Insurance - The Latest Outrage

[Vito Andolini]

It's time to choose insurance for next year, as you likely know. Where I work, we have 4 categories of worker:

Worker Only - about $30 per month for medical and Rx

Worker and Spouse - about $180

Worker and Child(ren) - about $53

Worker, Spouse, and - about $310

Children

So married people get seriously punished for being married.

What do you think of this?

[TiffyRN, BSN, PhD]

I think it's really good to hear comparisons of health plans. I remember just about 6yrs ago hearing about grocery store employees striking in California. One of their big complaints; They were going to have to pay a $5 co-pay for prescriptions (instead of getting them completely free). This was the year my insurance quit covering Nexium (use Prilosec OTC instead they said) and at the time I had no generic option for my migraine meds, the co-pay on 18 tablets of Imitrex was over $100. So I think it's good to hear from others. Doesn't make poor coverage ok, but gives us goals to aim for.

Yes, I'm waiting with bated breath for the government to come and fix it all. Don't get me wrong, I want everyone to have great coverage, I'm just not holding out hope for the government (any government, any party) will get it right.

[tewdles, RN]

While I will agree that some employers are cheap when it comes to providing access to group insurance policies for the employees I will also comment that if there are bad insurance policies you must look at the writer of the policy. What is the insurance company providing for the premiums that are paid? No matter how much we might want our employer to pay the entire price of the premium, or choose company A over company B, the employer remains simply the consumer...choosing oft times between several over-priced and under-performing insurance options and insurance companies. Generally speaking, the smaller the employer the less comprehensive and the more expensive the insurance options.

[Vito Andolini]

consider this too, if your spouse has insurance thru employer then that insurance will be the primary and yours would only pick up after that, and at a smaller percentage. contracts vary of course but you need to know. your insurer is trying to hedge bets that the reason you want your spouse on your plan is because he/she is ill and cannot work full time. not true all the time, just enough of the time to make the plan go broke if there are too many such cases

that is what the company rep said - that spouses are risky.

well, children are also risky. kids can get hurt or be sick with asthma, for example, and frequenting the er if parents don't choose a pcp who will order a nebulizer for them and let them do home nebs prn exacerbations, for example. i hear this from several people at work - their kids have asthma, doc won't order nebs at home, forces them to er. some coworkers don't even know how to get a primary care doctor! and the are paying for insurance plus still running to the er for everything.

yes, children are risky. and my kids shouldn't, on the average, cost them any more than the children of single employees.

premiums should be based on income, not on marital status.

also, for all i know, employers are forced by law to cover spouses.

[Vito Andolini]

Of course the employer doesn't set the price for the provider of the insurance.

The employer chooses how much of the premium they (the employer) will pay and how much of the cost they will pass onto the employee.

If your insurance sucks it's because your employer chose to offer you a plan that sucks.

If your insurance is expensive it's because your employer chose to have you (the employee) pay more of the premium so they (the employer) can pay less.

True!

The coverage is probably not really bad. The trouble is the huge disparity between the cost for adding one's spouse. I don't see why married people must pay 6 or even 10 times more than single employees for the same coverage. It is discriminatory and I think it is part of the socialist/communist agenda afoot in America to try to move us ever closer to socialism/communism/look to government for all the answers/get rid of traditional institutions like marriage. That's my point.:angryfire

[Neveranurseagain, RN]

"Premiums should be based on income, not on marital status.

Also, for all I know, employers are forced by law to cover spouses.

Basing premiums on income is what the Obama administration is trying to do. And there is no law forcing employers to cover spouses. Heck, there isn't even a law stating that employers must offer health insurance at all!

Why should your health insurance be related to employment at all either? Your car insurance isn't!

[mamamerlee, LPN]

Vito - your employer is picking up part of YOUR premium, consider that a blessing. They are not obligated to pick up any part of anyone elses' premium.

This is not a part of a political agenda; it has always been like that. Be thankful that your employer offers a decent policy at all.