New Teaching Contract

[Koronin]

I know when I looked at insurance when my husband was unemployed it was horribly expensive and there was no way to afford it. (Couldn't afford Cobra either). I ended up with insurance through the restaurant I worked for at the time, but in truth that insurance was not really worth anything unless you ended up in the hospital. I actually was shocked the first time I looked for insurance after graduating college and moving. My dad retired from GM and always had great insurance. I've just been surprised how horribly expensive it is. Currently through my husband's work we do have very good insurace, low co-pays, $5 for generic prescriptions (20% for non generic), we pay just over $200 a month out of his paycheck. Dental and vision are less than $10 per paycheck and are together in a plan that is sperate from the health. I agree with the rest of you that health care costs are crazy.

[Irulan]

Currently through my husband's work we do have very good insurace, low co-pays, $5 for generic prescriptions (20% for non generic), we pay just over $200 a month out of his paycheck. Dental and vision are less than $10 per paycheck and are together in a plan that is sperate from the health. I agree with the rest of you that health care costs are crazy.

These kinds of plans, as wonderful as they are for those who have them, are part of the problem in that real costs are hidden. I mean, if you are paying $2400 a year for coverage, and a handful of change, that doesn't begin to cover the actual costs of checkups, regular visits, prescriptions etc for two people assuming you have regular type issues.... but then again, the system is so screwed up, who knows what things really cost, eh?

We were out to dinner a few weeks ago and one of the guys works for Big Pharma, regional sales rep or something. For some reason the conversation got on to health care costs, and he was saying it was so great that no one had to pay more than $5 for a prescription. I was all, "what planet do you live on?" He was, "you can get yours at Walmart for $5, right?"
Well, the answer is absolutely not. He didn't believe me at first but It's not on the list. My plans doesn't cover it, and it's $300/month at most box stores last time I checked. Thank God for Costco Pharmacy.

[tulip]

I have an individual (non-work related) plan that costs $155 per month. It's not bad in my opinion. The deductible is high, but when I had a lower deductible, I only met it once so what's the difference? I save alot more in premiums with the higher deductible. It is an incentive to stay healthy--to keep my premiums low. It includes three doctor visits per year at $35 copay. Historically, I have rarely gone to a doctor three times in a year; usually it's just the one check up per year. Having insurance means getting insurance rates, which are much lower than non-insurance rates, so even out of pocket expenses are lower than if I didn't have insurance. Frankly, I really like having a non-work related plan. I spent way too much of my life tied to a job I hated just because it had insurance. Never again.

I could never afford $1000+ on premiums that some of you pay. There are alternatives out there.

When I got sick in Europe and had to go to the ER, I didn't pay anything. That was refreshing.

[OakLeaf]

It is an incentive to stay healthy--to keep my premiums low.

As you know (with your history of TBI), healthy behaviors are a choice, but being healthy isn't. And not all states allow individual rating. I'm paying the same premium as any 53-year-old female on the same plan as I am, whether they've been in perfect health their entire life, or whether they have serious chronic illnesses.

I could never afford $1000+ on premiums that some of you pay. There are alternatives out there.

Not when you have a pre-existing condition and insurance. If you're willing to go without insurance for six months, then you're eligible for open enrollment, and for the high risk pools in states that have them. Otherwise, I'm stuck with the insurance I have.

When I got sick in Europe and had to go to the ER, I didn't pay anything. That was refreshing.

No kidding. I was with my parents when my dad got sick in Austria. It wasn't nothing that he paid, but it was less than $200 including doctor visits and a prescription that would have been $300 all by itself in the US.

[Irulan]

Don't forget that the "free" health care in Europe comes out of a tax base, or pools that everyone pays into. So it's not really free, but at least the systems and coverages are consistent within each nation.

[OakLeaf]

Don't forget that the "free" health care in Europe comes out of a tax base, or pools that everyone pays into. So it's not really free, but at least the systems and coverages are consistent within each nation.

I don't think anyone suggested it was "free." On the consumer side, it's consistent from individual to individual, which is the key point of this thread ... on the provider side, costs aren't inflated with huge marketing bills and duplicative administrative expenses.

[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.

[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!

[Koronin]

These kinds of plans, as wonderful as they are for those who have them, are part of the problem in that real costs are hidden. I mean, if you are paying $2400 a year for coverage, and a handful of change, that doesn't begin to cover the actual costs of checkups, regular visits, prescriptions etc for two people assuming you have regular type issues.... but then again, the system is so screwed up, who knows what things really cost, eh?

We were out to dinner a few weeks ago and one of the guys works for Big Pharma, regional sales rep or something. For some reason the conversation got on to health care costs, and he was saying it was so great that no one had to pay more than $5 for a prescription. I was all, "what planet do you live on?" He was, "you can get yours at Walmart for $5, right?"
Well, the answer is absolutely not. He didn't believe me at first but It's not on the list. My plans doesn't cover it, and it's $300/month at most box stores last time I checked. Thank God for Costco Pharmacy.

My husband works for the Federal Govt (Dept of the Navy as civil service, good luck figuring out what exactly the cost of the plan actually is. I do have pay a good portion of any lab work. It's somewhere between 40 and 50% for any lab work done. I know this because I know how expensive that can be without insurance. And my old doctor did what she could with not doing more than she had to with lab work then, and got me a discount by having it billed to the office instead of billed directly to me. Although I did see what the cost was before the deduction.) Our insurance is through an insurance company that is apparently only for govt employees and actually has very few doctors even in a military city that takes the coverage. The other insurance packages from other companies which are very similar in benefits are between $50 and $100 more per paycheck than the one we have. 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 know you are correct about Walmart not carrying some prescriptions. They don't even carry the birth control I take, forget getting it for $5, you can't even get it there. Actually that prescription I pay more than $5 for anyway (well until that part of the ACA kicks in).

[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.

[lph]

I don't think anyone suggested it was "free." On the consumer side, it's consistent from individual to individual, which is the key point of this thread ... on the provider side, costs aren't inflated with huge marketing bills and duplicative administrative expenses.

To me the real bonus is not that our health care is "free", because it's not, but that paying for it is not optional. And that good health care is not only for the well-to-do or for those who plan well. It has a cost, but these are still good things in my book. But I realize that these are hot political topics in the US and I won't pretend to know what it's like. It's a different world.

[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.