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What kind of health insurance coverage do you have?

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  • What kind of health insurance coverage do you have?

    What kind of general coverage do you have for heath insurance?

    Out of pocket max, deductible, premium, coverage you are required to pay (80/20, 90/10, etc)

    I'm told my insurance is high end, but I was just wondering how it compared.

    I pay 160$/ 2 weeks for me and my wife. Family would be 220$ per 2 / weeks Kids are still on state currently, however.

    Its a 90/10 plan. 300 Individual deductible / 600 family. 2000 out of pocket max individual / 4000 family. 25$ co-pays for normal and specialist. 50$ ER.
    Everything happens for a reason. Sometimes that reason is you're stupid and make bad choices.

    Current Occupation: Spending every dollar before I die

  • #2
    When you say you were told your insurance was "high end" do you mean expensive? Because I think your costs seem pretty low. We pay $485/mo for family, but I know people who pay $800-$900/mo out of their pay checks fro family coverage. And $50 for an ER visit is crazy low! ours is $100, $60 for UC.

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    • #3
      Originally posted by GoodSteward View Post
      What kind of general coverage do you have for heath insurance?

      Out of pocket max, deductible, premium, coverage you are required to pay (80/20, 90/10, etc)

      I'm told my insurance is high end, but I was just wondering how it compared.

      I pay 160$/ 2 weeks for me and my wife. Family would be 220$ per 2 / weeks Kids are still on state currently, however.

      Its a 90/10 plan. 300 Individual deductible / 600 family. 2000 out of pocket max individual / 4000 family. 25$ co-pays for normal and specialist. 50$ ER.
      My insurance is Tricare for life from my military retirement and matches yours exactly. But I don't pay any monthly fee for that coverage. Compared to what my work offers, I would be paying $1200 / mo for similar coverage. I am blessed to have this coverage.

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      • #4
        Family of 5

        Aetna POSII plan.

        $750/mo covers medical, dental, vision

        $750 deductible, but you don't have to pay that unless you go out of network or end up in the hospital.
        $20 co-pay for in network providers
        $35 co-pay for specialists, chiropractor, etc....
        Last edited by dawnwes; 06-29-2016, 04:00 AM.

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        • #5
          $1600/mo for two of us.

          Deductible $250 individual; 500 family
          Out of pocket $1200; 2500 family
          Office $15; ER $150; urgent care $50
          "There is some ontological doubt as to whether it may even be possible in principle to nail down these things in the universe we're given to study." --text msg from my kid

          "It is easier to build strong children than to repair broken men." --Frederick Douglass

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          • #6
            Originally posted by Joan.of.the.Arch View Post
            $1600/mo for two of us.

            Deductible $250 individual; 500 family
            Out of pocket $1200; 2500 family
            Office $15; ER $150; urgent care $50
            Private or with a company? That premium is very high either way. Unless you visit the dr, or have medical issues I can't see the good coverage being worth the possible need for it.

            I'm out of touch with private prices, so this might be good. I am not sure.
            Everything happens for a reason. Sometimes that reason is you're stupid and make bad choices.

            Current Occupation: Spending every dollar before I die

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            • #7
              GoodSteward, it is the group plan at the public institution my husband retired from. His retirement health "benefit" is simply being allowed to stay on the group plan as long as he pays the entire amount, including the amount the employer paid when he was actively employed. I think of it as being like eternal COBRA.

              We did look into private insurance and no company would offer us anything, but that was before ACA. ACA plans are available to us, but I fear Congress finally getting around to revoking ACA, which would leave us without insurance and uninsurable. We asked the employer and they said if we leave the plan, we cannot get back on later.
              "There is some ontological doubt as to whether it may even be possible in principle to nail down these things in the universe we're given to study." --text msg from my kid

              "It is easier to build strong children than to repair broken men." --Frederick Douglass

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              • #8
                Originally posted by Joan.of.the.Arch View Post
                ACA plans are available to us, but I fear Congress finally getting around to revoking ACA
                Ain't. Gonna. Happen.

                Republicans have been promising to close down government bureaucracies since at least 1980 (Reagan and the Department of Education), but they all still exist, and the the federal budget is 5.4x larger.

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                • #9
                  Joan your premiums are insane but I guess considering the alternatives it is better than getting hit with catastrophic medical bill that could wipe out your life savings.


                  My employers offer a cafeteria plan that provides $812 per month to "shop with." I have United Healthcare HMO for $660. As soon as photobucket is up and running I'll post a picture my actual cafeteria plan and my elections for coverage.

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                  • #10
                    learning how to delete,,,,
                    Attached Files
                    Last edited by Outdoorsygal; 06-28-2016, 10:09 PM.

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                    • #11

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                      • #12
                        Right now we pay $650/month for family of four 37, 38, 6, 3, obamacare is great because otherwise we'd be uninsurable. It's for the worse insurance HDHP $6500 deductible/$13k family deductible and we pay everything OOP. Sucks hard. No vision or dental.

                        Dental cost me $250 for one visit during this year and $200/per kid 2x since they went in December and June. DH hasn't gone yet but he'll go in August when his new insurance kicks in.

                        I think PPO is $260/month or EPO is $280/month family plan. Trying to read through the material. PPO deductible is $500 and EPO is $0. I'm not sure what else. Insurance plans are crazy and I'll be happy to be back on employer provided care after our foray into buying out own.

                        I hate to say this but it really cost us a lot to buy our own compared to what the company offers. No it did not save us money to buy our own. Because honestly I doubt the company would raise DH's salary by $x amount they pay for his medical premiums and while it might be more than $650/month even if it's $1300/month it wouldn't cover the level of benefits we could buy as individuals versus a company plan. I know because I priced out cheaper HDHP and even paying $1k/month we were still looking at $2500/5k deductibles no pharmacy coverage.
                        LivingAlmostLarge Blog

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                        • #13
                          Originally posted by LivingAlmostLarge View Post
                          obamacare is great because otherwise we'd be uninsurable.
                          Of all the negatives of the ACA, this is one of the major benefits. My mom works for a chiropractor. Before the change, there were only 16k codes ( think that was the number). Now, there are 60k. One of the benefits is with what they can call preexisting. According to what I remember, for instance, the back was divided into 2 or3 parts( I believe). So if you hurt your low back, and then a different vertebrae later in life from a different issue but similar location, they would claim it was preexisting. Now,every vertebrae has it's own code. Those of you who are medical Dr can correct me if I"m wrong, but I believe that is how it works. I do know it cleared up a lot of the issues for preexisting claims on the insurance part, and it also forced people who used to be persisting to no longer be after a short time.
                          Everything happens for a reason. Sometimes that reason is you're stupid and make bad choices.

                          Current Occupation: Spending every dollar before I die

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                          • #14
                            We had an ACA plan when they first came out for our family of 4. The first year the premium was around $1200 per month. Then it went up about 30 percent at renewal. I quickly figured out that wasn't sustainable.

                            We moved to "Medi-Share", which is not technically insurance but operates just like it. The terminology is just different. Instead of premiums, you have "sharing." Instead of "deductible", you have "annual household portion."

                            It is very comparable to what we had under ACA except no prescription coverage, and our monthly "share" amount is about $600.

                            We look at this as a catastrophic plan. The only thing we need insurance for is hospitalizations, which could conceivably bankrupt us if we didn't have insurance. I'm not worried about the prescriptions and doctor visits.

                            Since Medi-Share is considered a religious/charitable organization, members are EXEMPT from ACA! (for the time being).

                            This one is a winner, folks.

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                            • #15
                              We currently have an HMO but we are in the process of switching to a HDHP with an HSA. That will hopefully start August 1. The premium will be $1,160/month. The deductible is $4,700.

                              I'm looking forward to the change as it will save us quite a bit of money. The premium alone is over $100/month less than the current plan. The HSA will save us about $140/month by enabling us to pay medical bills with pretax dollars. So all together, our costs will drop by about $250/month.

                              ETA: Our plan doesn't include vision or dental.
                              Last edited by disneysteve; 06-29-2016, 08:36 AM.
                              Steve

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