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2 Bumps

Health Insurance HELP!

Today SO went to a meeting for work & they informed him that they changed his insurance plan from a PPO to an HRA (heck if I know exactly what that means). Now we pay our weekly whatever for the insurance but this new company will only pay after we have reached $1,500 for the year! Meaning we pay out of pocket on EVERYTHING scripts, appointments, ER you name it but once we reach $1,500 they start to pay for everything!

Now the good part of this is his company has set up accounts with each employee & given us $1,000 to use towards this so after its all said & done we only pay $500 out of pocket. We still feel like this dosent seem/sound right! Granted the weekly rate went down by a few bucks but um still I'm not sure how this makes a lot of sense!?

I dont know I just feel like we are being taken for a ride ya know? We were thinking maybe we could get something cheaper if we dont go through the company? SO dosent really think so b/c he is in a group rate with a bunch of other people so we wouldnt get that discount. But what if we dont have the cash on us & our daughter has to go to the doctors? We are working on saving etc but the point of having it taken out of our weekly paycheck is to not worry about it to not have to make appointments around other bills to be paid!

I'm ripped, what do you think of all this? Is this how your insurance operates? Does this sound right/good to you? I just feel like they arent doing their job right or something (BTW nothing we can do about it world wide company & a few complaints from us wont do anything).

 
Mel30248

Asked by Mel30248 at 3:45 PM on Apr. 5, 2011 in Health

Level 26 (25,898 Credits)
This question is closed.
Answers (15)
  • Well that sounds like you have a $1500 deductable. How much are your co-pays? My dhs work insurance was almost $700 a month for family coverage with a $1200 deductable and $30 co-pays. We went with a company that costs $400 a month no deductable and no co-pays. It's still pretty new but so far so good. You might want to shop around. But whatever you do, DO NOT talk to a broker talk to someone who actually works for the company. A broker will charge you higher rates because thats how he gets paid. Just some words of wisdom. Good Luck!
    luvmygrlz

    Answer by luvmygrlz at 3:53 PM on Apr. 5, 2011

  • Sounds like his employer is doing everything they can to keep their employees insured. I don't think it sounds so bad at all, many employers have had to cancel that benefit.
    meooma

    Answer by meooma at 3:48 PM on Apr. 5, 2011

  • Sounds like you have a good health plan, my hubby has to pay $4,000 (out of his pocket to have ins thru work) and our ins won't pay ANYTHING until we pay the $4,000 deductible! So we end up paying $8,000/yr for crap ins that does not cover very much!
    Anonymous

    Answer by Anonymous at 3:52 PM on Apr. 5, 2011

  • His company is #2 in the world for what they do, they have unimaginable amounts of money & just throw it around. Giving us decent health insurance isnt going to hurt! Our old plan just wasnt like this so making such a switch has made well everyone upset but again with such a huge company & so many employees we can make all the noise we want but wont get heard in the end on this subject. Just want the old plan back thats all!!!!!
    Mel30248

    Comment by Mel30248 (original poster) at 3:52 PM on Apr. 5, 2011

  • we have to pay 5000 out of pocket before they cover expenses, but there are restrictions, like a 30 copay for dr visits, but that's about it. I'd love to have the plan that you are on!
    bdflykisses

    Answer by bdflykisses at 3:52 PM on Apr. 5, 2011

  • Anon wow that is insane! For that much I wouldnt even pay to have it! Just go without seriously! I know though incase something big happens & once your sick health insurance wont take you on yadda yadda yadda..... makes sense but it dosent at the same time!
    Mel30248

    Comment by Mel30248 (original poster) at 3:54 PM on Apr. 5, 2011

  • Wow you ladies sure are making me feel awful for my rant on our insurance! We didnt realize how bad it really was! We're young & well this is the first okay second time we've signed up with insurance through work so yeah had no clue that deductables were so insanely high for some of you! Seems like us people are getting robbed here. If they werent able to turn you away when if you got sick & didnt have insurance then they wouldnt be able to get away with stuff like this..... wow insane! Sorry for my rant when some of you really are paying an arm & leg for health insurance!
    Mel30248

    Comment by Mel30248 (original poster) at 3:59 PM on Apr. 5, 2011

  • We have an HRA. Sure, it seems like a lot. But thing is, in a ppo, you have copays on everything. Dr here, scrip there, etc. Not in a hrs. Our family deductible is $5000, and my mom WORKS for the ins co. They pay the first $1500, which means we only have to pay $3500 before they start paying.

    Example: I went to my physician for pain. After extensive bloodwork, he referred me to a neurologist, who diagnosed me, gave me medication, and referred me to a rheumatologist. My brother had warts removed after wrestling season, my sister was treated for allergies, and our deductible has been met for the year. However, I have a breast reduction surgery coming up soon, and instead of paying a ppo's $1500 deductible and 20-25% of the charges, I only have to come up with 15% until we reach an out-of-pocket amount of $10,000 when they will then pay 100%. What this means is the most my family will spend in a year is $8500 for healthcare.
    matobe

    Answer by matobe at 4:02 PM on Apr. 5, 2011

  • Anon wow that is insane! For that much I wouldnt even pay to have it! Just go without seriously! I know though incase something big happens & once your sick health insurance wont take you on yadda yadda yadda..... makes sense but it dosent at the same time!
    ************************
    I WISH we could cancel, but we have 3 kids and going w/o insurance is NOT an option! Ahh the joys of being a responsible adult and parent.....
    Anonymous

    Answer by Anonymous at 4:04 PM on Apr. 5, 2011

  • Anon - joys is right! We are in the same boat obviously we need something for our daughter, the state has buckled down hard on people getting insurance through them (not that I think its an option anymore things have changed with SO's job majorly this year), & we cant go without on her so we must pay...... I really didnt realize though that rates are so much higher then what we are paying so now I feel bad to whine about our situation b/c it did sound high until you ladies let us know what your paying!
    Mel30248

    Comment by Mel30248 (original poster) at 4:11 PM on Apr. 5, 2011