How much gets deducted from your pay for health benefits?

  1. Hi all. I haven't been on much lately now that I am working in the 9-5 mode in front of a computer, but I am curious and need some input, plus I thought this was a topic we haven't seen in relation to salary issues etc... Sorry if I missed a thread where it was discussed already in advance.

    My husband had to re-apply for his job, his job was out-sourced, but they love him, so they insisted he be the one assigned by the new company st the old site. I was finally at a level where I was used to United Health Care, and knew how to get claims paid within the system, etc. Made a few appeals and won, etc... Now, we were forced to enroll in a new plan...and it is yanking my chain big time.

    The new company is Blue Sheild on CALIF!! Yes, we live in NJ, so it is a HUGE PITA, all my calls have to be on california time, they request so much paperwork from the docs they are moaning. So, we have considered, now that I am staying in one place, happily, for a while, we should investigate my benefit options.

    Here are my dilemmas, and options...

    An HMO with Referrals req'd 100% Coverage in-network $50 nper pay (q 2 weeks)

    A PPO with 100 % cov in network, 70/30 otherwise, $65 per pay & still need referrals

    A POS where I can go anywhere in or out of network, lower office vist co-pays, etc... NO REFERRALS...........$145 per pay!!!!

    So, for the first time, we are considering going to the HMO plan. Hubby's POS plan is $65 per pay, also q 2 weeks, also no referrals. BUT it's the California hassle. The paperwork dust is about settled, so cost-wise, unless I choose the HMO, we really can't afford those kinds of deductions, and maybe we should just stay w the California vs. NJ hassle.

    For those of you who do the HMO Route, how much of a PITA is the getting referrals process?? All of our docs are in-network, so we figured why not try it??

    And, how much, approx, are your deductions? For what kind of plan? What hassles do you have?

    Isn't it a sin, that as healthcare workers we get so screwed w health benefits?? And, I am ashamed to say I work for a major health plan myself, and those are my deductions!! We get less of a break than the average employee in the workforce other than Health Care workers that is.
    •  
  2. 20 Comments

  3. by   TweetiePieRN
    Quote from hoolahan
    Hi all. I haven't been on much lately now that I am working in the 9-5 mode in front of a computer, but I am curious and need some input, plus I thought this was a topic we haven't seen in relation to salary issues etc... Sorry if I missed a thread where it was discussed already in advance.

    My husband had to re-apply for his job, his job was out-sourced, but they love him, so they insisted he be the one assigned by the new company st the old site. I was finally at a level where I was used to United Health Care, and knew how to get claims paid within the system, etc. Made a few appeals and won, etc... Now, we were forced to enroll in a new plan...and it is yanking my chain big time.

    The new company is Blue Sheild on CALIF!! Yes, we live in NJ, so it is a HUGE PITA, all my calls have to be on california time, they request so much paperwork from the docs they are moaning. So, we have considered, now that I am staying in one place, happily, for a while, we should investigate my benefit options.

    Here are my dilemmas, and options...

    An HMO with Referrals req'd 100% Coverage in-network $50 nper pay (q 2 weeks)

    A PPO with 100 % cov in network, 70/30 otherwise, $65 per pay & still need referrals

    A POS where I can go anywhere in or out of network, lower office vist co-pays, etc... NO REFERRALS...........$145 per pay!!!!

    So, for the first time, we are considering going to the HMO plan. Hubby's POS plan is $65 per pay, also q 2 weeks, also no referrals. BUT it's the California hassle. The paperwork dust is about settled, so cost-wise, unless I choose the HMO, we really can't afford those kinds of deductions, and maybe we should just stay w the California vs. NJ hassle.

    For those of you who do the HMO Route, how much of a PITA is the getting referrals process?? All of our docs are in-network, so we figured why not try it??

    And, how much, approx, are your deductions? For what kind of plan? What hassles do you have?

    Isn't it a sin, that as healthcare workers we get so screwed w health benefits?? And, I am ashamed to say I work for a major health plan myself, and those are my deductions!! We get less of a break than the average employee in the workforce other than Health Care workers that is.
    I have pacificare insurance HMO. Both my hubby and I are covered and it is $14.43 every 2 weeks. Add in dental and vision and the grand total is $15.82 per 2 weeks!! If we had kids...the total amount would go up by $6.50! I have not had any probs with referrals. My hubby was referred to a neurologist...easy as pie! Plan is pretty good! ER visits are $30, $10 generic drugs and $20 brand names, DR office visit is $5, immunizations $5, wellbaby $5. No charge for lab/diagnostics, no charge for skilled nursing (up to 100 days a year!), no charge for inpatient and outpatient hospital services, no charge for hospice care, no charge for DME!!! Annual out of pocket maximum is $750 per individual. Overall this is a great plan!
  4. by   hoolahan
    OMG!!! That is great!! You bring up a point, the fees I mentioned are for family coverage as well.Weare obviously getting ripped off!
  5. by   pcelest2003
    51.00 me and spouse p/pd ppo, Nortwestern Memorial Chicago
  6. by   txspadequeenRN
    All you folk are lucky ,If I took the insurance at my job 389.00 per pay check. That is for me ,husband and kids. This is also last years rates it goes up every year. I like to eat so we do without insurance. How sickening is all this....:angryfire
  7. by   OKRN
    I pay 300 per month for my HMO and 40.00 for dental per month, this covers myself, husband, and kids.
  8. by   NRSKarenRN
    Glad to see you Hoolio!

    Blue Cross Personal Choice PPO: family of 4 $148.83 q2wks.
    No Referrals, Covered 100% in network, 70% out network with $1,000 family deductible.----sounds similar to your POS plan.

    Penn Dental2 Plan family 4: $23.91 q 2 wks for $1,000 and it's worth every penny----they've paid full amount for all dental work needed past two years.


    I deal with California, Illinois and Boeing Blue Cross weekly for home care clients: UGH, I feel your pain.
  9. by   rjflyn
    For me and the wife I pay NADA, ZIP, ZILTCH, 0, course new contract being negotiated so who knows what but it could be an issue. Office visits $15, no sweat with referals. RX 7, 14 and 24.
    RJ
  10. by   Gator,SN
    $56 q2weeks for family medical. In network $15 co-pay per visit. $500 deductable per year.
    No dental offered
    No vision offered
  11. by   moonbunnie
    i used to work for blue cross blue shield and had the most awesome insurance benefits ever. it was 10 dollars per month, not pay period, for ppo and dental, and for ppo we could see any doctor, no referrals, no deductible, 10 dollar copay. and the dental was pretty good too. then i quit to go to nursing school, and my moms insurance wont even cover me because 23 is the cutoff age. so now i have some crap that i paid 400 dollars for a 6 month temporary policy and just hope i dont get sick any time soon
  12. by   Cali
    I only pay $40/month for medical and dental combined. I pay a $10 co-pay for medical office visits and $10 for prescriptions. I don't have a dental office co-pay unless I have a major procedure done.
  13. by   ?burntout
    I pay around $250 per pay period (q 2 weeks) for BCBS of AL health and dental. If you are full time, you pay around $75 per pay period.

    Our health coverage is pretty good...the dental ain't great.
  14. by   traumaRUs
    I pay $80/every two weeks for hubby and me (family plan). Includes dental - and vision. Don't know about referrals but meds are $20/if they are on the forumulary.

close