Well, I knew my medical insurance was expensive, and now it's official

[clifffaith]

I pay $814 per month for medical insurance from Anthem BlueCross (Cliff has Medicare, that won't be an option for me for several more years). The rate has gone up pretty substantially every year. This year it went from $683 to $814. I grumble and pay it. I recently received mail from Anthem that starts out "Please read this required notice from the Department of Insurance". It goes on to say that "The Insurance Commissioner has determined that the rate for this product is unreasonable or not justified after the Department of Insurance reviewed information in the rate filing submitted by the insurer. Although the Insurance Commissioner has determined the rate to be unreasonable or not justified, state law does not give the Commissioner the authority to reject this rate. Under state law, the insurance company may still impose this rate, notwithstanding the determination that the rate is unreasonable or not justified."

Back in the day when they could reject you for preexisting conditions, Anthem was the only one who would insure me because I had a history of migraines. I'd been with Healthnet for at least 20 years before that, but once Cliff retired they cut me loose. At that time I opted into a High Dedectible/HSA Compatible plan. We started to do research after receiving this letter, but no one wants to talk to us now because the 2018 rates haven't been set. So I guess I'll join the hoards looking to make a change during Open Enrollment this fall.

 

[Patri]

I heard on the radio today that many companies are raising their rates 30-50% because of the uncertainty of the future...ie how many people will enroll next year, how healthy they will be, what program will be in effect etc.

 

[PamMo]

Yes, it sure IS expensive! We (DH and I) have a $6,500/pp deductible, and monthly premiums of almost $1,400. Every plan we looked at would cost us $25,000/yr if we had a major health problem. Fortunately, we're healthy and don't need to use the system, but we still have to pay almost $17,000 for insurance this year, which was the lowest price we could find. We're expecting rates will go up next year.

 

[vacationhopeful]

I used to pay around $675 ... before the ACA.

Then, I had to get a 'real' policy per ACA .. that was $1500 for the same... so I downsized to $1000 per month. Had to change all my doctors because, they closed up their offices

And again. ... the next year, as my less than 1 year policy would not be offered. Back to the Marketplace and another ... chop out, downsize to get to around $1100 per month. And again, all my doctors left closed their offices and had to FIND another new doctor.

And again ... this year, new policy, new doctors and another, "cut out" options to get to $1100 per month policy ... after they insurance provider cancel last year's policy (ok, NOT OFFER THAT POLICY).

3 months later, for April now qualify for Medicare .... And I have to figure out which options and etc. Just spent 3 hours on the phone today to get Part A & B (or whatever) signed up. So, I am ON MEDICARE ... and still got a BILL for ACA's $1100 policy for April ... They have my birthdate; I am paying for an individual policy; do they even know what Medicare is? Or do they think I am THAT OLD & DUMB to keep paying them?

I decided to just send it back ... marked CANCELLED .... and call every couple of days and WHINE & complain ... and cancel again. And call & cancel again. And call & cancel again ... Think they know what call blocking is? I know they did not suggest or provide me with ANYTHING regarding Medicare ... they KNOW I am OLD .. that I will just keep paying them $1100 per month.

These ACA agents ... are commissioned possessed...IMHO.

 

[klpca]

Our family has unfortunately had some major health issues this year. An overnight visit - ER/ICU/medical procedure - was $92,000 before the "negotiated rate", and ~$35k after. I feel that the insurance cost cannot be discussed without discussing the cost of the underlying medical care. I don't know what the answer is, but after paying for coverage for over 35 years that we rarely used, I am so very thankful that we have insurance. I am worried that it may not be available to us in the future.

 

[TUGBrian]

got a notice last month to announce mine is going up over 40% starting in July.

and I have the cheapest HSA plan blue cross offers. 5000 deductible..no perscription/dental/etc all out of pocket.

laws of economics are finally catching up.

 

[dougp26364]

I'd love to comment but, every time I start to write it out, it gets to close to political. Let's just say both mine and my wife's employer sponsored plans premiums keep going up, the deductibles have grown considerably and the benefits have shrunk. It wasn't great before but I'm worse off now than I've ever been in the past, and it wasn't always so great in the past.

 

[VacationForever]

Without getting political... USA health insurance system is broken. I would love to see a form of Universal Health Care that is based on negotiated rates, much like Medicare. People do have to pay for health insurance, but may get either subsidies and/or tax credit back depending on income level of individuals. The main issue that I see is that there is not a real negotiated reimbursement rates outside of Medicare system. Right now if someone has not worked their 40 (or whatever) credits by the time the person reaches Medicare-eligible age, the person may pay full freight, which is about $1K per month. I studied this quite a bit for a friend who has been toying with the idea of bringing his elderly parents over from Venezuela. This is much lower than someone in their 60s pay in the private market with worse medical benefits compared to Medicare.

 

[Panina]

It seems the insurance companies are able to charge whatever they want. I agree the system is broken.

I am part of a group plan that I was able to stay on after my husband passed away. I pay full freight , no subsidies from the company. I pay their actual cost to keep me on the plan. $7,200 a year, great coverage $200 deductible and can get coverage in any state, every doctor I wanted to go to accepts the insurance. Since the ACA took effect my rate has stood the same. Everyone thought I was crazy not to take the subsidies as my insurance rate the first year would have been thousands less. I opted not to because once I left my husbands plan I could not go back on and ACA to me was risky.

My current significant other, with his deductible, his insurance costs more then double of what I pay in the ACA system. He can only see selected doctors , which each year changes, in our state. If he gets sick, out of state, he can only go to the emergency room and pay hundreds in a co payment, thats if he met his thousands in deductible. His insurance is the same company I have.

Makes you wonder, we both have the same insurance company but from different sources. Seems the private sector negotiates better.

 

[Bucky]

The hospitals and insurance companies are forcing us to consider some form of universal healthcare IMO!

I spent 14 days in the hospital last October where I had surgery to implant an LVAD. The bill for the hospital, doctors, etc was $850K.

I recently spent another 10 days in the hospital where they did a cardiac ablation! Haven't received a bill for that yet but I'm sure it will be several hundred thousand. Shoot, just the medivac flight to the hospital, only 36 miles away, was a little over $45K.

This cannot continue for much longer IMO. Unsustainable charges and payments. Thank God that I have Medicare and Tricare which paid for it all.

 

[Brett]

"USA health insurance system is broken"
"This cannot continue for much longer"
"I agree the system is broken"

This NY Times best seller book details why Americans pay significantly more in health care costs than other developed countries

https://www.amazon.com/American-Sickness-Healthcare-Became-Business/dp/1594206759

unfortunately it's going to get worse before it gets better

 

[macko420]

This is why I love TUG! Honestly, this is the first discussion about insurance where people are having an actual intelligent discussion about this instead of calling each other some horrible name that I have seen in the last 2 years
THANK YOU! I, too, am struggling with health insurance payments. I am self employed and get mine thru the Marketplace but also have pre-existing conditions so I am very grateful to have this as an option. Anyway - I am worried sick (no pun intended) about what is going to happen..

 

[VegasBella]

Without getting political... USA health insurance system is broken. I would love to see a form of Universal Health Care

Agreed. The issue is very complicated and involves multiple factors. It's not just an 'insurance' issue. As explained in the book mentioned above, it has to do with various multiple players in the healthcare system, not just insurance.

Personally, I pay more for insurance than I do for my mortgage. Insurance is my largest monthly expense. I know a big part of that is because of my high income and good health I am subsidizing others. I don't have a huge problem with this but I would like for my money to actually help other people who need it rather than line the pockets of CEOs. And I would like many other factors of our healthcare system reformed.

 

[vacationhopeful]

macko420,

We all have learned to listen and converse about many topics ... I now have Medicare.

I spent time and energy for months which turned into years counting the months til I turned 65 last month. Not that I was retiring or starting social security, but because the health insurance thing has become a monster which any individual or family is forced to make decisions so as to afford or get into a group/corporate policy. I was paying over $1100 monthly for a policy during early 2017 ... no help ... way MORE than any monthly mortgage bill I ever had in my life. And every year, the current policy gets 'phased out/cancelled' and another end of year HUNT had to be done. The is NO policies for individuals NOT issued thru the ACA.

I have seen couples who have run small businesses for years where one spouse had to get a job with health insurance ... any job. And I have seen others keep a job which they HATE, because they can't find another job WITH health insurance. And I have another person, who changed jobs .. turning multiple job offers down because the new companies would only start health insurance after 90 days of employment. He started a new job and 2 weeks suffered a gall bladder attack & followed by surgery ... seems his new employer LIED to him ... no health insurance coverage. Seems he felt COBRA was too expensive.

 

[elaine]

years ago, my mother did not qualify for Medicare, but my Dad hit 65 and cobra ran out ( which covered my Mom). She had all her physicals, etc. before it ran out and went without Ins. for 18 mths until she hit 65. Her premiums would have been $1000+/mth with $5K deductible and pre-E not covered. Luckily, it worked for her. I kept my job instead of being a stay at home Mom in order to have good health ins after seeing my parents. As a kid of a self-employed parent, I NEVER recall having regular physicals, etc. and we only saw the Dr. if we were REALLY sick. I only got treated for allergies/asthma at age 22.

 

[bluehende]

As many have said the real problem is the underlying cost of health care. There are many things that insurance companies can be criticized for, but as long as health care is 16% of our economy it will be a huge drain on consumers. I will try very hard to stay non political. I worked for a company that made products that we always talked about value in use. In other words we can charge a lot of money if it has high value to the consumer. When it is your life on the line the value in use is astronomical. As long as the profit motive interacts with our lives we will not solve this problem.

 

[Talent312]

IMHO, part of the problem is that docs+hospitals run up bills by gaming the system.

A few years ago, DW spent 3N in a hospital for a TIA (MRI; observation; no surgery).
The insurance company paid ~$30,000, which I'm sure they applied to their new wing.
Their food wasn't even edible. I had to bring her food from outside.

It seems to me that hospitals are like TS salesmen.
We were only out $100 + the food, so how can I complain?

.

 

[macko420]

One thing that has increased costs is how you need to be referred to any specialists by your primary care dr. This often requires you to visit them first and even if it doesn't, there is still paperwork to do the referral. This increases the need for office staff, etc. If you don't go thru this process, your insurance might not pay for the visit with the specialist. It didn't used to be like that

Another thing that really bugs me - the constant bombardment of commercials for expensive meds! It's not like we can buy them over the counter. Why are they spending massive amounts of money to advertise to an audience that may not be interested in the product. I'm sure that contributes to the astronomical cost of meds. I would like to see this practice discontinued. Tired of hearing how any particular med is going to kill whoever takes it....

 

[WinniWoman]

As many have said the real problem is the underlying cost of health care. There are many things that insurance companies can be criticized for, but as long as health care is 16% of our economy it will be a huge drain on consumers. I will try very hard to stay non political. I worked for a company that made products that we always talked about value in use. In other words we can charge a lot of money if it has high value to the consumer. When it is your life on the line the value in use is astronomical. As long as the profit motive interacts with our lives we will not solve this problem.

It's a double edged sword because without the profit motive there is no incentive for innovation.

 

[bluehende]

It's a double edged sword because without the profit motive there is no incentive for innovation.

Now to put a third edge on the sword. Americans are paying for all of this innovation by the price we pay. I am not sure how much more innovation we can afford. We pay twice as much for our healthcare and our outcomes are not as good. If we do not change soon the price we will pay long term is going to be ugly.

 

[Bunk]

It's ironic but to some extent, Medicare has a rule against preexisting conditions. As I understand it, along with Basic Medicare, you can get either Supplemental or Advantage coverage. Medicare Advantage is significantly cheaper and is a good choice for the "younger seniors" who are not very sick.
But I was told that if you are on Advantage and want to transfer to Supplemental because you are now sick, the insurer does not have to accept you if you try to transfer with a preexisting condition.

 

[clifffaith]

My birthday is December 30th; I turn 62 this year. Anyone know if my first SS payment starts that month, or does it start the next? (Cliff is 18 years older so we have always figured I'd take SS ASAP; then back issues that often render me unable to walk without a cane and the slowdown of our business pretty much have forced our hand that way anyway). Same with Medicare three years after that-- does it start in Dec or Jan? I remember my dad crowing that he got to count me as a dependent the whole year I was born, even though I was born two days before the end of the year.

 

[vacationhopeful]

Medicare starts the MONTH of your birth .. I just signed up last month.

 

[b2bailey]

I have been a supporter of Obamacare because it got my husband through brain cancer treatment and two surgeries. However, I just spent some time with my nephew and learned he (age 27, perfect health) recently cancelled his marketplace policy because he could no longer afford $325/mo premium and his share of rent on a San Diego apt.

 

[vacationhopeful]

I have been a supporter of Obamacare because it got my husband through brain cancer treatment and two surgeries. However, I just spent some time with my nephew and learned he (age 27, perfect health) recently cancelled his marketplace policy because he could no longer afford $325/mo premium and his share of rent on a San Diego apt.

Did you ask him how much was his cell phone bill monthly?
Is he driving a newer car? And does he have insurance on the car?
Could he get a part time job?
Has he cut out primo coffee and lattes?
Did he look for a cheaper apartment?

His premium is less than $85 per week.