Health Insurance in ER?

[dgoldenz]

That seems really low, even for his age if it's individual...must be in Ohio, where they hand out health insurance like candy.

 

[TargaDave]

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.

 

[Mulligan]

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.

 

[dgoldenz]

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.

 

[Dimsumkid]

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?

 

[dgoldenz]

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?

 

[Mulligan]

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"

 

[Dimsumkid]

My zip is 60091

 

[easysurfer]

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

 

[dgoldenz]

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.

 

[Dimsumkid]

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.

 

[dgoldenz]

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.

 

[Dimsumkid]

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.

 

[dgoldenz]

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.

 

[Dimsumkid]

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.

 

[dgoldenz]

The decreasing deductible is only on individual market plans, not group/COBRA. It's also a standard part of the plans, no extra charge. Extra helpful if you are choosing a higher deductible like $7k or $10k. United Health One is also technically a different company than UHC, but they are all under the same company umbrella and UHO uses the United Healthcare ChoicePlus network.