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View Full Version : OT: Q for anyone who knows about Health Care Coverage


nadja la claire
04-22-2007, 06:16 PM
My COBRA coverage ended in Feb. I've signed up for Aetna Advantage because I thought I was going to get good coverage and same some money. Well I'm going to get good coverage but unfortunately I'm not going to save a dime, instead of paying $312/month, which is the base premium, I have to pay $468/month because I had a minor case of vertigo in Dec. I don't know what to do. The letter they sent me sounded like they were just looking for any little thing to up the premiums. Can anyone suggest something? Maybe another carrier? If I have to I'll pay the higher premium but it'll be tough. Some of my friends have said to just forget about the coverage because I'm healthy and that it's not worth it, but after seeing what's happened with my DH (thank God he has good health care) I'm just not going to tempt fate.

BTW does anyone know of any good Medicare supplements?

Thanks all

:muah: :hug:

Nadja xxx

stitchwitch
04-22-2007, 07:16 PM
If you aren't big into frequent doctor visits you may want to look into a Health Savings Account (HSA). It is combined with a high deductible health plan and whatever you put into the HSA is yours when you retire to do whatever you want with. You can take withdrawals from your HSA for medical related expenses only(eye glasses, doctor visits, meds, etc.) without penalty and your contributions into it are tax deductible. I have one because my husband is self employed. Our deductible for both of us is $5660 (I know, really high but that's for family you by yourself would be lower) but our premiums are really low. Once we pay the deductible our health coverage is 100% so no copay, coinsurance. For us it works out great, we put enough in the HSA to cover the deductible if one of us needs serious care and for the rest of the stuff (obgyn, etc.) we just pay out of the HSA. It does require some discipline though to keep putting away money into the HSA for your doctor visits and stuff but at least you wouldn't be paying a high premium for insurance if you aren't a frequent doctor visitor.

zkimom
04-22-2007, 07:41 PM
Am I the only one who thinks the HSA is the biggest sham ever foisted on the American Public? The deductibles are high, you still pay a premium, and you have to put your own money into the HSA. Then you get to use your money for your health care until you meet your deductible. Ok, so there is a tax advantage but you have to have used the money in your HSA in order to get any of it. What about those in this country who can't afford to set aside that kind of money just to pay medical bills plus pay their premiums?

I'm sorry but insurance in this country is a huge scam designed to profit only the insurance companies. And yes, Nadja, you are right -- they are set up to find any loopholes they can to avoid covering you and they look for every reason to raise your premiums. Until there is universal health care in this country, most of us are pouring our money down the drain and then paying out of pocket for our health care anyway.

Ok, off my soapbox.

Susan

nadja la claire
04-22-2007, 07:50 PM
Who's your carrier? Aetna and Blue Cross, Blue Shield PA, have HSA's but they don't cover much and they're expensive.



:muah: :hug:

Nadja xxx

Jan in CA
04-22-2007, 07:53 PM
First of all do NOT go w/o health coverage if there is any way you can afford it. My daughter's ex husband fell skiing and broke his neck and back and he was between coverage. Ouch. (He's fine now btw) Insurance may be a huge scam, but we can't do w/o it.

We have health coverage through PERS (public employee's retirement system) here in CA and we also have to pay a huge amount. We have Blue Shield Access Plus HMO now and I think the whole thing is about $900, but we pay about $500 of that. No deductible thank goodness, but we are retired so that is a huge chunk of our fixed income. :doh: I don't know the answer, but an HMO might be cheaper if you can find it. I've heard ehealthinsurance (http://www.ehealthinsurance.com/) is a good place to start, but I haven't used it so I'm not sure. I think if I went with the lowest bidder I'd be afraid that you'd end up with one of those companies that dump you after one claim. :shock:

You might check consumer affairs and the better business bureau..or something like that if you are doing research.

nadja la claire
04-22-2007, 07:58 PM
Am I the only one who thinks the HSA is the biggest sham ever foisted on the American Public? The deductibles are high, you still pay a premium, and you have to put your own money into the HSA. Then you get to use your money for your health care until you meet your deductible. Ok, so there is a tax advantage but you have to have used the money in your HSA in order to get any of it. What about those in this country who can't afford to set aside that kind of money just to pay medical bills plus pay their premiums?

I'm sorry but insurance in this country is a huge scam designed to profit only the insurance companies. And yes, Nadja, you are right -- they are set up to find any loopholes they can to avoid covering you and they look for every reason to raise your premiums. Until there is universal health care in this country, most of us are pouring our money down the drain and then paying out of pocket for our health care anyway.

Ok, off my soapbox.

Susan

I would love to see some kind of universal health care. I mean our millionaire elected officials from the prez on down get health care paid for by us, just because they're "federal employees". I don't know if I'd like to see the government in the health care business but something has to be done.

:muah: :hug:

Nadja xxx

nadja la claire
04-22-2007, 08:02 PM
First of all do NOT go w/o health coverage if there is any way you can afford it. My daughter's ex husband fell skiing and broke his neck and back and he was between coverage. Ouch. (He's fine now btw) Insurance may be a huge scam, but we can't do w/o it.

We have health coverage through PERS (public employee's retirement system) here in CA and we also have to pay a huge amount. We have Blue Shield Access Plus HMO now and I think the whole thing is about $900, but we pay about $500 of that. No deductible thank goodness, but we are retired so that is a huge chunk of our fixed income. :doh: I don't know the answer, but an HMO might be cheaper if you can find it. I've heard ehealthinsurance (http://www.ehealthinsurance.com/) is a good place to start, but I haven't used it so I'm not sure. I think if I went with the lowest bidder I'd be afraid that you'd end up with one of those companies that dump you after one claim. :shock:

You might check consumer affairs and the better business bureau..or something like that if you are doing research.

Trust me I have no intention of going w/o coverage. I know anything can happen. The one thing that really makes me mad about the coverage that I have now is that even though I'm paying $468/month I can't get sick for a year because they won't cover it.

Thanks for the link.

:muah: :hug:

Nadja xxx

brendajos
04-22-2007, 08:12 PM
The HSA doesn't really have much relation to the insurance itself beyond being made for people with high deductible insurance. I mean they pay for what the insurance doesn't of course but it isn't that much different than an FSA except you don't automatically lose your money if you lose your job for one reason or another or at the end of the year.

That being said, yes they are all bad. I have Aetna through work and it is fairly horrible and I pay way more than I think I should for cwappy insurance.

Unfortunately, just about all insurance you are going to go solo on is bad. They are pretty much able to disallow anything they want to. If you can do anything to get on a group policy, that is the way to go.

Sorry I don't have better answers for you. Insurance is an evil thing (and I used to make my money in that industry! :teehee:

nadja la claire
04-23-2007, 06:02 PM
I was able to get on a conversion plan after my COBRA ran out. You might want to ask your old insurance company if they have something similar. It was not quite as good as my previous plan, but pretty close -- it didn't include mental health, but my regular doctor was able to write my AD scripts for me so it really didn't matter. The Rx copay went up a little too, but not significantly. (The conversion plan actually cost a little less than the COBRA so that made up for it.) My premium had just been raised to about $300 before I switched to a new plan through my employer in February. I was sad to let go of it because the new coverage isn't nearly as good, even though my employer is paying more for it. (My annual exam and labs used to be completely covered, but now I will have a copay, and I will have to pay a higher percentage for other services.)

If you are having difficulty getting affordable coverage because of a preexisting condition (vertigo, maybe?), you might want to see whether your state has a high risk pool plan (http://www.cahi.org/cahi_contents/consumerinfo/whodoIcontact.asp). People also recommend looking for a group plan through professional associations and such, but I'm not sure you'd get a better rate. Might be worth looking into, though.

Oh yeah. You probably already know about this, but you can get a tax deduction if your medical expenses exceed 7.5% of your AGI. Self-employed folks can also get a deduction. (Just a couple things that might make the bite a little more bearable...)

I was going to do the conversion but it didn't cover RX or optical and I'm not willing to do without RX coverage. Thanks for the link.

:muah: :hug:

Nadja xxx