New Teaching Contract

[Catrin]

When I start complaining to myself about how much my employer covered insurance has changed over the past 11 years, I will remember this thread. It may not be as good as it was at one time (then again, how many of us can say that), but my premiums are only around $80 a month as a single individual (we have a wellness program that decreases our premiums a bit). We didn't used to have co-insurance and deductible requirements at all until 4 years ago - but I know what it is like to not have access to insurance. I am thankful to have what I have - and it is an incentive to continue with healthy behaviors. It gets frustrating when I know I should go in to get something checked out, but I have to be very careful about that. I am now responsible for 20% of all scans (outside of a simple x-ray) and many other treatments. No more flat co-pay that we used to have on everything. Thankfully mammograms are still fully covered...

[OakLeaf]

Thankfully mammograms are still fully covered...

Only because the law says they have to be.

Cripes, who got me started?

[Irulan]

Only because the law says they have to be.

Cripes, who got me started?

Probably me. I think you and I are on the same page about this.

[Selkie]

Probably me. I think you and I are on the same page about this.

I'm with the both of you. As I've gotten older, I've become more and more progressive in my views.

[tulip]

Well I do have two pre-existing conditions. They put me at Level 2 ( of 4 levels). The lowest premium level is Level 1. So I do not pay the same premium as every other 45 year old woman; the insurance company considers more than just age and sex. I had to ask about my options because my premiums on my old plan (same company) went from $185 to $329 over 6 years and I've hardly used the services. I could not afford the $329 so I called them up and found out what my options were. It took perseverance but I now have a plan that I can afford. If my premiums were $1000+, it would not be possible to pay them on my income--the premiums would be more than my mortgage! I do not see how anyone on a normal income could afford that; it's like having 3car loans or an extra mortgage !

I just want people to know that there are options. They might be hidden and take a while to uncover, but I was surprised to find out that affordable options do exist.

[emily_in_nc]

Just read this entire thread with interest as we (my DH and I, both retired) are in the process of looking at individual health insurance plans prior to our move back to the US in the spring. We have had a catastrophic Latin American plan provided by a UK company for the past year an a half that we've been living in Belize and have not used it once. But it's not something I'd take the risk of going without.

I've been comparing plans using ehealthinsurance.com, and it looks like we'll be applying for the very least expensive plan that UnitedHealthcare offers, the Saver 80, with the highest deductible ($10K each for my DH and myself). It covers preventive care (because that is mandated by law), which is in many years all we ever get or need. And other than that, it covers just inpatient care if we should ever meet the deductible (no outpatient coverage). They also have an interesting new benefit where if you don't meet your deductible in a given year, it is reduced by 20% the next year, and so on until it is reduced by 50% max.

The base cost of the plan is $358/mo for the two of us. To get a plan that covers more (Rx, outpatient care, etc.) the costs just go up up up. Since we retired early, we knew we'd have to pay for most of our medical care other than really huge catastrophic problems, which we hopefully won't have for a long, long time.

We just feel very fortunate that we can afford to self-insure up to the limits of our deductible and pay for our own dental and vision care. So many people could not do this, and could not manage a $10K deductible, so have to pay for much more expensive policies. We also have no children to cover.

I do realize how lucky we are, and how very fortunate we were for decades to have "Cadillac" plans sponsored by our large corporate employer. We are very healthy and use very little health care, even in our 50s, but it may not always be that way. And an accident can happen to even the healthiest person.

I just hope we get approved!

[OakLeaf]

The one through Blue Cross Blue Shield is the most expensive and actually covers less, yet is the one my husband was told is the one most people opt to use.

I'd hazard a guess that's because most doctors, hospitals and labs are in-network with BCBS. Knowing whether your provider is covered is just as important as knowing whether the service is covered.

I do not pay the same premium as every other 45 year old woman; the insurance company considers more than just age and sex.

Your state allows that. Mine doesn't. When my insurance company raises my premium, I get a form letter with a grid on the back. It's got three columns, "Male," "Female w/o Maternity," and "Female w/Maternity," and ten or twelve columns with (mostly) five-year age ranges. Those are the only criteria they're allowed to use in setting premiums for individual policies.

I do not see how anyone on a normal income could afford that; it's like having 3car loans or an extra mortgage!

They can't. That's why over 18% of all adults in the USA are uninsured, and over 70% of adults under 25..

I just want people to know that there are options. They might be hidden and take a while to uncover, but I was surprised to find out that affordable options do exist.

Again - in your state there are options, and I'm glad that there are. In a few states there are even more options. In most states, there are not, at least not unless and until the ACA goes fully into effect (and we have yet to see what may happen with that, in terms of either implementation or affordability).

My first husband has several family members in the insurance industry, so if anyone is familiar with the options in my state, they are. He is older than I, but his health history at the time was similar. After our divorce and after his COBRA ran out, he couldn't afford premiums. He went bare for a couple of years, longer than the six months it took for him to be eligible for open enrollment. He found a fly-by-night policy that claimed to cover catastrophic conditions, after that company went out of business he went bare for another couple of years, until he was able to get eligibility for VA. If it weren't for the VA he'd still be uninsured.

[Koronin]

I'd hazard a guess that's because most doctors, hospitals and labs are in-network with BCBS. Knowing whether your provider is covered is just as important as knowing whether the service is covered.

I'm sure of that. I was still living near Charlotte when hubby got this job. My old doctor there took any coverage they knew about because they wanted to make sure if their current paitents ended up with different insurance for any reason they would be covered there no matter what. When I was choosing a plan I also looked up doctors on line where I was moving to. Of course not knowing anyone here had no idea who was/was not worth seeing. Strange part about that is the doctor I ended up picking who takes our insurance is apparently one of the best in the area. Like my old doctor she tries to make sure she takes any insurance she knows about. Of course here well over half the population is military and many of them just use the facilities on base. I picked the doctor I did because she does have over all good reviews on line (the major complain is wait time), and a big thing is that as long as you are a patient you do not need an apt to see her or the nurse practitioner, you can go as a walk in. (Which I was extremely thankful for a couple weeks ago). The vast majority of doctors here do not allow walk ins, you have to call for an apt. before they will see you. I figured being able to walk in if need be was worth waiting a bit longer in the waiting room.