Healthcare deductables

LadyFree28, BSN, LPN, RN · Jan 23, 2015

Welcome to the brave new world so many of you voted for. Enjoy.

Um :no:

This has been an issue for over 20 years, as well as for people who have had their own insurance independently.

For about 10 years of my working life, I had my own insurance, have dealt with increasing premium rates did to age, and high deductibles, oh and the risk of being dropped because you've had a major medical event and just became expensive-happened to me.

Like The Commuter stated, most people who have employer contributions, they have NO idea how much insurance costs; although those who have had insurance and had to deal with it upfront, have known all along; the silver lining that I always seen is that ALL of my expenses were tax deductible and helped with my tax return.

If anything, revealing how much health insurance costs is a great way to usher in further reform, IMHO.

I'm pro not having to worry about pre-existing condition penalties, either.

Now, what's YOUR solution? :blink:

LadyFree28, BSN, LPN, RN · Jan 23, 2015

I do not perform direct patient care (thank goodness). The less face time with patients and their families, the merrier!
In addition, one must be willing to give positivity in order to receive it. Positivity is not something to which we are automatically entitled. Good luck to you. :)

THIS.

A tall cup of WOOOSAH is in order.

CriticalCareRN1 · Jan 23, 2015

@commu... ha! Only those spoken of those who live of this world sweety. Positivity and words from the heart of sincerity is what I give all day. Now whether you take it in a different light is up to you. The Creator knows whats in my heart is all that matters, and He takes care of you, of which He does on a daily basis. The Devil is a liar sweety, and will always try to pry his way in, but never wins in the end.

poppycat, ADN, BSN · Jan 23, 2015

This whole thread makes me so grateful that my husband is a Teamster & our insurance is through his employer. We pay no premiums, no deductible, nothing for prescriptions, & only $10 copay for office visits.

applewhitern, BSN, RN · Jan 23, 2015

You just now noticed? Wow. I pay a $50 co-pay just to see my doctor. It used to be that my labwork, xrays, etc., were completely covered, but now I get bills for those. My deductibles are ridiculous, too, but my premiums (single, just me) are only 154 per month. Dental is cheap but barely pays for anything, and maxes at $1000 per year. Even though I am in the healthcare field, my cost has always been a lot more than my best friend, who is a school-teacher. She pays like five bucks for meds, co-pays, etc., and her eyeglasses cost her 2 bucks. My friends in other fields pay around $15 for a doctor co-pay, and they think that is high! I was hoping to retire at 62, but that dream has ended because I cannot afford insurance on my own.

elkpark · Jan 23, 2015

@Positivity and words from the heart of sincerity is what I give all day.

(Just so you know, that is certainly not how you are coming across here (sweety ...)

xoemmylouox, ASN, RN · Jan 23, 2015

Welcome to the brave new world so many of you voted for. Enjoy.

Hmmm... I voted to have no more pre-existing conditions, to have the maximum "caps" removed so those with cancer do not max out their plans in 2 treatments, to have wellness coverge provided to all to assist with prevention vs just treatment, etc. I will pay more for my plan happy to know others have options where before there were none. It is not a perfect plan, but is sure as heck beats what we had before.

brandy1017, ASN, RN · Jan 23, 2015

Welcome to the real world. I don't know what you've been doing for health insurance up to now since you are a new grad maybe you have been blessed to be on your parent's health plan. The market place is very expensive, most people will be better off getting health insurance thru their employer, although it has become very expensive and crappy now too! Not a $6,000 deductible though. Was that a bronze plan? There are several different plans, the ones with lower deductibles cost more per month.

If you are young and healthy a high deductible health plan may be the way to go if it is offered by your employer. You can set aside around $3300 tax free every year and it builds, you don't lose it like a flexible savings plan. While not commonly thought of it can be a great tax free start to your retirement planning and also helps you build up an healthcare emergency savings fund for the future. With regular insurance deductibles are going to upwards of $1,000 for single coverage with lots of copays and out of pockets and the maximum is usually $3,0000 to $4,000 or more now. You can only set aside $2500 for a regular account and that needs to be spent or you lose it and it must be for dental and healthcare. Whereas you can actually set aside another $2500 for a limited flex plan in a high deductible health insurance specifically for dental or vision. If you ever need a root canal or crown it will cost you a lot of money. While the HSA builds every year and it is your own money that you can take with you when you go, the limited FSA must be used in the year or you lose it. Some hospitals will contribute to an HSA but it is usually piddly, by us it's only $250 a year, but it is your money and you can take it with you if you don't use it. Also you can see a Dr once a year for preventative care and if you need prescriptions try to use the $4 Walmart generics plan. Other stores have similar plans and Costco is the cheapest overall place to get prescriptions for cash because they limit their profit to a flat fee on all their meds across the board. If only the rest of the pharmacy's would follow suit! lol

Hospitals are notorious for giving out cheap health insurance and pushing the out of pockets onto the workers. The affordable care act limits out of pockets to around $6250 a year single coverage so all your copays and prescription cost goes to the maximum. Before there was no limit in out of pockets! Also before parents couldn't keep their children on their health insurance till 26 and insurance companies could refuse to give health insurance to anyone that wasn't perfectly healthy or they would exclude their illness from health coverage. Neat trick refuse to insure the sick or exclude their illness, great way for the insurance companies to pad their profit! Most hospitals are self insured and so try to keep costs low by pushing them onto workers. The latest gimmick is the wellness plan where you are poked, prodded, measured, weighed and penalized if gasp you actually aren't healthy! God forbid if you are overweight, smoke, have diabetes, high cholesterol. I think they can penalize you up to 30% for adverse health conditions and 50% for smoking. Now your privacy is invaded and they are pushing step counters for you to wear that can even record how much you sleep. Very big brother to me! I don't need someone questioning how much I weigh or walk or sleep for God's sake! But if you don't participate in the wellness plan expect to pay a huge privacy tax!

I never thought I would switch to a high deductible plan, but I did and I'm not a young healthy person! Decided I could save money why pay $1500 more a year for a regular plan when I already get $4 generics now so don't need the prescription plan from a regular account. The maximum out of pocket ends up being the same with both plans, but if I'm well I get to keep the $1500 plus build my healthcare and retirement savings fund. I'm not thrilled about this and wish we had national healthcare but since that is just a pipe dream, I'm making the best I can of a bad situation. I'm very disappointed by the healthcare choices we are offered and by the stupid wellness plan. They can shove it! So I end up paying the privacy tax. lol

azhiker96, BSN, RN · Jan 23, 2015

This whole thread makes me so grateful that my husband is a Teamster & our insurance is through his employer. We pay no premiums, no deductible, nothing for prescriptions, & only $10 copay for office visits.

Poppycat, enjoy that union Cadillac plan while you can. If the unions had not obtained a delay then you'd be in similar shape to me.

My premium through work did not increase this year but deductibles and copays increased greatly. I am now buying my prescriptions out of pocket because it is cheaper than buying them with my insurance. My copay for a 3 month supply of a generic was $72. When I refilled I went to my grocery store where it falls on their $4/$10 formulary. There I pay $10 for a 3 month supply. My wife has separate insurance through her employer. Her copay for an office visit is $120.

This is an example of how our employers have had to increase our share so the plans will not be considered Cadillac plans and face a 40% tax. If the unions are not able to eliminate this tax, they will feel the change in 2018.

Labor Unions' Latest Problem: Obamacare's 'Cadillac Tax' Harms Their Gold-Plated Health Insurance Plans - Forbes

Spangle Brown · Jan 24, 2015

Yes, we voted for something. THIS is what BOTH party's could agree with. Can't blame just one group, both worked on it. The reality is, one group tried their best to prevent having anything at all, or making the whole thing a joke. THIS was forced through, as something to start with. "They" knew there was problems, that is why they passed it. The insurance company's have big stakes in this game and they do not want us to go to a one payers system. That is also an issue.

High Deductible plans are like auto insurance. Your not suppose to have to use them. But if you do, it should cover the cost and not loose your house, etc. They are also to make people more connected to their own cost of care. So they make realistic choices.

When I started reseraching, i noticed that our HD plan premiums PLUS monthly payment in my Health savings was cheaper then the HMO plan for the year. Plus, I still had to pay a copay with the HMO. Making the HMO much higher in the long run. And if I was healthy, the savings rolled over to next year. perfect for us.

Red Kryptonite · Jan 24, 2015

Yes, we voted for something. THIS is what BOTH party's could agree with. Can't blame just one group, both worked on it. The reality is, one group tried their best to prevent having anything at all,

Wrong. Zero republican votes for the ACA. Look it up.

Also, the Republicans had many good ideas and still do. When the ACA was debated, the Democrats would not allow the Republicans to propose amendments. Again, look it up.

You can't do that "both sides are to blame" stuff with THIS law. It was shoved down our throats in the most dishonest ways, with kickbacks and open bribery, by ONE party.

And then we got illegal unilateral executive action changing the law to give exemptions to that party's friends. Please don't try to portray this as some kind of compromise reached by actual debate and hearing from both sides.

MunoRN, RN · Jan 24, 2015

Wrong. Zero republican votes for the ACA. Look it up.
Also, the Republicans had many good ideas and still do. When the ACA was debated, the Democrats would not allow the Republicans to propose amendments. Again, look it up.
You can't do that "both sides are to blame" stuff with THIS law. It was shoved down our throats in the most dishonest ways, with kickbacks and open bribery, by ONE party.
And then we got illegal unilateral executive action changing the law to give exemptions to that party's friends. Please don't try to portray this as some kind of compromise reached by actual debate and hearing from both sides.

What are the republican's alternative ideas? Republicans did not vote for the ACA, although it wouldn't appear that can be assumed this was because it didn't include anything republicans like.

The basic principles of the various republican health reform platforms have all included the same basic principles the ACA is based on; tax breaks to buy private insurance plans, a mandate to purchase insurance, no public option, etc. The ACA was written by the senate finance committee, a bipartisan committee, and actually included a number of amendments brought forth by republicans. For instance, one amendment required that the government cannot in any way ration care, which is specifically included in the ACA (although I'm not sure how committed republicans are to this idea since they now champion Ben Carson's views, which specifically include preventing a large portion of people currently admitted to hospitals from being able to obtain acute care), and setting a point at which congress would be required to address healthcare costs, which the republican amendment put at 25% of GDP and the ACA ended up using an even more stringent requirement of 20%.

There were a number of republican amendments that weren't included in the ACA, most of which proposed cash giveaways to their states or corporate interests in their districts.

If the health insurance industry sees the democratic party as being their main defender, why do they give more to republicans?

Who is it that you think was exempted from the law?