“There is no real ending. It’s just the place where you stop the story.”

― Frank Herbert

Sunday, November 3, 2013

Bad news on the insurance front.

My wife's school district finally gave her the brochures that deal with our "new" health insurance.  We can only choose Blue Cross.  Blue Cross and I have an adversarial relationship going back 15 years.  My experience of them has been entirely negative.

Worse, we are not allowed any choice of what kind of insurance we plan to have.  Our previous standard policy with United Health Care, which wasn't very good itself, has been cancelled.  You can only choose from a single plan, the notorious Health Reimbursement Account (HRA).  This is not really insurance. You pay into an account every month, and you draw the money out as needed. That's a simplification, but that's what it amounts to.

The "choice" we have is how much we want to "contribute" to the HRA every month. We can "contribute" $800.00, $700, or $450 a month.  The more you "contribute" the less you have to spend on medical expenses as a family per annum before you can access the funds in the account.  If we pay $800.00 a month, we have to meet a $6000 family aggregate payment per annum before the insurance will pay for anything.

When these came out, they were acknowledged to be "catastrophic" health insurance plans only because unless you had huge medical expenses they didn't pay anything at all.  How the state can make this the only possible plan for teachers and their families is beyond me.

15 comments:

  1. I am thankful for the NHS. Yes the people who work pay for the people who don't. Yes I had to sleep on a mixed sex ward that was dormitory style, but I would never have been able to pay for my care on the kidney unit if it wasn't for the NHS. People who can pay to see a private doctor can. I have twice when I would have had to have waited 6 months to see a consultant. Yes it is faulty in places, but for the millions who use it, it does us well. It cant be that bad, as we have 100s of 1000s immigrants who want to live here. So we cant be that awful

    it is the same over here, nurses and school teacher who give their all to the people of the country are h

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    1. Part of our problem consists of hordes of illegal immigrants who consume public services like health care to the extent that social services here are on the verge of collapse. They don't pay any of their costs so people who have insurance have those costs passed on to them.

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  2. sorry accidentally pressed enter. continued...

    are having their pension and benefits reduced. you pay in to get less. these people look after you when you are sick and educate their kids and look after them all day. it is a poor way to treat people

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  3. My buddy has a plans omething like this and it actually works out quite well for him. He has a history of cancer so insurance was a bit tricky. His solution was to dump $5k into an HSA and then get a plan that had a $5k deductible. For the Mickey Mouse stuff like a few stitches, office visits and other little stuff like that he just pays it out of pocket. But if he winds up with a baseball-tumor in his lung, a car accident, a clogged artery, or an aneurysm he's covered. He pays the $5k deductible and his insurance picks up the other hundred grand. Other than dropping the $5k in the HSA, his expense were something like $180 a month for the policy. Since most of his medical visits were for minor stuff that never amounted to more than a few hundred bucks, he'd just pay those outta pocket and know he was covered in case something Really Big happened.

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    1. That's why this is catastrophic care insurance. But we will get run right into the ground and be nickel and dimed to death with this. My doctor visits and lab alone amounts to over 300 a month, my daughter's are much higher. The way it looks to me I will be paying the huge monthly premium in exchange for 400 from the district and that is about all the good I get out of it. Ten years ago she paid zero for our insurance, we had no copay and no coinsurace and no deductible. Now what she gets through the district is a snow job.

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  4. Wow, my HRA works so much differently. It's through my employer so payroll deduction for the premium but my company gives us up front money that is used up for deductibles and whatever isn't covered. The doctors discount our bill for being with Cigna. Then if you use up all the company's money the deductible you pay kicks in. I also fund through payroll deduction an FSA card. I tell them how much I want to contribute over the course of a year but the company gives me immediate access to the entire amount. This is for everything else not covered, out of pocket expenses, glasses or other OTC approved things. I can have the Dr. write a prescription for the balance of the OTC that is not automatically allowed on the FSA card. I do have to use or lose it- even though it is my money so at the end of the year you buy glasses or other covered things. I had the full, full coverage before but it would have been more expensive than if I had to pay the deductible plus all out of pocket. My husband went to the hospital for a week and we had very little not covered by Ins, Employer allowance or my FSA card.

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    1. Kathy, my wife's district is putting in 400 dollars. We have to spend 6000 out of pocket. Then, and only then, can we access out own money in the account to pay 65 percent of the bill, and the rest we pay out of pocket. As far as I can see all we get out of this is a discount on medical services if we stay in network. I am going to call Blue Cross tomorrow and ask some questions to try to clarify this but I have little hope of any good news.

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  5. Maybe we have finally reached the point that the states and munies begin playing loose with their coverage. It's gotta happen sometime as even they are running out of money now.

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    1. The coverage we had with United health care was lame but this is not even insurance and it costs 300 a month more than we were paying already.

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  6. Health Insurance Is a joke for sure. It will be the hot topic in the 2016 elections for sure.

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    1. It's a murderously bad joke, though. The health care industry is the only one I know of where you just sign a blank check for all the different entities involved in your care. No control over costs on the consumers part, and no control over how many different medical billings you get from different companies.

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  7. Sounds AFFORDABLE to me.... for all the CARE you are going to get... even if you ACT a fool.
    I feel your pain. One of my employee's is trying to get coverage for his family and has spent well over 30 hours on the project. Apply for state (free) health care. If denied, use the denial code to apply for another something.
    This morning I told him it wasn't called the easy care act for a reason.

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    1. I am trying to get a handle on this thing. I have been calling the information number Blue Cross gave us for questions repeatedly. In the finest traditions of Blue Cross, it's always busy.

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  8. Sorry it isn't a better plan. Ours is not that bad but I have not been thrilled with the new coinsurance that started with it this year. I had a procedure done that previously would've been a $40 copay. Thanks to this new coinsurance I had a nasty $700 surprise bill show up in the mail.

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    1. Lisa, if the government would stay out of our lives to the maximum extent possible, we would still be getting robbed by the insurance companies. But now, I'm getting robbed and getting no benefit at all from the process. That bill you got is a harbinger of things to come for all of us.

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