Help! What health care should I get?!?!?!?!?!?!?!

[crw]

Cujet speaks wisdom! I wish all plans were like this... that is...

I have a family of seven. We all visit the dentist twice a year, just for checkups. Assume for this discussion that a checkup costs $100. That's $1400 a year right there. It's a planned expense. One way or another, you as the individual are paying for it. When your company pays for it, it's a benefit, but we should not call it insurance.

Insurance should be for those catastrophic things we need once every 10 years or so, on average. OK, . ;-)

 

[PandaBear]

The reason going with insurance is cheaper is that they have the volume to make them a huge power in negotiation. Unless you are a very famous specialist with too many patients already, chances are you have to accept every insurance out there even if you are losing money on the patient.

Hospitals do the same thing. Sutter Health suppose to be a non profit but they buy up and merge with so many other groups that they are now willing to refuse blue cross unless the price is right, as well as closing down hospitals to create an artificial shortage in suppliers. This has in some way cause blue cross to hike its rate by 40% (so it claim). No such luck for a general practitioner with his / her own practice.

PPO has to subsidize the doctors who will not accept a "pre negotiated rate" to be in the network, and therefore much more expensive.

 

[rg200amp]

Originally Posted By: crw
Quote:

I was planning to stick with my HMO. However, there are rumors trickling down from the top floor that next year (2013), there will be no choice and the DHP-PPO will be the only choice. And so, there will be no $1000 bonus next year, when your forced into the DHP-PPO.


OK, now this is starting to make sense.

First, the idea that you'll be forced into the high deductible plan next year,... you can pretty much take that to the bank. It WILL happen.

So, when I said that I got an extra $100 per pay check when I switched, for you it's the same (sorta) when you get the $1000. The deal is, the company was up-front with me in what I was paying before I switched. For you, you think you only pay 4.50, but in reality the company is putting money in on your behalf.

I hope an HSA is part of this. If you don't have any immediate health concerns, I think you should take the $1000 and put the entire amount into an HSA, and then start saving part of each paycheck to it. Well, you haven't mentioned an HSA... I would not want to be on a high-deductible plan without it. If they aren't giving you that option, wow, I don't know what I'd do.


Yea, my company pays $470 a month for each person on the HMO plan. We only contribute $4.50 a pay check.

Last year we did not pay anything. . .

And no, a HSA is not offered. However, I could set up a little savings account just to cover the $1500 should I need it.

The reason we think that the HDHP is going to be the only option next year is because all new employees hired after 1/1/2012 will not be offered the HMO.

I just like knowing exactly whats expected with the HMO.

With the DHP, I could have a $1500 bill at any time just POP up if I go to the ER. . . .

Like, the whole reason I want health insurance is to prevent thousand dollar hospital bills popping up!!!!!! lol

 

[Al]

Originally Posted By: rg200amp

With the DHP, I could have a $1500 bill at any time just POP up if I go to the ER. . .


But they are already giving you 1000 bucks and you save over 100 in premiums so your total out of pock is 400 bucks.

Most people pay double that for monthly premiums with co-pays and deductibles added.

 

[PandaBear]

Originally Posted By: Al
Originally Posted By: rg200amp

With the DHP, I could have a $1500 bill at any time just POP up if I go to the ER. . .


But they are already giving you 1000 bucks and you save over 100 in premiums so your total out of pock is 400 bucks.

Most people pay double that for monthly premiums with co-pays and deductibles added.


The main point of health insurance is to protect you from the $100k bill for surgery, not the $100 bill here and there.

 

[kb01]

Originally Posted By: Cujet


My insurance costs me over $22,000 per year. I have no real choice in plans with my situation. I'd much prefer a $10,000 plan with catastrophic coverage. Quite simply, I'd come out ahead.


Ouch. For my family, I'm currently paying $12,000/year and it's going up to $15,000 at renewal (and this is with a $5,000 deductible HDHP/HSA).

Our best hope for staying insured is a $10,000 deductible HDHP/HSA that we're currently waiting for the application to be processed, after submitting all of our medical records and physician statements.

If all goes well, we'll save over $7,000/year in premiums while our deductible only goes up by $5,000. The downside is maternity and prescriptions aren't covered.

 

[Al]

Originally Posted By: kb01
Originally Posted By: Cujet


My insurance costs me over $22,000 per year. I have no real choice in plans with my situation. I'd much prefer a $10,000 plan with catastrophic coverage. Quite simply, I'd come out ahead.

We are pretty much arriving at a point that only Government workers have gold plated insurances. The rest have insurance that banks on having no claims, medicare, Medicade, or nothing. The system is quickly sinking and is in many cases sunk.

I am a retiree and for the most part I was paying 200/month and my company paying the rest. Additional costs were around 300 co-pay and maybe 150 for drugs.

This year my company is phasing us out of medical benefits. They are giving us 6K bucks/year for 3 years. I elected to get the best (Part F Medigap and suppllemental drug insurance.) The costs of that are around 3700/year. It pays 100% with no copays. In addition we pay 2400/year for medicare.

Unless the system totally collapses..with the leftover each year and the fact that I no longer pay the premium of 200 to the company but pay for Medicare...I will be set fot 4 1/2 years with no medical costs. That takes me to age 70. At that point unfortunately I will need to cut back.

I have no complaints. But it will become more than ugly for most.

I can't imagine anyone starting a family these days

 

[goodtimes]

Either is better than most get, that non profit is spending some real money on you. I believe most group plans of any size spend about $500/mo. for an individual. Either way you pick, it is a good deal.
I saw the bill on my recent standard office yearly checkup, with a $30 flu shot, $404. My back surgery in 2006 was over 100k. There were three of us lined up and he had us done in one day. 300k for less than eight hours is not a bad rate.

 

[Blaze]

Originally Posted By: PandaBear
Originally Posted By: Al
Originally Posted By: rg200amp

With the DHP, I could have a $1500 bill at any time just POP up if I go to the ER. . .


But they are already giving you 1000 bucks and you save over 100 in premiums so your total out of pock is 400 bucks.

Most people pay double that for monthly premiums with co-pays and deductibles added.


The main point of health insurance is to protect you from the $100k bill for surgery, not the $100 bill here and there.
I no longer call it health insurance,,, I call it paying my "bankruptcy insurance" when I send my monthly insurance check.

 

[Al]

Originally Posted By: Blaze
I no longer call it health insurance,,, I call it paying my "bankruptcy insurance" when I send my monthly insurance check.

This...but also look at it as charity..you are helping to pay for those (many who shouldn't be here) who can't/won't pay their medical costs.

 

[PandaBear]

Originally Posted By: Al
Originally Posted By: Blaze
I no longer call it health insurance,,, I call it paying my "bankruptcy insurance" when I send my monthly insurance check.

This...but also look at it as charity..you are helping to pay for those (many who shouldn't be here) who can't/won't pay their medical costs.


and those 25M CEO salary in the "non profit" organization.

 

[CivicFan]

Originally Posted By: PandaBear
Originally Posted By: Al
Originally Posted By: Blaze
I no longer call it health insurance,,, I call it paying my "bankruptcy insurance" when I send my monthly insurance check.

This...but also look at it as charity..you are helping to pay for those (many who shouldn't be here) who can't/won't pay their medical costs.


and those 25M CEO salary in the "non profit" organization.


Not for profit tax returns (990 forms) are available to the public on the internet. You will be hard pressed to find a NPF CEO salary of more than $1 million. The only one I have seen so far has been the CEO for the Girl Scouts who makes around $1.5 million.

 

[PandaBear]

Originally Posted By: CivicFan
Not for profit tax returns (990 forms) are available to the public on the internet. You will be hard pressed to find a NPF CEO salary of more than $1 million. The only one I have seen so far has been the CEO for the Girl Scouts who makes around $1.5 million.



In 2008 (the most recent year for which available), Sutter had nine executives who were paid $1 million a year or more. There were five others whose compensation approached $1 million. With annual increases, those five have likely since joined the seven-figure club.

John Muir CEO J. Kendall Anderson was by far the highest-paid not-for-profit hospital executive in California--if not the nation--in 2008, with compensation totaling $7.45 million.

http://www.fiercehealthfinance.com/story...roll/2010-10-26

 

[Al]

Originally Posted By: PandaBear

and those 25M CEO salary in the "non profit" organization.

I would guess this is a very small part of the 2.5 Trillion health care bill and I would suggest we get illegals off of the health care rolls and then maybe if the CEO's are doing something illegal we could look at that.

 

[Cujet]

"Bill", a contractor that works for me at the airport, does the "self insure" thing.

He has a large sum of money in the bank, and it's for medical only. I'd guess it's North of $250K.

He has remarkable stories of expensive, prolonged hospital stays, negotiated settlements and so on.

In his case, he has successfully reduced his invoiced expenses by negotiation. Often the final cost is 1/4 the initial cost.

My point is simply that it's not only insurance companies that can negotiate with health care providers.

 

[CivicFan]

A far cry from the for-profit world of the health insurance...

In the non-profit side of the health care area, we would easily get impressed when executives from the drug companies or payers would come to meetings with us in their private jets while our executives flew coach.

Quote:
Humana's proxy statement accounted for McCallister's $1 million salary, $3.4 million in stock and options, a performance-related bonus of $1.8 million, plus retirement savings, insurance, and use of a company aircraft.


http://www.fiercehealthcare.com/story/hu...2009/2010-03-10

 

[Blaze]

Originally Posted By: Al
Originally Posted By: Blaze
I no longer call it health insurance,,, I call it paying my "bankruptcy insurance" when I send my monthly insurance check.

This...but also look at it as charity..you are helping to pay for those (many who shouldn't be here) who can't/won't pay their medical costs.
lock em' up in work camps if they refuse to pay and until paid off in full!