I am paying out the a$$ for health insurance. I have PPO and it keeps going up. Who do you have?


I am paying out the a$$ for health insurance. I have PPO and it keeps going up. Who do you have?





Yep. Blue Cross/Blue Shield of IL, Blue Choice PPO, Gold Individual Plan. $3500.00 max yearly out of pocket expense, $1500.00 yearly deductible. Includes prescription, dental & vision.
MANY MEN WANTED TO LAY ME DOWN, BUT FEW WANTED TO LIFT ME UP
-Eartha Kitt


Bupa. Expensive but worth it



BCBS PPO through my employer. $40 copay, $3000 ded, 70/30, $6350 oop. I'm switching to high deductible plan next year so I can get some procedures done then not have to pay anything other than my premium.
I work in health insurance so if you've got questions, I've got answers![]()





in a word, none ...
If something simple comes up, being seen at the local gov't run clinic costs all of US $10. And since local pharmacies can directly sell antibiotics and many other medicines 'over the counter', many times it isn't even necessary to go to the clinic. The cost of generic antibiotics etc. is also something like US $10. The local dentist charges US $20 for a filling.
For anything serious, I travel to the nearby Mexican provincial capital. They have a truly 'world class' hospital ... and the hospital rooms cost like US $80 a day !!! Seeing a specialist doctor costs like US $60. Generally speaking, cash price for medical procedures is about 25% of what the procedure would cost in the USA.
BCBS through my employer. Even if you are looking for individual coverage though I would recommend them.
"There are different kinds of darkness. There is darkness that frightens, the darkness that soothes, the darkness that is restful. There is the darkness of lovers, and the darkness of assassins. It becomes what the bearer wishes it to be, needs it to be. It is not wholly bad or good."
- The Court of Mist and Fury










I had a Humana plan for 7 years that started at 150 a month and in the end was 360. I got insurance on the ACA website for half. It's humana as well but it doubled the second year and they're raising rates 20% this year. I"m going to look for something else because I have to get referals for everything. Huge PIA.










Medicaid..so 0


I have blue cross/blue shield of california. I pay almost 900 a month. It just keeps going up. I need to change my plan. When I first got it, it was 200 and I never changed anything. I also have no health problems. Had all kinds of bloodwork done, so its not that.
Blue Cross Blue Shield. I pay $218/month for very decent insurance. I found this on ehealthinsurance.com, which might be a good resource for you!



United Healthcare. I like them, and all my doctors take them except my dermatologist. Very nice customer service too!





Aetna. I pay about $1,000 per month for a family plan with copays, high deductibles, a requirement that I designate a primary care physician (PCP) for each member of my family and referrals needed for anything away from the PCP. Oh, and a lot of the area doctors won't accept the particular Aetna plan that I am now using.
I did not choose this plan per se, but rather was rolled into it by Aetna after my previous plan was discontinued. If I knew how bad it was going to be, I would have shopped around some more. I liked my old plan a lot more since it covered more of the stuff that we use, was accepted everywhere and was far less restrictive. But then more of the mandates kicked in and our old plan was discontinued. I don't qualify for subsidies, so I am paying full freight for a very mediocre plan and, from what I hear, it is only going to get worse.





I feel obligated to make a comment regarding the references to signing up for ( expanded ) Medicaid coverage by previous posters. There is a 'joker in the deck' which you are almost certainly unaware of which may cause you to think twice before signing up ...
Prior to the ACA, being eligible for Medicaid required that a person have extremely few personal 'assets'. With the enactment of the ACA, eligibility for ( expanded ) Medicaid now waives the personal 'asset' requirement. So from a short term standpoint this means that people who own decent cars, who 'own' some money in the bank ( or a retirement / investment account ), etc. are now eligible for Medicaid as long as their income level falls below the eligibility threshold. And that threshold is 133% of the Federal Poverty Level or something like $325 per week of earnings. However, this income eligibility threshold is significantly higher if children / family are involved, if they live in a high cost of living area, etc.
Just because Medicaid coverage will cost the eligible person nothing today does NOT mean it will cost them nothing tomorrow. For a fact, states keep track of the total amount of money they have spent to provide ( expanded ) Medicaid benefits to a particular individual. The states also add an administrative fee on top of the actual payout amounts to doctors, hospitals, etc. Why does this matter ?
Under laws intended to repay the state for providing nursing home and other expensive medical care, states have the authority to place liens against personal assets such as houses, cars, bank accounts etc. of Medicaid beneficiaries age 55 and older, or who are 'institutionalized' at any age. In the past this didn't matter much, because anybody who was able to qualify for Medicaid pre ACA could not have a significant amount of assets. However, with the ACA waiving the assets test for ( expanded ) Medicaid eligibility, this may not be the case in the future.
Putting this another way, if a 25 year old American signs up for ( expanded ) Medicaid, and remains under Medicaid coverage for several years, the state could very well run up a total of $100,000+ in costs for direct payouts to doctors and hospitals, as well as indirect administrative costs, to provide that person with 'free' Medicaid benefits. With today's setups, the amounts paid by the states ( a.k.a. Capitation Payments ) to insurance administration companies can actually cost significantly more than the direct medical care costs !!! Then, say, several years later, that person obtains a college degree thus a higher paying job with benefits ... substituting private / other health insurance for ( expanded ) Medicaid coverage.
Say that person then goes on to build a career, buy a house, put aside some savings / investment / retirement money, have children, etc. However, the state will not forget about that $100,000 worth of Medicaid benefits it provided 20+ years earlier. Once that person reaches age 55, the state will then be able to place a $100,000+ lien on that person's house or other assets ... which the state will collect when that person eventually dies or becomes 'institutionalized'. This in turn may place that person's children in a situation of not being able to inherit their parent's house, car, savings / investment money etc. because the state will have 'first dibs' on any assets as repayment for ( expanded ) Medicaid benefit costs it previously incurred.
Also, the existence of a state lien may prevent the person from being able to sell their house once they reach age 55 ... unless they are prepared to pay the state's Medicaid 'bill' by liquidating other assets to get the state's lien removed to clear the property title prior to attempted sale.
see
(snip) In Arizona, where all Medicaid beneficiaries are enrolled in a managed-care plan, their estates could be repaying “benefits” even if the enrollee never actually received any goods or services. Information provided by the Arizona Health Care Cost Containment System (Arizona’s Medicaid program) explains that the program makes a monthly capitation payment of around $3,340 to “program contractors,” who arrange for services, if any. It warns, in bold print: “It is important to be aware that capitation payments can exceed the actual costs of services provided during the month.”(snip)
Yes that means that Arizona ( expanded ) Medicaid beneficiaries are racking up a 'bill' with the state to the tune of $3,340 per MONTH regardless of whether they actually received any medical services under ( expanded ) Medicaid. It's unknown how many states also use contracted health insurance companies to administer their Medicaid programs, versus self-administration via state employees and direct state Medicaid payouts to doctors and hospitals. But either way, the level of costs involved are substantial ... and either way the state will eventually try to recover those costs from ( expanded ) Medicaid enrollees' estates.
Obviously, if those ( expanded ) Medicaid beneficiaries remain at a low income level throughout their lives, remain renters rather than home buyers, don't save any money etc. then the state will actually collect next to nothing. However, if those ( expanded ) Medicaid beneficiaries obtain a higher future income level, become home buyers, and save money / accumulate assets, the homes and money / assets they worked so hard to accumulate may in fact wind up being the property of the state rather than their children.
Last edited by Melonie; 06-14-2015 at 07:09 AM.





That is scary, and I didn't know that. I know someone who gets Medicaid because she lost her job but once she gets another job will drop it. Of course that assumes she gets another job.





^^^ it seems that a major effort has been made to specifically avoid widespread publicity !!! And, to some degree, it varies from state to state depending on how individual state Medicaid recovery laws were written.
Last edited by Melonie; 06-14-2015 at 03:22 PM.





NHS. Overrated.
My boyfriend just switched from contract to perm and I am so over the moon, we now have private health insurance through CIGNA (had them a few years ago they were great), dental, travel, home, and he'll have a life insurance plan. I cannot wait to have to have the option of private health care, the NHS is slow as fuck to get anything done.
I still don't have insurance yet and it scares the F out of me.I keep looking for affordable insurance but so far no go and moving states hasn't helped
Yeah just my story. I moved out 3 states in 4 years and still don't have insurance![]()
I too have Aetna. Compared to some other plans I've had ( Atlantis - UGH ! ) it is better but not as good as GHI ( the BEST I ever had ). My current plan is a quasi - HMO type with a PCP and referrals to specialists in the network BUT I am allowed to go out of network where I have to pay 20 % IF the Dr. takes Aetna. Fortunately most do.
Like you I am paying full freight for myself and my employees and the price has been going up by more than 10% every year. In fact I just got a lovely letter from Aetna advising me that they are going to ask New York State for an 18 % increase next year. I'm sorry but I have no way of increasing my fees to cover those kind of increases. So far I have been able to carry everyone but the tipping point is approaching where I will have to go to a "nuclear option " i.e. not offer any health insurance and let my employees do as well as they can with the Obamacare Exchanges and just pay for my own policy. Since starting my first business in the late 1980's I have NEVER not offered health insurance to my employees but what I am supposed to do ? I'm running a business and not a private charity.
Last edited by Eric Stoner; 06-25-2015 at 11:10 AM.




Moda Health purchased through www.healthcare.gov. I pay $600/mo for myself and my husband. I have a pretty high deductible ($4000/yr per insured individual) but I don't really know how that works as most of our medical services have been paid in full by Moda. My Rx plan sucks. It supposedly covers a lot of different medications, but I apparently need meds that the plan doesn't cover.





Maybe a bit off topic, but if you as employer choose not to offer ACA compliant employee health insurance coverage, and your employees sign up via the state public health exchange and receive taxpayer funded subsidies as a result of their income levels, you as the employer may be 'charged back' for ( some of ) the cost of those taxpayer funded subsidies. Of course this depends on the total number of people your business employs, whether or not you allow your employees to work more than 28 hours per week ( limit of 'part-time' status ) etc. Even so, the cost of the employer 'penalty' tax may be significantly lower than future year ACA compliant employee health insurance premiums.I have no way of increasing my fees to cover those kind of increases. So far I have been able to carry everyone but the tipping point is approaching where I will have to go to a "nuclear option " i.e. not offer any health insurance and let my employees do as well as they can with the Obamacare Exchanges and just pay for my own policy. Since starting my first business in the late 1980's I have NEVER not offered health insurance to my employees but what I am supposed to do ? I'm running a business and not a private charity.
United Healthcare, most of the time I have no complains.
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