Health Insurance Help - Non-Employer?

[Sam and Ben 2]

So... I need a little help.

Getting used to health insurance here in the States is one thing, but hubby and I are paying astronomical amounts of money for ours through his company. They were supposedly shopping around for better insurance when it came up for renewal at the end of March, but told everyone that no one would provide them with better service, so we were sticking with our current providers.

Aaaaand the rate went up.

One of our biggest problems is that, by adding me to the plan, we're automatically a "family", which more than tripled my husband's old rate. Is that right? Is that normal across the board?

My other question is, is it possible for us to inquire for a provider outside of employment, where we might find a better rate?

I'm at my wit's end with how much of a strain this puts on us financially. Everyone else I've talked to have told us that we are easily paying a hundred dollars a month over what they are, if not more than that. It's incredibly frustrating.

If there's any insight to be had.. please... offer it up!

[Hugglebuggles 60]

Do you mind me asking how much you guys are paying? Because when I was added to my husbands health plan my first reaction was to be angry at the costs, but after asking around I discovered that it was a fairly typical rate for the state. When I was added his rate more than doubled, since apparently his work (aka his parents ) pay for half of his insurance costs, but we pay 100% of my cost. If we were to have a child and add them onto the policy, the rate would go up yet again.

So, its a standard family rate that would stay the same even if you had kids? That could possibly be good in the future, but now if you're paying more than you need to because of that, then that's definitely not ideal.

It is possible to find insurance at a better rate from a different source. Here in Colorado we have a company called Rocky Mountain Health Plans that sell insurance to both businesses and individuals. Apparently, you pay for the type of coverage you need or want, so you can avoid huge monthly costs in favor of a larger deductible. I don't use it, but I have heard good reviews from people who do. I can imagine that there are similar operations around the country, so hopefully someone in Florida can refer you.

It's pretty ridiculous how they get away with charging you so much, and then charging you additional costs for different services.

I hope you find something!!

[Sam and Ben 2]

We're paying ~$107 a week, with dental as an additional cost. He was paying ~$32/wk as an individual.

And yes, they don't differentiate between couples and families... I'm sure there's a limit to how many kids could be added or some such, but we are on their "family" plan as they had nothing inbetween.

I do agree, that it's ridiculous they can charge so much, and then I still have a co-pay when I visit a doctor. I can't wrap my head around it.

[Peachey 10]

We're paying ~$107 a week, with dental as an additional cost. He was paying ~$32/wk as an individual.

And yes, they don't differentiate between couples and families... I'm sure there's a limit to how many kids could be added or some such, but we are on their "family" plan as they had nothing inbetween.

I do agree, that it's ridiculous they can charge so much, and then I still have a co-pay when I visit a doctor. I can't wrap my head around it.

Sounds like you're paying for all of your coverage. You can always get insurance outside of your hubby's work. Captial Blue Cross I think is what my SIL uses. There's other ones out there too. Depending on what coverage you want will determine what your payment will be.

Keep in mind these other insurance companies have weird policies. My SIL's policy indicates that she must tell her insurance company a year in advance if she's having a child and their premiums will go up 500/month.

[canadian_wife 1,822]

Your husband does not have to add you to his plan. You can find your own plan and be classified as an individual and not as a 'family'. I'm not sure what state you're in but here in Georgia, there are plans as little as $20 per week with a $10 copay for doctors and prescriptions.

Good luck

[Udella&Wiz 325]

To give you an example...we have family coverage (fam of 5 and no it doesn't matter how many kids, the rpice would remain the same ) and WE pay $265 every 2 weeks which is 40%...my husband's company pays the other 60% ...which means our total monthly is about $1320

$102/week or $408/month isn't really that bad....just saying

Depends on what type of coverage you get...we have pretty decent coverage and frankly we still have plenty of copays and fees...paying less for insurance just means more is coming out of your pocket if you have an expensive medical event.

[trailmix 77]

Yes, that would appear to be normal, based on your experience and on ours, in Florida. That is about what we were paying as well, it included dental and vision for him I think but not for me, can't remember - and yes, adding the spouse increases it astronomically.

For what you are paying we had a $6000 deductible, after that they would then kick in some paltry amount, like 20%, but the full deductible for the year was 11k - so basically it was only ever good - well no it was really good for nothing lol

So I did shop around, i'm sure you have seen those commercials from the Florida government - you spoke, we listened, now there is affordable health coverage for all! Well, guess what, that's not true I checked it out and it would have cost us the same with blue cross and in fact for the $400 a month we would only get basic coverage, like doctor's visits etc - so nothing to be gained there.

So i'm sorry i'm not really of much help here, just to say I did shop around and didn't find anything better and if your deductible isn't 11k a year - you probably have a pretty good plan.

[SapphireDreams 71]

Sounds like they are only paying for your husband and then partially for you. My employer does it like that. We would pay $120/month for a single or $450 for a family (which would be a a couple as well). My employer would pay 75% for the employee and then 25% for the spouse/family portion. So technically the total amount would've been more without their contribution.

Do you have deductables or co-pays? What do you actually get for that $107/week? I mean, my husband's insurance is a lot better than my employer. It's $200/month for both of us pre-tax, our co-pays are low and we have no deductibles. My employer offerings would be $450/month, co-pays are high on one plan or deducitbles are high on the other options.

I mean it can't hurt to see what else is out there, but honestly sounds exactly like my employer's coverage.

[Sam and Ben 2]

His company apparently picks up 50% of the bill.

For a larger family, I'd understand it (or at least, understand it moreso), but for two people, I feel it's rather insane. If there's the option of looking on our own, which everyone's saying there is, then I think I'm definitely going to do some looking around.

Your husband does not have to add you to his plan. You can find your own plan and be classified as an individual and not as a 'family'. I'm not sure what state you're in but here in Georgia, there are plans as little as $20 per week with a $10 copay for doctors and prescriptions.

Hah, that'd be awesome. It'd be nice to find something like that around here.

Edit to reply to Sapphire:

Doctor co-pay is $30 in network... $4 for generics, $40 for "preferred" brands, $70 for non-preferred. Deductibles are high as well, from what I read through our policy.

I don't know how to determine what they're portioning for coverage between hubby and I.

Edited April 15, 2010 by Sam and Ben

[Udella&Wiz 325]

Make you wish for decent government Healthcare Oops....that'll just start an argument.

I think we're all pretty shocked since we've never really had to pay. Even back in Canada though...I paid a reasonable amount for good covereage at my company.

[SapphireDreams 71]

To give you an example...we have family coverage (fam of 5 and no it doesn't matter how many kids, the rpice would remain the same ) and WE pay $265 every 2 weeks which is 40%...my husband's company pays the other 60% ...which means our total monthly is about $1320

$102/week or $408/month isn't really that bad....just saying

Depends on what type of coverage you get...we have pretty decent coverage and frankly we still have plenty of copays and fees...paying less for insurance just means more is coming out of your pocket if you have an expensive medical event.

You are exactly right. You really do get what you pay for here. God forbid you get into a car accident and you have a $10,000 deductible... even a $5,000 deductable would be insane and could really harm you even worse financially. Or when I was thinking about it, let's just say I got pregnant, sure I could opt for a cheaper monthly plan, but then when I have a baby my hospital stay is only covered 80%, and the difference could be anywhere from $2,000+ depending on if I have a natural delivery vs. a c-section vs. a baby that needs to be in intesive care etc.

It might help for you to call your husband healthcare hotline and talk to their consultant about your plan and what's covered, what the deductibles are, etc. We just had a session at work and I learned so much and now totally understand how things work here. It was really beneficial and would help you if you are starting to shop around. You might find that an outside provider would be cheaper, but might not give you as much when you need to actually use it.

[Hugglebuggles 60]

Are you guys kidding me with these prices?! Wow. We pay $63 a week for both of us, so around $250 a month. Our co-pay is $30, but things like standard checkups and physicals and immunizations are free (anything considered preventative care) as is all prenatal care. There is no deductible according to the information I have (you all prompted me to read up! ) but there is a $1,000 hospital admit fee, and it costs $1,000 to deliver a baby. We also don't have any dental coverage, which I would really like.

I dunno Sam, even if your coverage is good, for that price and at the point you are in your life now, I think that's way to much. You're young, healthy, don't have kids and probably aren't going to have kids anytime really soon, and you're not able to work yet, so that's an unreasonably high bill for the two of you to carry. I think at least looking around into other options would be a really good idea.

[Udella&Wiz 325]

Are you guys kidding me with these prices?! Wow. We pay $63 a week for both of us, so around $250 a month. Our co-pay is $30, but things like standard checkups and physicals and immunizations are free (anything considered preventative care) as is all prenatal care. There is no deductible according to the information I have (you all prompted me to read up! ) but there is a $1,000 hospital admit fee, and it costs $1,000 to deliver a baby. We also don't have any dental coverage, which I would really like.

I dunno Sam, even if your coverage is good, for that price and at the point you are in your life now, I think that's way to much. You're young, healthy, don't have kids and probably aren't going to have kids anytime really soon, and you're not able to work yet, so that's an unreasonably high bill for the two of you to carry. I think at least looking around into other options would be a really good idea.

Yikes...so if I divide that $1000 into 26 pays per year...that's an extra $38 per.....so imagine if even one of you has to enter the hospital....your per week is now up to Sam and Ben's.

I totally get that the younger couples here aren't in a position to pay these fees, neither were we 10 yrs ago....insurance is just that...you may pay for a couple years and not get your money's worth...but man will you be thankful when that horrible event comes along as Sapphire said.

It is probably worth seeing if they can explain some of the benefits and details for you.

[darkchilde794 5]

Sam, you can get an individual plan. That is what I did -- my husband gets a full health coverage from his employer, but we would have to pay for mine (which would be almost 300+ a month!). So I went on an individual plan with CareFirst Blue Shields (excuse me, but #### you CareFirst Blue Shields hehehe they are holding our money hostage but thats a diff rant) and pay 73 dollars a month for insurance. I have a 30 dollar copay for PCP and 40 for specialist, etc. We might change my insurance because they did something wonky with me... but Im insured and we are not paying an arm and leg for coverage

Also, my in-laws have told me that I can choose to only pay for catastrophic insurance (not sure if that is the legal term for it). This means you are insured in the event of an accident and will have coverage for medical fees, etc. I am thinking of doing this as I basically see my doctor once a year and am not in any prescription (except for you know). If you choose to only get catastrophic coverage, your rates will likely be less, but you'd be paying full price for visits.

[Hugglebuggles 60]

Yeah, I mean, everyone has different priorities. If one of us ends up in the hospital, yeah, that will be horrible. But at the same time, we are both young and healthy, and really aren't about to plan our lives based on a "what if" situation. Personally I'd rather pay a lower rate now, and then fork over the $1,000 to enter the hospital if I really need it, than pay the higher weekly rates now and be admitted for free. We have some savings, $1,000 wouldn't totally break the bank, and saving $150 a month is nice. Just my thoughts. I'm also young and naive and have never had a medical emergency, so I guess part of me has that "It won't happen to me" mentality, even though it definitely can. I've seen it happen to a lot of people.