Yet another healthcare rant

I doubt people realize how fast all the "regular" stuff adds up. They are thinking they are just hedging their bets against the biggies like cancer, etc.

I think it would be really helpful for people to know what things actually cost and what their options actually are. You can online price/feature shop just about everything except healthcare. How much does an xray cost? Does that include nurse, a tech to read it, and the follow up? Don't bother asking the doc. They don't know. The staff will (never) get back to you on that.

Paying yourself, out of pocket? Are you paying double what I pay cuz my insurance cut a good deal? Who knows? Just pay pay pay.

My own rant: Please pay some other company cuz the doc outsources all their billing to a bunch of idiots in another state 3 time zones away. Who double bill but will never call you back. Ever. Good thing I have low deductible insurance cuz they never argue about paying for anything.

I work for a large employer, and the high deductible plan is ONLY $100/month LESS for the entire family than my plan.  I pay the highest premium but have no deductible, no required referrals to specialists, no copay with core network providers and unlimited physical therapy for my achilles tendons with NO additional out of pocket.  Plus, I pay NOTHING to get my regular mammogram, OB/GYN visit, physical, etc. with in network or core.  If I go out of network, I can do so without permission and I get 75% paid.

That's worth $100 more, period.  I know me, and for years I was stuck on my husband's icky plan and never went to the doc unless I had a fever of 106 and was fading in and out of consiousness.  Yes, that happened once.  But, the utter hassle of going to the doctor kept me from going, which was what they wanted, I'm sure.

I really think a high deductible plan is for someone who has a lot of liquidity and/or is willing to foot out of pocket payments for basic things that I listed above - and acutally go to the doctor.  I have liquidity, but I will NOT pay five grand out of pocket for the basics.  That's a pretty nice tri bike!

It's all about what works for the individual, but often times the monthly savings on the "high deductible" plans aren't worth the risk for most Americans.

Andi

Yeah, I am lucky that my employer is pretty big and the choice is EASY!  If I were self employed and couldn't rely on a spouse's insurance, then I would just have to save and go with a high deductible.  But, you'd be amazed how many people in my office at my large place of employment are on the high deductible plan.  It's really surprising. (These aren't young people, healthy people, or people of great means at all.)  I think these folks in my office just don't want to pay for insurance. (I think they are waiting for nationalized HC - which is another topic all its own!)

I'm going to disagree with you on this one.  I have a HDHCP and I LOVE LOVE LOVE it.  Why?  Because they put $300/month into an account for my wife and I to use and after the first year, THEY (Atena) have paid our deductable.  That's right...they paid our deductable.  I have the option to put money in myself, but chose not to.  That was a gamble on my part.

What do I get for saving 50% on my insurance premiums?  I get FREE, read NO deductible, FREE preventative exams.  My wife and I each get a physical, 2 dental cleanings and x-rays, $300 towards glasses and an eye exam, all of her girl exams and some other items for a grand total of $0. 

Because I made a calculated risk, for sure.  I could have taken the $1560 I saved in premiums the first year we had this plan and added it to the $3600 Aetna is putting into our account, but I didn't.  My wife still saw the dermatologist for some hand skin issues, I still saw the dermatologist for some acne issues.  If my wife or I were sick, we still went to the doctor.  Our medicine was paid using the CC that Aetna provided.  I have not paid a single dime out of pocket (outside of my premium) since getting a HDHCP.

So..tell me again how these plans are bad for the generally healthy person?  I will agree with you that they are NOT for eveyone.  But for the generally healthy individual that thinks ahead, they are GREAT!

Oh..and did I mention that the money I don't use from the year before I get to keep and the account keeps growing even if I choose to switch insurance companies? 

i opted for HDHP my first year at my current job and i put half the deductible in an HSA (which you can keep, rolls over at the end of the year, and matures like an IRA should you have a balance) and the company matched it.  which was OK since that year i did stay healthy.  but was horrible because if you are on any regular prescription, you pay the full price for it until you hit your high deductible.  on two asthma meds i was paying over $200 a month on scripts.  granted it came out of my HSA so it was either pre-tax or free money, but once i hit my deductible i was still paying 30% out of pocket!  people with any chronic condition are completely f-ed.  next year, our insurance is going to ONLY HDHP.  you have no choice any more.  awww carp.

This unfortunately, is too true.  Yet they will be the first to scream they are not making enough money to stay in business.

in what planet?  i'm an engineer and don't have access to that kind of cash...

I will admit to being clueless about regular health care plans.  I'm in the military and my wonderful healthcare is free.

But I've dealt with quite a few "off base referrals" and the whole thing honestly mystifies me.  I had one procedure that the bill totaled up to $5000.  And I swear that in the end the insurance only paid $500ish.  If a doctor is willing to take that little money why does he charge $5000 in the first place?????

I had to see a few docs as "cash pay" because my insurance wasn't in the loop.  Nothing illegal...for example I wanted to see a good ortho in Boulder to fix my ITBS.  The military wasn't fond of the idea so I did an office visit with him to try to see if he could fix me.  He knew I was cash pay and thus totally hooked me up with the cheapest billing option he could find for me.  If I had not talked the AF into paying for the surgery he recommended, the "cash option" wasn't all that bad.  I guess I just find it crazy that they charge insurance companies so much more...almost as if they know the insurance companies pay on a rate and in order to get what they want they have to charge more.  I'm not sure if I'm making any sense, but I guess my point is that we are stabbling OURSELVES in the foot with this process.  By having insurance we are forcing doctors to charge more.

Am I crazy?

Let's see if I can keep this from becoming a hijack.

I would say that having a deductible like that IS hedging against something catastrophic.  It's like having a high deductible on your car.  Maybe you can afford $1k, but you couldn't afford $10k.  Same thing with healthcare.  It's a gamble.  If you don't get really really sick you don't pay a lot.  If you do get really really sick you don't pay a lot.

But I could see people avoiding the doc for simple things to avoid paying that $5k.

I would probably go for a higher monthly premium...because I think in the end I would end up paying less.  The monthly premium increase would have to be over $400/month to come out to $5k over a year...right?

well i've been working on it and, no, so far i've been unsuccessful.  single income and homeowner, i do what i can but 5K is a LOT.