I work for a hospital that is part of a large and growing healthcare system consisting of multiple hospitals. Currently, employees have health insurance through a large national health insurance company. We have coverage for any care provided by hospitals within the insurance company's network. We do get a smaller copay if we stay within our healthcare system.
Starting in 2019, we will only be covered for care if we stay in a new "custom network." This new network consists of only our healthcare system as well as just a few other hospitals. Three very large nearby hospitals and many smaller community hospitals will not be covered except for life threatening emergencies.
I think this is unfair to employees. It also seems very convenient that the uncovered hospitals are our biggest competitors.
I always ask as well, and like you health insurance issues caused me to leave my last job. They went to a plan like the one the OP posted, I would have lost all my specialists, PCP I've had for a decade and my dentist.
Put my resume out the day they announced the change and ironically got a job in the parent organization my PCP belongs to. And yes I did ask if "we took our own employees insurance"before I took the job
My out-of-pocket costs for my annual MRI/Neuro-Onc follow up this year vs last year: $50 vs $2100+. That alone makes changing jobs worth it.
When I resigned from my last job, I was honest and said that the benefits were insufficient to meet my needs. When my boss (who was very new and I actually never met before I gave him my notice) asked me if money was the reason I was leaving I said "no, but the new job does pay more and will save me thousands a year in medical costs." He didn't believe me. It already has.
I don't understand what you don't like about it. You said it is a "large and growing" healthcare system. Does it not include specific doctors you already see?
And, the lack of choice may not be the fault of your employer. It's possible the other hospitals weren't willing to offer rates that made sense for your insurance company.
I did not say health care should be deregulated- our president did. Our legislators did.
That is the current direction of our administration. Deregulation of healthcare is a priority. Our director of Health and Human Services is the former high level drug company executive. He spent the prior five years maximizing profits for Eli Pharmaceuticals. I have no reason to think he has changed his objectives.
What I did say is that a big part of the "make america great again" movement is the deregulation of business, including healthcare. The idea being sold, and bought, is that when these big companies make money, we all will prosper.
If you feel an employer has a responsibility to offer a certain level of health insurance, vote.
Obamacare made a already heavy regulated industry even more so. The most heavily regulated industry that exists today.
It seems many here are complaining about costs and lack of choices that have continually gotten worse.
One of the ways in which you are compensated for your work is with health insurance. As with other forms of compensation, like salary, vacation, and sick time, the employer can offer whatever they want, as long as it is legal. The employee cam accept the offer, or look for a better one.
We are American. Apparently, we like the free market economy. When government steps in to regulate it, we yell, and call it socialism, which is, apparently bad.
They can offer whatever they want. You can take it, or look for a better offer.
For anybody who doesn't like the system: Vote. Mid terms are coming up. A big part of making America great again is deregulating businesses like the ones we work for. If you want them to have to offer you decent health care like most of the rest of the 1st world, vote.
A big part of MAGA would be getting insurance companies out of health care. Health care should not be a business.
I think we are the only civilized nation that abides this criminal shame.
As for OP's situation - I wouldn't like having to have care from people I work with and having my business known far and wide. Despite HIPAA, I think people still talk. I guess you can buy your own coverage elsewhere. Elect not to take benefits from your employer and buy your own.
My out-of-pocket costs for my annual MRI/Neuro-Onc follow up this year vs last year: $50 vs $2100+. That alone makes changing jobs worth it.
When I resigned from my last job, I was honest and said that the benefits were insufficient to meet my needs. When my boss (who was very new and I actually never met before I gave him my notice) asked me if money was the reason I was leaving I said "no, but the new job does pay more and will save me thousands a year in medical costs." He didn't believe me. It already has.
What did you give up to change jobs? Pension? Amount of PTO? Seniority? Friends? Good schedule? Shorter drive? Culture? Etc.?
Maybe it was a good move all around for you. I hope so. I'm just wondering about the trade-off you might have had to make.
The hospital I work for does this too and I dislike it for more than one reason. One reason being I ran into a doctor that did a procedure on me. This is a doctor that has seen me partially nude, and is now a coworker? And we're all supposed to be ok with this type of situation potentially occurring? I'm glad he's an incredible doctor and professional, but can you imagine otherwise? People talk. Like someone else said, regardless of HIPAA, word can get around and things can get very awkward.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
One of the ways in which you are compensated for your work is with health insurance. As with other forms of compensation, like salary, vacation, and sick time, the employer can offer whatever they want, as long as it is legal. The employee cam accept the offer, or look for a better one.
We are American. Apparently, we like the free market economy. When government steps in to regulate it, we yell, and call it socialism, which is, apparently bad.
They can offer whatever they want. You can take it, or look for a better offer.
For anybody who doesn't like the system: Vote. Mid terms are coming up. A big part of making America great again is deregulating businesses like the ones we work for. If you want them to have to offer you decent health care like most of the rest of the 1st world, vote.
Exactly. If you don't like your choices now, see what kind of choices you get under a socialist system. The grass is usually not greener...
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
A big part of MAGA would be getting insurance companies out of health care. Health care should not be a business.
I think we are the only civilized nation that abides this criminal shame.
As for OP's situation - I wouldn't like having to have care from people I work with and having my business known far and wide. Despite HIPAA, I think people still talk. I guess you can buy your own coverage elsewhere. Elect not to take benefits from your employer and buy your own.
That used to work great until Obamacare all but eliminated catastrophic coverage. I had a great plan, low premiums, covered the basics and a doable out of pocket maximum. Until I got a letter saying the plan was going away. I looked for a reasonably-priced catastrophic plan on the ACA exchange. Didn't exist.
As of next year my employer is also offering a plan costing the same weekly as the current year's option, which restricts non-emergent care to their own hospital system, and a more expensive PPO. The restricted options do not impact me as I do not have specialists or chronic conditions, I mainly do a somewhat annual checkup and routine screenings and already use my own company's services for these. I am also double covered by my spouse's insurance that does not have those restrictions. So I am happy to stay with the less expensive plan. However, I do have several coworkers who are upset by the changes and I understand their situations. I am constantly weighing several factors to decide if I stay put or start looking, and insurance is a big component in that decision along with factors mentioned by other posters: pay, schedule, coworkers, 401K matching and PTO. There are certainly plenty of jobs out there if I feel the need to move on. It looks like this is a growing trend and will have to be part of the job search decision for all of us in the future.
Considering that this is part of the compensation for work performed and not a gift given out of the goodness of a corporation's heart, yes I don't think it is right. I don't really get how they are able to skirt anti-kickback and antitrust laws with stuff like this; but that's my ignorance talking.
Indeed. Employer-sponsored health insurance originally only covered hospital charges and was offered at a single hospital (first to teachers, then to hospital employees). Considering employers are offering a benefit which you are under no obligation to accept, it would be pretty difficult to conceive of a reason why the employer owes you a benefit somewhere else.
If you worked in retail and the store offered you an employee discount at that store would that be antitrust? No, because you don't have to use your employee discount. The store has a vested interest in not giving you a discount at their competitor (both from a financial and PR standpoint). Health systems have the same interests. It would look bad it the nurses from X hospital won't even go their themselves/see the doctors in that system.
If you don't like your choices now, see what kind of choices you get under a socialist system. The grass is usually not greener...
On the contrary, in all the other industrialized nations that have "Socialized" healthcare, people pick their providers, get better quality care, and pay less than half. In single payer healthcare systems, there is no such thing as in/out of network. You choice is literally any provider you can get to see you.
This is becoming common practice. Most health providers are HIPAA compliant and are very professional. There could be some caveats though, if you live greater than say 50 miles then most insurances will allow you to see a different provider or if there is a shortage/no available of say neonatal providers than you can see out of network providers at in network rates.
Your statement " They can offer whatever they want. You can take it, or look for a better offer."...and " Deregulation, for example, will result in more and more pre-existing condition coverage denial, among other bad effects (for insured folks) because it's all about maximizing profit by minimizing benefits.
Insurance company shareholders and CEOs will definitely like the results, however." This is misleading and here is why;
Your health insurance package is sort of like say a computer program that you buy off the shelf. You can get different version of the same program i.e. upgrades. If you want to spend a lot of monies then you could have a program developer "customize" a program for you. Insurance is like this too.
The company you work for goes to one of the Insurance companies and tells that insurance company what they want for their employees coverage. The insurance company says well we have this common insurance plan that covers all you want and it cost XX per person per month. Or the company say our employees are young and we live in Aspen-we have a lot of injuries that cause us to seek out orthopedics a lot can we get extra coverage for that too.
The insurance company then sell the program to the company but it is not finished yet. The company says we want coverage for up to XXX or we want coverage up to XXXX for each employee if they go over that what can we do? The company can get another coverage of over the limit. Think babies born premature and cost over a million dollars. Say a mid size company had 3 premature babies born that year how does the company pay for that excessive cost---another insurance policy.
The insurance company only manages the benefits that company has picked for its employees. There is no incentive to deny and then pocket that monies. Monies not spent go back to the company. There is an incentive for people to get the medical care they need and have benefits for, to return to work.
Each state has a division of Insurance so those people can "inspect" insurance companies to see they are adhering to regulation. There are time constraints to timely replies. Insurance plans that increase or decrease in cost must go through this department. New programs must be approved from this department.
What I am saying is this....it is not all the insurance company and there are others viewing what we all do to assuring regulations are being kept.
What you need to do is go back to your company and ask them for better benefits.
KelRN215, BSN, RN
1 Article; 7,349 Posts
My out-of-pocket costs for my annual MRI/Neuro-Onc follow up this year vs last year: $50 vs $2100+. That alone makes changing jobs worth it.
When I resigned from my last job, I was honest and said that the benefits were insufficient to meet my needs. When my boss (who was very new and I actually never met before I gave him my notice) asked me if money was the reason I was leaving I said "no, but the new job does pay more and will save me thousands a year in medical costs." He didn't believe me. It already has.