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This year for our company health insurance the out of pocket portion for health/dental/vision for a family has gone up to $8k which is around $666 a month. Is this in line with your company? Our company contributes another $12k. It is insanely expensive.
This is a PPO. 90%/10%. We have $2600 to spend where they pay 100%. In addition, annual check-up and vaccines are not counted against the $2600. Once we exhaust this $2600 we have to pay 100% out of pocket until $6000. After that they pay 90% and we pay 10%.
Details matter. How many covered people in the family? Ongoing health issues? Prescriptions? Does anyone use prescription glasses/contacts? Anyone need orthodonture?
IMHO "averages" may not be all that meaningful when you try to apply it to an individual situation.
Right now I have the worst health plan I’ve had in my career. I did work for the government for a while so I was spoiled for a while so I think everything is horrible.
Currently I have a 70/30 PPO. $20 a month.
$2250 deductible before the insurance pays 70%
$3850 maximum out of pocket for a individual
I rarely use the insurance but if I was to be a heavy user and hit the $3850 yearly maximum the health plan would cost about $340/mo including the maximum OOP plus the $240
In yearly premiums.
What this type of plan does is it makes you not want to go to the doctor for small things that could be big issues down the line potentially? When I had a copay plan where every doctor visit was $15 or $25 I would go to the doctor a lot more. And I get that’s the point of high deductible plans but sometimes I wonder what I may be missing by not getting some things checked out because of cost.
I have a cdhp for my family. I add on VSP and a separate dominion dental plan. Annually it's $5451. The begining of the year they put $2400 into a health reimburse account which rolls over if you don't use it all. It's similar to a health savings account except it has a cap of 10k and isn't portable if you leave the plan.
$4400 family deductible or individual $2200 deductible. If you have enough in the HRA it can pay everything including your deductible. After you hit the deductible, we're on the hook for 15%. $13k catastrophic limit.
We really like the plan. The hra has paid for everything and we've been able to roll over and built up $5400 so far. When my wife was pregnant, all her prenatal visits were completely covered and we didn't pay anything for the delivery.
This year for our company health insurance the out of pocket portion for health/dental/vision for a family has gone up to $8k which is around $666 a month. Is this in line with your company? Our company contributes another $12k. It is insanely expensive.
This is a PPO. 90%/10%. We have $2600 to spend where they pay 100%. In addition, annual check-up and vaccines are not counted against the $2600. Once we exhaust this $2600 we have to pay 100% out of pocket until $6000. After that they pay 90% and we pay 10%.
$11k per year for medical insurance and another $1,500 per year for dental. Family of 4
IMHO, "health" insurance is the most gawful gambling scheme imaginable.
It has been the driving factor for skyhigh medical costs.
Instead of a patient just paying a doctor or a hospital, the patient has to now pay dividends to the stockholders of the insurance company, the administrative staff to deal with the paperwork, the increased overhead expenses, as well as the embedded taxes for all these employees, assistants, office managers, and intake clerks.
Let's not forget the meddling in what is considered to be "covered" by the insurance scam, and the problems that it creates.
- - -
No matter how you slice it, the patient loses, when "the house" always gets their cut.
This year for our company health insurance the out of pocket portion for health/dental/vision for a family has gone up to $8k which is around $666 a month. Is this in line with your company? Our company contributes another $12k. It is insanely expensive.
This is a PPO. 90%/10%. We have $2600 to spend where they pay 100%. In addition, annual check-up and vaccines are not counted against the $2600. Once we exhaust this $2600 we have to pay 100% out of pocket until $6000. After that they pay 90% and we pay 10%.
This is similar to what my company offers. On the plus side, employee contributions for the insurance are low with my company picking up most of the tab. What I do is contribute to an HSA (monies are pretax rather than post tax and that money carries forward from year to year). I know my company puts in $500 to an HSA for everyone too each year.
DH could qualify for Medicare, but I only have him on Medicare Part A and then have him on my insurance.
Given our tax bracket he'd have to pay $330 a month for Part B and then would need a supplement and part D (more additional costs). I haven't looked specifically at how much a supplement and Part D for prescriptions cost yet either. As expensive as the group insurance is and as high as the deductibles and out of pocket costs are for the group insurance is, although we will have lower deductibles and co-pays with Medicare and a supplement given how much we'll be paying for the insurance when I retire (about two years from now) due to high cost of insurance overall it looks like we'll be paying more not less for Medical Insurance. I want to get a Medicare supplement and Part D for prescriptions for us when we retire instead of an advantage plan.
This year for our company health insurance the out of pocket portion for health/dental/vision for a family has gone up to $8k which is around $666 a month. Is this in line with your company? Our company contributes another $12k. It is insanely expensive.
This is a PPO. 90%/10%. We have $2600 to spend where they pay 100%. In addition, annual check-up and vaccines are not counted against the $2600. Once we exhaust this $2600 we have to pay 100% out of pocket until $6000. After that they pay 90% and we pay 10%.
It is true that it's a good idea to have emergency reserves for the Out of Pocket max. In my family's case for the past 20 years we are usually way under the out of pocket max in our medical expenses, so HSA monies we contribute go forward from year to year. But one surgery or hospital visit for one family member and you are there. We have had two years in the past 20 when we hit our out of pocket max. The one was when DS needed two surgeries on his knee back in 2012 and quite a bit of physical therapy after each. The other was when DH had to have a hip joint replacement in 2021. Even though it was just one overnight (and counted as outpatient - meant no Medicare Part A) that and the physical therapy got just a little over that out of pocket max.
Under the ACA Insurers must spend 80% of the premiums collected on providing medical care. They can use the remaining 20% for overhead and profit. WHERE IS THE INCENTIVE TO CUT COST?
What is better for an insurance company's bottom line; a 10,000 dollar procedure or a 20,000 dollar procedure? With the 20k they would be able to pocket 4k whereas at 10k it would only be 2k.
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