High Deductible Healthcare

This year, my company decided to change our healthcare plan so we pay a substantial amount towards healthcare. It's called a "High Deductible" plan. The deductible is $3,000. and then after you meet that everything is 80/20. Plus we have about $100. per pay period taken out of our checks towards healthcare. Prescriptions that are not generic will not be covered such as Asacol.

Last year, my insurance was $120. per pay period out of my check, $25. co pay and then $10. for prescriptions.

Apparently from what our company benefits department has told us, this will be the wave of the future for employees -- because of healthcare reform. I know it's open enrollment for many companies, so I was wondering if any one else is dealing with these healthcare issues?

It's a pretty scary situation for many people. It's even a higher deductible for those with more than two on their plan so if there is children involved, I cannot imagine what those people will do. Apparently the plan will pay for preventive care such as mammogram and prostate screenings, but if you have a chronic illness...oh well!

Nope, they do not cover non-generics, even when there is no non generic available. It sucks

What kind of company is this?

IMHO these increasing charges have nothing to do with the enacted healthcare reform. They are part of the still-prevailing U.S. insurance philosophy: STICK IT TO THE CONSUMER!!!!!! I retired from my longtime job in Jan. and applied for Medicare Part B. (Covers doctors & labs, principally.) All the available govt. lit advised to submit a form from the employer to prove that I had alternative health insurance past age 65; otherwise, the govt. would add a penalty (for life) onto the standard monthly fee. Well, I submitted the employer form, but the govt. raised the standard monthly fee for new enrollees in Part B-- by 10%-- without any prior warning or explanation!!!!!! Was I annoyed? You bet, but the worst was yet to come-- because the part of my job-related health insurance that was supposed to carry over to retirement (Rx benefit, mainly) and had been operating thru a carrier that covered my brandname UC med with prior authorization, was suddenly converted to an HMO operation which would grab my Part B payments but not cover my longtime gastro nor my needed med!!!!!!!! That was absolutely infuriating, and I fought for 7 months to get out of the HMO conversion; luckily my gastro & staff helped with the required paperwork. Lonie-- most everyone is being hassled because private insurers care most about their profit margins, which drives every other sector of health care. This goes back decades; I can remember my parents having to deal with high deductibles & co-pays when I was a kid. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

My husband and I have been forced into this type of health care because as a small business owner this is the best coverage he can afford to offer (and at that, it's $16,400 per year!).

I am unable to work full time now but if that was possible, I'd work for a large company with excellent benefits (similar to what we had when I battled colon cancer in 1999).

I shudder to think what would happen if I needed more surgery. I know my former 1999 bills (total? $1400.00 for two hospital stays, totaling 12 days) would be even laughable to compare to what we have now.

I know political debates are frowned upon but until the rest of the country is reduced to this type of coverage (or lack there of), the vast majority in this country are not going to ~fully~ understand why we need health care reform. While I don't want others to virtually go w/o insurance (this is what I often joke we have now, none), if even 50% in this country would agree that premiums, copays, deductibles, etc. are out of control, then we'll never get anywhere trying to change things. Sigh.

Post Edited (Marsky) : 11/4/2010 5:42:56 AM (GMT-6)

No it should not have to be this way. I completely agree.

I have a PPO 80/20 plan that I have kept for years because when I need medical care I want to be able to choose who I see and not be told who to see. I pay about $160 per month for that insurance with a $250 deductible per year. This year Anthem offered up a PPO/HRA plan that will cost me $75 per month with a $1000 in HRA kicked by my employer and then a $700 deductible. This plan is perfect for me since it still allows me to pick my own doctors. And since I have no health problems and take no prescription drugs, my out of pocket expenses will be $0. According to the presentation I went to, this is the way healthcare is moving.

Sue

I have had high deductible PPO insurance since 1983. I lowered my copay to $2500 a few years ago. I have $6500 out of pocket with 80/20. $125 brand and $30 generic for drugs. My premium is $262/month. It went up 66% over 2 years when I turned 50 and the following year. I paid about that much a year when I got insurance.

The high deductible actually worked out well for me because I was never sick. Low deductable plans often cost more than paying the entire copay, deductible and premium.

Healthcare reform is being used as a BS excuse. Companies are on hard times and slashing coverage to reduce costs. Insurance companies are actually adding benefits(my BCBS put kids up to 30 when the law only required 26 then blamed Obama). A big reason for higher premiums is because the economy is bad, people are losing coverage and healthy younger people are dropping coverage leaving sick people on insurance. Uninsured means we get charged more.

While insurance companies definitely make a buck wherever they can, providers are a much bigger problem. The actual cost of health care is just insane . Drugs are a total rip-off compared to other countries. If medicare tries to control costs, people on insurance are just billed more. There is really nobody serious about controlling costs. If you want an eye opener, take a look at the growth in revenues at you local hospital or the salaries of upper management. Just outrageous and they cry poverty all the time.

Hopefully when the preexisting condition ban takes effect in 2014 we will be able to shop for coverage. Until then we are at the mercy of whatever plan we have.

Dropping all brandname drug coverage seems incredibly harsh. There are only to generic maintenance meds for UC . Most drugs to induce remission are brandname and $$$$.

I was trying to find a primary care doctor yesterday. The new trick is to ask what insurance you have first. If you don't have a generous plan the receptionist tells no new patients or March is the next available appointment. It took me 9 weeks of waiting for appointments to get diagnosed and on medication. Best health care system on earth my @#$%

Lonie said...
Yes, I don't believe (or anyone else for that matter) that this is driven by healthcare reform. This is definitely driven by a new president and board of directors that want a better bottom line for shareholders. Amazingly, this is a huge aerospace company with many campuses around the United States, a company you'd think would have great healthcare benefits. So it's stick it to the employees and hope they jump to other healthcare policies (like my husband's) so they don't have to carry the burden. The sad thing is that I had an HMO, and was perfectly happy with the way it was working; no fuss at all. Now I have to change all my doctors including my GI because my husband's company doesn't carry Kaiser insurance. I'm trying to think positively that maybe change is good, and that seeing another GI might be for the best. Thank heavens I had a reaction to Remicade or I'd be really in a quandry about stopping that med. Thanks, Jano. When I switch to my new doctor, I'll ask him about Lialda. Maybe I should move to Canada or Europe, ha.

I just switched from Kaiser to BCBS, and am thankful for the change. Where I moved to, everything is done in the doctors office. You can get your blood drawn in the office and you don't have to walk to the lab to get it done. My OBGYN also has an ultra sound technician in the same office. I'm liking the change and what the offices offer than what Kaiser did. Although, I can't get my results online like I was able to with Kaiser, that's the only downfall, but other than that, I'm liking this change.

Yeah, I was with Kaiser for 22 years, so it's the only thing I was used to. Hope the adjustment goes good for you.

UPDATE: An article on Yahoo today states that some employers (including Boeing, AARP) ARE starting to shift health insurance costs to their employees thru higher deductibles and/or co-pays to lower the value of their health care plans ahead of the 2018 tax increase on so-called "high-cost plans", which will be 40%-- as stipulated in the Affordable Health Care Act. The threshhold for "high-cost plans" has been set at $10,200 for individuals and $27,500 for family plans. The stated purpose behind the law was to discourage purchasing of such plans, mainly favored by upper income consumers and corporations providing CEO coverage. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)
'

The health care is out of control.Went to a seminar given by the payroll company today. Unfortunately the reform bill was not written for the employer. We pay 100% of our employees coverage.We can no longer afford to do so.The main reason that things are going up is the reform mandates. The insurance companies can not offer the same plans.We currently pay 13,000.00 per year for our family of four, and have for years.That does not include dental. our plan is no longer offered so MVP will roll us into a new plan that after the deductible we have to pay 50%.Believe me I am not protecting the insurance company's at all. The attorney that gave the class said he has read the bill 3 times and still is confused about it. I hear people complaining about 50 or a 100 per check for insurance that is nothing compared to a small business. These changes will affect me greatly as I am still on asacol.Reform does not mean we should cover all the illegals.There are penalties for the employer even if they offer health care and the employee does not like it and goes elsewhere to get it,under reform the employer has to write the employee a check and they can go purchase it cheaper and keep the difference and the employer still gets a fine from the fed. I sure hope that everyone is getting the change they voted for in 08