My Employer Pays $700 A Month For Health Insurance I Almost Never Use

[stopbush]

It's true.

I work at a non-profit with only 3 employees. My employer pays our premiums every month. Because we have such a small staff, we get gouged on insurance.

My wife and kids are on the insurance from her job. I could add them to my policy, but I would pay $600 a month for wifey and $300 a month for both kids. It's cheaper to have them on her policy, so that's where they are. Her policy covers less stuff than does mine, but we still win, even with higher out-of-pocket than they'd have on my policy.

But here's the thing - I turn 55 on Sunday, and I almost never use my expensive insurance. Sure, I get the yearly check up, but there's never anything wrong with me. I'm on no medications. The only doctor I see regularly is my chiropractor - I get my back aligned once a month or so and do some physical therapy. Of course, my Anthem BC policy DOESN'T COVER chiro, so I pay $75 out of pocket per visit. I also see the dermatologist occasionally, but the treatments that I get prescribed at the dermo are also NOT COVERED by my policy. They would be covered if I was being prescribed pills, but I'm not being prescribed pills.

I pay for family dental through my job, and that we use a lot. The insurance pays up to $1500 per year per family member at 80% per procedure. It also pays for two check-ups and cleanings per year per person, so we all see the dentist at least twice a year (I actually get a cleaning 4 times a year, paying for an extra two out of pocket, but my dentist gives me a deal on that). My son just got braces, and at a cost of $3500, it's nice to only have to pay $2000 of that cost (my daughter will also have braces in due course).

I keep the health insurance and my employer continues to pay this ridiculous rate because I - like everyone else - must guard against a catastrophic health problem, like cancer or getting injured in an accident. In the meanwhile, I have no reason to use the insurance because the physical ailments I do have aren't covered by the insurance. I'd like to be able to find an insurance policy that actually pays for the treatments I do need, rather than guarding against illnesses I've never had and probably will never have.

My family would be perfect candidates for a Medicare/Medicaid-plus type insurance, or some kind of "basic" plan that Obama mentioned tonight. It would be much, much cheaper than what I currently have, it would cost my employer less, and it would probably cost me less as wifey & the kids could also be on the plan (maybe??). If something catastrophic did happen, then we could move into the other plan Obama spoke of tonight. Beyond that, we're all in very good health, yet large amounts of money are being sent to insurance companies each month to insure us from the possibility that our health might go south.

At present, Anthem is making $8400 a year off of my policy for doing basically nothing. While I knock on wood for my good health, doesn't there seem to be something terribly screwed up with my particular situation? Or is my situation actually all too common?

[GreenPartyVoter]

1. From what I hear, It's pretty darned common.

[Hannah Bell]

20. if the insurance corps are making money, it's the most common situation.

[Oregone]

2. You may not use it, but the shareholders most certainly appreciate it

They get a decent cut of that monthly by sitting around and watching their thousands of acres of grass grow

[CountAllVotes]

3. Anthem/Blue Cross

I have their supplemental insurance for Medicare. It cost $825.00 a mo. for two persons. It covers not much except for drugs.

Medicare is another $200.00 a mo. on top of it for two people.

Tell me what a great deal this is.

:kick:

[Okie4Obama]

4. Very common

This is the first year I've ever used our insurance. Both my husband and I had minor surgeries, and we are still going to end up paying about three or four grand this year out of pocket, in addition to the 365 bucks a month. I don't know how much my husband's company pays for our insurance. I used to use the Health Savings Account/Catastrophic Insurance option but I knew we were both having surgeries this year so I switched us to a PPO. It still feels like a rip off, both of our procedures were outpatient and minor but still mucho dinero goes to the hospital.

[paulsby]

5. my employer pays $900

a month for mine. what's nice is i can add family members at no charge!

[SharonAnn]

6. One of you gets diagnosed with treatable cancer. That's hundreds of thousands in bills.

Literally. I'm absolutely shocked at what my husband's colon cancer chemotherapy is costing. Thank God he's on Medicare. If it were me, still on employer insurance, my insurance would be paying these huge amounts and I'd have larger co-pays than he does.

I pay for car insurance every year, but haven't needed it for many, many, many years. I pay for house insurance every year and have never needed it. My husband and I both have life insurance but we're still alive.

The point of insurance is that you're betting you'll need the coverage and the insurance company is beting that you won't.

Yes, insurance can be expensive, but not having it is even more expensive.

[lonestarnot]

7. It's just crazy. We pay for something that isn't even insurance, don't even use it for whatever

reasons, even when ill. Some will be taking a double whammie for their greed. Tax cuts for richies dies next year doesn't it? And the competition formed around public option is going to be interesting to watch. :D

[Control-Z]

8. you can't be added

to your wife's policy? that seems odd. you are part of the family.

[stopbush]

11. Yes, I could be. I've spoken with my employer about the possibility of them

cutting a check to cover me on my wife's policy, thus saving them money.

The problem is that IF something really bad happened to me, I'd get better coverage on my present insurance. My wife had cancer surgery 5 years ago. When she has tests run, we pay 30% of the cost. When tests cost $1400 - 3000 per, 30% can add up to a lot of money. That's her crappy United Health policy, which is a PPO. My policy at work is an HMO, at $700 a month!

When I was out of work, the whole family was on wifey's policy. It cost us $350 per month for the family. Then, I got my present job, so she had to go part time (we have school-aged kids). As a part time employee, she couldn't be on the regular policy. She had to go on a COBRA. She and the kids on the COBRA cost me $755 per month. That was still less than the $900 per month it would cost on Anthem BC. Recently, she added a 4th day to her schedule, so as of Oct 1, she is eligible for their part-time employee benefits, which sort of splits the difference between the $350 we used to pay and the $755 we paid on the COBRA.

it's all a fucking scam.

[Control-Z]

19. It really is a scam.

My husband is self employed. We have three kids. You don't want to know how much we have paid for insurance over the years. And our insurance is terrible. Our only debt, aside from our mortgage, is medical that wasn't covered by our policy. It is amazing how quickly it adds up with just everyday family medical care. Broken bones, stitches, migraines, colds, flu. Our drug expense (for migraines, asthma, allergies) alone is enough to keep us broke. Yep. It is a scam. It is criminal.

[Kaleva]

9. My mother's medical bills were around 1/4 of a million

What she had paid in premiums didn't come close to what her bills ended up being. Thankfully, she had great coverage.

"In the meanwhile, I have no reason to use the insurance because the physical ailments I do have aren't covered by the insurance. I'd like to be able to find an insurance policy that actually pays for the treatments I do need, rather than guarding against illnesses I've never had and probably will never have."

The purpose of insurance is to guard against the unexpected. Being 50 years old, I don't plan on dropping dead anytime soon but I have adequate life insurance to provide for my family just in case I do.

[stopbush]

12. Yes, I understand all of that, but it pisses me off that Anthem won't cover

conditions and treatments I do have. Other insurance policies I had did cover chiro and derma. This one doesn't. The only reason I have it is because it's the plan my employer opted for. I had no say in the matter. I would like to have some say in the matter at some point.

[moondust]

10. My premiums DOUBLED in 4-1/2 years and never filed a claim.

Self-employed, catastrophic private plan with high deductible. Finally dropped it in 2005.

Imagine where premiums will be in another 5 and 10 years without serious reform. :scared:

[WillowTree]

13. "If something catastrophic did happen, then we could move into the other plan Obama spoke of ,,,,,"

That's EXACTLY the kind of thinking that led to the application of pre-existing conditions clauses in health insurance in the first place.

I suppose you think you should be able to only insure your house for $10,000 to cover the smaller, more common claims for years and then call your agent and raise your coverage to $200,000 after it goes up in flames, too.

At $700/month, you (or your employer) would have to pay into a plan for over 5 years just to pay the hospital bill alone from the last time my Dad was in the hospital, and that would not account for what it costs the plan to operate. If you were to run-up $100,000 in expenses, which is very easy to do these days, you would have to pay in for almost 12 years.

You're paying into the plan now so that the plan will have funds available to pay those catastrophic expenses if and when you need them.

[stopbush]

16. That would be fine IF there was anything resembling job security these days.

But there isn't. I could leave this job before the end of the year, or my employer could opt to go with a different provider.

As far as home insurance, my $385,000 home in Fresno cost me under $600 to FULLY insure PER YEAR. The $390,000 home I previously owned in NJ cost me $700 to FULLY INSURE each year. The smaller claims I generally paid out of pocket so as to not have my home owners premium go up. You want to make an apples to apples comparison, then fine: I'd be more than happy to pay $700 per year for $390,000 worth of catastrophic medical coverage, rather than $700 per month.

As far as the "plan having the $ to pay those catastrophic expenses," seems to me that we're currently paying into the plan to pay ridiculously high administrative costs - including multi-million dollar salaries and bonuses - advertising costs, lobby costs and, of course, a healthy dividend for the shareholders. What's left over for the "fund" that may eventually have to pay for a catastrophic illness is anyone's guess...not to mention that a catastrophic illness is often the "trigger" used by the insurance company to cancel your policy and leave you high and dry, in debt and bankrupt.

[WillowTree]

17. Ah, but you're talking about the government plans.

You want to pay minimal premiums to get minimal coverage under Medicaid until you get seriously ill or injured and THEN opt into a better plan that will afford you coverage that you haven't paid for and that whatever your premiums are for that increased coverage couldn't hope to pay the cost of.

[stopbush]

21. I turn 55 on Sunday, so I'm getting close to Medicare age anyway.

If they lowered the age to 55 to buy into Medicare, I'd jump.

As far as "coverage I haven't paid for," I've paid and my employers have paid tens of thousands if not hundreds of thousands of dollars to private insurance companies over the decades for health insurance. I've been on Anthem BC/BS, Aetna, PruCare, United Health, Kaiser, Oxford and others I can't remember. Some were good, most were substandard. I ended up under all those different marketing companies' plans because I either switched jobs or - just as often - an employer changed providers midstream. In every case, I had no choice in the provider. My choice was "yes or no" to the coverage, period.

On an individual level, I have more than "paid for" coverage over the years. I am not talking about options for a 21-year-old. I'm talking about options I would like to have for myself as I head into the backside of my expected life span on this planet.

[msongs]

14. if u stay healthy n die suddenly u will be anthem's idea of a perfect customer nt

[drmeow]

15. I've always thought that

theoretically that's the way its supposed to work. You may pay a lot of money for something you don't need and you are subsidizing people who do need it. The way I was thinking about it the other day was with homeowners insurance. Lets say I pay $1000/year for 10 years. That's 10,000. And 25 other people pay the same amount. $250,000. In that time one of our houses burns down and it costs $200,000 to rebuilt/replace. If it wasn't my house, I've subsidized part of that $200,000. If it was my house, a bunch of other people subsidized it. To a certain extent all insurance used to be "socialized" in that we all paid a bit of the cost when something went wrong for someone. And it was worth it for everyone for the reasons SharonAnn pointed out.

In the meantime the insurance company invested the money and earned income on it (historically that's where insurance companies real profits used to come from ... returns on all the premium money they invested and earned interest and dividends on). Now they both invest the money AND deny claims, drop people, and otherwise screw us over. This is why non-profit health insurance companies were so much better. For profit insurance companies earn interest and dividends but they also are expected to pay dividends. Non-profits still earn the interest and dividends but don't have to pay any out so they can use the interest and dividends to pay their operating costs and don't need to screw customers to pay their shareholders.

[Liberal_in_LA]

18. That's how insurance works. For company to make a profit some of customers must UNDERUSE it

[Joanne98]

22. It's extortion.