Health Insurance Advice

[GlockSpock]

In the debacle that is American Healthcare, everyone is to blame.  2.ooohhh is right.  Dr's and pharma companies charge more than the market will support because there is no true market, and they jack up their rates/rpices to pay for mal-practice insurance and frivolous lawsuits, and to have a big tax write-off for the piece of their bill that the insurance won't pay.  The insurance companies won't pay Dr's and pharma what they charge because the rates are artificially jacked up, and they argue with the patient about what they will cover.  The patient doesn't pay any of the true costs (only the teenie co-pay) and so don't practice good consumerism (hence the broken market), then they jump on board to sue a Dr or Pharma whenever they can (at the Trial Lawyers behest) so the Dr and Pharma have to have raise their prices...

 

The piece that has always been missing is the patient's input and responsibility.  Healthcare went out of control about the time insurance became common because it shielded the patient from the consequences of thier actions.

 

I will temper all this by pointing out as bad as it is, we have the best doctors and medicine in the world.  Even the poorest among us can get medical attention.  We have incrediby high standards and expectations as Americans, which is why we are the greatest nation the world has ever known.  But I was in bed last night thinking "man, I wish I had more/nicer stuff", then it occured to me that as a middle-class American, I have it better than 99.9% of the population of earth since the beginning of time.  If I earned minimum wage, I would only be in the top 99.7%

 

This is all something I'm familiar with. Unfortunately one of the major parts of the problem is that a lot of Americans do not take care of themselves. With government considering pizza a vegetable and junk food being subsidized to the point it is cheaper than quality, fresh food, you have a large part of society that cannot afford and doesn't care to eat healthy, doesn't care to exercise, and then expects to get free healthcare, well to put it lightly you have a very screwed up healthcare system. We have the best available healthcare in the world, but consumers aren't interested in taking steps such as living a healthier lifestyle to bring the overall cost of healthcare down. They'd rather just expect someone other than themselves to pay for their healthcare. It's depressing.

[GlockSpock]

Right now health premiums are deducted pre-tax, so you pay nothing on them. 

 

Meaning that essentially I can take my gross income, subtract $,4,320 that I pay for healthcare, and then be responsible for the taxes on gross income - $4,320?

[Sam1]

correct, keep in mind if you're close to the top of a tax bracket, that the additional $ being taxed from the premiums may also push you over the edge and into a higher tax bracket.

 

just say for example you're single and currently with your deductions you have $35,000 of taxable income in 2013, you'll be in the 15% bracket. If you make the same money, but no longer have the health premiums deducted, you will have to pay tax on that money + the $4,000 taxable income increase will push you into the overall 25% tax bracket.

[GlockSpock]

correct, keep in mind if you're close to the top of a tax bracket, that the additional $ being taxed from the premiums may also push you over the edge and into a higher tax bracket.

 

just say for example you're single and currently with your deductions you have $35,000 of taxable income in 2013, you'll be in the 15% bracket. If you make the same money, but no longer have the health premiums deducted, you will have to pay tax on that money + the $4,000 taxable income increase will push you into the overall 25% tax bracket.

 

Understood. 

[atlas3025]

...With government considering pizza a vegetable and junk food being subsidized...

Lol, but, but Worf...I mean Michelle tells us we are fat!  That is government looking out for us!

[Guest ThePunisher]

Lol, but, but Worf...I mean Michelle tells us we are fat!  That is government looking out for us!

She's obviously never looked at her big fat a..

[KahrMan]

I oversee healthcare for my company.  We just renewed our policy two weeks ago.  We are a fairly health company so our increase was not to bad.  

 

We offer two plans:  PPO and High Deductible w/ a HSA(Health Savings Account)  To add a spouse to our plan it costs 322 for the PPO and 293 for the HD.  Like others have said, a lot of things effect the monthly price.  Co-pays, deductibles, total out of pocket, prescription benefits etc.

 

It is not right for everybody, but a High Deductible Health Plan is worth looking into.  Generally the total out of pocket is less.  This is because they expect you to be more frugal with healthcare because you pay 100% of the cost till you hit your out of pocket.  There are no co pays.  The advantage to this is you get to have a HSA.  HSA's are funded with pre-tax dollars, like a 401K.  By funding it with pre tax dollars, it does two things. 1) it reduces the taxes you pay.  ex. you make 1000 a paycheck.  You put 200 into your hsa.  Your taxes taken out of you check are based on the 800. 2) Since you are paying for medical with pretax dollars, it is like getting a discount on your medical.  If you are in the 20% tax rate then in effect you are getting a 20% discount on your medical bills.  The money in your HSA can ONLY be used for medical expenses and it does roll over year to year.

[Guest MoonMan]

I work for a prominent insurance company in tn and the way I explain it is you either pay more up front at the doctors office and Less in premium or less at the doctors office and more in premium. On the individual plans where I work there are I believe 62 different plans. Also if there are any medical problem you may have riders. The big thing I see I the prescription coverage. With the prescription overage you have different options and sometimes only generics are covered.

[npgunner]

this may be a little off topic ... but since we're talking about health insurance prices ... my wife was signing up for insurance through her company the other day and sent me this picture of the prices she would be charged depending on who she covered ... now i don't mean to offend anyone and excuse my french, but WTH is up with this pricing structure?!?!?! SSDP = same sex domestic partner ... is cheaper than a married couple?!?! a SSDP family is cheaper than a married family?!

 

Edited February 8, 2013 by npgunner

[Sam1]

I work for a prominent insurance company in tn and the way I explain it is you either pay more up front at the doctors office and Less in premium or less at the doctors office and more in premium. On the individual plans where I work there are I believe 62 different plans. Also if there are any medical problem you may have riders. The big thing I see I the prescription coverage. With the prescription overage you have different options and sometimes only generics are covered.

 

In January 2014, all conditional riders are being absolved though aren't they?

 

 

npgunner, uh yeah that is some screwed up stuff. The straight couples need to start addressing that issue with management because it costs you $120/year more because of your straight sexual orientation.

[peejman]

this may be a little off topic ... but since we're talking about health insurance prices ... my wife was signing up for insurance through her company the other day and sent me this picture of the prices she would be charged depending on who she covered ... now i don't mean to offend anyone and excuse my french, but WTH is up with this pricing structure?!?!?! SSDP = same sex domestic partner ... is cheaper than a married couple?!?! a SSDP family is cheaper than a married family?!

Wow. That's hard to believe. Seems like a form of discrimination.

We've often joked at work that we should form a commune. We'll all be domestic partners and adopt each others kids so the "family" rate is split across about 50 people. That'd show 'em... Edited February 8, 2013 by peejman

[2.ooohhh]

Perhaps they are just recognising you as having a SSPD but not actually covering them, is there an explanation somewhere else that possibly states that SSDPs aren't eligble for coverage?

[Dennis1209]

I have been. Been paying it ever since I started as a full-time employee. I won't be quick to make any decisions. I did contact TRH to see what they have to say. I have a feeling that in the grand scheme of things, $360 is probably a good amount to pay. I think I could certainly pay a whole lot less...for a whole lot less coverage. 

 

Also consider this making your decision on premiums, coverage and out of pocket. If memory serves, medical bills are the #1 or #2 reason for filing bankruptcy.

 

My daughter was a passenger in a bad vehicle accident with her uninsured friend. It doesn't take long for the bill to amount to hundreds of thousands of dollars, and if you have a good plan that pays 90% of everything, that's still a good chunk of change out of your pocket. What if it only pays 60-70% of your medical bill?

 

My daughter was 18 at the time and I found out something I wasn't even aware of. As the policy holder of the family medical insurance policy that my daughter is covered under, the policy holder (not the treated) is ultimately responsible for all expenses not covered under the policy. And it's reported to all three credit reporting agencies if payment is not made.

 

Fortunately, I was extremely pleased I made the decision for the higher coverage at that time.

 

What's really fun if you have never had the pleasure yet, is sitting down with say... the literature of three medical policy coverages to determine what's what, what's covered, what's not, what's most likely to occur in your lives, what's not, etc. Financially, it's one of the most critical decisions you can make if disaster strikes. Good luck.

[GlockSpock]

What's really fun if you have never had the pleasure yet, is sitting down with say... the literature of three medical policy coverages to determine what's what, what's covered, what's not, what's most likely to occur in your lives, what's not, etc. Financially, it's one of the most critical decisions you can make if disaster strikes. Good luck.

 

I've been doing that with not only medical insurance, but also car and rental insurance. I'm sure most people's gut reaction is to get the monthly premium to as cheap as possible. But then you quickly counteract that with acknowledging "Something like that actually could happen to me". At this point you realize you'd rather pay a few more bucks per month rather than face tens or even hundreds of thousands of bills. It is a very big decision. 

[GlockSpock]

this may be a little off topic ... but since we're talking about health insurance prices ... my wife was signing up for insurance through her company the other day and sent me this picture of the prices she would be charged depending on who she covered ... now i don't mean to offend anyone and excuse my french, but WTH is up with this pricing structure?!?!?! SSDP = same sex domestic partner ... is cheaper than a married couple?!?! a SSDP family is cheaper than a married family?!

 

 

I could be wrong, but I'm wondering if the price difference comes from the theory that SSDP's are less likely to have children? I think it is common knowledge that being unhealthy, for example smoking, raises your premium because you are more likely to get cancer and have other complications. I suppose statistically SSDP's are less likely to procreate (and much much less likely to procreate accidentally/unexpectedly). Sense they are less likely to procreate, they get cheaper insurance. Just like people that don't smoke get cheaper insurance. It astounded me how much more "maternity" coverage is for family insurance. Look it up. Perhaps the above for SSDP's doesn't include maternity insurance while family without SSDP does include maternity?

 

At first it looks like discrimination. And although I'm not saying that it certainly appears discriminatory, I do think it calls for more investigation before everyone gets our their bullhorns.

[Sam1]

Cz, I misread it, it looks like there's a $59 difference between a straight family and a same sex couple with hildren, that even worse than I initially thought...

If they receive the same benefits, I would be pissed, that's about $700 cheaper annually than straight couples get it for

[Guest tntitan08]

The price difference is for maternity coverage. SS couples obviously don't need that. I would be interested is knowing if they covered fertilization (invitro, etc.) for the SS plans. My guess is they don't.

[Sam1]

The price difference is for maternity coverage. SS couples obviously don't need that. 

 

Lesbians would

[atlas3025]

Its not discrimination if DP coverage is less.  Its because the cost to cover DP's is less than that of a spouse.  It is discrimination if they charge one married couple more than another married couple when they are both part of the same class and rated the same.  If they charge me less than they do a smoker, that is not discrimination. 

[Sam1]

It may not be state law yet, but, by the end of O's term, there will be federal protection specifically listing sexual orientation as a protected class in employment which would go both ways.

 

There's about 15 states that already prohibiting it in employment conditions, and health care coverage/expenses would be part of that... TN is a bit behind the times, I submit to you the dumbest bill that has ever existed: the "don't say gay" bill by the guy that said AIDS started by a "guy screwing monkeys".

 

With that kind of thinking, void a federal regulation, it will be 50 years before anything is passed in state.