| Author |
Here's to Your Health:  Private Health Insurance?  |
|
|
Ninibini
True Blue Farmgirl
7577 Posts
Nini
Pennsylvania
USA
7577 Posts |
 Posted - Mar 08 2013 : 04:30:06 AM
|
Hi girls -
A very dear friend called yesterday in a total panic. The cost of her husband's health insurance through work is suddenly going up almost $600 a month (no apparent increase in benefits), and his employer just notified the employees that they will be responsible for paying the increase (insurance has always been part of their benefit package, but he just cannot afford to cover the cost for all of his employees). In addition, they also will have an increased deductible, as well as an increase in co-pays. She is on a very expensive medication, and after discussing with the insurance rep at the meeting, they have learned that her prescription co-pay is also going up SIGNIFICANTLY because she cannot use the generic brand. Long story short, their anticipated monthly increase in cost is upwards of $1000. They are absolutely strapped right now as it is - this additional cost is absolutely freaking her out becuse she doesn't know how they're going to pay for this. Someone she knows told her that she should look into private health insurance because it actually could be less expensive for her to go that route rather than remaining on their current plan through her husband's employer???? Currently they have family coverage. Her friend told her that it might be beneficial for them to switch to a private insurance under family coverage, OR for her to switch over as an individual insured, and leave her husband and daughter on their own policy through the company. Is that right? Do any of you know anything about this? It just doesn't sound right to me, but with all the new changes, who knows?
Since last fall, we're going through our own little nightmare with insurance, too. Our premiums were going to increase significantly, so my husband's employer scrambled to find a new plan. They found a plan with similar benefits at a lesser cost. Long story short, they were trying to negotiate the cost of the original plan (which we had had for years), but the insurer wouldn't budge, so we had a two-week notice of the provider change. Suddenly, I had to scramble to ensure my physician and specialists are in network, and we were hit with a higher deductible and co-pays. Thankfully, my regular M.D. was accepted by the plan because she was covered under the umbrella of the medical group itself; but in December she left the practice. (I almost cried. I really loved my doctor. REALLY. It too me so long to find her. She is the best doctor I ever had, and now I'm back to square one. Wah. Well, I'll get over it. Just need to put on my big girl boots and move on.) Needless to say, now I am scrambling to find a new physician. What's worse, NONE of my providers are in the network, so I have to start all over with all new doctors. This is a worrisome and poses a problem because not many doctors specialize in or are even familiar with the illness I have (it's rare, little research, etc.). What's worse, to get to most specialists in this new network (including a new gynecologist, when I find one), I'm going to have to drive over an hour away to see them. IF I want to go to someone out of the network locally, I do have that option; but I would have to pay 100% up front (Can you imagine that would cost me?) and submit the bill for an 80% reimbursement, which could take a few months to receive (really great when you consider I see some doctors on a monthly or quarterly basis!). This, of course, after an even larger deductible is met AND as long as the provider and treatment are pre-approved through the insurance company, which "should" only take 3 - 6 weeks to approve before the actual appointment. Needless to say, I am also curious as to what private health insurance might offer us. Realistically, however, I'm sure it would be even more expensive and an even greater hassle.
Yes, my head is swirling, but I'm fine. I am very grateful to have health insurance, but eghads, have things changed! I'm trying to keep upbeat and not cave to crankiness, but forgive me, I do feel a bit whiney! My girlfriend's phone call yesterday is just really gnawing at me, too. I feel so bad for them. They really are in a hard place with all of this. I would love to be able help her by finding some concrete answers about the private health insurance. Any information and insight you may provide would be greatly appreciated. Again, I doubt we would benefit from it; but if my girlfriend's friend is correct, perhaps it would benefit her family?
Thanks so much for your help!
Nini
Farmgirl Sister #1974
God gave us two hands... one to help ourselves, and one to help others!
|
Edited by - Ninibini on Mar 08 2013 04:49:30 AM |
|
|
Madelena
True Blue Farmgirl
1919 Posts
Mary
Central
TX
USA
1919 Posts |
Posted - Mar 08 2013 : 05:28:45 AM
|
Yes-- this is the new reality for lots of Americans. It is a glitch in the AFFORDABLE CARE ACT. There are many families where the cost will be so prohibitive that they will not be able to cover the family, only the worker.
Costs for the employer's insurance is going up because there are lots of "no cost" services offered thru this act that must now be provided. SOMEONE has to pay for it. Guess who...
AND because the worker gets what is considered "affordable" health care for himself under Obama Care. The family WILL NOT.. REPEAT WILL NOT BE ELIGIBLE TO BE COVERED BY THE State "EXHANGES." In other words, cough up the $1000 or $2000 monthly premium for the family or they will have NO HEALTH INSURANCE AT ALL.. or family members will have to seek independent coverage on their own. And yes VERY VERY EXPENSIVE.
This little GLITCH was all over the news last week. It's one of those things that you vote for and then READ IT LATER. The real problem that caused this is a number of people each wrote provisions of the health care law, and this inadvertantly was writtten in. (Guess no one read it or understood it if they did.)
THE ONLY WAY to correct it is to amend the law -- and we know how well everyone is playing together in Washington these days. At this point, any family that can continue to remain on their spouses work-health care should consider themselves really lucky. (???)
The best thing a family can do is have 2 wage earners who have their own individual policies from their own employers and then put the kids on the most affordable of the two plans.
Every family needs to decide the best they can and hope the law can be tweeked a bit to make it more AFFORDABLE. :)
"There is no unbelief: Whoever plants a seed beneath the sod and waits to see it push away the clod, he trusts in God." (Kate Douglas Wiggin) |
 |
|
|
kysheeplady
True Blue Farmgirl
1291 Posts
Teri
KY
USA
1291 Posts |
Posted - Mar 08 2013 : 05:58:01 AM
|
Under Obama care, small companies can no longer afford to pay or offer ins. to their workers. Some upwards in to ten thousand dollars! And here is the loop hole ... if they don't offer it ... or stop paying for it, they will be finded about 2400 ... so as a small business person ... it really is a no brainer. This not only hurts the growth of the ecomony, but working people.
It sinks for those of use who have to pay for all this ... I work for a VERY LARGE corp. and my cost went up as well, and I now have a deductable and get less ... Ins. is the only reason I work.
Teri
"There are black sheep in every flock"
White Sheep Farm
www.whitesheepfarm.com |
Edited by - kysheeplady on Mar 08 2013 05:59:27 AM |
|
|
| |
Here's to Your Health: Private Health Insurance? |
|
|
|
Private Health Insurance?
Topic Locked
