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06/09/2009 04:12:44 PM · #1 |
My wife's company provides our family's health insurance and it goes up every year. We just got the options for next year (effective July 1) and out cost is more than doubling!
We spent about $3000 last year with premiums, copays, deductibles, office visits, etc. If we are as health next year as we were this past year that number will be near $8000, and probably higher since we now will pay some kind of co-insurance payment of 20% (we paid nothing before for this).
So if I wanted to get insurance as a self employed business owner, what options are there? Does PPA or WPPI offer any group plans?
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06/09/2009 04:29:54 PM · #2 |
Zoinks !.... one reason I'm glad to live in Canada.
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06/09/2009 05:02:47 PM · #3 |
If you find something do tell because self employment usually means you pay more not less when it comes to health insurance. You may be better off going the HSA (i.e. Health Saving Account) route and coupling that with a high deductible low monthly premium plan.
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06/09/2009 06:31:31 PM · #4 |
People(Republicans)don't want a public health insurance plan. They say it should remain in the private sector. Insurance companies have been reaping billions in profits by denying people care and coverage for years. No wonder they don't want to compete with a public health insurance plan that would keep them honest and be accountable to the people. That's just not the Republican way. So you will continue to get crappier coverage for more and more money and it will only get worse. Other countries have a National health care system that works just fine. The only drawback is some politician can't get his pocket filled by lobbiest.
Message edited by author 2009-06-09 18:33:43.
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06/09/2009 08:16:12 PM · #5 |
Health insurance in the US is broken, no matter how you pay for it, whether it winds up being affordable because of your situation or not.
Case in point - i had surgery in April to remove a cancerous thyroid gland. We currently have an HSA plan with a $6K annual out of pocket. No worries - the premiums are covered entirely by our employer, and they also contribute $2K to the HSA, and we contribute the annual maximum, which brings our annual account balance to just shy of $6K. So if we max our out of pocket, we're covered, and if we don't, we have money in the bank.
We easily hit the $6K limit with this surgery. I got another bill today, and some quick math in my head told me that we should have already paid our limit, and insurance should be kicking in. Went online to check the account, and saw that sure enough, the bills so far have hit nearly $8K.
But the bill i got today was for the anesthesia during surgery. The surgeons fee was approved and covered (and paid by us). The hospital fee was approved and covered (and paid by us). The pathology fees were approved and covered (and paid by us). When they got to the anesthesiology fee, which would not have been paid by us (since we have hit the cap), all of a sudden they decided it was not covered, because it wasn't pre-approved. WTF?
So tomorrow, i will be arguing with someone that probably has no information and no authority to change anything, starting the usual battle with an insurance company that denies payment just because they can. And either i will pony up $1615 to the anesthesiology doctor and preserve our credit, getting the money back (hopefully!) in a few months, or take a hit to our credit for a late payment on something that the insurance company should have paid with no questions asked.
Message edited by author 2009-06-09 20:18:51. |
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06/09/2009 08:59:11 PM · #6 |
Originally posted by NstiG8tr:
People(Republicans)don't want a public health insurance plan. They say it should remain in the private sector. Insurance companies have been reaping billions in profits by denying people care and coverage for years. No wonder they don't want to compete with a public health insurance plan that would keep them honest and be accountable to the people. That's just not the Republican way. So you will continue to get crappier coverage for more and more money and it will only get worse. Other countries have a National health care system that works just fine. The only drawback is some politician can't get his pocket filled by lobbiest. |
Give it a rest...
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06/09/2009 09:29:33 PM · #7 |
If you're healthy, and probably won't use it, private insurance is available, but you're probably going to pay a lot more for it than getting it through your wife's employer. Of course, if you're at all sick or might actually use insurance, you're screwed.
FWIW, 25% of ALL personal bankruptcies in the U.S. are due, at least partially, to significant to medical bills not covered by insurance.
That's F'ed up.
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06/10/2009 08:34:33 AM · #8 |
Originally posted by Strikeslip:
Zoinks !.... one reason I'm glad to live in Canada. |
Living in Canada most certainly does have its benefits Slippy, but it's not like we are getting a free pass. Free medical coverage is good, but there are some drawbacks. Last year I needed an MRI and yes it is free if I want to way six or more months... for $750.00 I got one the next day. I have an irritated sciatic nerve which required some rather expensive treatment... to the tune of $4000.00... guess what, not covered by insurance. If you require regular deep tissue massage therapy, you will be in for a surprise... there is a limit of something like $300.00 per year that is covered by insurance.
The sad truth is that if you work for yourself, unless you are prepared to pay for separate health and dental insurance, the services you get leave a great deal to be desired.
... and contrary to popular belief it ain't free... a quick look at the total tax deductions on your pay slip should give you a hint as to just how much all these freebies are costing us.
Ray |
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06/10/2009 08:36:46 AM · #9 |
Originally posted by shamrock:
Health insurance in the US is broken, no matter how you pay for it, whether it winds up being affordable because of your situation or not.
But the bill i got today was for the anesthesia during surgery. The surgeons fee was approved and covered (and paid by us). The hospital fee was approved and covered (and paid by us). The pathology fees were approved and covered (and paid by us). When they got to the anesthesiology fee, which would not have been paid by us (since we have hit the cap), all of a sudden they decided it was not covered, because it wasn't pre-approved. WTF?
. |
I agree it's broken and seems to be getting worse. This increase is ridiculous - did medical costs rise this much in a year? No way. Their 'info sheet' says premiums are going up 'as much as 30%' but I don't know what second grader did the math. If we opt for the cheapest plan (we have the middle plan of the three offered) our monthly premium will rise 50%, if we go for the medium plan again it just about doubles - and dental/vision is now seperate (at just under $400/year). Plus the office visit copay is up 25% and now once you pass your deductible amount you have a copay of 20% (cheap plan) and 10% (medium plan).
All we had were some tests last year (wife had a kidney stone...or did she? $975 out of our pockets for various things and the end result? "We don't know"). My daughter has a test every other year - first year we paid like $100, 2 years ago $550 and this past year $975 - so in addition to the increased premium we still paying off the $1950 from those two tests - no procedures mind you - no broken bones, no shots, no bandages, nothing fixed (or even diagnosed) and we pay $2000. Still paying.
It's time for this system to get fixed. I say remove all insurance and see what happens. Suddenly you'll have doctors that make real incomes and not millionaires. The biggest building projects around here are hospitals and other health related businesses. At least we know how they can afford it.
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06/10/2009 09:48:47 AM · #10 |
Originally posted by Prof_Fate:
Originally posted by shamrock:
Health insurance in the US is broken, no matter how you pay for it, whether it winds up being affordable because of your situation or not.
But the bill i got today was for the anesthesia during surgery. The surgeons fee was approved and covered (and paid by us). The hospital fee was approved and covered (and paid by us). The pathology fees were approved and covered (and paid by us). When they got to the anesthesiology fee, which would not have been paid by us (since we have hit the cap), all of a sudden they decided it was not covered, because it wasn't pre-approved. WTF?
. |
I agree it's broken and seems to be getting worse. This increase is ridiculous - did medical costs rise this much in a year? No way. Their 'info sheet' says premiums are going up 'as much as 30%' but I don't know what second grader did the math. If we opt for the cheapest plan (we have the middle plan of the three offered) our monthly premium will rise 50%, if we go for the medium plan again it just about doubles - and dental/vision is now seperate (at just under $400/year). Plus the office visit copay is up 25% and now once you pass your deductible amount you have a copay of 20% (cheap plan) and 10% (medium plan).
All we had were some tests last year (wife had a kidney stone...or did she? $975 out of our pockets for various things and the end result? "We don't know"). My daughter has a test every other year - first year we paid like $100, 2 years ago $550 and this past year $975 - so in addition to the increased premium we still paying off the $1950 from those two tests - no procedures mind you - no broken bones, no shots, no bandages, nothing fixed (or even diagnosed) and we pay $2000. Still paying.
It's time for this system to get fixed. I say remove all insurance and see what happens. Suddenly you'll have doctors that make real incomes and not millionaires. The biggest building projects around here are hospitals and other health related businesses. At least we know how they can afford it. |
What kind of Insurance plan do you have???
Getting back to the cost issue. I have several medical issues along with my wife. Up till the 16th of last month, when she was lost her job, we were paying around $250/mo. insurance premium, $3000/yr. Doctors visits were only $15 copay and most all medications were $5. We had a 20% copay for hospital expenses. To me that's not bad. Premiums were before tax and all other out of pocket expenses were tax deductible. And it was a PPO plan not a HMO or other.
Now that she is out of work we have to pay $0.00/mo premium, 100% doctor bill and 100% medications. In just the one month she has been out of work we have shelled out $1131.06 in medical and medication bills. That's after a lose of $2600/mo in pay.
You would think that I would want gov't run heath care since my wife lost her job last month but NO I DON'T!
Message edited by author 2009-06-10 09:49:29. |
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06/10/2009 09:59:56 AM · #11 |
Originally posted by RayEthier:
Originally posted by Strikeslip:
Zoinks !.... one reason I'm glad to live in Canada. |
Living in Canada most certainly does have its benefits Slippy, but it's not like we are getting a free pass. Free medical coverage is good, but there are some drawbacks. Last year I needed an MRI and yes it is free if I want to way six or more months... for $750.00 I got one the next day. I have an irritated sciatic nerve which required some rather expensive treatment... to the tune of $4000.00... guess what, not covered by insurance. If you require regular deep tissue massage therapy, you will be in for a surprise... there is a limit of something like $300.00 per year that is covered by insurance.
The sad truth is that if you work for yourself, unless you are prepared to pay for separate health and dental insurance, the services you get leave a great deal to be desired.
... and contrary to popular belief it ain't free... a quick look at the total tax deductions on your pay slip should give you a hint as to just how much all these freebies are costing us.
Ray |
It's all just depressing. :-(
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