Hopefully, a non-political Health Insurance question

[Mr Blotto]

OK - I told myself that I would not post up in Free Speech anymore (cause I just don't enjoy the vibe in here sometimes, and I am NOT confrontational by nature), but I have been asking around and have not found any good answers to my question (and perhaps I am too lazy to do some hard-core research). So alas, here I go....

From what I can tell, the major health care companies (Aetna, Blue Cross Blue Shield, United Healthcare, etc) catagorize plans as (1) Single, (2) Couple and (3) Family coverage. My issue is with the "Family" coverage, becuase you pay the same if you have 1 child or 8 children. How is that fair to the people who have just one or two kids? The difference between "Single+Dependent" or "Couple", and "Family" coverage is HUGE (like 300-500%) to compensate for the fluctuations in family size.

With the cost of healthcare skyrocketing this year (our rates with Blue Cross Blue Shield of Illinois went up 37% - I will not get into why), I get a little ticked that I (family of 3) have to pay the same amount as a family of 4,5,6,7,8 etc.

This is nothing against you folks with large families (OK do think the Duggars are a bit nuts ) - I just think that we all should be paying based on the number of dependants we actually have rather than a "one-size-fits-all" approach.

Tawk amongst yourselves...

[RussellK]

My individual plan covers each family member separately. So within the plan when the monthly bill comes each member is listed with the corresponding cost as determined by age and rating.

Group plans rate differently from individual plans and while I see your point it would be a short leap from charging for more family members to charging more for members with medical conditions and that would defeat the purpose of having a group.

[vdubyah73]

good point. Just thinking out loud here. What if they did that and you have a tight budget with the cost of a 3 member family figured into it. Then you and your wife have an unplanned moment? Ruh roh scoobie your insurance cost could double with the new comer. Spread the pain I guess.

[RussellK]

If its a company plan you might be able to opt out of the family coverage and go individual on your wife and child. My wife has an employer provided plan but its more economical to cover the kids and me on an individual plan and stay off hers.

[Sylvester]

I did not know there was a choice, single for each family member, or group for all. I never asked.

[RussellK]

Where my wife works they cover her in group coverage as a benefit and will add the rest of us in and deduct that additional cost from her paycheck. It was a cheaper for us to go out and buy our individual coverage in the market. I was really surprised by this.

[Mr Blotto]

If its a company plan you might be able to opt out of the family coverage and go individual on your wife and child. My wife has an employer provided plan but its more economical to cover the kids and me on an individual plan and stay off hers.

We checked into that, and yes it is significantly cheaper, but the deductables for the individual (non-group) plan was really high. I am a conservative thinker in terms of financial risk, and can't justify the risk.

The minute we go on that high deductable plan is when someone (god forbid) gets sick...

[RussellK]

If its a company plan you might be able to opt out of the family coverage and go individual on your wife and child. My wife has an employer provided plan but its more economical to cover the kids and me on an individual plan and stay off hers.

We checked into that, and yes it is significantly cheaper, but the deductables for the individual (non-group) plan was really high. I am a conservative thinker in terms of financial risk, and can't justify the risk.

The minute we go on that high deductable plan is when someone (god forbid) gets sick...

Oh Yeah. We massaged the numbers every way we could. Higher deductible lower premium vs Higher premium lower deductible and no matter which way we sliced it there was no clear cut answer. The insurers have got this figured out so it goes their way. We finally rolled the dice and picked a $2500 plan. Its not too terrible. Pharmacy benefits, office visits and labs aren't affected by the deductible. Procedures and emergency room visits hit up against the deductible and that hurts.

[zblair]

My soon-to-be-nonexistent employer has a high-deductible plan in place and I have experienced what Russ outlined with the exception of an HRA - Health Reimbursement Account tied to a debit card that my employer deposits 166.67/mo into which if not touched, covered the annual deductible and carried over to the next year. That HRA became rather valuable last spring when Jeffrey's insurance did not cover much of his double-hernia surgery expenses, but my HRA account did.

Problem is now we are facing my medical expenses with very little in that account, so while my spending is counting against the UCR (Usual, customary and reasonable) charges placed against my deductible, I still haven't hit 2500. yet due to delayed billing so every time something comes up (which has happened 3 times now) we pay out of pocket. Cobra through my present health insurance provider will cost us slightly over 300./mo which is a far sight cheaper than if I go on J's insurance - it's 500. and change a month with fewer provisions.

What we can hope for is that we both experience better health (I'm actively working on that) and that I find a job soon that will have health coverage so that there won't be much of a monetary lapse between Feb. 15th and the unknown.