So I got my HC plan from my employer for 2011...

[fighttheevilempire]

And I'm really confused. Here's the short version:
My old plan had a premium of about $10/week, and had a $250 deductible...
The proposal for 2011 switches me from a HMO to a "high deductible PPO", which means that now I'm facing a $1300 deductible (+520%!!!!) and a premium increase from about $10/week to $13/week (30+%) for crappier coverage. They're trying to push us into "Health Savings Accounts".

Do I really have to buy this coverage under the new HCR bill? Because I'm young and healthy, and this bill provides no real coverage for me. I'd just as soon drop coverage altogether, since it appears I won't break even on this plan until I run up medical bills of over $2000. If I don't purchase this, do I get fined by the IRS now? How big a fine? I sure as hell don't want to be paying 30% more for coverage that went from decent to non-existent. Most of this money is only going to make some fat cat richer, and I'm buried with 36000+ in student loans. I don't have money to waste on this stuff right now. What do I do?

[Seedersandleechers]

1. See if your employer

will increase your wage if you opt out of the insurance.

[Statistical]

2. I don't believe there are any penalties in 2011. Peanlties begin in 2014.

Since you are young and healthy HSA makes more sense. Put $200 to $500 a month aside into HSA, get the tax advantage (federal, state, medicare, SS), and if you do need coverage in future you have some funds saved.

Another thing to check is if your employer puts anything into your HSA for you (employer contribution). My wife's employer pitches in $1000 a year towards the HSA. We put in another $300 a month. Now we have nearly $15K in the HSA (tax free and earning dividends).

Sure the plan has $2400 family deductible but that is a deductible we can pay out of the HSA rather than reach into our pocket. For us it makes sense I concede HSA isn't for everyone. My wife's employer offers a traditional HMO but the premium is $420 per month. Sure it has no deductible but $420 * 12 = $5,000 per year paid in premiums.

[fighttheevilempire]

5. thanks for the reply

They are offering a 'one time' contribution of like $300 (don't have the paper right here w/ me) if we sign up for the HSA. That's it, no future anything. Add in that I only make like $24k, and I don't really have an extra $200-500 a month to put anywhere, much less in some healthcare-only rainy day fund. Maybe when I get married it'll make more sense, but for now I'm just not seeing it.

[Statistical]

6. Well that is pretty crappy. One would think w/ raising everything else they could help contribute.

The "good news" is some employers use HSA to offer a different but real coverage. Sadly some simply use it to pass off worthless coverage (and cut cost). To answer your original question you won't be penalized until 2014 for not having coverage.

You may want to consider getting the coverage just to protect you from catastrophic loss and to use the HSA (even if you can just contribute $50 a month) to cover every day expenses.

The largest understated advantage of ANY COVERAGE (including HDHP) is you get "insurance pricing".

Here is an example. My wife went to Patient first. They billed $370 for visit, xray, some blood work. With no insurance we would have paid $370. The insurance company knocked that down to $180. Now we ended up paying the $180 w/ HSA because the plan has a large deductible but having the power of the insurance company reduces the amount paid (even if insurance company pays nothing).

[ieoeja]

23. However, a lot of companies will not let you work there without proof of insurance.

Their liability insurer often requires it. In fact, it would not surprise me if this is an almost universal requirement for any company with more than a handful of employees.

[sinkingfeeling]

3. There is no fine until something like 2014 for not having insurance. But, consider this.

You are young and healthy today, but you still have the same risks of developing something like cancer or being in a wreck as any other person. How would you pay a $100,000 medical bill?

[Coyote_Bandit]

4. Ummmm......

I have a $10,000 deductible, a 20% co-pay beyond that, doctor visits are not covered and my monthly premium is about $350. I've never smoked, have no pre-existing conditions or documented risk factors other than age. I'm in my 40's. I'd be delighted to have the same option that you do.

But I guess pain depends on point of view.

[Barack_America]

7. This is exactly why we needed the public option.

And why a health care bill without it isn't really reform at all.

[fighttheevilempire]

12. I said the same thing

We really should have had a medicare for all type option. And revoke the anti-trust exemption. This coverage is quickly becoming worthless. Anyone know if they'll be forced into using 80-85% of the premiums on actual healthcare anytime soon?

[txlibdem]

46. Too bad that a Democratic President threw out single payer before any debate started

And didn't do a thing to fight for or even voice an opinion in favor of having a mandatory robust public option.

What would have happened if he HADN'T thrown out single payer? Might he have been able to use that as leverage to get a public option?

[LynneSin]

8. Health Savings Accounts are good things

I have about $250 leftover with my HSA and using it to buy glasses at the end of the year.

I'll probably get them in December when I know I can spend the money and not worry about any outrageous medical bills coming up.

But HSA was handy when my doctor put me on some really expensive prescription medicine (which didn't work - he wasn't my regular doctor, I had to go back and my normal doctor put me on the cheap stuff and it cleared up quickly). I had just paid off a bunch of bills and really didn't have the extra $100 for the prescription, but thanks to my HSA card it was all good.

[eridani]

47. Sure, for healthy affluent people

They are a great way to withdraw big piles of money from the pool that must suffice to pay for everyone.

[NEOhiodemocrat]

9. I wonder what you are complaining about?

Your premium is going from "about $10 a week" to "$13 a week". And if you are a young healthy adult this is providing exactly the coverage you need. Coverage in the event of a unlikely but possibly financially devastating accident or serious illness, and insured person discounts for the medical services you do incur. The fines for not carrying insurance have not taken effect yet, which I am sure they explained at the meeting companies have when they present their plan. So feel free for now to forgo the $13 a week insurance if you want, just don't be complaining if something unforeseen happens and you are not only facing $36,000+ in student loans and a like, or much higher, amount in medical bill if something happens. This is what insurance is now, paying some now to keep from paying much much more if something goes wrong. Personally I would jump at the chance to pay $13 a week, that is small compared to what most people pay. Sounds like you want a premium plan that pays for every time you see a doctor. Those plans are things of the past unless you want to pay a much, much higher premium. Insurance companies have scuttled those plans, they are not paying to cover services for us anymore, they are just negotiating our payment down for being insured and covering us in the event of a catastrophic medical event. And even that is not guaranteed, although Obama's health care reform has taken some steps toward that with the removal of lifetime limits, pre-existing conditions, etc. I hope since you don't like the insurance company's offerings that you were a supporter of universal national health care, which would have been the best health care reform for the people of our country.

[fighttheevilempire]

15. $700+ a year for worthless coverage is"what I need?"

Really? I drive a 13 year old car with over 168,000 miles because it's all I can afford. I dont have anything left over the way it is. I'd have foregone insurance long ago if I were faced with the costs I'm reading in some of the replies in this initial post. I don't own anything of any value like a house, so they really can't take anything from me. And if I do get really sick like with cancer, I'd lose my ability to work and my coverage. What then? Sounds like the Winchester health care plan for me then, lol.

[NEOhiodemocrat]

17. as I said, what you need is Universal health care

this may be the cheapest and best you can get without that option.

[Statistical]

18. Couple points

1) having any insurance gets you insurance prices. Cash cost for health care is often 2x to 3x the price you pay w/ insurance. So $120 w/ insurance vs $360 wihtout insurance. $900 emergency room vist w/ insurance vs $2700, $3500, $5000 without it. So having any insurance has some value.

2) While you may not have any value. They can seek a judgement and that stays with you for 10 years. You might not have any value today but you might in 10 years.

3) If you lose your job you can stay on COBRA. Now it might not be worth it but for example if you had cancer paying the $70 a month might get you $70,000 worth of coverage.

Just some things to think about. I pay $500 a year in car insurance and haven't had an accident is 7 years. I still consider it "worth it". Long run I likely will never receive benefits greater than premiums & decuctible but it provides protection against financial uncertainty.

Still 2011, 2012, 2013 you still have options. Starting in 2014 the penalty would likely be more than your premiums.

[Barack_America]

16. Still not being able to afford health coverage despite "reform"?

And actually less able to afford it because of the "reform".

Not to speak for the OP, but a $1300 deductible is nothing to sneeze at, particularly when you're young and not getting paid as highly.

[uncommon]

10. Ha, my plan is $240/month and has a $3K deductible.

Your situation still sucks but it could be a lot worse. My plan covers only me and I am the very picture of youth and health lol.

[sweetapogee]

11. hard to tell

Putting the law aside for a minute, insurance in general is what it is. If you don't need it, it seems like a waste of money. One trip to the ER and it is no longer a waste.

I run with my local volunteer fire company as a firefighter/EMT. Although we are a rural area, we have several high volume highways in our district. People do crash their cars and it's never planned or predictable. It is sad when a seriously injured patient tries to decline an ambulance ride to the ER because they don't have insurance. Even with insurance, the inconvenience is an issue with some but an accident where your paid off car (with no collision insurance) and HC bills can impact you in the wallet for years.

These are just my thoughts. If you drop your HC, you may have to wait for an open enrollment period to get back on and you may become sick in the meantime. You have a tough decision to make and I wish you good luck and wisdom.

[uncommon]

14. One trip to the ER when you have a deductible over $1,000 and it is absolutely still a waste.

For those with low or no deductibles, health insurance can be great. For those of us with $1,000 $3,000 or higher deductibles, we are only going to see a benefit when something really really horrible happens to us.

I pay $2,880 per year for my insurance. My employers pays the other $2,880. That's a $5,760 a year policy with a $3,000 yearly deductible. It's a ripoff unless I get cancer or get in a life threatening car accident or something.

I would much rather pay $2,000 in taxes to go to universal healthcare and be able to walk into a hospital or doctor's office without seeing a bill. These health insurance companies need to get out of the picture immediately. They are lining their pockets on our misfortune.

[treestar]

13. One serious illness or trip to the ER and you more than "break even"

Besides, the concept of insurance is that we all pay into it and hope NOT to have to use it. It's there "in case."

I've paid health insurance premiums for years and never had to "use" it. I hope NOT to have to use it. I've been lucky. Not going to cry about having pretty good health. It's there in case of accident or illness, so I won't owe tens of thousands of dollars in that event.

[Hekate]

44. I guess the OP just "knows" no one will ever T-bone his car while he's driving it

My son did a face-plant on a rock in a bicycle accident when he was 16 years old. The bills from Blue Cross were easily in excess of $125,000 before all the plastic surgery, hospitalizations, dentistry, and neurological exams were done. We ended up being some hundreds of dollars out of pocket, but my God, if it hadn't been for my husband's work-related health insurance we would have been ruined. I can't give you exact figures because I was in such shock I could barely function, and my husband handled all of the many negotiations and kept track of everything...

The OP is whining like a foolish child.

Hekate

[NNN0LHI]

19. My 28 year old niece(my favorite niece) was diagnosed with MS a few years ago

She was young and healthy too. Last week she had to have surgery to remove blockages in her neck veins. Never smoked and hardly ever drank. Exercised a lot and ate good. She still came down with MS.

I am not sure what her bill for all her care has been but I bet its been a lot. Having insurance is the only thing that has kept her out of bankruptcy. That I do know because she told me so.

Don

[shraby]

20. How in the hell are you getting insurance for $52 per month?

It costs more than that for Medicare part B. Consider yourself lucky. Even my policy that only covers 20% that Medicare doesn't cover is higher than that per month.

[Statistical]

21. It is called being young....

A 30yr old male in Virginia can get....

HDHP plan w/ $2500 annual deductible and then 100% coverage (0% coinsurance) for only $47 per month.

Note thing is private individual insurance w/ no benefit or cost reduction from employer based plan.

http://www.ehealthinsurance.com/ehi/ifp/plan-details?planKey=22116700:11

[uncommon]

26. I'm 29 and pay more than that per week.

[Statistical]

31. Then maybe you should switch.

Of course you may also have better coverage.

Like saying a BMW has higher payments than a KIA.

[uncommon]

35. Well I have a total of a $480 per month premium with a $3,000 deductible.

My copays are low but that just tides me over until I get the bill. I get decent prescription coverage and my OB/GYN visit this year was covered other than the copay.

But regular doctor visits and ER fall under the deductible.

[uncommon]

36. Maybe I should switch??

This is the insurance plan offered by my employer. Should I venture out on my own so I can pay the entire premium instead of half? Hardly seems wise.

[Statistical]

40. Remember your employers plan is the average for all employees.

So if your employer has large number of older workers, or higher than average number of claims the per employee price can be higher.

All that matters is level of coverage and price. There isn't anything magical that makes employer based coverage better. It is possible that in your specific situation private insurance could be cheaper than employer based insurance.

If it were me and I was paying $400+ per month for plan w/ $3K deductible I would take $50 per month private plan and put $350+ into my HSA (same out of pocket expense but build up a nest egg).


Note I am NOT recommending that you (or anyone else switch) rather that you should look at your options and make your own informed decision.

[Gaedel]

22. Medicare Part B

I fell that an expansion of medicare into a single-payer system is the way to go.

However, that being said, if everybody on DU had to pay Medicare Part B premiums per person with the deductible and co-pays of Medicare, a lot of them would be screaming bloody murder. Check into it what it costs for Medicare Part B.

[shraby]

25. I have Medicare Part B. Less than a hundred a month, and

I pay 160.00 for a policy that covers everything that Medicare part B doesn't..absolutely everything except medicine. That I carry Part D for.

[HughMoran]

24. I pay $900/month

PPO with $1500 deductible. :shrug:

[spin]

27. Self delete. Replied to wrong post.

[HughMoran]

28. Don't know, but I'd be happy to form a citizen's posse to take over these places

I've had enough and am ready to revolt.

[spin]

30. I actually wanted to reply to the OP ...

but thanks for the reply.

I think Obama had good intentions but he allowed Harry Reid and Nancy Pelosi to push the healthcare bill through Congress.

We were sold out.

[spin]

29. RIDDLE ME THIS, why should our insurance cost be increasing ...

We already have the most expensive healthcare in the world.

Slowing the Growth of Health Care Costs — Learning from International Experience

Karen Davis, Ph.D. N Engl J Med 2008; 359:1751-1755October 23, 2008

High health care expenditures and the growing number of people without health insurance set the United States apart from all other industrialized countries. The United States spends twice per capita what other major industrialized countries spend on health care1,2 but is the only one that fails to provide near-universal health insurance coverage. We also fail to achieve health outcomes as good, or value for health spending as high, as what is achieved in other countries (see graphsHealth Expenditures per Capita (Panel A), Rates of Deaths That Could Be Averted through Medical Care (Panel B), and Rates of Infant Deaths (Panel C) in Selected Industrialized Countries.).

The United States has been slow to learn from countries that have systematically adopted policies that curtail spending and enhance value. Chief among these are mechanisms for assessing the comparative cost-effectiveness of drugs, devices, diagnostic tests, and treatment procedures; implementation of information technology, including electronic repositories of patient medical information, across sites of care; easy access to primary care, including organized systems of off-hours care; a strong role for government in negotiating payment for care; and payment systems that reward preventive care, management of chronic conditions, care coordination, and health outcomes rather than volume of services.

No single silver bullet will transform the U.S. health care system, but a series of coordinated policy changes has the potential to substantially bend the curve of projected health care spending.4 Recent estimates prepared for the Commonwealth Fund Commission on a High Performance Health System indicate that $1.5 trillion could be saved over a 10-year period if a combination of options, including universal health insurance, was adopted. These options were specifically designed for the U.S. health care system and would preserve its mixed private–public system of financing rather than being contingent on the adoption of a single-payer system.
http://www.nejm.org/doi/full/10.1056/NEJMp0805261

[Jamastiene]

45. I wish your post was an OP

so more people could see it. I would like to know the answer as well.

[BlueDemKev]

32. Even a mild ailment

...even a mild ailment like a kidney stone attack or a hairline bone fracture will result in medical expenses which will DWARF the cost of your new coverage. Your entire annual premium (weekly rate you mentioned x 52 weeks has only gone up $150 (for the entire year). What percentage will your insurance company pay after you meet the $1,300 deductible? If it's 80% or above, you definitely should sign up (if this plan is your only option).

Finally, I'm just curious....how many employees work at your company?

[MissB]

33. You have a good deal.

Seriously. The $10/week or $13/week is dirt cheap. The HSA will be there until you need it. You might not see the need, but it's a pre-tax set aside for you to tap when you need it (and there are different kinds of accounts - health care savings vs health care reimbursements. Generally when an employer is providing you free money for setting up an HSA, they're offering you the kind of account that doesn't have to be burnt through each year). When you need it = when you're 65 and trying to pay for medicines for your chronic conditions.

As others have pointed out, one bad illness or accident can wipe you out financially.

Beyond that - being insured now means that you can't be denied coverage later. Guess what? You'll get older. Unless you're a vegan who runs 100 miles per week, chances are pretty good that you'll develop the same ailments that the 50-60 year old age group develops. Even if you're a 100-miler/week vegan, you may suddenly develop a chronic condition. It's hard to see that when you're young and healthy, but all of us age.

My husband found out he had Ankylosing Spondylitis at age 34. Nothing he did caused it - and it's a damn young age to end up with a form of arthritis in ones back. If he was diagnosed with the condition at a time when he was uninsured, then any insurance is going to deny him insurance because of an existing condition.

(Reforms to health insurance includes removal of existing conditions, but I bet it doesn't say anything about the ability to charge those folks more!)

[wisteria]

34. Doesn't sound like much of a deal does it?

I can't wait to see what happens with our benefits. It seems these high deductibles are going to become quite common. And, this is not going to be good for Democrats to try and explain. But, you need medical insurance-without it, you are one unforeseen catastrophe away from total ruin.

[northzax]

38. and this is the fault of Democrats, why?

it's the inevitable result of the long term structural collapse of the for profit health care market. as 'insurance' companies take more and more money out of the market, they are going to charge more for less. and people will pay it because the alternative is so terrible, and because they don't really pay attention to what they are buying. people don't realize that insurance companies aren't actually in it for the care, they're in it for the money. used to be places like Blue Cross/Blue Shield, as non-profits, had a primary mission of paying for health care. now the for profit ones have a primary mission of making their shareholders money.

[BlueDemKev]

39. Here's the "explanation", which is the simple truth

Health insurance may cost a bit more right now, but this is largely because of our expanding senior citizen population. But yes, it is also because policy rescissions for anyone have been outlawed (as of 9/23/10) as have lifetime maximum caps on a person's insurance policy. In a little over three (3) years from now, adults will no longer have to worry about being denied coverage if you are currently sick or have previously been sick. With more people visiting the doctor for preventative care (which is often passed up by those who don't have insurance), ailments can be caught sooner and nipped in the bud before they become major illnesses which send medical costs skyrocketing...(for the patient, the insurance companies, and the taxpayers). Eventually, the new law will bring down the overall cost of health care, although not as quickly as everyone hopes it will.

[SoCalDem]

37. The employer may WANT a significant percentage of the employees to drop coverage

That might just open the door for them to halt coverage completely and just pay whatever fine is associated with not covering employees.. It's bound to be an "easier" option for them....no muss no fuss..just a straightforward fine, and they may be able to wiggle out of that if they can prove that they "offered" a plan but not enough people opted in.

[TBF]

41. $13/week? We pay over $1,000 month and that's before the

deductibles and co-pays. I've got arthritis and we are middle-aged with children. I remember when I was your age and my employer's coverage was free (not family coverage though - that always cost a bit more).

The only answer is universal health care, but for now my advice is to take the plan. Sometimes illness comes out of the blue (like my arthritis in my 40's), and accidents happen. I'd hate to see you get hit with major medical bills while you still have those student loans to pay back.

Good luck to you.

[grahamhgreen]

42. keep fighting for medicare for all - its the only real choice

[Hekate]

43. $13/week? Are you joking? Count your blessings.