Crazy health insurance rates???

[Bob]

A few more comments, just to point out a few realities from my experience. Sorry this is long winded.

My former Fortune 500 employer had excellent health insurance, but even so the last several years it went to a high deductible model (and the employee cost went way up). That is pretty much what you will get now from all the insurers. The differences among plans being a trade off of the amount of the deductibles and out of pocket maximums against the premium amount. OTOH you can no longer be penalized for pre existing conditions. The premiums do go up by age, though. Also the details of % copays vary a lot too.

The higher deductibles mean we need to shop for health care, since we foot the bill at first. The problem is that is is almost impossible at present to find out what some health care costs, so it is not yet a free market situation where you as the consumer can make a judgment about all the costs. Also, the insurers are getting much more careful about paying for expensive drugs now that the drug companies are trying to charge a fortune, so more expensive drugs aren't covered or only with very high copays.

However, this is changing, but very slowly. Right now you can at least call your providers and get the cost for some things, like office visits and routine office procedures. There are also estimates online for medications, or better, ask your pharmacist or look at the "cash" price on your receipt. Good luck though if it is something like surgery, because there are too many providers involved and the hospitals have no idea what their costs are and they just put together crazy numbers to negotiate with the insurers and make the books balance out. I know, I tried to find out the costs on some things.

OK, so what does this mean in practice for getting insurance?

Well, this means that you as a medical consumer, need to look VERY carefully at the various plans offered and make a judgement about the premium vs deductible vs out of pocket maximums based on what you think you will need.

You need to check their network of doctors if you are wanting to stick with particular ones. It isn't the case anymore that they all accept the major insurers.

You need to choose an insurer who will cover your expensive drugs if you have some. They all publish their "formulary" which shows what drugs they pay for. But, it can vary by plan even for the same insurer, and it can be hard to find-Google is your friend here, or call them up and get a link.

Bottom line is that even though it is really not a "market" like we normally deal with, it still requires that you do your homework on the details to get the best plan for your particular needs.

[Serious Offroad]

My neighbor is in the insurance business and he recently returned from a conference on heath insurance. He let it slip that the only reason insurance companies are jacking up rates is as a hedge against the future collapse in the health insurance market after Obama-Care is repealed.

If they see the writing on the wall, could there be an end in sight?

Sadly politics has creeped into the free-market in many ways, this is a fact of life. What bothers me about it is that we are not allowed to drive the price as consumers should be doing. We decide what products are worth our hard-earned pay...except when it comes to insurance.

If you haven't examined exactly what you're paying for...you really need to do so.

[Chris]

The key words there is "after Obama Care is repealed" which is really "if Obama Care is repealed."

I'll just say that's a really big "if"

Either way it gives them a reason to tell themselves that's their motivation - greed wouldn't be a word they use.

[Jim]

And I'm sure all of us could have a grand time rolling down the ObamaCare rabbit hole.

I was curious if others were having / encountering large increases this time around. That is all.

Thanks all for the info.

[Bob]

Chris previously posted:

[Bob]

Jim previously posted:

[Java]

So we got this put to bed yesterday and were surprised at our new, much lower rates than last year, and we even upgraded our plan to a lower deductible. The actual rate from Cigna is less than half the quote we got a few weeks ago. We also got an approval for me for Medicaid in the mail, so we thought our broker screwed up (again- we just paid $3600.00 to make up for his mis-filing last year) and had only put my wife on the policy, but apparently Medicaid is making a common mistake (again) and approving people who don't qualify, be aware if it happens to you too. Also decided our broker is an a-hole, looking for a new one if the universal proposal doesn't pass and they're all out of business.

As I was told, (and it makes sense to me but I haven't vetted it) the reason for the lower cost / higher subsidy is that the insurance lobby is manipulating the Obamacare subsidies for Colorado to attempt to discourage people from voting for the Universal healthcare proposal on Colorado's 2016 ballot, which would be bad for them, by temporarily lowering rates for the election year. I'm not making a political statement, just parroting what I heard.

[Java]

Chris previously posted:

[Chris]

Paul previously posted:

[Java]

The Medicaid BS is nothing new, this link is me yelling at Connect For Health Colorado just about 2 years ago to the date when they sent out denial of coverage emails on Christmas Eve based on the Medicaid error, despite knowing it was happening. Dumbasses. I hope the universal care passes just to put these idiots and my broker out of work. https://www.facebook.com/connectforh...tal_comments=3

[carpenle]

newracer previously posted:

[Chris]

carpenle previously posted:

[carpenle]

I was in the information stream and it was not any better. The problem is we are a small group, larger groups would get better rates and coverages.

[Jackie]

Dr. David Belk is a friend that my husband and I grew up with, He practices medicine, but he does so much more. You might find his web site an interesting read: http://truecostofhealthcare.net/introduction/

[gm4x4lover]

I have decided for 2016 I am going to drop my medical ins and just continue to pay out of pocket like I have in the past. My rates for 2015 were almost 1k per month. I am insured through kiasers. My kids had a couple of doctors visits, I ended up paying 100% out of pocket because the negotiated rate was more than the cash price. I can't find a pharmacy that execpts my insurance either. And I didn't look real hard. Cash price on generic meds is only $5. I was going to have a hurnia repaired. I had 4 or 5 surgical appts over the course of 3 months, I went through pre registration( the day before) and registration ( the day of ) only to find out that, just before they were going to operate, that even though kiaser thought the hospital accepted my insurance ( and gave them the auth # approving the procedure), I was denied at the last minute. It's cheaper carrying a non aca Catastrophic and paying the fine than it is paying the high deductibles and still paying everything out of pocket.

[fredrok]

SO biting my political lip right now.

[Chris]

gm4x4lover previously posted:

[gm4x4lover]

I belive after my adjusted gross income, it will be around $1200 or $1300 dollars. The cheapest I am looking at $250 per month so 6k for the year. The cheap insurance doesn't really buy me anything so I am still the same amount out of pocket.

[Jim]

I ended up with a PPO, willl pay the fine, and come out less costly overall with seemingly better coverage than the HMO (which I just cancelled 30 minutes ago).