.  So I guess it can be done.  It is business for the insurers, so I guess they would rather have you as a cheaper customer then not at all.

I work for the US government and choose to buy into one of the plans they offer.  I have over 400 insurance companies to choose from.  I pay about $100 per month for Blue Cross/Blue Shield.  The price does vary with income, and the coverage level you purhase (singel or family).  Blue Cross is one of the more expensive companies, but I choose them because I can go to vitually any doctor or any hospital and they cover most if not all the costs.  If I get sick outside the country, they cover that too.  I do pay the first $250 for procedures in a year, but after that Blue Cross pays the rest.  I also pay $20 per office visit, and a little for some prescriptions (6MP is $30 per month, percocet is $3 per month).  A negative about Blue Cross is their dental coverage.  I could choose a less expensive insurance company, but I elect to choose Blue Cross for its flexibilty (I got approved for remi in 2 weeks, and Blue Cross does not need to approve before I go to a doctor).  Over all I am happy with my insurance, and am very thankful I can afford it.

I had government aid before when I had a job before I qualified for insurance (I had to work there for 2 years) .  As long as my job does not offer me insurace then I can get it through the state, especially if I have a pre existing condition...once I hit my limit I will no longer be "offered" insurance through my job, and I will re-apply for assistance. I've also gone through "free care funds" through my hospital, and I have had assistance through my hospital as well. All of my co-pays and meds (Crohns related) are covered by my assistance through the hospital.

To be honest I'm not sure what exactly it's called, but I went through Welfare to get it.  I had an Access card and all that jazz.  It covered ANYTHING Crohns related....meds, dr's appointments, it covered my 90k surgery.

They have a maximum amount of money that you can make to qualify, as long as I do not make more then that it's fine.

 

jeanneac, you were doin' great till your last sentence.

ivy, it seems you are beginning to get a handle on it. for extra credit, you might check out a movie from a couple of years ago called SICKO! it will explain things in a way that this thread may not achieve in a thousand posts. one of the points you will take away from michael moore is why i said what i said to jeanneac........even those who THINK they have insurance, may find THEIR illness, or procedure, or medicine IS DENIED!

vv

I agree with GDen they can not deny you for a pre-existing condition. I'm sure every state is diff. but I know in a few you can not go longer than three mnths without insurance if you go longer than that they can deny you, but I think its only for a short time. If you are married, your significant other can add you to their insurance and they can not deny you. But again every state is prob diff. since they have diff. laws I would contact the billing office at your doc office they might know the answer you are looking for.

I used to think that I had really good insurance through my wife's employer until I saw what Fitzy has to pay for her deductible. Man I am getting robbed blind but know plenty of other people with a lot worse situations. We are insured through a large company that you would think had the best insurance since it is a company that nearly took down the U.S. and world econony.(Citi) They raised our deductible this year from $100 per person to $500 per person and our out of pocket from $1,550 per person to $3,000 per person. Luckily it did not raise our monthly co payment but we still have to pay about $220 a month. In my state they can deny you for a pre existing condition or make it so expensive that there is no way that a person could afford it unless they are in that famous 1 % of the richest people. It is something that for now is based on a state by state decision.
I have read a few comments on here that may not be clear about the social security disability. I am on social security disability, as many others are also, but I am not bedridden. While it can be a hard and extremely discouraging process, you can still live a good life and be on disability. What i mean by this is not that a person that can work should be approved, but that you don't have to be on your deathbed. There are so many people here that are worse off with their Crohn's than I am but I was approved because I can not be dependable with my symptoms. My employer paid for the law firm to help the approval process, but due to all of my surgeries and the hospitalizations it did not take long to get approved. Talk to many people here and others like myself who have been approved, I have learned that 2 things will help the process along. 1st: Your doctors must all be 100% on board with you applying and their reports and tests must back their support claims. 2nd : You must have a firm diagnosis of the health condition that you are applying for disability from. There are a lot of people who are still in the process of getting diagnosed when they apply and it gives the person doing the approval a reason to deny you. Nearly everyone is denied the first and second time. I bring this up because those that are approved for Social Security Disability are also eligible for medicare health insurance. We chose not to accept it because it would cost more for us to buy insurance for my wife through her employer and then pay another copay for me through medicare. We were given medicare part A for free which covers my hospital stays and will not have to pay a penalty down the line if I decide to switch to medicare b because I did care my own insurance.

My husband and I just went through a long and hard choice about our health care. His company was bought out and we had to pick new insurance as of January 1, with all new options. After looking at all the choices, we went with a high deductible plan. So our per pay cost is roughly $100, so $200 a month for a family plan. We have to meet a $3000 deductible before the plan pays for anything except the basic care (one yearly exam, preventive care, mamograms....) After meeting our deductible, we pay nothing, no copays, no prescriptions, nothing for emergency rooms. Plus the Company gives us the option of taking online programs where we can earn back up to $1200 toward our $3000, and we can put money into an account before taxes to pay for the deductible. So when all is said and done, we should be better off. The most we would have to pay out is $3000 and in reality just my prescription copays and doctor copays would have gone up to at least that or more. And its not even the end of January and I'm more than 1/3 of the way toward my deductible, so I think they will lose out on me.

VIETVET, I have seen SICKO and liked his other movie too! lol.... I totally agree that sometimes we just THINK we have good insurance. Just from reading this forum, you can see the differences of coverage. I've had people who were on disability tell me they had a hard time making their co-pays. And yes, the statistics support that a fairly large percentage of the bankruptcies in this country are from health care costs from people who were "supposed to be" insured. I've known people in this situation even years before things got this expensive. Also, in this country, many high paid executives don't have to pay a dime for their healthcare premiums, check ups or procedures. It's part of their executive "package." I know this first hand from a friend who had a serious operation at one of the nation's best facilities. I asked him about his insurance and he said he didn't pay the first cent. This from someone who already made a six figure salary and could afford something. So, these are the things that we face here. Like many things here, the inequities are here and the middle class has all but dissolved. Health care has been one of the core problems of this situation. Anybody who thinks differently, is living in a cave.