A bit of a rant re: health insurance

[frugalone]

Wow, this really made me feel crummier than I do already. I have been seeing a therapist for a couple of months. I got several free visits through our EAP at work. Before my ACA-sponsored health insurance plan bites the dust yet again at the end of December, I was able to squeeze in one more appointment. My therapist kept expressing surprise that my copay will be $60. "Oh my! I've never heard of one that high before." Jesus, lady, why don't you rub it in?

Worse yet, if I stay on the exchange, my copay will be $90. The clinic I'm going to won't bypass the insurance system and let me just pay up front. So it looks like I have to switch to one of the crummy cheapo plans at work. The reason I was ON the freaking exchange to begin with was because the plans at work stink unless you pay nearly $500 a month.

I like Obama, and I will miss him, but I am sorely disappointed in how the insurance companies ran with this ACA thing and made it the Unaffordable Care Act. I miss the HMO I had with my last employer. We never paid for anything, except an occasional $15 copay.

Sorry. I just had to get this off my chest.

[Teacher Terry]

That is really terrible. This is becoming a huge problem for many people.

[ApatheticNoMore]

My therapist kept expressing surprise that my copay will be $60. "Oh my! I've never heard of one that high before." Jesus, lady, why don't you rub it in?

actually it's probably nothing unusual at all but standardized for that metal level (bronze I'm thinking or possibly silver). The metal levels are very standardized, sure if you went gold or platinum the copay would be less (and the premiums more), it's all very standardized with ACA or ACA compliant plans. Much about health insurance purchasing isn't standardized at all (size of network for instance), I guess I'm glad something is ...

true employer group plans may have less copays.


Worse yet, if I stay on the exchange, my copay will be $90. The clinic I'm going to won't bypass the insurance system and let me just pay up front. So it looks like I have to switch to one of the crummy cheapo plans at work. The reason I was ON the freaking exchange to begin with was because the plans at work stink unless you pay nearly $500 a month.

I like Obama, and I will miss him, but I am sorely disappointed in how the insurance companies ran with this ACA thing and made it the Unaffordable Care Act. I miss the HMO I had with my last employer. We never paid for anything, except an occasional $15 copay.

if it's any comfort everyone's plans are getting crappier pretty much. Oh some tiny proportion of the population has really nice plans and will stay that way but for the rest of us it's just watching the plans getting crappier and crappier every year. One thing about healthcare provided through work is the cost of the plan will usually be before tax income (so because of tax savings you won't end up paying that full amount even if you don't itemize), so the plans may be a little more reasonable than they look.

[frugalone]

Perhaps it's just the new world we live in, ApatheticNoMore. I lost my job in 2009, so for all I know, my old employer has crappy plans too!

We're on the silver level.

[befree]

the "Affordable" Care Act is a sad disappointment. I don't think it could have been sustained, even if the Republicans hadn't won. The rich can afford better insurance, the poor get subsidies that make it very very cheap (although the deductible is still so high they can't afford any diagnostic labs or procedures), and those in the middle are looking at the ridiculous prospect of paying $5000+ a year for virtually nothing.

[Tybee]

I think the poor also get the prescription meds free that I cannot afford (in the middle.) Makes me pretty bitter.

[MaryHu]

Quote "Oh some tiny proportion of the population has really nice plans and will stay that way"

Yeah that tiny proportion is called "congress" and they get it at our expense while denying it to the rest of us!

[bae]

I miss the sort of reasonably-priced sort-of-reasonable coverage catastrophic plan we had before the ACA. I was not allowed to keep it. And by this point in the ACA rollout, my county has been red-lined by most of the carriers, so what lame, expensive insurance we've had recently is no longer available. Luckily this year we qualify for a free ride due to no income, so Alan is paying for sorta-OK care from the state.

I had a conversation over lunch today here in London with a nice local couple, and they thought I was making things up when I described US insurance/health-care. They explained theirs to me, and I also thought they were pulling my leg.

[LadyInRed]

I've been worried about health care for the past 2 weeks.. we are bracing for a lay off for my husband.. which means I NEED to get a full time job with benefits.. to cover our larger family.... anything else would , as I understand cost us an arm & a leg.. and I don't want to be without coverage in between jobs, if at all possible....

IF some medical crisis came upon us- without coverage.... it could cost us every penny in savings.. I've read horror stories where they could come after your house if you can't pay Medical bills.. I am so disgusted this country with it's wealth & CEO pay being 500 times what a worker makes...does not have Universal Health care.. I have been reading Quora write ups on this today....

Some good discussions here (I understand this is a debate for many):

Is healthcare a right or a privilege? ( https://www.quora.com/Is-healthcare-a-right-or-a-privilege )

Is healthcare a fundamental human right? Should it be? ( https://www.quora.com/Is-healthcare-a-fundamental-human-right-Should-it-be )


Wish we knew what Trump is going to do..

[catherine]

I miss the sort of reasonably-priced sort-of-reasonable coverage catastrophic plan we had before the ACA.


I agree.. My DH has multiple health issues and the drugs that go along with it, so I don't mind the high rates for him, but when I first realized that I couldn't opt in for a catastrophic plan, I was surprised and bummed. My doctor (who I see once every 2-3 years) tells me my insurance company loves me, but the feeling is NOT mutual. If I really wanted to live dangerously, I'd consider not getting insurance at all, rather than shelling out 10k a year--for NOTHING. And the fact that I have to buy pediatric dental and vision just drives me crazy.

I'm doing an interesting market research study now.. I'm interviewing pharmacy benefits managers, managed care directors and retail pharmacists about their opinions with regard to drug pricing. Wow! Am I getting an earful. Everyone is blaming the other guy for the problem. "It's the pharmaceutical companies." "It's the government." "It's the middlemen." Let me tell you--if you think you're frustrated, even the industry guys are REALLY frustrated. The only ones not frustrated are the pharmaceutical companies. I hate to bite the hand that feeds me but... Of course that's not the only problem. Drugs are just one part of the craziness of the health care system here.

Hey, I just enrolled for Medicare Parts A & B. Who says getting old doesn't have its rewards?

[ApatheticNoMore]

IF some medical crisis came upon us- without coverage.... it could cost us every penny in savings.. I've read horror stories where they could come after your house if you can't pay Medical bills..

yes but most medical bankruptcies are people WITH insurance coverage, not sure how this comes about but I could think of many ways:

- deductibles and maximum out of pockets greater than the money one has - not everyone has 6k to meet a deductible which isn't unusual for bronze plans
- getting any care out-of-network that isn't covered under emergency coverage with a HMO which can easily happen without one knowing about it as in-network hospitals hire out-of-network staff
- balance billing games with out-of-network providers with PPOs - you think they are going to cover the out-of-network 50% but they aren't due to balance billing and only cover a tiny percent of the cost.
- probably others but who can keep track of the moving target of what is in many ways an ever morphing scam

About the only way to avoid unexpected expenses entirely is to go with something like Kaiser where it's a whole in-network system including it's own hospitals, but it has it's advocates and it's detractors.

[Yppej]

At my last job I paid $4500 a year for a single plan so meager it did not meet Massachusetts Minimum Creditable Coverage requirements so employees paid a penalty when filing their state income taxes although Federal ACA requirements were met. And I was told by the state I could not purchase an individual plan through the state healthcare connector because I had an employer plan available to me.

I am out of work now and looked at temporary work. Only one agency had a plan that met state requirements and it would have cost a third of my take home pay. So I am not working, getting a subsidized pan although I would rather be independent, and trying to find a permanent job with a plan the state approves. There are many jobs across the state line in New Hampshire that will not qualify. The health care system is a mess. People should not be penalized when no option/affordable option is available to them.

[sweetana3]

Agree completely. Wait until May when the insurers have to announce whether they will offer any ACA plans for 2018. If Mass is going to require insurance and not let you buy outside of employer's plan, it is on them to ensure all employer's meet the plan or forgive the ee's the penalty.