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Old 01-03-2011, 11:13 PM   #21
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The Pharmacy deductible per Individual on the Costco plan is $500 (does not apply to generics). Generics are $15/20 (ind/family) deductible waived, preferred brand $30/$35 after deductible and non preferred brands are $45/50 after deductible.
Sounds good then. Their plans work differently here in VA. I have seen too many people opt for plans without full Rx benefits just because they were a little cheaper. I won't even sell a policy without full Rx benefits because of the "you never told me that" amnesia people seem to get when they have a problem. Too easy to blame the insurance agent...
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Old 01-04-2011, 05:52 PM   #22
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I'm curious, aetna told me only transplant patients incur rx's in the 1k and up per month level. I'm sure cancer patients may also. Were all healthy and have to weigh generics only for $455/mo or add in preferred rx's, but that option pushes premiums to $590/mo
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Old 01-04-2011, 06:11 PM   #23
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I'm curious, aetna told me only transplant patients incur rx's in the 1k and up per month level. I'm sure cancer patients may also. Were all healthy and have to weight generics only for $455/mo or add in preferred rx's, but that option pushes premiums to $590/mo
That's laughable and whoever told you that should be fired. Try pricing up any of the following:

Oxycontin 80mg
Betaseron
Avonex
Rebif
Enbril
Baraclude
Orthoclone
Zenepax
Avastin
Remicade
Humira

The list goes on...I could probably name 100 more.
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Old 01-04-2011, 10:39 PM   #24
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I am stunned by some of the premiums my fellow early retiree's are forced to pay. I flat out couldnt afford to be retired if I had to pay what I am reading here. I just called BC/BS today because my monthly bill hasn't came. They said it was delayed shortly because of adjustments to new health reg's. I asked what mine was and she said it will be $61 a month. I had been paying $72 monthly. It went down! I have a HSA with $5000 deductible (I am 46). By funding my HSA each year, I essentially get my health insurance for free. I guess I should be very thankful.
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Old 01-04-2011, 11:10 PM   #25
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I am stunned by some of the premiums my fellow early retiree's are forced to pay. I flat out couldnt afford to be retired if I had to pay what I am reading here. I just called BC/BS today because my monthly bill hasn't came. They said it was delayed shortly because of adjustments to new health reg's. I asked what mine was and she said it will be $61 a month. I had been paying $72 monthly. It went down! I have a HSA with $5000 deductible (I am 46). By funding my HSA each year, I essentially get my health insurance for free. I guess I should be very thankful.
This is individual insurance - not through a group? Then it may be your age. I'm envious.
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Old 01-04-2011, 11:21 PM   #26
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That seems really low, even for his age if it's individual...must be in Ohio, where they hand out health insurance like candy.
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Old 01-05-2011, 05:31 AM   #27
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Blue Cross HSA with $5k deductable. Also 2 kids on the policy. Think we're something over $700/month. Biggest expense we have (water playing running a close second). Work hard at staying healthy. Far better quality of life that way regardless of insurance. We also like staying semi-ER. Fits our style and at least mitigates the health care abyss.
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Old 01-05-2011, 12:20 PM   #28
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Actually it is from Missouri and it is an individual policy. Now, I do not have an rx co-pay with that, so I'm on the hook for first $5k in all health care including scripts, then they pay 100% of everyting after that. I dont take any med's currently, but I hear Flomax, Lipitor, and Viagra are all coming off patent in next 18 months or so maybe that will be all I need until medicare MO appears to be cheaper than alot of states, I just asked a retired friend of mine who is in his early 50's along with his wife. They pay a total of $485 for family insurance that also includes 2 teenagers ($2500 individual deduction with total 5K maximum out of pocket for family.
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Old 01-05-2011, 12:33 PM   #29
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That's a pretty slick deal, can't beat that price....if it's that cheap I would imagine a $2500 or $3k deductible doesn't cost much more.
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Old 01-05-2011, 12:34 PM   #30
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That's laughable and whoever told you that should be fired. Try pricing up any of the following:

Oxycontin 80mg
Betaseron
Avonex
Rebif
Enbril
Baraclude
Orthoclone
Zenepax
Avastin
Remicade
Humira

The list goes on...I could probably name 100 more.
Dgoldenz,
This is the response I got from Aetna, I know cancer drugs get up there, I had a brother that had cancer, but most of his expensive stuff came via IV's. I'll take your word that they're omitting a lot. What I'm concerned is getting best overall coverage and not miss something. Maybe since I'm in the Chicago area, rates tend to be higher. Like I had mentioned before, we're a family of 3, I'm 48, DW is 47 and son is 11. No real health issues, but I have a non issue that got flagged, early arthritis of the hip, which I take no meds for, not even aspirin. Aetna raised my rate an extra $25/mo for this. What type of policy would you recommend that I pursue and which insurance companies would you prefer to choose from?
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Old 01-05-2011, 12:39 PM   #31
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Dgoldenz,
This is the response I got from Aetna, I know cancer drugs get up there, I had a brother that had cancer, but most of his expensive stuff came via IV's. I'll take your word that they're omitting a lot. What I'm concerned is getting best overall coverage and not miss something. Maybe since I'm in the Chicago area, rates tend to be higher. Like I had mentioned before, we're a family of 3, I'm 48, DW is 47 and son is 11. No real health issues, but I have a non issue that got flagged, early arthritis of the hip, which I take no meds for, not even aspirin. Aetna raised my rate an extra $25/mo for this. What type of policy would you recommend that I pursue and which insurance companies would you prefer to choose from?
I'd look into a $5k or $7k family deductible HSA compatible policy with full Rx coverage. What's your zip code?
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Old 01-05-2011, 01:15 PM   #32
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That's a pretty slick deal, can't beat that price....if it's that cheap I would imagine a $2500 or $3k deductible doesn't cost much more.
You are correct, dgoldenz, it wasnt alot more, maybe $30 or so a month. But, I dont understand/trust insurance companies so I was afraid if I started lower and then they jacked up my premium they might jack me again if I tried to go to a higher deductible, so I took the max I knew I could afford and figured with medical inflation is the way it is $5k deductible would eventually be the "new 3k deductible"
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Old 01-05-2011, 02:23 PM   #33
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Old 01-05-2011, 02:35 PM   #34
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BCBS HSA/High Deductilble Plan here. $5K annual deductible, then 100% covered after deductible met. Only $20 copay for physicals (reminds me, I need a checkup ). Knock on wood, I've been healthy enough to not even come close to the annual deductible. Also, I am not on any regular prescription meds.

Had the policy since 2008. Premium increased yearly. Was $139 when started, now is about $170 a month
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Old 01-05-2011, 03:54 PM   #35
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My zip is 60091
Humana $5k family deductible HSA plan with full Rx coverage = $419/month. If you want a co-pay plan, $2500 deductible w/ co-pays for office visits and Rx = $522/month. Max OOP on the co-pay plan is $4500 per person up to $9k per family. BCBSIL seems to be in the same ballpark, $432/month for a $5200 family deductible HSA plan.

The Humana HSA plan is called Autograph Total Plus Rx. Their co-pay plan is called Portrait Share 80. I know nothing about their network in IL though, so you'd want to check that out.
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Old 01-05-2011, 04:21 PM   #36
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Humana $5k family deductible HSA plan with full Rx coverage = $419/month. If you want a co-pay plan, $2500 deductible w/ co-pays for office visits and Rx = $522/month. Max OOP on the co-pay plan is $4500 per person up to $9k per family. BCBSIL seems to be in the same ballpark, $432/month for a $5200 family deductible HSA plan.

The Humana HSA plan is called Autograph Total Plus Rx. Their co-pay plan is called Portrait Share 80. I know nothing about their network in IL though, so you'd want to check that out.
Thanks for the quick feedback, we're not married to Aetna, just needed to get off Cobra w/no discount and DW miscalculated our roll off date from 1/1, it was actually 12/1. So we were really under the gun to avoid paying $1200/mo for Cobra.
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Old 01-05-2011, 04:24 PM   #37
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Thanks for the quick feedback, we're not married to Aetna, just needed to get off Cobra w/no discount and DW miscalculated our roll off date from 1/1, it was actually 12/1. So we were really under the gun to avoid paying $1200/mo for Cobra.
Understandable. The biggest benefits with the HSA plans are capping your family's entire max OOP to $5k (or whatever deductible you choose) and the tax advantages. If you haven't read up on HSA's, there's probably some good info on the forum here.
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Old 01-05-2011, 04:32 PM   #38
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Understandable. The biggest benefits with the HSA plans are capping your family's entire max OOP to $5k (or whatever deductible you choose) and the tax advantages. If you haven't read up on HSA's, there's probably some good info on the forum here.
I've never used one of these, I was hesitant to use Aetna's HSA (via Costco). Here's the summary of what they could offer me:

IL HSA Compatible $3500 Deductible with Dental
Total premium: $671.00*|Medical: $629.00*|Dental: $42.00
Deductible Co-Insurance Out-of-Pocket Maximum
In Network $3.5k Ind/$7k Fam 0% after deduct $3.5k Ind/$7k Fam
Out of Network $7k Ind/$14k Fam 50% after deduct $12.5k Ind/$25k Fam

My actual premium would've been closer to $700/mo due to me being a slighter higher risk. If I can get closer to what you quoted, I will definitely move over to one of those.
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Old 01-05-2011, 04:49 PM   #39
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I've never used one of these, I was hesitant to use Aetna's HSA (via Costco). Here's the summary of what they could offer me:

IL HSA Compatible $3500 Deductible with Dental
Total premium: $671.00*|Medical: $629.00*|Dental: $42.00
Deductible Co-Insurance Out-of-Pocket Maximum
In Network $3.5k Ind/$7k Fam 0% after deduct $3.5k Ind/$7k Fam
Out of Network $7k Ind/$14k Fam 50% after deduct $12.5k Ind/$25k Fam

My actual premium would've been closer to $700/mo due to me being a slighter higher risk. If I can get closer to what you quoted, I will definitely move over to one of those.
Depends on the state, but Aetna tends to have the highest rates of any company here in VA. The plan you noted above has a $7k family deductible (always look at the family number for HSA plans), so it's $250/month more than the Humana policy and the deductible is $2k higher than Humana. United Health One isn't far behind either Humana or BCBS on premiums, but their underwriting can be tougher. One feature that UHC has that the others don't is a decreasing deductible - if you go the full year without hitting the deductible, it reduces 20% the following year for up to 3 years in a row up to 50% of the original deductible (i.e. a $5k deductible could go as low as $2500 after 3 years). If you hit the deductible, it just resets to the original level.
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Old 01-05-2011, 04:57 PM   #40
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Depends on the state, but Aetna tends to have the highest rates of any company here in VA. The plan you noted above has a $7k family deductible (always look at the family number for HSA plans), so it's $250/month more than the Humana policy and the deductible is $2k higher than Humana. United Health One isn't far behind either Humana or BCBS on premiums, but their underwriting can be tougher. One feature that UHC has that the others don't is a decreasing deductible - if you go the full year without hitting the deductible, it reduces 20% the following year for up to 3 years in a row up to 50% of the original deductible (i.e. a $5k deductible could go as low as $2500 after 3 years). If you hit the deductible, it just resets to the original level.
That part about the decreasing deductible is a really nice feature...I never heard of this and our Cobra coverage was with United Health Care. Not sure if they offer this here, but definitely worth asking about.
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