Is this a bad health insurance plan?

[Husker4ever]

Okay, I have family medical insurance at my job. It's an 80/20 plan with a 1000 dollar family deductible. I paid 90 bucks a month and change for it (10 percent of the policy cost). Our union went to arbitration and won out on wages but lost on the medical coverage. It now costs me 225 dollars a month with the same 80/20 coverage and deductible. Generica prescriptions are 20 bucks.

Here's the rub....the rest of the county (I'm in law enforcement) only pays 10 percent still while we now pay 25 percent. I think we got fucked in arbitration and I'm not sure this is good coverage. the 4 percent raise I got covers the additional cost but the raise was intended for cost of living/inflation.

Sound like a good plan? Call me a socialist...but I think we have a shit health care system and a scandalous health insurance industry in this country (affordability) that needs immediate reform.

[Wolfman]

OK --
you're a socialist !
feel better ?

[smackaholic]

I'll go you one better. You're a commie!!!

As for the health care system we have, IMHO, it is fukked up. We are tyring to run a private system that pretty much works like the euro single payer systems. And that's not a good thing.

Back in the day, I remember them calling it hospitalization coverage. In other words, you had insurance for catastrophic shit that generally put you in the hospital. This is the way insurance should be. It covers unforseen unplanned high expense shit. When little joey has an ear ache, you should go to your local doc and write a check for it. Health insurance should be no different from any other type of insurance.

Yeah, there is the arguement that if you have to pay, you will put shit off until it ends up being a hospital trip. I understand that, but, I still don't think it is the way to go.

The trouble is, with the system we have in place, joey's earache costs a few hunnit bucks, mainly because the doc has to have an army of paper pushers on his staff. My GP's staff is him, a PA, a RN practicioner, a couple of med techs and 4 or 5 chicks out front shuffling through records and insurance forms. Those insurance paperwork chicks are a fuggin' waste of money.

A few years ago, I went to my doc near the end of the year, I hadn't yet put a dent in my deductible, so I told them I wanted to just pay cash. The RN told me that in that case it would just be 30 bucks. Why do you think that is the case?

[Wolfman]

Back in the day, I remember them calling it hospitalization coverage. In other words, you had insurance for catastrophic shit that generally put you in the hospital. This is the way insurance should be. It covers unforseen unplanned high expense shit. When little joey has an ear ache, you should go to your local doc and write a check for it. Health insurance should be no different from any other type of insurance.

exactly !
--imagine what your car insurance would be like if it
paid for oil changes and tire rotation !

--that's part of the problem with many of these health plans !!

[Husker4ever]

Husker4ever-

Your health plan seems pretty good. I guarantee your employer's health insurance premiums have increased greater than 4% in the past few years. You have received a health care cost of living raise every year that the employer's premiums went up, you just didn't see it in your check. But your employer saw it.

I am self employed and cannot affort to provide traditional 80/20 plans to my employees or to myself. But there is a fairly good health insurance product out there for people like me. It is called a Preferred Provider Organization (PPO) Health Savings Account (HSA) plan. Basically, it is a high deductible 0/100 catastrophic health insurance plan (similar to what smackaholic mentioned), which has four added benefits: (1) I am permitted to make contributions to a health savings account that are roughly equivalent to the amount of the deductible each year (~$5,000), with those contributions being considered page one 1040 tax deductions; (2) if my family does not use up the deductible in any year, the amount remaining in the health savings account is allowed to grow to provide tax-deferred funds for retirement; (3) I get the benefit of the negotiated lower rates in the PPO by the group health insurance plan; and (4) because the deductible is so high, I get a lower annual premium with 100% coverage for everything, including prescription drugs, after the deductible has been met. My family HSA plan costs me about $500 per month, plus the $5,000 annual deductible. And, our plan has dental, vision and quite a few first pay dollars (well visits for the kids, a gyno visit for the OL, an annual for me etc. etc.).

Your employer is getting boned on the 80/20 plan. You're not. Next time you guys arbitrate, you should suggest having the employer contribute the deductible for an HSA plan. The employer contributions are not first page 1040 deductions, but caysh is caysh, and you'll have a cheaper, better plan that, if you stay healthy, will provide you with some cash for retirement or old age.

Now that just makes too much sense. Why can't employer subsidized plans be like that? I like your ideas on it.

Part of the problems out here regarding PPO's is there is little choice among providers/less competition and our local hospital has been called out many times for charging 40% above the national average for procedures...routine or emergency. It's so bad that they just accept whatever the insurance company writes them a check for and then makes feeble attempts (that never go to collection) at trying to get patients to cover the rest. I'm like, "Fuck you....I paid my deductible" "Talk to my insurance company" and they stop sending bills. If you have no coverage....you pay it all or go to collections.

We either accept this or drive a hundred miles to another hospital. Heart attack victims are their favorite patients ya know? It's ridiculous and they are crooks, IMO. But, they keep getting away with it. They are also a Catholic hospital so they don't pay shit for taxes on their outrageous profits which is why they were able to pay cash for a 65 million dolllar expansion that's still being built. I imagine they are part of the reason our plans keep getting shittier.

[Derron]

Quit your fucking bitchin.

That plan you have is fairly common among public sector employees. Consider you are getting FAMILY coverage for $ 225 a month plus the "out of pocket" expenses. My OL has the same type plan working for a major state funded hospital in Portland.

It took care of us and 5 kids and our current monthly out lay is about $ 340 for our portion of it, for just her and me.

I checked with 2 of my friends, both sherrif deputies and their plan is the same. My bro in law works for CDC at Pelican Bay, and they fucking pay for everything, but thats Cali for you.

I pay $ 158 per month each for my employees for an 80/20, plan $ 1,500 deductible plan, and am damn glad to have that for them. I pick up the whole tab on that one, and they have to pay for family.

I am curious about the HSA plan converting to a tax free savings plan. I will be putting in a call to my CPA this morning about that.