Behind the scenes, the GRS elves and I have been working to streamline the process for submitting reader stories, guest posts, and financial questions. As part of this, I've been reading through every question submitted over the past year. I've noticed some patterns.
One topic I'm seeing over and over again is health insurance. We've explored health insurance a few times in the past, but we don't do so often. For one, it's complicated. For another, it's boring. But even boring, complicated subjects deserve their day in the sun, right?
Over the next few months, I hope to explore health insurance in a little more detail. Today, though, I thought it would be useful (and informative) to do an informal survey. Today, I want to know: How much do you spend on health insurance?
More specifically:
- Where do you get your health insurance coverage? From an employer? From the government of the country where you live?
- What sort of coverage do you have? Do you wish you had more? Less? What are the pros and cons of your coverage?
- How much do you pay per month? Do you know how much your employer pays? What sorts of co-payments do you have?
I'm especially interested to hear from those who have picked up health insurance on their own. What do you do if you're self-employed and don't have access to an employer-sponsored plan? (This is a common question in my inbox, and I know many people are looking for an answer.)
Please note that I don't want this to turn into a debate over socialized medicine. There's no need. Instead, this is a chance for folks to compare their situation with others. (Previously, we've conducted similar surveys for spending on food, clothes, and gifts.) Now it's time to share: How much do you spend on health insurance? What kind of coverage do you have, and where do you get it?
Author: J.D. Roth
In 2006, J.D. founded Get Rich Slowly to document his quest to get out of debt. Over time, he learned how to save and how to invest. Today, he's managed to reach early retirement! He wants to help you master your money — and your life. No scams. No gimmicks. Just smart money advice to help you reach your goals.
Interesting post, looking forward to seeing the answers! I’m Canadian so I have health insurance from the Ontario provincial government. It covers basic care, emergencies and most of the things I need. I currently don’t pay directly for the coverage as I consider low income as a university student, but support it indirectly through taxes. As my income increases, I’ll pay a health premium based on my income level. Pros, I don’t have to worry about ever not being able to afford medical treatment or how I would pay for an emergency. Cons, unfortunately the Canadian system is struggling with wait times for procedures and it can be difficult to find a primary care physician in some areas.
An aspect of the Canadian health care system that I don’t often see discussed, and that much more closely resembles the US health insurance market, is catastrophic drug coverage.
Drugs are a major exception to the health care system here in Canada. Although your doctor’s visits, specialists’ visits, etc. are covered, drugs are not normally covered. A patchwork of different plans, private, provincial and federal, are used to cover catastrophic drug coverage (in my case, 20k a year for a single, patent-protected drug, although I’m lucky because the cost could be much higher).
In my case, given all that I had heard about people being bankrupted by catastrophic drug costs, I was surprised to learn that my private insurance actually improves for catastrophic drug coverage. While 80% of my drug costs are covered normally, once I reach over 3000$ in claims in a year, my coverage actually *increases* to 100%.
Apparently about 60% of Canadians are covered by such private plans, and the rest is made up of provincial and federal coverage, or none at all: http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0906-e.htm
One thing I am very aware of for my own health insurance is that my insurer has put out a warning letter in recent years. If the costs of drugs continues to skyrocket (and apparently 21% of *total* drug costs are for the same five rheumatoid arthritis medications, each at least 20k per year), then they will review the eligibility of those big 5 drugs for future years.
As such, one of our line budget items right now is a small charge to ourselves for my drug costs. Hopefully, if we can build up a small “nest egg” now, the financial pain will be less severe if we get hit with the catastrophic drug costs down the road. No matter how solid our finances now, I think a 20-30k line item in the annual budget will be tough to swallow. That’s (considerably) more than our mortgage.
I’m a Canadian as well, and I definitely agree with your assessment of our system. While I do appreciate some of the advantages our system has over the one in the USA, I would like to experiment with a two-tier system that would take the strain off of the public sector a little.
Drug reform isn’t big on government’s today list, because all government employees and the their families have great drug plans that usually pay for 90% of the cost (this is what I get as a teacher, and what my parents go because my mom was a nurse – even though dad had his own company).
That’s something people overlook far too much in Canada. While our basic health care costs are paid for by the government (by way of our taxes), not everything is covered.
A short list of what we have to pay out of pocket or through our own insurance: the costs of prescription drugs, dental work, chiropractic/RMT/accupuncture, depending on the circumstances you have to pay for non-MD specialists (registered dietitians, psychological care).
Basically, taxes pay for the basics – everyone has equal access to doctors and emergency care (in theory), but there is LOTS that we pay for ourselves.
Here in BC (can’t speak for other provinces) I believe that what you’ve stated about catastrophic drug coverage is partially inaccurate. My understanding is that these kinds of high costs drugs may be covered through the PharmaCare* program, if your doctor follows a set procedure before prescribing them. The procedure basically entails requiring you to try pretty much entails you having to try all of the other drugs that might effect your condition first.
*PharmaCare covers prescription drug costs for BC residents once they have claims over a certain amount in a year. The amount seems to be somewhere between $1500 to $3000 per year, but it depends on income level. However, PharmaCare doesn’t cover all drugs, including some of these crazy biological drugs that cost in the $10s of thousands of dollars.
I’m Canadian too, Cass. Hospital /Surgical wait times are long here, you’re so right. Without going into all the reasons why that may be, the other side of that coin is that if you present with an emergency (broken bone, car accident and multiple broken bones and internal injuries, ruptured spleen/appendix)… you’re dealt with immediately and your hospital stay is covered.
What a relief that was for me when I spent three nights in hospital for an accident. It would have been a terrible burden financially, otherwise. No idea what it would have cost: ambulance, surgeon, drugs, nursing care for 3 nights…
Aside: have supplemental health & dental (and limited eye care) coverage through my husband’s place of work. That covers 90% of non-emergency, non-hospital-given prescription drugs, for instance. His firm offers a choice of 3 or 4 tiers of coverage, at 3 or 4 tiers of cost.
Canadian here too.
It’s hard to quantify what I pay for health insurance. A rough estimate of what I pay in income tax here versus what I would pay in an average US tax state might work? I think our level of government services are comparable apart from health care being paid for in Canada.
In Ontario we have a “Health Care Premium” tax levy on top of income taxes as well. According to a tax calculator my marginal rate on my annual income is 43.41%. In Ohio it would be 33.74%. So roughly ~10% of my gross income is spent on health insurance if we agree the primary difference in tax rates is due to health coverage (certainly debatable).
I think as a healthy 30 something non-smoker I’m probably paying more (subsidizing others more) than I would if I had a private policy in the US (especially through an employer).
In the end, if your employment is stable and provides health insurance you’d likely rather be in the US since the hospitals are just plain better by and large (Read that MacLean’s article that lambasts the current state of our health care/hospitals, it’s not just my opinion). But for eveyrone else, it’s better to be here in Canada.
Anecdotally I had lithotripsy last year in Toronto, and while the procedure was expensive and covered, the hospital was dirty, run down, the staff (outside of doctors) were not exactly happy to be there or knowledgeable. Mold, cracked tiles, urine puddles, etc. I really really wanted to be home ASAP.
Contrast that, my sister had her baby in a brand new Texas hospital last year, and it was astonishing. The hospital was clean and beautiful, the staff were chipper and sweet and her room looked like a luxury hotel suite. My sister is not rich either, and has just a basic policy not through an employer (though I don’t know how much she pays).
For a little perspective, Canada spends approximately 10.5% of its GDP on health care and the U.S. spends around 16%. The U.S. also has a much higher growth rate for its health care costs.
My employer provided plan costs $1150 and provides 85/15 split. In general health care plan premiums have increased around 8% per year for the last 10 years or so. In 2001, the health care premium was around $450.
We have a longer life expectancy too :)
I’ve been hearing bad things in the news about some Toronto hospitals lately, but that doesn’t mean they’re representative of the entire city or even the entire province. I’m sure there are run down hospitals in the U.S. just like there are clean, efficient hospitals here in Canada. (Though I suspect most hospitals in both countries are somewhere in between.)
Hospitals vary widely in both Canada and the U.S. You can’t judge all by one.(I’m Canadian as well, by the way). Ive been in some pretty nice, clean and friendly Canadian hospitals. Yes, wait times can be bad in some places, but I will never ever complain after the experience I had with my mother’s cancer fight. All my siblings and I (and our husbands) put together, could not have afforded the incredible care, treatments and end-of-life help she got. I won’t even mention the kindness of V.O.N. nurses, as I swear those people come from some higher plane of being. Amazing.
Yes, we’ do have to pay for things, and that’s fine. I’m more than willing to contribute. Its totally worth it.
Canadian, working at a University. My union negotiated a 25/75 split on our medical insurance costs. I pay:
BC Medical (basic med – doctor visits, lab tests, partial prescription costs) = $16/mo
Extended Health ($100 deductible), covers optometry fully, some drug coverage, and ‘alternative health’ (naturopath,physio, massage, nutrition) at $20-30/visit. = $11/mo
Dental Insurance, covers 85% of 2 cleanings per year and 50-85% of dental work (major/minor) = ~$12/mo.
One misconception I often see is that Americans think Canadians have “free” healthcare. Nope. But we do have an amazing safety net, in that low income people DO have free BASIC healthcare… but anyone who makes more than $22K/year pays something and over $30K/yr pays the full premium. It’s very inexpensive compared to many insurance plans in the US ($64/mo single person), but it isn’t free!
It is almost free at $64 a month compared to our $520.54 per month for family of 2 .
From an employer, family coverage (no eye or dental) at just under $500 a month.
Similar situation here. Employer-provided, no eye or dental, I pay $400 a month for family coverage and I have to pay a deductible of $1750 per year, after which I have to pay 10% of covered costs in network. My employer pays about $320 a month for the premium and contributes 1750 a year for the deductible (so the total cost is actually $700 per month with a 3500 deductible).
My wife and I have individual coverage from our employer (same company, separate coverage). Health + Eye (no dental this year) and it costs us about $50 each a month.
The plans are an HSA PPO with a moderately high deductible.
This is perfect since we’re both young and in excellent overall health. We’re amassing cash in the HSA accounts for when we really need it later in life.
I pay about $90 a month through my employer and there is a $20 copay to visit my primary care doctor, $10 copay for prescriptions. As a doctor, I just want to add PLEASE DO NOT BE CHEAP WITH YOUR HEALTH INSURANCE!! It may sound like a great idea to go for the PPO with a high deductible because it’s cheaper per month, but you will pay for that decision later a lot of the time. DO NOT GET SUCKED INTO HORRIBLE MEDICARE ADVANTAGE PLANS! They are often offering less than Medicare at only a slightly lower cost. The bad ones make money by cutting you off from care. IF YOU ARE A WOMAN UNDER 40 DO NOT CHOOSE A PLAN WITHOUT GREAT PREGNANCY COVERAGE! Please read about the provider you are choosing on insurance rating sites. When you really need it, you want health insurance that will cover almost any procedure by any doctor you choose. I have seen patients get into serious debt because they needed a surgery and their insurance covered the surgeon, but the anesthesiologist or some other provider was out of network. You cannot afford to go without good health insurance no matter how young, healthy and insurable you are unless you can afford to be crippled by debt after one bad diagnosis. One night in my ED will cost you around $800 minimum. If you are young and healthy and have to qualify for insurance on your own NOW IS THE TIME TO DO IT! Not when you actually need it! Then you will either no longer qualify or pay a huge premium. The same for disability insurance. I pay less than half of one month of my salary for disability insurance and that insures that I will not be bankrupt if I am injured.
I want to second the disability insurance! A young niece 24 was just diagnosed with a malignant brain tumor. NOBODY should go without disability insurance. Now she is without income, and cannot work for at least several months. And she will never be able to get disability insurance now. She has to move back in with her parents, not exactly much to her delight…
And don’t rely just on disability insurance from your employer, either. When the job ends, so does the insurance. You may not be able to get a policy when your job ends. Get your own policy, and never, never let it go! It is dirt cheap in your 20s.
If you’re paying too much, you should consider moving to Spain :) I have public health insurance (everything except dental), and I pay 45 euro monthly (a bit less than $60) for the whole family. Works like a charm.
I have a small S corp and being 55 now costs me $2200 a month for my wife and I. BCBS of NC.
We live in a country with socialized medicine; for this year it’s zero, because we just immigrated six months ago and haven’t had any income. My husband is about to start a new job that pays ~40K (euros), so the “social charges” (equivalent to the Social Security/Medicare/etc. taxes in the US) will come to ~6K. We have five kids, so this is a substantial savings over what we would have had to pay for COBRA in the U.S. (it would have been $1300/month over there). The cost to us is somewhat less than the social charges because those charges also cover things like our version of Social Security–but I haven’t been here long and my command of the language leaves a lot to be desired, so I don’t know what portion of the social charges actually are attributable to healthcare.
Additionally, we do pay copays just like folks with U.S. insurance, but they are pretty low (something like 6 euros for a visit to the doctor, and we’ve never paid more than 5 euros or so at the pharmacy). Still, most people here have supplementary private insurance through their employers to cover copays and things that are not reimbursed very well, like optical and dental care. If we decide to purchase this on the open market (we’re not sure yet if my husband’s employer offers it), it would be 100-200 euros/month for the entire family, depending on the level of coverage.
I have individual health coverage (high deductible health plan with an HSA) from my employer. They pay the entire premium, and contribute $500 a year to the HSA. The insurance pays nothing (just sets the rates at the same level they WOULD pay vs. self-pay) until I reach my deductible. It pays 90% in-network after deductible of $1250 and 70% out of network after deductible of $2500.
This year, I’ve probably paid $700 towards healthcare (one prescription, got blood work done once, and doctor visits every 3-4 months for renewal.) So I’ve only paid $200 myself, which is more than the amount of taxes I’ll never have to pay on my maxed HSA contributions.
So, works out pretty well as a young, relatively healthy single person with no dependents. Probably a little more inconvenient for some of my coworkers with families.
I have pretty similar coverage for my family. through my employer. My coverage (and I thought this was true of all HDHPs) includes free preventative care, so all of my 1 yr old’s regularly scheduled doctor visits and immunizations are $0 out of pocket. We each get a free physical, my wife gets a free PAP, and basic blood work is also 100% covered. So it works out OK for relatively healthy families as well.
Including vision and dental, my medical costs are about $2600 a year ($100 every other week). The best part is that my employer kicks in half the deductible to the HSA, effectively a $1500 rebate that we can use for the random prescription, sick visit or OTC medicine (with a prescription, of course), or save for the future.
We have family coverage from my employer. We pay 350 a month for health and 40 for dental. We have a $30 copay and no deductable. We also have a health savings plan.
I’m in the US, single, young and in good health with an employer that does not provide health insurance.
I use medical mutual and pay $90/month (including dental but no vision) for a high deductible plan and have an HSA with HSA Administrators that lets me invest in Vanguard funds.
I keep it primarily as disaster insurance as I rarely go to the doctor and my dentist visits are just 2 cleanings a year. I maximize the HSA portion and consider it a supplemental retirement account.
I have employer provided coverage with monthly payroll deduction of $350 including Med, dental, eye, life insurance, STD, LTD etc. hey also offer HSA program
I pay about $70 a month for a high deductible plan that only covers preventative care. So if I need to see my doctor for something other than a physical, it’s subject to deductible. Need labs, subject to deductible. Considering this is my first job in healthcare it is by far the worst insurance I have ever had in my life.
I’ve been self-employed for 15 years. Until 2 years ago, I had a medically-underwritten individual policy with CareFirst BlueCross BlueShield in Maryland. I had very good coverage, but the cost went up considerably every year. The last year that I had my individual policy I paid $400+ per month for my medical policy, and $21 per month for dental/vision.
Two years ago, my husband accepted a job at a local hospital with good coverage at a reasonable price for employees and their family. Our premiums for my husband + spouse is now $150 per month. A considerable savings. I will admit that I was hesitant to go on my husband’s policy since he previously had a history of not staying at a job very long. But, luckily for us, he’s satisfied with his present job and employer.
Having coverage through my husband’s employer has saved me a lot of money per year. Plus, my accountant recently informed me that I can deduct the expense of my portion of his premium payments on my taxes.
i have employer provided coverage for the family with a monthly payroll deduction of $260 dollars a month including medical, dental, and vision, and life insurance. I have a high deductible account based health plan with an HSA that my company pays the maintenance fee on and contributes $1000 a year. The most out of pocket I can pay in one year on a single family member is 1500 then they cover 100% or for the whole family $3000 then they cover 100%. all preventative visits are 100% covered.
Ok, you asked for it … I’m a freelancer in NYC. Nowadays, that sometimes means employers hire you “permalance,” so basically I’ve been in the same place for over 3 years but they can fire me at will (they didn’t need me for 3 months this summer) and while they’re required to offer me health insurance after X amount of days, it’s a terrible policy with something like 10k lifetime benefits. Most people I know in this situation buy insurance through the Freelancer’s Union. But I had a book published 5 years ago so could join the Author’s Guild, and can buy a plan through TEIGIT, the teacher’s and entertainer’s guild.
My plan costs me $1047 a month. I choke every time I get the bill. Over 12k a year I could have saved up to buy an apartment, or put towards retirement (because of course I’m paying for my own IRA, too).
My deductible was lowered from 1k this year to $300. I pay $25 per office visit, and about $30 per each med (about $100 a month).
I could buy a cheaper plan, for $899 per month, with a 2k deductible. But I had cancer 5 years ago and this year I’m going to have some follow-up surgery. With the cheaper plan there’s a $500 hospital admission and a co-pay up to a large amount (can’t remember the exact amount) which puts me at over the total for the more expensive plan. Also, I’d have to pay $100 for all imaging, and my experience is I need a lot of imaging. When pricing plans you really need to look at all the stuff they do and don’t pay for and total up best and worse case scenarios.
This year I’m going to look for a “real” job. Freelancing used to make sense because in theory you could make more money, but not anymore. I’m making less per day than I made in the ’90’s, with much higher out-of-pocket costs. And everyone puts their freelancers on a W2, anyways, so in the eyes of the government you’re on staff and don’t get the same tax breaks as a small biz. I want this 12k monkey off my back and am interested in what an employer would pay.
Before I had cancer, I had a cheap health insurance policy with the idea that if I got sick, I’d switch to a better plan. In NY, if you’ve been constantly insured, you can switch even with pre-existings. So that’s what I did. I was young, strong as a horse, vegetarian, racing cyclist, but when your health goes south it can do so really fast. After my initial surgery I was in the ER twice, all in the space of 10 days, on the phone trying to upgrade my insurance plan. :) And for anyone who’s never seen a bill for just one round of chemo, it’s $250k.
In a weird way, paying so much for insurance encourages me to use it more, because I figure, “hey, I’m paying through the nose, I’m going to get my money’s worth.”
I’m going to end with a plug for disability. I bought a private plan in my early 30’s for $128 a month (3 mo waiting perdiod), Mass Mutual. I once tried to cancel it but my broker talked me out of it. They paid me $3500 a month when I was sick. If I worked, they paid me a percentage if I made over X amount based on the prior year’s salary. Best buy I ever made.
Hope this isn’t too much info. I go a little nuts on the whole health insurance question. I lived in Canada for a year and still remember the letter my doc sent around at the end of the year asking for a $25 donation to help pay her office costs. That’s the only money anyone ever asked of me. Incredible.
Thanks for the plug on disability insurance. We each got policies in our 20s, and when my husband was 37 he became permanently and completely disabled with chronic fatigue syndrome. Our private policy really saved us!
I know there is a higher probability that a working adult will become disabled as opposed to dying. So I know there is a critical need for disability insurance. However, my DH (Dear Husband) is in law enforcement, most insurance companies decline to offer disability coverage for that field. I will have to do some further research to see what our options are, first step would be to maybe check with the union. His job has limited coverage.
I’m sure laws are different in every state in regards to disability insurance. In my state (PA) I am not able to get disability insurance if I am already covered by my employer.
Somebody lied to you. You CAN buy an individual policy even if you are covered by your employer. I just called MetLife and asked, and they verified that you can buy a policy.
I have great insurance now through my employer, but for a while I was only employed part time and for $50 per month I was getting limited-benefit health insurance through my employer. I’m still not sure what the ‘limits’ were. I never got around to reading the paper work thoroughly but I’m pretty sure I was screwed if I had gotten cancer or something similar.
Also, now that I have a full time job, I contribute $43 twice a month for a ‘PPO’ and my company contributes $151 twice a month also. It’s the most expensive plan they have and it only covers myself.
Also I do not get the non-tobacco user incentive.
This will be our first year participating in my husband’s firm’s new high-deductible insurance plan. I am keeping my fingers crossed that it is not a HUGE mistake. Last year, for our family of 6, we paid roughly $750 per month for a 100% in-network Blue Cross plan (no dental or eye care). We had no deductible and co-pays of $20-$40 per visit. We also contributed $400 a month to the flex-spending account – this went to vision, orthodontia and out-of-network therapy for one of my children who has OCD. We also contributed $50 a month to a dental plan that subsidizes our visits – since there are 6 of us, it works out OK. In all, we paid over $15,000 in medical expenses last year (though much of it was pre-tax). OY.
This year, our plan will cost $250 per month (no dental), plus an extra pre-tax $450 that will go to our HSA. Our deductible is. gasp. $5200 – and after that, we are covered at 80%. However – after we reach a max of $11,000 (not counting the $250 for the cost of the plan) for the calendar year, we are covered 100% for everything. I figure that even if we reach that hideous max, we will still be in the same ballpark as we were last year. And there is always the chance that we will all be super-healthy and actually end up with money LEFT OVER in our hsa. Time to buy some serious vitamins and a neti pot.
This is us almost verbatim – family of six with some higher medical costs in recent past switching to an employer-offered high-deductible plan and HSA for the first time – and also very much hoping it’s not a huge mistake :)
It’s worked out for us–family of 4. 2011 was the first year we’ve done the high-deductible plan with the HSA. My husband’s employer put $1000 in the HSA in January and our premiums are less than half of what they were. We were nervous going on this plan, but I computed the worst case scenario and the overall cost was about the same as for the lower-deductible plan available to us. So we decided to go for it, figuring that in good years we would be ahead, and in bad years no farther behind. We’ve had some surprises in medical bills this year, but it looks like we’re still slightly ahead of where we would be otherwise.
Kate and Debbie, I described my plan above, we have family HDHP & HSA and it has worked out pretty well. Even prior to reaching your deductible, you may get an insurance “negotiated discount” on services that can be pretty significant. For example, Labcorp might charge you $300 for basic blood work, but their negotiated rate with your insurer could be $20 to $50 if you aren’t getting anything too fancy. Also you could get some preventative care 100% paid for, regardless of where you are with the deductible.
The deductible can be daunting, but to me, the benefits of the HSA, plus the significantly discounted premium make it a no-brainer, especially if you don’t have any major on-going health problems. Our PPO option had a premium twice as high, with a $900 family deductible, and had the same network of doctors and almost identical coverage (after deductible).
I have been self-employed for 15 years. My husband has carried our family plan for us during that time. At his previous job (municipal employee) it cost $500.00 a month, one week’s take home pay. Since he lost his job a year and a half ago and has only been able to obtain part-time work, we have the teens on the state’s plan for kids (one will fall off next year when she turns 19 and goes to college) and we pay $80.00 a month for the two of us through the state’s income tiered plan.
Hi, what state do you live in? Thanks.
Another Canadian here! I’m glad to see J.D.’s question phrased so inclusively. I’m curious to hear how other countries compare.
My health care is paid by:
1) the government, which doesn’t cover everything but is paid for out of our taxes.
2) my employer’s benefits plan (which I pay 50/50 with my employer) which covers things not covered by the government like most of my dental, some eye care, some specialist treatment like physiotherapy and most medications. If I needed a semi-private room in a hospital or an ambulance, it’s my insurance rather than the government that pays for it.
3) out of pocket for deductibles (the % not covered by my employer’s health care plan) and any alternative or complementary therapies I use. Canada isn’t big on integrated medicine… yet. I have also paid for blood tests not covered by the government.
As you can see, it’s possible for Canadians to spend a lot of money on health care even with a “universal health care” system.
My husband and I are insurance brokers that specialize in health insurance and medicare supplements. We currently serve North Carolina. We have a HSA with a 10,000 deductible which costs us $316 a month for a family of 4.
I live in Colorado and have an individual high deductible plan with a $10,000 family deductible. (We are 35 and 37 y.o.) We pay about $150 per month, but our insurance broker told us that it is going to go up to almost $500 per month when our baby is born next month. (We will have to pay the $10,000 deductible out of pocket for my c-section which will be required b/c of a medical condition I have.) For the most part, we’re healthy and so have been okay with our high-deductible plan that has lower premiums, even though we’ll be paying up big time this year. But it sounds like you’re getting a much better deal in North Carolina if you’re only paying $316 for a family of four.
Family HMO plan though a US employer. Our share is $325 a month. HMO covering visits with in network offices, preferred providers, preferred medical facilities, some preventive dental (cleanings and a couple of simple fillings), and copays for visits and medication and all the good and bad that comes with an HMO.
Above the monthly $325 I have averaged another $100-125 a month in copays for visits, medication, and emergencies over the last couple of years just because of incidents with the family. Knock on wood no major issues, just a lot of physical therapy and a few emergency room visits.
I pay $120 for medical for 2 people. Plus about $20 a month for dental. It’s Cigna with $20 copays and high coinsurance for hospital stays.
What I like is that my employer started a “employee plus one” covergae choice. It’s much chepaer than “family” coverage.
It’s nice to be acknowledged as a childfree couple or a great option for someone not married with only one kid.
here’s some fun- I clicked “sumbit” and the computer told me “I am posting comments too quickly. Slow Down”!!!
$39/month, single coverage through employer (public school district), includes dental and medical.
100% coverage for all preventative care.
80% coverage for nearly everything else.
$2000 deductible, with $500 being reimbursed each year.
I’m in the US: 26, male, single, athletic, non-smoker. I don’t have health insurance currently and haven’t since I graduated college (2007) because the only jobs I can find in my field are contract jobs with no benefits and I can’t get private insurance due to a preexisting condition that runs me a whopping $1000/year for exams and drug costs. I tried to sign up through my state’s PCP plan, but they basically told me that my condition was too minor and their limited funding would be better spent on people with serious diseases. I totally understand that, but it sure does put me in a tight spot. Pretty much all I can do is not get sick until after 2014 and hope the health care bill doesn’t get repealed after the elections.
Let’s work to make sure it doesn’t get repealed then.
99% 26 y/o don’t understand this. You need health insurance coverage. There is no option. I am a trauma physician and see young people ruining their life as they have no insurance
He tried. The problem is that he can’t be insured because of a pre-existing condition. So he is part of the 1% of 26 year olds.
We are self-employed, no kids, healthy adults ages 46 and 58. We pay $336/month this year with $5,000 annual deductible per person/$10,000 per family, no co-pay for annual physical but have to pay for lab tests out of pocket for the annual physical. Otherwise generally $25 co-pay including annual GYN exam. Interestingly, the high deductible plans had better drug coverage than the ‘normal’ low deductible plans…at least last year when we reviewed in detail.
But we just moved across state lines, not sure for this year – similar high deductible coverage is available where our sister lives 3 counties away, but online that coverage isn’t available here through brokers. ‘regular’ low/no deductible plans are closer to $1,100/month. Something for me to work on – we may keep our other coverage for a while…
Also, we used to have a small business group policy. When we got down to 2 employees, we switched to individual coverage. With a group plan, the insurance company will cover all employees (won’t turn down for most/all health conditions) BUT you pay a higher overall premium for that. For a big business I assume it’s peanuts per person, but for us our monthly cost went from $1,100 to $800/month (at a low deductible plan at the time).
We have family coverage through my wife’s employer. It is a PPO with a low deductible and $25/$35 co-pays. We do not pay anything –one of the benefits of being a resident.
Through my employer, I pay $288/month for my husband and me. My employer’s portion is $864. Dental and eye are also included; our deductible is $1500. We have the usual co-pays ($20/dr visit) and pay up to 50% of diagnostic testing until our deductible is met.
I’m starting to think I’m overpaying. :) As a grad student, I have an option through the school that is super cheap, but currently do not use it for a few reasons. So, my insurance is entirely on my own, and I pay a little less than $200/month (rates just changed, so I don’t remember the number). It’s a mid-range deductible, prescriptions aren’t covered, eyes are covered, dental is not. But, all preventative stuff is covered (shots, exams, etc). Emergencies aren’t. Of course, after a lifetime of being well and young, I’ve ended up utilizing it more than I anticipated, and am thankful for it. I would like to switch to my school’s option next year, since ~$100/semester is much better for my grad student salary.
I’m 29, married, kid on the way. I pay $30/month for an employer plan(I work for a large corporation), with a deductible of $1500, and then pay 20% after I meet that deductible, with max out of pocket of $3000. Preventitive care is covered 100%. Once I give birth I will add the baby to my plan, doubling the deductibles and increasing my monthly costs to $50. I also have an HSA through my job and my employer will contribute up to $850/yr into it for things like not smoking, completing online health questionaires, and getting a basic health screening at work.
My husband works for a small law firm and has a plan through the local bar association. He pays $350/month, but his employer reimburses him for it in full. He has no deductible and a pretty standard copay plan ($20 for meds, $30 for drs visits, $150 for larger procedures, not sure what it is for hospital stays).
So out of pocket we pay $30/month, plus I contribute $100/month to the HSA pre-tax (just increased that knowing the labor/delivery costs are coming next year) plus whatever bills we incur as copays/pre-deductible payments. I hate how complicated everything is…trying to figure out what we have to pay based on what type of procedure it is, where I am in my deductible, and how much is in my HSA is a huge pain.
I have basic med/den coverage through large group plan @ $ 180 oer month.I am fortunate. What is scary are the many young people in my neighborhood who use the emergency room for medical care. There is just no way they can afford med/dental premiums. Sad.
I have a high-deductible plan (CDHP) and pay $0 in premiums for the coverage – my employer covers that cost completely.
However, due to the nature of the plan, the first $1,200 in expenses every year is out of pocket (that’s the deductible for a single person plan) and my annual out-of-pocket max is $3,600. We don’t have any prescription coverage through it but medications do count towards the deductible/max.
My husband and I are in our 50s and own our own business. We recently moved to Mexico, but before that, we were paying $500 a month for catastrophic insurance ($10,000 per year deductible) through United Healthcare/Golden Rule. We paid an additional $65 a month for dental and vision coverage.
In Mexico, the government-sponsored catastrophic plan costs us per year what we were paying per month in the US. We set aside a portion of the difference to self-insure. Since a doctor’s visit here cost about $30, paying out of pocket is doable for the smaller things.
My employer provides insurance, and I cover my family which includes myself, my spouse, our two children and my step-son. The plan is a Self+Adult+children, with no difference in my cost regardless of the number of children.
Medical is $192.92/month, Dental is $88.90/month and Vision is $16.96/month. I also contributed $500 into a Health FSA account this year, with deductions taken from my bi-weekly paychecks. The deductions are pre-tax, reducing the amount of my taxable income.
For medical, we have deductibles and out-of-pocket maximums per individual and family for in-network ($350/$700 and $1500/$3000) and out-of-network ($700/$1400 and $3000/$6000), $15 copays, and various coverage rates ranging from 100% to 60% depending on the service and whether it is in-network or out-of-network.
For dental, there’s a deductible of $50/indv and $150/fam, and an annual max of $1500. Coverage ranges from 100% to 50% depending on the procedure. Orthodontia is covered at 50% with a $1500 lifetime max for children under 20.
Vision coverage covers lenses once a year, and $130 towards frames every other year, or $125 allowance toward contact lences in lieu of glasses annually. $10 copay.
I am covered by military health- socialized medicine. We moved close to a base so we could find a doctor that would take us as patients.
More interesting is my extended family.
Brother on high deductible health insurance provided through the state. It costs him 200 a month and is supplimented by the state. He recently had an operation that took seven months to set up because doctors wouldn’t accept his insurance.
Brother-49- who is uninsured. His kids are covered by ex wife who is a nurse at a Catholic hospital that offers great health care at a low price.
Sister who has a chronic illness covered by a 500 a month/ 5000 deductible who is afraid to go to the doctor at all because she might get canceled.
Sister-51- owns a small business with a high deductible program for her and employees (which includes a son-30- in another state that does things for the company) she pays a bit over 500 a month for her coverage- but has a great set of doctors and pays for her employees co pays.
All of my siblings are just holding on until they hit Medicare age for real health care. The question comes- which doctors will even accept them when that happens?
Mom -81-on Medicare- but pays about 400 a month in long term health insurance and 200 a month in supplemental.
When my daughter’s husband got out of the military we paid 2000 for Cobra for four months. They now are covered by his office. 300 a month for a family.
My school district offers teachers with families for 435 a month.
All of my siblings and my mother got their insurance through an insurance broker. Women are on some variation of Blue Cross.
The largest conversations we have as a group is how our children will survive, or not survive health care costs.my nephew has congestive heart failure. his doctor told him to get a new heart and immediately declare bankruptcy. Az will not cover a heart transplant for a medicaid patient.he is 28 and never had a medical issue before.fortunately he is currently on the payroll of a large corporation who is willing to keep him on the payroll until the new heart can be found.
My husband and I have a high deductible plan (have to hit $10k before the health insurance company covers anything, but then it covers 100%), and it costs $150/month. We’re young, though, and in reasonably good health. All prescriptions, including birth control, come out of pocket, so that’s about $80/month. I purchased this plan on my own since my husband and I are both self-employed. Wish there were a “self-employed” pool of people we could join for insurance. One major problem I have with the health insurance is that if I get pregnant, it covers nothing. I have to add maternity insurance, which is incredibly expensive, have it for 6 months without being pregnant, and then I can get pregnant. If I get pregnant before those 6 months, it still wouldn’t cover anything. Thanks you, BCBS. I *think* the health reforms might be changing maternity insurance, but I’m not really clear on how.
Erica–
I was/am in the exact same situation, with basically the same BCBS health insurance plan, as my husband and I are self-employed. We delayed trying to get pregnant for probably about 3 years b/c we didn’t have any maternity coverage,and couldn’t afford a fancier health insurance plan. Finally, as I started to creep into my late 30’s we realized we just couldn’t wait any longer, and we decided to try having a kid anyway– figuring that we’d either bail to our state’s CHP plan (Colorado), which covers pregnant women & children within certain income guidelines, and if that didn’t work, then we’d have to move to a group plan (where they couldn’t reject us for a pre-existing pregnancy), and just pay the very high premiums at least for the duration of the pregnancy.
Well, long story short (sorry if this is TMI but I think it is important), we waited too long, and had a lot of issues with infertility, most likely b/c female fertility just declines a lot in 30s and 40s. It took us 2.5 years to get pregnant– ultimately with quite a bit of medical intervention (all paid out of pocket). Once I was pregnant, I told my insurance broker, and he informed me that, as a part of healthcare reform ALL plans must include maternity coverage– so everyone with insurance is now covered. We ended up staying with our high deductible HSA plan (yes, we will be paying $10,000 out of pocket for the delivery), but I comfort myself with the knowledge that we’ve gotten away with pretty low premiums for quite a few years, and that we’ll have all our medical expenses covered 100% for the rest of the year.
I guess what I’m trying to say is that you probably ARE covered for maternity. You NEED to talk to your insurance broker ASAP. (If they aren’t helpful, find a different one– it can take some searching to find a good one, but it’s worth it once you do.) Depending on your age, please take action and don’t delay your life because of your health insurance coverage, because while you have to be responsible, you also can’t wait forever. And infertility is an expensive form of living hell. Sorry to be so pushy, but I feel very strongly about this, and I know firsthand what a crappy situation it is to be in. If you are in Colorado, or have any questions, respond here and you can PM me. Seriously, our health care system is a mess, but don’t let it rule your life. Been there, done that, and it sucks.
I pay $262.75 per month (I just checked the statement) for family cover (family of 5)
It covers full hospital (with a small deductible – I think its a max of $250 per year per person) dental, optical and medicines that don’t fall into the govt scheme. GP visits aren’t covered, but the govt scheme refunds a big chunk of that.
My son spent a day in hospital a couple of years ago with a suspected appenditicits and the bill was $1500 – I only had to pay $50.
My other son has had multiple surgeries for a congenital issue and I’ve only ever paid for some small pharmaceuticals.
I pay my insurance myself – its very rare for employers to provide health insurance here; why would they? – and I selected it myself; Ive been with the same fund for years.
I’m in Australia.
I get a family PPO health plan from my employer. It runs $250 biweekly and includes vision. Our dental is an extra $20 biweekly. Our deductible is $500/indiv $1000/fam and our copay is $30. We contribute to a flexible spending plan to get tax benefits on a portion of the deductible amount and copays.
Our employer actually self-insures, so all of our claims are paid out of his pocket. He recently set up wellness centers at our facilities where we can see a PA or a doctor on certain days without having to pay a copay. This was to encourage preventative care (which actually helps limit his costs).
This will be a little different….but we are a part of a sharing program. Works a little different than traditional insurance.
We spend $195/ month for my wife and I. In a few weeks, they will pay about $900 for a recent medical bill (the entire amount) my wife had.
If anyone is interested in knowing more, let me know. Sounds like an interesting blog for me to post soon!
Please post details. We are interested
Yes, please do.
Hey Nj…I just did a post on “Alternatives to Health Insurance.” I will soon write on the program I mentioned. However, I found something called direct care homes that can function much like insurance but, in some cases, be significantly cheaper. You still would have to keep a high deductible “traditional” health insurance plan. Make sense?
I live near Chicago, IL and I work for a grocery store chain. My wife and I are covered under my employer’s plan for health, dental and vision all for $110 a month.
My husband and I are self employed, late 50’s. We pay $670/month for coverage with a $3500 deductible – no vision, dental or preventative care – with a 70/30 split after that. If we use a provider outside the network, the deductible goes up to $7000.
Like babysteps (18), we discovered that where you live is a big factor in healthcare costs. When we moved to Texas four years ago our healthcare costs almost doubled – and I had to cut back on coverage in order to keep the cost even somewhat reasonable. Previously we paid about $375 for a policy that included dental and preventative, had a $1500 deductible and an 80/20 split
I have insurance through my employer, and I pay about $150 a month for what I consider to be pretty good coverage. When I was unemployed, I had insurance that was very paltry and pretty much only covered disasters, and with a high deductible. It didn’t even cover routine daily medication. It seemed to me like there were not a whole lot of options out there that wouldn’t break the bank.
I purchase a high-deductible plan on the open market. I use Regence Blue Shield ((http://www.wa.regence.com/agent/products/individual/).
I believe my deductible is $3000/year, though whether it’s $2000 or $5000 is academic. It’s there for surgery, cancer, a car accident. My premium is $100 (up from ~$70 4 years ago). I don’t smoke.
I’ve done this for years while starting different companies and it’s made a few things clear:
1, A low deductible is rarely worthwhile. I could have a deductible anywhere between $5000 and $0… and would pay over 90% of it in premiums (they were all options presented side-by-side). It’s a bad deal for everyone – the insurer because they have to expect the worst, and me because I’m motivated to spend more.
Many employer-provided services either don’t offer a high-deductible plan, cover enough of the premium cost that the employee doesn’t receive the premium savings, or the premium tax deduction (and non-deductible expenses) makes a high deductible artificially attractive.
2. Almost no one asks how much a routine service costs. I recently chose a new eye doctor. My choices included an optometrist (that is, 4 year degree) for $x and a board-certified opthalmologist (that is, a doctor) with more experience and a thriving practice for 40% less. There’s no relationship to quality, but you have to ask.
3. Patients often expect a lot without being at all interested in how. I was just at the dentist and overheard a loud conversation between a patient and the receptionist about a co-pay that had risen from $20 to $40.
Eventually the dentist got involved and was – amazingly – completely willing to talk through the reimbursement changes that precipitated the higher co-pay. The patient just wanted a $20 teeth cleaning and had no interest in whether the numbers worked for anyone else. (I was paying ~$175 cash for the same service and still considered it a great value.)
Finally, I can’t speak highly enough of the company I purchase insurance through. Imagine Kayak for health insurance, with quotes and comparisons over the web: http://www.ehealthinsurance.com/
Also, if you’re into health policy or making decisions that might affect employees, I strongly recommend “Tax Benefits for Health Insurance and Expenses: Overview of Current Law and Legislation” from the Congressional Research Service. It’s only released to legislators but leaked all over Google:
http://opencrs.com/document/RL33505/
I totally agree with all your points. Except that I’d like to add out that, in our current health care system, it can be EXTREMELY difficult to find out costs up front, which makes it difficult to make educated, informed choices. It is one thing to find out the cost of an office visit (though even that can be difficult), but for things more complicated, it can be nearly impossible and usually involves being treated like a major “problem” by the administrative staff (in my experience, this tends to be less of a problem with actual healthcare providers.)
I recently considered getting an “optional” diagnostic test, and spent over an hour getting the run around– during which time I surmised that the test would likely cost somewhere between $500 and $3000…. not terribly helpful, and a total exercise in frustration. Perhaps the problem would decrease if more people purchased high deductible plans and thus demanded to know what their services were likely to cost.
My wife and I are fortunate to work for a company that’s generous in the benefits department. We each have our own plans (health, dental, and vision) that our employer pays for in full in addition to depositing $53 into our individual HSAs each month. We’re both in our 20’s and in good health. (Although we could both be in better shape!)
Just last week we went to the dentist and I had to get three fillings. After insurance I owed $112, which was easily covered by the money I had in my HSA. Neither of us currently contribute any additional money to our HSAs but we probably will soon since we anticipate having children at some point :).
What company?
I purchase an individual high-deductible plan ($2500) through BCBS of MI. I’m 36 so it costs me $110 per month right now. I originally purchased this insurance in 2008 and the cost was $85 at that time. I have no dental or vision insurance but do make 2 dental check-ups and a vision check-up each year out of pocket (and cover my expensive contacts/glasses for my very near-sighted astigmatic eyes!). My health and well being are worth it. As a 15 year cancer survivor (who got dropped by my father’s insurance at the time since I missed a semester of college for treatment. thank goodness my parents could afford COBRA, or I might not be here), I appreciate my reasonable coverage and actively care for myself to keep it reasonable for all the routine stuff. I also look at keeping healthy food in the fridge, managing stress and making time for exercise as part of my health ‘insurance’. I think of my BCBS coverage as coverage for the big unexpected injuries or health issues beyond my control not to bail me out of poor health choices down the road.
In the US, there’s a huge difference in costs and availability of insurance plans depending on which state you live in.
Until last month, we were on my husband’s plan at a major corporation that was generous with benefits. His insurance was free; mine was $150 a month, and everything was covered 100%, no copays.
Now we are on my corporation’s plan: $350 a month, $20 copays, 100% coverage in-network, 80% out of network, $2500 per person deductible, $5000 per year limit out-of-pocket.
I had always investigated buying insurance privately. The lowest cost plan in Massachusetts is over $500 a month. To replicate what we have now with my company would be $1,200 a month. To replicate what we used to have with my husband’s old company is impossible — you cannot buy that quality of insurance privately, period; it is simply not available.
I have a friend in Maine who pays $20,000 a year for insurance for her and her husband, and it’s not good insurance.
I am a federal employee and have a pick of insurance plans. I personally have BCBS with a Metlife Dental supplement. The premium is $90/pp. My agency contributes about $350.
My partner (unemployed due to medical) has COBRA for $608/month which runs out this year. Overall, in 2011 with ongoing medical bills in the tens of thousands, the premium is worth it once the deductible is met. She is diabetic and is uninsurable due to “pre-existing” condition. So we don’t know what to do except to apply for financial aid from drug companies and health service providers. Wish us luck!
I thought Obamacare did away with the “pre-existing conditions” exception. I think it is already in effect – no company can reject you because of pre-existing conditions.
Can anyone confirm? Maybe your partner can try looking again.
Starting 2014
Most of those protections don’t go into effect until Jan 1 2014. Although I thought as long as you had less than 63 days without coverage out of the last year they could not use the preexisting clause against you? It seems to vary by state and whether you are talking group or individual insurance.
We have family coverage through DH’s employer and pay about $500 per month for a HMO. His employer pays for Dental, and we pay about $15 per month for Vision. For next year, the premiums are about the same, but the coverage is changing to 90% with a deductible.
I have a PPO through my employer (no dental, small vision reimbursement). It covers 80% of costs but we hardly ever use it. The good part is that my employer covers all the premiums so I only ever spend money if I’m actually receiving care.
Individual plan, $188/month, 2500 deductible, the insurance doesn’t cover a lot, I’m in my twenties.
I’ve been self-employed for thirty years. I’m 57. From 2001-2008 I lived in CA and had Kaiser insurance, $500/month premium. Ripoff! From 2008-Sept 2011 I lived in Nevada, and my high-deductible ($5k) Humana insurance plan (no co-pays, 100% coverage after deductible, includes dental coverage) was $250/month premium. Sept 2011 I moved back to California, with the very same coverage, and Humana increased my premium to $545/month – solely because I’m now in CA. Absolutely absurd.
okay question!
i was talking to my insurance guys and inquiring about disability insurance. i’m an illustrator, and if my hands got mangled i’d be pretty sol, but technically able to do like, phone service or something. so my insurance guy said they couldn’t cover my occupation specifically. i jokingly said i should just insure my hands, and the insurance guy thought it was a good idea.
is this crazytalk? the only place i could find that does such things is lloyd’s of london. most articles about it were “haha beyonce has a million dollar butt but srs it’s expensive so no butt-surance for you”. anyway, i would love to get some PF commenter’s opinion.
fyi, the painting is like black india ink on white paper with a brush, so it’s mega fine motor skills. a flare up of carpal tunnel makes my drawings awful. switching to my left hand would get me laughed out of the publisher’s office.
An interesting exercise is trying to find maternity coverage on an individual policy. It is practically nonexistent in Texas. Some states cover it included, with no waiting period. Others charge you so much in premiums you’d be better off paying cash…
I get mine from my employer.
I have premium coverage. I do not like that I have to pay a 500-1000 deductible to see a doctor before 100% coverage kicks in.
I believe I pay 170 a month starting in Jan.
Deductible makes me think twice about seeing any specialist. Just the annual physical is free.
I am Canadian so I have free health care. We do not pay anything to see a doctor or to receive treatment in the hospital.
Through my husband’s employer we have supplemental health insurance which covers the things that are not covered by provincial health care, particularly dental care and prescription drugs (80% of the cost). (Also covers things like nutritionist and psychologist visits, upgrade to semi-private room in hospital, etc.) My husband gets deductions on his paycheque for this. For family coverage it’s about 40$/month.
In my province if you do not have prescription drug coverage through an employer, you must join the public drug insurance plan. You pay for this at the same time as you pay your income tax, and the fee varies depending on your income. (The maximum is $563 per adult.) If we did not have prescription drug insurance through my husband’s employer, we would have to join the plan with my employer, failing that we would have to join the public plan.
I am thankful that my employer provides a very good medical benefits. For my individualt plan, I was paying $25 biweekly for medical and $5.45 biweekly for dental. I just got married so now I have a family plan, its $110 biweekly for medical and $16.50 biweekly for dental for the same plan to cover both my husband and I. The family plan doesn’t change based on the size of the family, so if we ever have children, our portion of the premiums won’t increase. Our copays are $25 for office visit, emergency room is $75 and hospitalization is $300 no matter the length of stay. My plan also includes prescription coverage, and its fortunate because my migraine medication is $120+ dollars for six pills, my plan gets me 18 pills for $60 which is about a 3 month supply.
The ironic thing, my husband works in the health care industry and it was cheaper to add him to my plan than for him to continue to purchase individual health insurance from his employer and my employer provided plan provides better coverage.
I have an employer Blue Cross plan, for which they deduct about $90 per month or $1,100 per year. When I was self-employed, I paid $3,000-$4,000 per year for Blue Cross via BeneCare.
One thing I am amazed by is how many billboards I see advertising health insurance. In my experience, the individual consumer rarely has the opportunity to choose a “brand” of insurance. The employer picks and that’s that. Individuals without insurance have even fewer option.
Here, it’s rare to find an employer who will pay for insurance. When they do, it’s for full time employees only, and those jobs are less common as the recession wears on.
I pay for my own insurance: $650/month. Since I have a pre-existing condition, that’s the only plan I can qualify for. (Believe me, I’ve tried to get on cheaper plans.) The deductible is $1000 and while I can get drugs paid for, I use Rite-Aid’s plan instead, it’s cheaper. And unfortunately, I have a lifetime cap on covered expenses of only $1 million. Thanks to a couple of hospitalizations, I’m well on my way there.
My husband has a catastrophic plan, $160/month, $500 deductible, no prescription. No lifetime cap. It’s an awesome plan, the only drawback is that all his care has to be in-state.
I just went through open enrollment so have these numbers handy. For my son and I, costs for medical, dental and vision are $175/month for a “middle of the road” PPO option – not an HSA, not the most expensive (no deductible, low co-pays) plan. According to my employer, they pay $805/month for my coverage.
Deductible is $750, preventive care is covered 100%; other care covered at 80%. Co-pays creep up every year, this year they are $35 for a primary care visit, $55 for specialist, $125 for the ER. We can contribute to a tax-free Flexible Spending Account so I usually put between $500-$1K/year there.
I count myself fortunate to be healthy and to have such affordable coverage. I occasionally think of going freelance but the health coverage issue always makes me pause. With a small (age 5) child I really value the stability of employer-sponsored benefits.
We have insurance in the US through my wife’s employer. We pay about $202 every two weeks. There is a single $700 family deductible and they cover almost everything. My employer chips in $70 a month for me to not use their insurance.
$160/month for medical & dental, through my employer. It’s a step down from my old insurance, as it only covers about 80% of regular doctor visits etc., but I am very glad to have it.
And now I’m trying to see every doctor I have before the first of the year, since I overpaid my FSA! Ha.
My husband recently joined the National Guard, we now have Dental for $79.36 per month and Health Insurance for the three of us for $192 per month.
Previously, we were paying $300 out of pocket, and his company matched $300 for Health, no dental or vision.
My husband and I have health insurance through my employer. It costs us $450 a month not including dental or vision. It is a good PPO plan. My employer pays 100% of my premium but pays none of my husbands. The deductible is $1000 a year and the co-pays are in the $25 range (more for specialists). All and all, I feel tremendously lucky.
I’m self-employed in Indiana with a high-deductible policy ($2500 individual/$5000 family) from Anthem (plus an HSA). My wife and I pay about $250/month plus $120/month for a maternity rider. So far, we’ve only spent about $200 a year out of pocket, but it’s good to know that we’re covered if something disastrous happens. Preventative care is also covered, but so far that’s only meant annual physicals (not including blood work). We’ve gotten blood tests done at hospital outreach events to keep them cheap ($2-20 for cholesterol and glucose testing).
For the maternity coverage, we had to have it for 12 months, but it will cover everything after a $2000 deductible.
We’ve switched health plans every year for the last three years and probably again this year because rates keep going up (12-33%, depending on the year!).
If we keep our current plan next year, our rate will jump from $380 to $490/month, so we may switch to a higher deductible or a different plan entirely.
We’re in our mid-30s now. Health insurance was cheaper when we were in our 20s, even ignoring price increases over time.
My health insurance is 100% paid by my employer as long as I work at least 32 hours per week. My employer’s cost is about $450 a month, plus $42 for dental. For that, we have a $10 co-pay on doctor visits, 80-100% paid hospital (depends on what’s done), $10-50 prescriptions (depends on amount and if generic) and max out of pocket of $1500 per year.
I tried to get health insurance on my own right before I took this job and was denied because I had seen the doctor for a pulled muscle and have a prescription for migraine medicine.
I am going back to school for a second degree, and the fact that I could be eligible for the group insurance while working as little as 18 hours a week was a big factor in my taking (and staying at) this job. (Yes, I said 32 above. Between 18 and 32 the employees pay a pro rated amount of their insurance. Below 18 the insurance company kicks them off the plan.)
I pay $215/month for me and my kid. DH pays a bit less for just himself. Our employer pays 480/month for each of us.
The coverage is not great– the deductable is relatively low, $750, and copayments are around $30 (more if out of network) but the coinsurance costs (30-50% depending on circumstances) really get you. The out of pocket max this year is $5000. There are pages upon pages of things it doesn’t cover.
800 dollars a month for wife and I in the lowest risk, healthiest pool with an HSA 5K deductible per person plan. It’s essentially catastrophe insurance, although it does pay for one annual check up per year per person. We are self employed.
A timely post, as my health insurance premiums just went up 47%, making them prohibitively expensive and I am shopping for insurance on my own. I have always had insurance through my employer. But because we are a small company of 45 people, some of whom have major health problems, it is very expensive. It is over $1,000 a month to insure myself and one child. That is with a $2,500 individual deductible, $4,000 family deductible, and a 20% co-pay. My daughter and I are both young and healthy, but we are paying for the health problems of my co-workers. :-(
I’m finding that buying insurance on the open market may not be the best solution, though. Buying it through my employer means it comes out of my gross income as pre-tax dollars. If I pay out of pocket with after-tax dollars, you can only deduct health care costs that are over and above 7.5% of your gross income. Puts me in a tight spot and I’m not sure yet what I’ll do.
My husband and I are both self-employed. Ages 42 and 45. We have the cheapest individual policy I could find:
$10,000 deductible (each)
$7,500 coinsurance maximum (each)
$3,500 deductible for brand-name drugs (each)
We pay $195 per month (total).
We’re thinking about switching to an HSA plan which would raise our premiums by $100 per month, but could save us $800 per year (through tax deductions) if we deposit the $6,250 maximum to the HSA. I’m not sure we want more tax-sheltered savings, however.
I pay negative $150 a month. That is to say, my employer actually pays ME extra not to cover my wife as well. Otherwise it costs me $0 – solo, or full family.
Its also probably what most would consider a “cadillac plan”, covers everything, very little OOP.
I work for a hospital in NY.
Does your wife have coverage elsewhere?
Yes. In fact, I’m explictly prohibited from extending coverage to my wife if she has coverage elsewhere. I guess it’s a fair trade – we’ll give you and your children incredible coverage, but your wife HAS to use her employer’s healthcare if offered. They’d pay me another $200 a month or so on top of the $150 they already do not to cover my kids (if I had them), and put them under my wife’s plan.
I pay $73.66 for individual coverage every two weeks for health insurance through my employer. I have a $35.00 copay for Dr. visits. Our plan includes prescription drug coverage and dental.
My father is on Medicare and I hear so many people talk about Medicare like it is free, but he actually pays quite a bit for his coverage. His basic premium is 99.00 per month that comes out of his monthly SS payment. Then he pays $179 per month for Supplemental Insurance and about $35 per month for his Medicare part D premium. In total he pays about $300 each month in Medicare premiums. He has no co-pay for Dr. visits.
Employer BCBS for family coverage (state university): $70 a month with a $900 deductible and $2600 out of pocket stop loss. Generic drugs are free.
Each year since having children, we’ve hit the stop loss.
I get paid under private sector in wages, but the benefits are better.
Where do you get your health insurance coverage?
My wife and I both have coverage through my employer.
What sort of coverage do you have?
We have a High Deductible health plan combined with an HSA. It is perfect for two young, healthy adults. I would run the numbers again when we have our first child but going over 2011 numbers we have saved over $2000 vs. what we would have paid with the typical PPO plan.
How much do you pay per month?
Our premiums are (pre-tax) $260 per month.
Do you know how much your employer pays?
My employer pays for ~90% of my premiums, but I have to pay for my wife’s completely. For just myself the premiums would be about $30 per month. The only reason I have my wife on my plan is that her employer pays her $100 per month to opt out of her health insurance, so it all comes out in a wash.
What sorts of co-payments do you have?
With the HDHP we pay 100% of pretty much everything (minus preventative care and select other categories) until we hit the $5000 maximum for both of us. Then everything is covered up to…well, infinity I guess?
It’s tough at first to throw down $150 for doctor’s office visits, but there are still bargains for “in-network” services and if you buy generic medications there is no noticeable difference. If you realize you’re saving $100+ per paycheck and paying those doctor’s bills pretax the savings add up fast.
It’s also nice to know that everything is covered at 100% if stuff hits the fan, no 80% co-insurance or anything to worry about.
We pay $90/pay period (so $2,340/year) for health only (Dental is extra) through my job. That leaves us with copays/coinsurance, that, for my DH alone, would have been over $10,000 so far in 2011 (but he also has Medicare, so that’s another $90/month in premiums).
Next year we may switch to a high deductible plan with an HSA. It has a max family out of pocket of $4,000, and the premiums are cheaper (well, not cheaper than this year, but cheaper than what the other plan will be) and my employer will contribute to the HSA.
I’m self-employed and pay $721.74 every 2 months for an HSA (Blue Cross)with a $1750 deductible. Also, if anyone’s interested, I did a recent blog post on ways to benefit by using an HSA for its tax and retirement advantages as well as health care. http://havenfinancialsolutions.com/2011/08/using-health-savings-accounts-strategically
Wow! I am feeling seriously ripped off! I work for a small public school system and pay $754 a month for a BCBS PPO family plan which includes a little bit of vision coverage. We have a $20 copay for primary doctors, $40 for specialists, 3 tiered drug coverage, 80% coverage for hospital services after a $100 copay. We are a family of 4 with 2 of us on daily medications. There is a huge deductible if you go out of network. Our total costs for medical care are about $15000/year. I am approximately 5 years from retirement and I wonder all the time if insurance costs will derail my carefully-made plans….
I hear you Annie, but here’s mine
Maine Anthem
500 per month
2 adults, 1 child, pefect health
15k deductible PER PERSON
30k max out of pocket
(no co pays, or any other discounts or benefits, we pay 100% of our medical bills PLUS the 500 per month for insurance which is really just a catastrophic policy in effect)
Annie, my heart goes out to you. As a teacher here in Irelans(and i’m sure you couldn’t be earning much more than I) I couldn’t possibly afford such a premium. I’m amazed your employer does’nt contribute more. I am so relived and thankful that I live in a country with a public health system. I wonder if Obama Care will bring a solution for you?
Health insurance is not provided by my employer (but of course make too much to qualify for any assistance) and I have a pre-existing condition so the only health insurance I can get is a “high-risk pool” offered by the state. I pay $260/month, with a $1,000 deductible, and co-pays are a percentage. I also pay $38/month for dental, and out of pocket for vision.
I’m really afraid of what happens in July because that’s the time of year the monthly payments always go up and I’ll be turning 30, which will skyrocket the monthly payment.
We pay $416/month with Anthem for a HDHP/HSA plan. $5k deductible for the family. It is awesome considering we used to pay $800/month for a very similar plan through my work. It actually had a $6k out of pocket max and drug coverage. But we are healthy and not on any drugs. I’m 36, wife 30 and 2 kids – 4 and 1. This includes maternity which was about $100/month.
I really believe the HSA is the way to go for most people – you still get the insurance carriers lower rates for everything. The only big change is paying $50-60 for office visits instead of a $20 co-pay, but that is peanuts compared to saving $400/month. Within a year, the lower premiums “paid” for our deductible – not to mention HSA contributions are tax deductions.
This is REALLY interesting to me. I’m a state worker and have heard ever since the recession started that state workers’ benefits are well-beyond the benefits given to other workers so they should be cut drastically, but from the posts here so far, it doesn’t look like it at all.
I pay about $300 for medical insurance (dental and vision not included), and pay co-pays of $25-40 for each dr. visit, depending on whether the dr. is a “specialist”
My husband is a recently retired schoolteacher, and we did have our health insurance paid thru the district (we kicked in a bit..maybe $200 a month? He retired with a perk of $750/month to put towards health insurance for 2 years, then we are on our own. Based on the type of insurance we have now, we will be paying near $900/month for the same in two years. Ouch! I am self employed, so no benefits there. Crazy health care situation if you ask me!
I hope everything works out. Sounds like companies are coming up with innovative solutions to benefits. Having worked for an insurance company, I know that insurance companies are hesistant to even quote companies that have an open retiree pool, meaning new retirees are being added on an annual basis. Insurance companies are concerned about adverse selection – where the only people that are opting for the insurance are the ones that need it most. With the two year benefit, at least the two you have time to prepare to the extent that that’s possible.
My health insurance is a simple story: I pay about $60/paycheck (twice a month) for Blue Shield of California PPO. I have Delta dental for free through work and pay some tiny sum every paycheck to cover my husband because he has so many dental issues that he needs double coverage. Vision is VSP and free through work as well.
My parents’ insurance is more interesting: my dad just turned 60, my mom is almost 58. They’ve both been retired since their early 50s and are on private insurance through Aetna. They pay $1800/month because my dad has a previous condition. They wanted to move to Florida, but their plan is California only and they couldn’t find any provider to cover them in Florida. So they’re very much looking forward to Obamacare kicking in in 2014.
My husband and I have private HDHP with no drug or maternity coverage and a deductible of $6000 before we receive any benefits at all. For this we pay $200 a month, with premium increases of 20% the past two years. My husband is looking for a new job primarily so we can get group coverage and afford to have kids without paying $10000 out of pocket.
I work for a state university and pay $180/month for family coverage (employer pays $1060/month), including my spouse, child and child-to-be. It is an HMO plan with no deductible that covers all preventative care (including maternity and well-child) with no co-pay, $25 co-pay for other office visits, $50 for emergency room visits and $250 fee for hospital stay. I feel very fortunate to have such good maternity coverage and it’s nice to know that when this baby comes, all I have to pay is the $250 hospital bill, which will come out of my flex spending account. We had considered switching to a HSA this year, but found out I was pregnant right before open enrollment, so are staying with the HMO. I am also fortunate to live in an area where there are many providers that accept my insurance, so I’m not “stuck” with one particular office or hospital.
I’m lucky enough to have nearly full coverage provided by my employer — I work for a public university in a large state. I pay $35 per month for my family of three, with $15 co-pays for doctor’s visits outside of our “well baby” visits (my son is less than a year old) and $5 co-pays for generic prescriptions. We didn’t pay anything for my prenatal care or delivery either. Our HMO is a non-profit health-care provider focused on preventative care, which my husband and I both like especially since we’re healthy and in our 30s. It also keeps costs down since fewer people in our HMO have “catastrophic events.”
My employer pays about $1,300 per month on my family’s behalf. It’s a lot of money, but it’s also why I work in the public sector as opposed to the private sector — I would easily make a few thousand more per month if I did.
Public vs. private sector – there are so many ways to truly evaluate a job offer. It is not just about the annual salary.
I pay $5 a month for individual HDHP coverage through my employer, and my employer contributes $500 a year toward my HSA.
I just got married, so starting next month, my husband will be on my medical plan, too. Unfortunately, my employer is instituting a “Working Spouse Surcharge” for the first time – if my husband was unemployed, he would be an additional $5 a month. Because he has a full-time job, he will cost $105 a month instead. It’s still better than the plan his employer offers, but it stinks to be paying that much for a HDHP, when I’m used to much, much lower rates. (although, the numbers I’m reading in the comments are making me feel better about it)
Oh, and because it’s high deductible, I pay no copays – “preventative” care is completely free, and anything else (including prescriptions), I pay a negotiated rate for.
I am a single mom in Texas. My son qualifies for state children’s coverage for $35 per year, medical and dental.
I pay $121 for medical, dental and vision. I pay $30 copay for an office visit. My policy is with Golden Rule. Last year I had insurance through my employer (small nonprofit organization) and paid almost double for half the coverage.
I get the health insurance (no vision or dental) from my employer with 100% coverage, no out-of-pocket premium cost posted on my paycheck. I pay $45 co-pay for doctor office, and $15 co-pay on prescription. I think the co-pay is quite expensive, but if I don’t get sick, I don’t have to pay anything. I am thinking of buying my own policy- high deductible plan, so I can contribute money to a HSA plan for later medical cost with tax benefit.
My husband and I are both self-employed living in a major Northeast metro area. We’re in our 30s with one child and with thoughts of a second on the way, must have a plan with pregnancy coverage. We pay for a family HMO with no-deductible. It costs us about $800/month. Our co-payments are $25 primary care, $35 specialist, $100 emergency room, with hospital stays at $200/night, max five nights out of pocket. Prescriptions are $15 generic. We have vision coverage in this plan ($150 max annual) and pay separately for a family dental plan (about $1100/year). We’ve definitely come out ahead with the dental. All told, we spend close to $11,000/year out of pocket, and are probably paying for more risk than we need. There are high-deductible plans, but I’d rather have a predictable regular bill, than unpredictable and potentially major swings. It was important for us to follow that mantra, “better safe than sorry!,” should we find ourselves pregnant again.
I got an individual policy for my son and I for $200 a month when my employer closed down their plan, and a conversion policy for my wife that took over when she was laid off for $370 a month. We also have a supplemental policy for $40 a month from Aflac. About $600 every month in total.
The nice thing about my policy is an HSA feature, which I can use for my wife’s expenses as well. The deductible is $3K. The nice thing about hers is that it covers pregnancy, while we’re still planning to have more kids, and the deductible is only $1K.
I have been self employed since 1988 and purchased my own health insurance beginning at that time. This month, I will pay $588 for one month’s coverage, $7056 per year, through Kaiser Permanente just for me (I am 60). Additionally, my expenses average about $100 per month additional for co-pays ($25 per visit), drugs, eye doctor visits, glasses, and dental visits. I have no vision or dental insurance. I have considered going to a plan with a deductible and lower monthly payment to save money.
$52/MO for individual HSA PPO w/ $2,500 deductible.
Late 20s, male, no health issues.
Only possible with adequate HSA savings. IMHO.
My employer sponsored plan, last time I looked, was in the neighborhood of $300+/MO.
I am self-employed, 30 years old, single, no children, no major health issues. I have a PPO with BCBS of California.
-$200/month for medical and dental.
-$5000 max annual out of pocket.
-4 free doctor visits a year, after those 4, co pay is ~$35.
-Annual gynecological appointment is always free.
-Prescription meds (generic) are $10
-The majority of dental work is covered, but there is a 3 month waiting period to have cavities filled and a 1 year waiting period for major dental work like root canals.
-I know this may seem silly to some people, but I live in Los Angeles so it’s more normal for us: my dog has full medical insurance (with VPI) for $35/month. She is my baby and I would be shattered if something happened to her.
I live in Portland, OR. My employer covers my health insurance 100%, so I don’t pay anything. After 2 years of employment, they also our dependents 100%, but I don’t have kids yet. The owners view health insurance as a necessity and is a benefit that they vow to never cut. We’re a company of about 40 employees.
I live in NH, am 51 and have a 15 year old son. Both of us have preexisting medical conditions. When I became self employed, I maxed out my works cobra and then I purchased insurance from our states “high risk insurance pool” I was not insurable under the regular private health plans. I pay $1100 a month (yes a month) and it has a $1000 deductible per person. Drugs and doctor visits get a copay and aren’t subject to the deductible. (My son’s medication he needs is very expensive, so this is good) So we pay about $14,000 a year in health care costs. (But its still worth it to me because the income I earn being self employed is so much more than when I worked for someone else) I guess I should check to see if we have new options since the Affordable Health Care was passed
NH does appear to have pre-existing condition plans under the new health law, but according to the website I found the premiums can be as much as $1023 per month, depending on the region you’re in. Still, it’s worth checking into. Google “New Hampshire” and “pre-existing condition.” Good luck.
Self-employed young family (2 small kids). We pay $800/month for coverage with a $5000 deductible — no vision, dental or preventative care — with a 70/30 split after that.
All maternity costs for our recent addition had to be paid out of pocket – we used a local non-profit to keep the costs somewhat reasonable ($18k).
As others may have already commented, it’s only a boring subject until you DON’T have it. Just contemplating the financial implications of not having it at a critical time turns into a pretty interesting subject to me.
I work for the federal gov’t (U.S.):
My health insurance (for a single person) per month is:
Vision $9
Dental $27
Health $188
Re: the uninsured, my parents are on COBRA right now and it’s $1,250 per month total for the two of them.
@JD I know you mentioned you did not want discussion on socialized versus private healthcare, but if you ever do, please contact me! I’ve lived and worked in the UK and US and my family is Canadian, so I’ve got a pretty good perspective on both.
My health insurance is provided by my employer without cost. The hidden cost of healthinsurance is how you use it. I have a Flexible Spending Account (FSA) to use pretax dollars to pay for my health costs. If I did not take advantage of that, I would use aftertax dollars which is much more expensive.
I work full time with no health benefits. I pay $308.55 for Blue Cross Blue Shield of Illinois that covers medical and dental. It has a $2,500 deductible and $3,000 out of pocket expenses. Oh, and $30 copays for doctor visits.
My insurance doesn’t cover pregnancies, the premium to include it to expensive. Since I’m not dating anyone right now, it is not issue.
I have an s-corp in which I’m the sole employee, and have set up health insurance through my s-corp. Technically, it’s a group plan for the employees of the s-corp, but I’m the only employee; if I hired additional employees (which I have no plans to do, since it’s easier to hire subcontractors), I’d have to provide them the same health insurance benefits.
Anywho, I’ve set things up so that my s-corp pays 100% of the employee health insurance premiums. Currently, for my family of 4, that runs just a smidge over $1,200 per month. However, having the s-corp pay those premiums is essentially like paying with pre-tax dollars.
Several years ago when I started my consulting business, our family had health insurance through my wife’s job; when she was laid off, we continued our coverage through COBRA until that expired (18 months is the limit). Before COBRA expired, we explored other ways to obtain health insurance, but knew we’d be denied, since my wife has a pre-existing condition (2 hip replacements). Fortunately, our state (New Mexico) legislature had created a program for small businesses to obtain health insurance, so we signed up with that, and that’s what we’ve stayed with over the past couple of years. Essentially, it allows small businesses to purchase group plans. Our insurance is through Blue Cross Blue Shield, and is adequate though not stellar. It does NOT cover vision or dental, so we pay those costs out-of-pocket, and plan accordingly.
So, although the premiums are expensive, it’s pretty much the only option, since we’d never consider going without health insurance–given our family situation and the knowledge that health-related costs are the #1 cause of personal bankruptcies in the U.S.
BTW, if you feel stuck in your day job because of the “great” benefits, think again; there are plenty of options for getting the same or better benefits while self-employed. Besides the health insurance benefit, I’ve set up a retirement plan through my s-corp (a SEP-IRA), where my s-corp contributes up to 25% of (my) employee salary to the SEP-IRA, and I have unlimited investment options. The SEP-IRA is an even better option than a 401(k), since there are none of the administrative fees of a 401(k) and I’m not limited to a dozen or so investment choices.
Besides, being self-employed, you can make a LOT more (I QUADRUPLED my former salary) and have MORE financial security, since you’re not dependent on a single employer for your income.
Greg Miliates
http://www.StartMyConsultingBusiness.com
State employee here, that’s the only way I could ever get any health insurance given all my preexisting condition issues.
Single, female, no dependents, mid 40’s.
Less than $10/mo for a really good HMO (consistently one of the top 5 in the country, well it’s a not-for-profit, more than 94% of premiums go for care, not profits or overhead). $25 copay for non-specialist visits, $40 for specialists. Drugs: $7/$25/$40 depending on generics or not. $50 for ER visit, max $250 for hospital stay. I had outpatient surgery this summer, major stuff, and paid nothing, nada, zilch. Two years ago I had inpatient surgery, major complications, ICU, one week stay etc. and paid a grand total of $250.
This is changing, of course, as a state employee I am told I have to “share the pain” in this race to the bottom, never mind that I make over 5X less than most of the people who graduated when I did (law school) now, no raises in 5 years, in fact I’m making less than I did 5 years ago.
Also, no vision or dental coverage — they offer plans you can pay for but they’re worthless. So I’m getting two (cracked — DON’T CHEW ICE EVER) teeth crowned in Jan. at a cost of $2400 or so out of pocket, at least that’s coming from flexmed pre-tax dollars.
It’s also helpful for people to mention which state they live in, as that information also has impacts on price/coverage of health insurance.
I buy insurance independently. I used the ehealthinsurance website to find my insurer/plan. I am in my 30s, female, non-smoker, WA state. I pay approx. $315/month for Regence, for $1000 deductible plan that includes maternity coverage. Previously, I paid approx. $150/month for a similar plan, with a higher deductible, that did not include maternity coverage.
I know $300 month (or even $150 month) seems like a lot of money to pay for insurance. However, at my last job, I prepared the checks that my employer sent to our insurer. The premiums were between $400 – $500 month, for a very similar Regence plan that had a much higher deductible. I can only assume that the higher rates were due to it being a group plan that was required to accept everyone, regardless of pre-exisiting conditions. (Even though there were still limitations on when they would start coverage for a pre-existing condition.)However, I don’t think I’m getting cheaper rates now because I’m such a image of perfect health on paper – I happen to have some pre-existing conditions, which I disclosed in my application. The big factor on price seems to be age and smoking status.
My husband is a member of a professional organization that gives him access to a group plan, and we looked into it for our family, and it seemed to be more expensive for less comprehensive coverage.
I am satisfied with my coverage. The insurer pays what they are supposed to pay. Knock on wood, no “surprises” thus far. But I’m an accountant, so maybe I am more used to digging through the front and back ends of numbers than other people are …
I’m self-employed. I get poverty coverage through a local hospital (NM), which is a disincentive to make money. Basically I need to remain within certain income guidelines in order to get medical care. My copays have run from $20 per visit in good times to $5 per visit when near ruin. This coverage includes mental health (therapy), which helps me keep sane and productive. It also covers prescriptions, though I’m not on meds (ha). This past year I had minor surgery and I’m glad I didn’t have to hock a kidney to pay for it. This thing is a beacon of light in an otherwise bleak world.
If I make too much to qualify for this program I could get private insurance for medical care only. The cheapest I could get is $200/mo with a $5K deductible. I could swing the $200/mo, but the deductible would kill me. I don’t have $5K sitting around. I would need to make enough of a leap in income to allow me to save $5K/year before I switch in order to be safe from bodily harm. Then I’d have to find an affordable shrink. This obviously sucks.
I also paid $500 for a recent oral surgery (X-rays + wisdom tooth nuking). They tried to sell me on the wonders of implants to replace root canals but with a price tag of $1700 I laughed it off.
2014 couldn’t be here sooner. I’d like to be able to focus on making more money without worrying about losing health coverage. I also can’t move out of my county if I want to have health care. We have a very stupid system in this country and the people who want to keep it that way are bananas.
Is there an asset limit along with the income limit to be eligible for this coverage? I live in the Midwest, and I had clients that received state benefits. They could not acquire assets beyond a certain point, and their bank accounts would be routinely audited I believe. I was just wondering would it be next to logisitcally impossible for you to save the $5K to transition to the private coverage.
I’m self-employed in my 50’s. Have an individual policy through Regence/BCBS. Pay approx $360 per month for policy with $3500 annual deductible. The policy is an HSA (Health Savings Account) which requires a high deductible, allows contributions to my savings account which are tax-deductible. Unlike a Flexible Spending Account, I don’t need to exhaust the savings account each year. I must use the savings account strictly for paying my medical expenses (can’t pay my premiums from the account.) However, I believe the HSA will allow me to use the monies to pay (or reimburse myself) for Medicare premiums once I reach that age (and if there are any funds left at that time!) Also, I don’t have to pay my medical expenses from the HSA, I can pay out of pocket if I choose and then include with with itemized deductions on year-end taxes if that is an advantage (some years it is…)
PROS: At my age (50’s) the premium is more affordable than an individual low-deductible policy. The savings account allows me to save for years when when I might not be so healthy. The tax write-off is handy.
CONS: This plan doesn’t include dental or vision coverage. (I can still use the savings to pay those expenses though) There’s also the risk that I might have expenses that meet or exceed the high deductible for several years in a row and exhaust the savings account, then would be forced to pay out of pocket. I think you would basically call this plan a catastrophic plan, with tax benefits!
I live in CA. I have an employer family plan. High deductible through Kaiser. We pay $409 for medical, dental, vision. $15 copay for docs, and we pay various other percentages for other services. Prescriptions are covered, $7 for one month generic, more for brand name stuff.
I choose the cheapest option available from my employer, an HMO, which covers me and my children. It costs $187 a month including dental.
Our family (of 4) plan is through my husband’s employer (in the USA). The premiums are $4,420/annually.
His company pays the first $2,000 of our out-of-pocket expenses toward the deductible, so things like prescriptions, office copays, etc. are covered under that. Well-visits are covered, one per year per person.
After the first $2k, we are on the hook for the second $2k. If we spend that full amount, then the insurance company will jump back in and we will pay 10% of costs, they will pay 90% up to $8,000/year total.
Whew, complicated!
We’ve only had this 6 months. I anticipate if we have a big expense, such as the birth of a child or a surgery or big ER visit, we’ll need to reach in our pocket and pay toward our deductible. In other years, we won’t.
We do not have vision or dental insurance, but we do have a private dental discount plan. The company’s dental insurance was really expensive and didn’t even cover very much.
I recently quit my job and picked up a $100 a month plan for my husband and I. It has a $5,000 per person deductible and it only intended to cover us if something horrible happens. I use walk in clinics and pay cash if necessary. We are in our late 20’s and luckily very healthy. My husband is also a veteran so anything that involves his back or knees is covered by the VA due to service injuries.
I have a PPO through my employer–$300 deductible, 100% coverage for most services. Extremely rich plan. For single coverage, this year I only paid about $60/mo for it but it’s risen for 2012 to about $80 due to the introduction of a lower-cost plan.
We also have nice PPO dental at 100%/80% with no deductible, $8/mo. Vision is VSP, one exam and glasses allowance per calendar year, $7/mo.
So for insurance alone I’m paying about $95/mo, pre-tax.
We also have FSA–I put in my deductible plus a copay or two for routine checkups, $26/mo.
With the FSA, altogether I’m paying about $120/mo pre-tax through payroll.
In 2013 it will most likely be something like $80 or $100 when forced to the lesser plan.
I get my insurance as an employee of the US Government. I recently signed up for the following (publicly available info):
GEHA High Plan (Self + Family): $202.33 biweekly
GEHA Dental High (Self + 1): $29.77 biweekly
VSP Vision (Self + 1): $12.12 biweekly
Total: $244.22 biweekly, $529.14 monthly, $6,349.72 annually – all deducted from my pay pre-tax.
My employer picks up 75% of the cost of my premiums, so they’re laying out $19049.16 annually.
This is not the most expensive or comprehensive plan available, but my analysis of the options showed it to be the sweet-spot of coverage (& satisfaction rating) for the money among high-coverage, nationwide offerings.
We want to start a family and will likely be incurring large medical bills this year. I do not want my wife to have to think twice about whether or not she should go see a doctor. I know that if I were to have to make per-visit financial decisions, then I would not seek medical treatment nearly as often as I should.
Hi All,
I am completely shocked and amazed at how much people spend on health insurance. It just doesn’t make any economic sense.
It’s also amazing to see how costs jump when you turn 50, and you don’t even have dependents anymore!
Pay more for maternity insurance? Guess the insurance companies found out where they are losing money. The thing is if you have maternity insurance for 6 months and then have your baby 9 months after that, can you then stop paying maternity insurance? If not you might as well pay out of pocket for it.
I’d say to make this discussion balanced you also need to mention the option of “self-insuring”. HSA’s were a step in the right direction, but they don’t go fully there.
I’d say to beat the insurance companies you have to be an actuary in your own right, and then make the best decisions from there.
We pay a premium on health insurance because people value their health so highly. But notice that they use the word “premium” when they talk about what you pay for insurance. You can’t really get regular or plus, you have to pay a premium for this service.
This is why we can’t really fix this broken system. There can’t be health care reform. There needs to be a whole revolution in the way we think about health and how we go about staying healthy.
Cheers,
Jeremy
Healthy young people sometimes think that they can self-insure but a serious illness (and people that get serious illnesses aren’t always people with bad health habits)can put you back hundreds of thousands – or even millions of dollars. Only millionaires can self-insure.
You can however self-insure for the basics and the less expensive health issues. It is called a high deductible plan.
Age: 25
Married (spouse age 25)
Bi-weekly premium: $60 ($1580 annually)
Annual Deductible: $1200 individual; $2400 family
Costs: 10% after deductible; 0% for preventative care
Prescription drugs: 10% after deductible
Annual Out-of-pocket max: $4000 self; $8000 family
HSA contribution (saving for pregnancy bills)
Me:$5650 annually; Employer:$600/annually
Canadian here! As others have mentioned, doctors’ visits and hospital costs are covered by my provincial health plan, which I pay for in income taxes and with a $600 yearly “health premium” that also comes out of my taxes.
I also have coverage through my employer. Looking at my pay stub… My gross biweekly income is $2,927.40. Off that comes my income taxes, Canada Pension Plan contribution, Employment Insurance contribution, employer pension contribution, group life and long-term disability insurance, extended health coverage ($9.13/paycheck) and dental ($5.76/paycheck).
Extended health covers 90% of drug costs up to a yearly ceiling, after which it’s 100% covered. It also covers $200 each per year of physiotherapy, massage therapy, orthotics and a few other things, plus an eye exam every 2 years. Dental is 90% covered.
I don’t know offhand how much my employer kicks in to any of these things.
I’m generally pretty satisfied with my coverage – I rarely remember or use up my massage and physio benefits but it’s nice to have them when I do. My dental and drug coverage is great. The only thing that could stand to improve is the vision coverage, which is fairly mingy if you wear glasses.
What are massage and physio benefits? How does it work — do all Canadians get these? Wow…
We typically get basic healthcare from government insurance, and can get extended health benefits from employers, depending on the job. These plans can cover things not covered by provincial insurance, like chiropractic, dental, massage (medically needed), eye doctor visits, prescriptions, etc. I have this through my university, it pays 80% of the cost of procedures and prescriptions until my annual cap of $1500, after which things are covered 100%.
For myself and my daughter I am charged per month:
Medical 792.60
Dental 72.96
Vision 12.29
And that looks HORRIBLE. Thankfully, I get credits from my employer to help cover these costs.
Medical 583.16
Dental 18.50
My actual cost for myself and one dependent each month is:
Medical 209.44
Dental 54.46
Vision 12.29
When my daughter goes on her own employer’s group insurance in January, I will be down to paying a LOT less. Like in the neigborhood of $20.00 a month for health. And that’s in Oklahoma, for those taking geography into account.
I live in NYC where health care costs are generally higher than average (that would have been a good data point to include in the survey). Right now I have excellent blue-chip medical and dental coverage through my employer. I pay $160 per paycheck, or $4160/year, for both medical and dental for me, my spouse, and children. My employer pays an additional $14,700/year, according to the benefits statement I get. Total annual cost: $18,860, with most of it covered by my employer. It’s a PPO plan with no PCP gatekeeping, mental health coverage, generous Rx benefit. 80/20 coinsurance (70/30 out of network) after meeting a $500 deductible.
I used to be self-employed and got insurance through a variety of brokers for independent contractors, or through professional organizations. Just before I took my current job I was paying $1400/month ($16,800/year) for medical only, a plan far inferior to what I have now: HMO, no mental health coverage, limited Rx coverage, limited specialist access, no out of network coverage. $25 copay for PCP, $40 copay for specialist.
Hi
Our insurance is a little high up here in Maine. We are 45 and 46 years old with a 10 year old daughter, non smokers, “perfect” health. We pay 500 per month with a $15,000 per person deductible (30k max for family). We have zero riders. we pay 100% of our prescriptions, dental, deductibles, etc. out of pocket. (we are grandfathered into a policy with no wellness benefit which is good, becuase cost for wellness almost ALWAYS exceeds the cost of the wellness visits by a large margin) We also have no co pays.
We thoroughly investigate options every year. Our company is anthem. We’ve toyed with the idea of using “mega” but just haven’t gotten the nerve to switch.
Unemployed on disability with a chronic illness, turned 33 on December 1st – to give you an idea.
Up until September 2011 my payment was:
$367/month
$1000 deductible plus 20% on all services.
Out of pocket health expenses exceeded about $250/month, not including my dental bill which is about $100/month right now.
My monthly healthcare output was over $717/month just for me which is a lot for someone on a fixed income.
I am now on Medicare, but still paying some of the monthly out of pocket costs from the previous two and a half years. I still pay about $250/month until its all paid off.
I pay $300 for an employer-sponsored plan that covers my son and me. It is a PPO, which gives us some flexibility with what doctors and facilities to use. I have co-pays, co-insurance amounts, and out-of-pocket maximums. Specialists are a $40 co-pay; general doctors are a $30 co-pay. My current out-of-pocket max is $10,000 per person, a big jump from last year’s $5,000 total. For most people, this is not a big deal, but our son will be having a third craniectomy this summer. Those surgeries cost in the six figures, guaranteeing that we will have to suddenly cough up the $10,000 and go even deeper into debt. There’s only so much to be done on a teacher’s salary and time.
I live in Pdx, OR and my husband and I are now self-employed with one child. I used an insurance broker to help us find a good policy (Sue Ober). My daughter and I are insured through PacificSource on different policies. I found it interesting it was less expensive to have two separate policies rather than one that covered us both. My policy is $210/mo and her’s is $140/mo. The deductible is $2500 with $20 co-pays. It includes chiro visits, rx coverage @ 100% for generics and dental.
My struggle was that we are very healthy–haven’t been to a dr in over 3 yrs for either of us–so I didn’t want to over-insure but I wanted to have good enough coverage in case of an accident. My daughter is very active in sports and there is always the possibility of broken bones/concussion/etc.
My husband is currently on COBRA paying $465/mo.
For Health insurance, my family pays $208 per month (for 2 adults and 1 child), with my employer contributing another $509 per month. We have no deductable, $25 copays for office visits, $100 copays for hospital visits, and we also owe 10% of the cost (co-insurance). I’m not positive what the annual max out of pocket is, but I think it’s around $4000 (above the 208 per month).
A lot of items are covered.
Dental and vision are separate and I pay around $60 a month for those.
I am forced to particpate in coverage through my employer. I phrase it that way because, as a single, healthy, non-smoking 25 year old male, I can get equivalent coverage on my own for HALF of the cost. My employer doesn’t cover any of the premiums, and the only way to opt out is with proof of another, equivalent (as decided by the HR gnomes) group plan – generally through a spouse’s employer, for those that are married.
My plan of choice is a HDHP with a $5000 deductible, and I paid just over $1800 in premiums last year – didn’t use the plan once. I’m maxing out HSA contributions as well.
For those keeping track, I live in Ohio. My aunt, intersetingly, is the head health insurance lawyer for Pennsylvania. I pick her brain on this subject pretty regularly, and have come to the conclusion that there’s basically no more affordable solution open to me :(
I work for a small/medium size company in MA and I dread this time of year because in the next few days I will find out how much my health insurance premium will increase. It’s increased every year in the 9 years I’ve been here. And often our employer changes insurance plans shopping for the least expensive. Right now I pay $639.50 per month for a family plan that covers my husband and me. I pay 60%, employer pays 40%. This is for a Harvard Pilgrim PPO which is a good plan but we have a $3000 family deductible before benefits kick in. Annual physical requires $20 co-pay. I’m grateful to have insurance but the cost is eating up more and more of my paycheck.
My husband retired from law enforcement, so we are covered under his plan through the police association. It’s $1400 a month for both of us, with a $250 per year family deductible. (We are mid-50s’ and our children are both grown and have their own plans through their employers.) The police association also pays an additional $400 a month, so the actual cost is $1800 monthly. We have dental coverage also that is included in the plan. Since we moved out of state, this was the only plan available for us…Blue Cross. If we had stayed in state, it would have cost us much less and we would have had other options; however, it was well worth it to move out of California to Oregon and a much lower cost of living and a higher quality of life!
We pay a small percentage for each doctor’s visit, medical testing, blood work, surgery, treatments,or hospital stay. A couple of years ago, my husband had a major medical issue. The total cost of his care for 1 year was over $100,000.00 We paid in addition to our premiums, about $10,000.00
In Ireland our basically free medical system isn’t pefect with waiting lists for certain procedures and some charges etc but the poor and elderly pay nothing. A person here would never be bankrupted because of illness. Most people accept that there are additional social security charges to pay for this. The American system seems so unjust and harsh for poorer/older people. Also having read the comments medical insurance charges seem enormous for Americans especially those not covered through a work plan.
I am a 27 year old female. I have a HMO choice program through my employer. They pay 50%, so I pay about $250 per month for myself. The copays are $20 for doctor, $30-40 for specialist. This includes vision (I wear glasses/contacts). My husband works for the same employer, but being a male his insurance for the same plan is significantly less (I can’t remember the exact number, but it’s around half of what I pay). We have dental on his plan for about $30.
I had a lower plan, but we are trying to have a baby, and the value ppo I had this year covered only 30% for hospital stays after a $4000 deductible, and the copay for a specialist visit was $60.
I would like to stay home when we have a child, at least to breastfeed, but our employer pays only 50% of the policy on the employee. So basically they would pay half of one third of the monthly cost. So to add myself and a baby to his current plan is going to be way out of our budget. I was looking at it during enrollment a month ago and it was somewhere in the $2000s per month for even the crappy coverage. I don’t know what we are going to do when that time comes. We live in FL, and there is a Healthy Start plan for children but I think I’ll end up SOL. Of course this is all contingent upon actually conceiving a child, which has yet to happen (we only started 3 months ago and my body is still regulating from ceasing BC pills).
Any advice (on the insurance, not the baby-making LOL)?
My wife and I are on two separate insurance plans. Hers is completely paid for by her employer. She had the option to switch to a higher plan which would have meant paying a premium, but also higher benefits.
I am a graduate student who buys insurance through my school for $1000 per semester ($2000/year). This was cheaper overall than adding me to my wife’s plan. Due to the peculiarities of my schooling, I had been getting a $500 subsidy from the school while I was on a teaching assistanceship, but now that I am on a research assistanceship I don’t get that subsidy.
Insurance through my employer, employee-only. (If I had a family the rates would dramatically increase and I would face a new spousal surcharge)
PPO, $300 deductible, 100% coverage, $20 copays
$40/biweekly, up from $28
Dental, no deductible, 100% preventative, 80% other
$4/biweekly
VSP vision, exam $10, lenses $20, allowance of $150 per frame once per calendar year
$3.50/biweekly, up from $.50
FSA, I contribute $13/biweekly to cover the deductible and a few copays.
In 2013 I will be moved to a 80% PPO plan with a $400 deductible, but with premiums back down at $28/biweekly.
I think I’m fortunate to have these options, but honestly I’d prefer a HSA with an employer contribution over the insurance–I’m young and healthy, and even the medical issues I’ve had wouldn’t have totaled to very high health costs.
My husband and I are self-employed, and so must buy our own health insurance through Blue Cross and Blue Shield. We will pay over $9000 next year in premiums for us and our one child. Our policies have $5000 deductibles, and our daughter’s has a $1000 deductible. This is for medical only, no vision or dental. We have carefully researched other policies and this is the most cost effective. But, do the math, and you’ll see that health care could easily drive us into bankruptcy if worse came to worst and we actually needed to spend our deductibles each year.
I work for a state agency. The total cost of my health insurance for my employer is $1,251 a month, and my part of that is $169.90 a month. My employer pays 100% of my premium and most of the premium for my two daughters (leaving the balance that I pay of $169.90). This deduction is pre-tax. My part was higher until last year when my husband got a job at a non-profit with a good plan. I took him off my plan when he became eligible. I don’t know how much it costs his employer, but he pays about $79 a month for his coverage.
We are very grateful we have this coverage. We are both in our fifties. We don’t take any Rx drugs and are healthy, but it’s there if we ever need it, plus, if I retire from this agency, I can keep the coverage.
At my last employer, I paid $950 a month for myself and one daughter. Prior to that, we were self-employed. Some years, we did without insurance. Others, we paid about $1,100 a month for a high-deductible plan.
I’m really looking for more options myself, since the family plan (medical/dental/vision) for next year is going to clock in at over $1500/month, and will go higher after COBRA kicks in. The open-market plans that I’ve been quoted on so far for similar coverage is similarly ridiculous! I’m hoping I can find a better option before medical becomes the majority of my budget.
I signed up for the cheapest plan offered (an HMO) through my employer. It does not cover vision or dental (those were offered separately at additional cost, and I declined. I just pay for eyecare and dental care myself).
It is an individual plan. I pay $45.28 per month and my employer pays $345.34 (total cost of insurance is $390.62). The costs for adding a spouse or a family are astronomically higher. If I could afford to choose the PPO (which is the level I enjoyed for most of my life — I’m now 50), I would be paying $275.45 per month and my employer would pay $345.34, for a total monthly cost of $620.79.
With my HMO, I pay $30 per office visit but $40 if I go to a specialist or urgent care center. All labs and x-rays are covered. I pay $100 if I go to the emergency room. My deductible is $500. My annual out of pocket maximum I pay is $2,500. The HMO covers everything else, however I MUST go to an in-network doctor. The only exception is in the case of an emergency, and then any doctor is fully covered. Prescription drugs are covered with no deductible and I pay $10 per prescription for generic.
I would much rather be able to choose my own doctors, but this is the plan I can afford. The employee portion of the insurance (which includes increased costs) increased this year about 22% over last year’s.
I am incredibly healthy and hope/plan to stay that way — that is part of my “health insurance plan.” (my own lifestyle choices)
I pay for insurance on my own. I pay $133/month. I’m a 25 year old female, healthy. I used ehealthinsurance to search for insurance options and picked the best one for my needs. So, I have a high deductible of $5,000. My regular doc copays are $30, specialist, $40, and emergency, $100.
I work for a small business and my employer doesn’t provide insurance. My insurance is pretty good in that my copays are reasonable and the cost for my only prescription, birth control, is reasonable. I wish I didn’t have to pay for it on my own, but it works.
However, I do know that when I went to a dermatologist with that insurance, when my annual statement arrived giving me options for cost, my current plan increased dramatically (by $40/month).
So, the biggest con of my insurance is the fear that if I go to a specialist for anything, my insurance will skyrocket.
I’m quite sure that it wasn’t you using your plan.
They all go up by about that much each year – at least. And, birth control can be had for free from local county health centers. They were always nicer, friendly, and clean too.
I’m 31, unemployed, and currently have short-term insurance that I pay $100 a month for. I think the deductible is about $2500 per year. It’s a pretty bare bones plan, but it covers the basics and my prescriptions. My medication copays are 20% of the cost, which for me is about $70 per month for all of my medication (I have a couple chronic conditions requiring daily medication). Doctor copays are $20, Urgent Care is $50.
But ask me again in February when the short term insurance runs out, and my answer will probably be that I’m not able to get insurance and my prescriptions now cost about $500 per month.
We have family coverage through my husbands employers. Costs us $782/month, not sure what employer pays. Our copays are $45 dr, $65 specialist (including ob/gyn!!), $300 ER copay. Our costs nearly tripled this year, same plan as previous years though. :( Blue Cross Blue Shield, it includes dental and eye, with a separate prescription plan through Express Scripts which is a nightmare!!!
Retired educators here in AZ and got insurance through the school as it was cheaper (!) than what the retirement system offered. Just for medical for me and my husband and 2 older sons not covered elsewhere, is $777 a month. Still have to pay for vision and dental about $250 a year. Benefits have eroded this last year and for a higher premium we have less coverage. Shaking in my boots to see how high the costs will be next season.
We get it through my husband’s employer, on the west coast, for a family with kids. Coverage is pretty good…no deductible in most cases, reasonable copays. We have to stay in network, but the network is huge. We pay 496/month out of his paycheck (pre tax). Last year the same plan was 373/month. I don’t recall how much the increase will be in 2012…I’d have to look that up.
We have five choices actually, but four of them are different plans with the same company. We choose the middle plan, if you go by monthly premiums, but of course, we think it’s the most cost effective for us overall…hence the choice :)
Oh, and we get “free” vision and dental through the same employer. I have a shaky grasp on our prescription coverage, because thankfully, we hardly ever have any to fill.
I live in Washington and we get our coverage through my husband’s job. It’s roughly $500 per month.
I’m also an insurance agent, and have a couple of thoughts:
*If you need to get individual insurance, you can start with online options, but I recommend finding an agent that you trust. It doesn’t cost you anything extra, and they can walk you through all of the details of the different plans. They will be your advocate with the insurance company if there are billing or claim issues.
*Families don’t all have to be on the same plan – if one person has a condition that requires more care, consider putting them on a plan with broader coverage.
*If adding your dependents to your employer coverage is too expensive, consider putting them on an individual plan. I am seeing this more and more as employers try to reduce costs by passing premium costs on to employees.
*Don’t forget to look at the maximum out-of-pocket costs of a plan. In WA, many of the HSA high deductible family plans have deductibles that are comparable to to the traditional plans, but the max out-of-pocket is less than half – $10,000 rather than $20,000+.
Individual plan purchased by me in NJ costs about $320 a month. Coverage is mostly catastrophic, no drugs, dental or vision and limit on doctor visits and labs.
$1,042 monthly for him, $985 for her, with a $5,000 deductible each! Healthy 60-64 year olds, although we are in Texas Health Insurance Risk Pool, where rates are mandated by State law to be twice the going rate for non-rated individuals! The risk pool didn’t even have to pay for the past conditions for which we received the ongoing rating.
Under the foul healthcare reform act, even though a reasonable cost national risk pool should be available, we are prohibited from taking part in it because we are already in Texas’ exorbitant plan.
I get single coverage through my employer. It’s a good plan. I pay $190 per month and my employer pays $340. The ratio is because I am part of management. Entry-level staff only pay 5% and the company pays 95%.
I wish I had time to read all of these. JD, are you going to do some kind of summary post? I hope so.
I am self-employed and buy my own independent policy. It’s $295 a month, including maternity coverage. $2700 deductible, then a 50% co-pay up to a total of $5000 out of pocket, after which I pay nothing. I can contribute $3050 each year into an HSA, which I do.
In 2011 and 2010, I had an unexpected surgery each year (no previous health problems). It was a relief to know the maximum I’d have to pay was $5000.
I keep my policy separate from my husband’s because he is covered at work for $20 a month (very low deductible, like $200) and because adding him to my policy would double my OOP max to $10,000. His health expenses in a year are typically about $100 total. To add me to his insurance would boost the cost to $450 a month (!!). Also, his insurance has no OOP max.
The worst part is paying for the maternity coverage for the past 2.5 years and not being able to get pregnant. I’ve wanted to drop it many times (the premium without it would be closer to $120), but I keep hoping every month that this will be THE month. :/
We pay $350/month for health, dental and this year eye. Deductible is $250/person per year, with max out of pocket at $3400. Copay is $25/visit and $30 specialist. Preventative care is now no deductible. Most years, we probably pay more than we get back, but it was well worth it for when I was pregnant and the subsequent 2 hernia surgeries I had to have. MOre than paid for it!
I get my insurance through Carefirst Blue Cross/Blue Shield. I’m 43, pay $166/month for a $3k deductible and then put aside another $85 into an HSA. I rarely use health insurance, and have considered going without it, as I did for many years, but the older I get…..
Self-employed, age 60. I’m extremely healthy. Only hospitalization was birth of my son. I have never once met my deductible, even when it was $500 per year. My premiums have soared over the past couple of years, so I increased my deductible. If I left deductible the same, I would be paying over $2,000 a month for myself only. I now pay $460 a month for myself – with a $5,200 deductible and out of pocket of $20,800. That’s if I stay in-network. Out of network is double that or 10,400 deductible. Basically, I pay for the privilege of self-insuring, with insurance kicking in only for a catastrophic event. Bah.
We are a family of 5 living in Southern CA. We are self-employed and have full medical and dental coverage through Blue Shield. It is a PPO plans with a health savings account attached (HSA).
We pay $615/month for medical and $123/month for dental.
The dental is great! Full coverage for 2 cleanings a year. It has been a great plan for our family. Before that plan, I would be trying to scrap together the $80+ for each child to go to the dentist only once a year. Now that it is automatically deducted from our account, I send all of us to the dentist twice a year. No cavities for us! Plus the kids will have 50% coverage for Orthodontics if needed.
Not as thrilled with the medical. It has a high deductible, $3,600 a year. We feel like we are constantly paying out of pocket for little things, plus co-pays. The premium is realatively low compared to some of my friends and it does not have maternity benefits.
Eventually, we’d like to be able to build up a large savings account.
We’re self employed so we buy our own health insurance. In Rhode Island there is only one (ONE) company that will sell you directly (unless your income is low enough to go on the state plan) – Blue Cross Blue Shield of RI. Luckily we qualified for the “prefered rates” (which I think is still too high). We pay $637/month for family coverage and a $4,000 deductable (which is not a high enough deductable for us to get the hsa). I’ve looked at the higher deductable plans but the premiums are still up there so it doesn’t seem worth it for us. Really hoping there are more options with the state exchanges….
I will be interested in tis topic to see affordable insurance. I have never been covered by insurance so I usually ignore things like broken bones or health issues. I know this is bad but is only recently where I would qualify for government insurance and even with that it would not cover the extensive dental I need done. Approaching my mid- 40s though I know it is real important for me to do something for insurance and soon!
My husband and I each have insurance individually through our employers. I added him to my dental plan because it’s better than his. I pay $22 per pay total for both of us.
We recently added a baby to my plan and pay $240 per pay for him.
Do you want to know the deductibles and copays as well?
Family coverage through my husband’s employer (all amounts are biweekly) – PPO medical is $204 and will be $220 in 2012. Dental is $30.50, and we’re changing to the the lower coverage option in 2012, so the premium will go down to $17.
I am one of the very privileged few Americans who has fantastic health coverage via my employer.
I do not have to pay anything. I have coverage via a private PPO for me and my husband. My husband is also covered for free. This includes dental.I am 32 years old. My husband is 35.
My employer also provides a $1000 per year health care account so, if I have to pay for co-pays, or new eyeglasses, or anything that the insurance does not cover, I can get reimbursed.
Wow, where do I sign up?
I have health insurance through my university employer in the US (California). It is an HMO type plan and I pay roughly $18/mo for both me and my huband combined. Dental, vision, and a basic life insurance policy is included at no additional cost to me. However, there are many plan offerings that are significantly more money with PPO type plans but I do not choose those. I am satisfied with my care although it has been frustrating if I want to go “out of network” and the claim is denied. My employer also has a tiered system where I believe the cutoff is $40K/yr salary. Those above that pay more of a health insurance premium.
My portion of insurance is about 5K a year, for family (no dental). This year it’s been running about another 1K in out of pocket expenses (this includes dental).
I am a 27 year old, healthy, active, single woman with no kids. I work for a large corporation and am also in a union. Although I have other issues with being forced to join a union, I guess I can thank them for the great benefits.
My employer offers three different plans each with different costs to the employee. The deductibles and co-pays are different (and maybe different networks, but I’ve never had a problem finding providers with any of the options for traditional medicine – only one plan covers alternative options like naturopathic medicine). All three options covers pretty much everything (basic care, hospitalizations, prescription drugs, mental health, pregnancy, ER, preventative care, eye, dental). There is also a high-deductible plan with an FSA to which the company will contribute $700 annually. I chose not to do this because it doesn’t cover prescription drugs.
I don’t pay anything toward the premium for the plan I have, which covers just me, but my annual deductible is $225 with an annual out-of-pocket maximum of $2000. I have $15 copays ($50 for ER) and the rest is 100% covered for in-network. The deductible doesn’t apply to preventative care. I also contribute $250 annually to an HSA. Prescription drugs are covered differently for generic or formulary and also if you use a retail pharmacy or a mail-order company. I have one recurring medication that I obtain through the mail-order company and costs me $10/month. According to HR, my employer pays $6116 annual for my portion of the group plan. I didn’t go the doctor this year so my expenses were low. This year, my out-of-pocket expenses were $120 for drugs and $135 for contacts.
My employer also provides basic life insurance (includes AD&D) and short-term disability insurance (80% of salary for 12 weeks and 60% of salary for another 13 weeks), which annually costs them $215 and $319, respectively. I add long term disability insurance (60% of salary after short term disability runs out until age 65 or until I am able to return to work) for $224 annually.
I’m a healthy, non-smoking, 34-year-old freelancer living in Texas. I pay $120/month for a $5000 deductible plan with HSA through Humana. I contribute $200/month to my HSA to cover dental, vision and mental health costs.
Two tips:
(1) Find a good broker – they can find better deals than you can. Mine was able to cut my self-employed mom’s premium in half!
(2) Dental insurance isn’t always worth it for the self employed. My cleanings and X-rays total less than $200/year. To me, I’d rather save for that possible emergency than pay for a premium that still doesn’t cover it all.
Country: Australia
Insurance: Self insured because of free public health insurance employers don’t pay. $108 per month includes full hospital and dental, optical, chiropractic, massage, physiotherapy etc.
Example: this year I had to get my gallbladder out. Emergency visit where they diagnosed the problem was free due to public health where operation was a 6-8 week wait in public system due to it not being life threatening.
With my paid insurance I went through the private system. I chose my own surgeon, got it taken out that week with $1000 in fees not payed by insurance.
I am 26 years old & generally healthy (up until the last month of the year of course.) A recent ankle injury has me paying ER expenses, x-ray costs, orthopedist follow-up fee, and MRI costs. Great. My employer (a small company) pays the premiums, not sure on how much they are. I have a $1500 deductible for medical expenses, after which I only pay co-pays. Vision and dental are not included, and they are not add-on options either. Only the upper-level scientists can get them, but only if they choose the family coverage ($3000 yearly deductible). I don’t have any disability coverage or life insurance options through my job, I got them separately on my own.
I’m 26, healthy, don’t smoke. I buy my own insurance because I’m a contractor.
I have an individual plan for $132/month (going up to $165 in January).
Out of pocket cap is $2500, doctor visits are $20/visit, prescriptions are $20.
I might downgrade because I don’t tend to use my insurance often.
I work at a university and pay $100/month for HMO for myself and my daughter. My husband carries his own insurance through his job which is free for just him.
Before this job, we were paying $500/month for the three of us.
I know my mother pays $520/month for a terrible plan with something like a $5K deductible. I feel like that kind of plan only insures you against being hit by a bus.
We pay $600 a month. The small business I work for doesn’t offer any health insurance so we pay out of pocket. This is for a family plan. Male 36, Female 35 and child 6. No vision, No dental and $1000 ded per person with a max of $3000 per family per year. Oh, and the maternity deductible is now $7500!
I live in Washington state, and I’m self insured. I pay $106/month for a basic HSA. Although I really liked it when it was $68/month, I’m finding it a bit more of a burden now. Prescriptions don’t count for my deductible, and I’ve had around $400 of them this year. Perhaps I will be looking into my companies insurance soon.
I am a graduate student at a University which requires us to have health insurance. With our teaching/research assistantships, we get an insurance subsidy, which lowers the cost of insurance.
For 2011-2012, my health insurance (for just me, and after the subsidy has been applied) is $776. That’s $65/month. I have a prescription discount and a dental discount (but not full coverage). I’m required to go to our University’s clinic for any medical treatment unless it’s an emergency or I’m more than 50miles away from campus at the time.
So far, I’ve only used the prescription discounts. Next month I’ll visit the Clinic and see if it’s any good (I hear it is!).
– Where do you get your health insurance coverage? Aetna
– From an employer? Yes, retired from Bank of America, not COBRA, been retired for 10 years.
– From the government of the country where you live? No.
– What sort of coverage do you have? Doctor visits, Hospitals, Labs, DME (Durable Medical Equipment, Prescription drugs, Dental and Vision.
– Do you wish you had more? No Less? No we have a choice from 6 different plans.
– What are the pros and cons of your coverage? Pros: Great coverage (for example, my CABG —Coronary Artery Bypass Graft – cost me about $650 out of pocket), no referral needed for medical specialists, very large network of Doctors and Hospitals, very good deals from Mail Order Pharmacy.
– Cons: Dental insurance coverage is weak compared to medical, for example, Referral needed for dental specialists, 50% co pay for crowns and dental appliances. Vision care insurance covers annual exam and lenses/contacts but new frames only every two years.
– How much do you pay per month? $1,415 total per month for Husband & Wife.
– Do you know how much your employer pays? No, we are told BAC subsidizes the cost for both employees and retirees but have never been told how much or what percentage.
– What sorts of co-payments do you have? Primary Physician $15 per visit, Specialist $25 per visit, ER $100, Hospital admittance $500 per admittance then 100% paid by Insurance, Dental visit $0, Vision exam $10, $0 for DME and Labs, $10 for 3 month supply of generic drugs and $20 to $80 for 3 month supply of brand name drugs. No deductibles to satisfy at all.
The background: I am 26, my husband is 25. The husband is healthy. We both don’t smoke, don’t drink but socially. I am clinically depressed.
The situation: My company offers insurance, my husband’s company does not. I got insurance thru my company seeing as independent insurance is hard to come by when you are depressed. For my personal HSA policy, I pay $34 deduction from my paycheck every two weeks. This gives me a $3000 deductible but till then, everything is out of pocket. Including medication. Prescriptive meds alone costs me $200 out of pocket. However, this is the cheapest plan my company offers as we are a small mid-sized company. If I were to add my husband to my policy, my deduction per paycheck would be $260 per paycheck. This is about 20% of my paycheck. Thankfully, since the husband is in great health and he is young, we are able to get him on a plan with Cigna independently. He pays $130 a month. He has a $1500 deductible, a $50 copay to the doctors and copays for his prescriptive meds. Not too shabby.
I pay $22 a paycheck for dental for both my husband and I. This is $25 copay and I pay 30% of cost for fillings, caps, etc which I come to understand is pretty affordable.
Our plan is through my employer. We pay $700 a month for our “in network” coverage with a $1500 annual deductible, $30 co-pay for primary care doctors and $40 deductible for specialists. It’s crazy expensive, considering we have employees at the starting levels who make $16,000 a year and the medical coverage alone takes 50% of their income.
In Idaho with a family of six, we have an individually purchased plan (with Assurant Health) for $1800/mo. We pay 100% up to our deductible of $5400, then they cover the rest.
I get my health insurance through my employer. I am fortunate that they pay 100% of my premium, which is just over $300/ month. We have $35 office visit copay; $60 specialist copay. 80% is paid by plan; no copay for preventative care. $0 deductible; $2500 individual out of pocket maximum. I’d like to complain, since we used to have a $10 copay plan, but I know I’m actually quite fortunate with this plan. Plus we just got cleared to have FSA accounts – pretax money for my prescriptions and copays?! Yes please.
My husband and I have 4 small children and are self-employed. We have paid for our own health insurance out of pocket for the past 4 years. We currently have a $5,000 deductible (10.000 for the family/per year) and we pay $386/month. We do not visit the doctor frequently, and typically choose chiropractic care over conventional medicine except in the case of acute emergencies. This system works incredibly well for us, and I feel like it holds us accountable and makes us responsible for our health, which is something I think is sorely lacking in the general American population.
I don’t pay for health care. My county (in California) covers low income people. Premiums fluctuate based on income, but I make little enough that it’s free.
We get health insurance though my husband’s employer, a very large corporation in the entertainment industry. We have coverage for us and our almost 2-year old daughter and pay approx. $472/month for a POS plan (hybrid between HMO and PPO). We pay $20 copay for visits, $30 for a “specialist” – if we want to get the most benefits, we have to treat the plan like an HMO…we are free to choose our own doctors, but out of network only pays 50% benefits. I choose carefully the ones I will do that for. We are also free to choose our own OBGYN but because of the way their system works, I have to call after every appt. to get it billed properly otherwise I am billed as if it was out of network. They do everything they can to make you use it like an HMO which sucks. That being said, we have coverage so I am happy for that.
I am freelance and have Kaiser’s (now closed) Steps Program. They start you at 20% of the full monthly costs and over the course of four years, raise it by 20% each year. The cost is determined by your age, income and number of dependents. It is a great idea, geared toward low income people/families just starting out. You must have had COBRA or Kaiser insurance previously to be eligible to join (for example, I had it through my parents until I was 23). When I started, I was paying $41/month with no co-pay. I am now in my fourth year and paying $177/mo, still no co-pay, with a few exceptions. Mine expires in April for good, there is no renewal allowed, as it is not meant to be a permanent program. It has served its purpose very well, and given me plenty of time to plan ahead about what I will do for coverage next.
Through my employer (U.S. state agency), fully paid by employer. The monthly premium is about $1300 for health, dental, pharmacy & vision. For the health portion, the only out of pocket expense to me is a $100 fee if I go to the emergency room & don’t end up getting admitted.
Considering that the main reason I went back to work 10 years ago was that I couldn’t otherwise get insurance because of a pre-existing condition, I know I am extremely fortunate.
The pharmacy, dental & vision portions have some copays & limits, but overall it is a “Cadillac” plan.
My husband has a chronic condition, so we purposefully went to work for a company that would provide good insurance coverage (a retail pharmacy). And they pride themselves on providing good coverage for their employees; looking at all of the comments I think they’re doing better than I thought.
2012’s premiums went up, as well as the deductible, but our PPO now covers 100% of all preventative care, and extra dental cleanings for diabetics, heart patients, and pregnant women.
We pay, for a family of 5, $327.24/ mo with a $3,000 deductible and 20% co-insurance. If we complete a health survey online, my husband’s employer puts $400 in an HRA (Health Reiumbursement Account).
We also pay $41.14/mo for dental for the whole family with a $50 deductible.
Our drug plan is separate from the medical plan. It requires us to buy generics if they’re available for whatever the doctor prescribes. It’s $5/mo for the prescription and $30/mo. for preferred brand name (which I assume means name brand).
In 2010 we had a baby and opted for a cadillac plan. It was $489/mo with a $500 deductible. They don’t offer that plan anymore. One thing I noticed and can’t understand, is that our employer offers two plans and they don’t really seem to be that different. One plan seems to be more per month with a smaller deductible, while the other is cheaper, but with a much higher deductible. In the end, the cost ends up the same. What is the point of that?
I have medical insurance through a Fortune 25 employer and pay approx $4000 per year for Medical, Dental and Vision coverage for family of 4. I am in my 50’s and my wife in 40’s with 2 teenagers.
I read through all US postings, and the more interesting element is that there are many self-employed / un-employed that buy insurance and it was interesting to see the rates around the country.
I have played with einsurance and assumed getting laid off to see what the rates would be for self-insuring on a medium to high deductible plan.
All answers lead to $600 t o$1200 per month for family of 2 (H+W), with a $3K to $10K deductible. This is pretty high, but considering that we can be free-birds off the shackles of employment doing the CYA daily, it might be worth it for us. We have no debt, good assets and education plan that covers kids.
Also, interestingly, our kids are covered through a Univ plan that makes it a mandatory Semester pay-plan for $400. So, technically, if we both quit working, then we can get on this plan, and stop planning for future and live the ‘life’ like the Vaco Vitae folks (earlier note by Maureen who has a website if you hover over her name).
Not sure what the future brings to each of our lives, but we have to focus on Life, and not on Work (means), and Health care (means to a good life), and Joy (purpose of life and living).
Kenny
location: CA, USA
2011 was a year of transition. Our family went from a company sponsored healthcare plan in which our out of pocket costs were in the neighborhood of around $3000 annually including all office visit and drug co-pays (with 2 of 4 in the family having pre-existing conditions requiring drugs and regular office visits) to going onto COBRA which cost roughly $2000/mo including all co-pays, back to another company sponsored plan which I beleive will cost roughly $4000/yr all in.
For our family, the most expensive part of being unemployed for that short period was rent and healthcare.
I get insurance through my job as a TA at a public university. The problem is that I’m not guaranteed a teaching position and thus can lose my insurance on a semester by semester basis. if I wanted to lecture for a course, I wld also lose my health insurance. i’m uninsurable (in two states) on the private market unless I try one of those high risk plans (which wld be $500-600/month for just me). My husband can get policies easily enough for $100/month.
For a family plan (i.e. more than 1 person) we pay $110/month, which just tripled in cost. (to put this in perspective if I were working full time I wld make about $25K a year w/a master’s degree and experience) Includes dental and modest eye care. Next month will also have a $500/per person (max $1000) deductible for everything except preventative care. Just had my wisdom teeth out; took sick leave to do it now and avoid paying that out of pocket. (That deductible equals about 40% of my monthly salary…) Prescriptions are $15 for non-generics, $5 for generics.
My wife and I are both recently retired. Since we’re not retired from Congress, a UAW employer, or any other large and onerous corporation, we have no affordable health insurance options except Medicare. Between Medicare Part B, Medicare Part D, and a Medigap policy, we spend approximately $300 a month for each of us on health insurance premiums. In addition, we’re on track to pay around $10,000 out of pocket for drugs, dentists, and eye care this year to cover some or all what the other “insurance alphabet soup” plans will not cover. This brings our “insured” health care expenses to an annual cost of around $17,000.
I’m a healthy individual, no prior conditions, no smoking, under 30 years old and when I’ve bought insurance on my own (in New York State) which covered in network emergency and preventative care (with copays ranging from $30-$200)…
It cost me $1200 a month.
Costs vary hugely between states, and New York is bad but other states aren’t consistently better.
I support not for profit medicine, and I’m okay with socialized because I’d rather be forced to wait on the basis of need/availability than on ability to pay.
I am in my late 20’s and have a high deductible plan. I usually spend between 2300-3000 of that deductible, plus my premiums. The premiums started at $20/month w/ a $1500 deductible within a few short years I now pay 30/month for a $3000 deductible (employer pays about $60/month). That is outrageous to me. I’m pretty healthy. Ophthalmologist (medical visits), annual w/ my doctor, pap, birth control, and some chiropractor visits spend the deductible pretty easily each year. One problem I have with my high deductible plan that I wonder if others experience is this: My annual check up, or the lab that does basic blood work, my pap– these always get billed under codes that my insurance company says are “not preventative” so they don’t cover the full cost as the plan states they will. They won’t correct it on their end and say I need to have the doctor/lab/or whomever re-bill the insurance under a preventative code. I’ve gone round and round on this and it never gets corrected– about $500/year in charges that are supposed to be covered. I like the idea of the HSA’s in theory but mine has turned in to an expensive headache.
We, my wife and I are self-employed and we live in the Netherlands. We pay 279 euro’s (about 350 dollars) per month for full coverage of us and our 5 kids. Covered are all medication, all doctors visits and hospital stays and operations and dental care, including braces for the kids. Within a year we have to pay the first 210 euros of medical cost ourself, thereafter the coverage is 100%.
The coverage is standardized by law, making comparison of the different insurance companies easy. The cheapest wins!
I live in the Netherlands as well, but I feel you’re over optimistic of our healthcare system.
There is a basic insurance that every person is obliged to have. You’ll get in real trouble with extra fines and such if you don’t have one. This basic insurance is free for kids, and about 100 euro’s per month. This includes most docters bills. Dental insurance is extra on top of that, as well as all sorts of extra treatments, such as physical therapy and accupuncture and such).
Not all medication is (completely) paid for either. Which, with a family of 5 is still a lot!
Besides that there is the first 220 euros own risk. So the first 220 euros medical costs are paid for by yourself (at least 220, could be more).
Generally the healthcare is very good here.
As far as costs are concerned. People with a low income get a subsidy to pay their health insurance, the amount differs depending on income.
Next to that 7.7% of your income is paid towards healthcare. That means, I personally pay about 400 dollars per month for healthcare just for me. My boyfriend pays about the same as well. Making it (wow, maths!) 800 dollars per month for the both of us.
I’m American (a Pennsylvania resident) and I have my own individual health insurance plan. I left a full time job w/ full benefits to pursue self-employment with my husband’s photography business. Health insurance was definitely the biggest hurdle and made me the most anxious. But surprisingly the process was simple: I found an insurance broker and worked with him to fill out the application and I knew within a few weeks that I was accepted. He didn’t find me better rates (it was the same rate I found online myself) but having him follow through with the paperwork was helpful. I made sure I had insurance before I formally left my job so I didn’t have a lapse. My insurance plan is a high deductible ($5,000) PPO plan through Highmark and I pay $130.20 a month. It also includes maternity which would’ve cost well over $300 through other providers. My biggest concern is actually going to the doctor when I have a problem because I’m always worried they’re (the insurance company) looking for a reason to cancel my plan or increase my premium (I’ve been paying the same amount since October 2010).
My husband is a different story. He had the state issued insurance until it was cancelled and when he tried to get his own insurance they denied him due to a bogus pre-existing condition. We appealed it with a letter from our doctor saying there was no reason to deny him, and yet again he got denied. So now he’s going on a year without insurance (we actually pay a lot less out of pocket for office visits- it’s amazing how little they charge when they don’t have to go through an insurance company!). We are currently working with a local business association to get on some kind of “group” plan but we might have to change our business structure and I will probably end up paying quadruple what I pay now.
In my opinion they should really look at what is considered “pre-existing”. Denying health insurance because someone has a problem that 75% of Americans have is ridiculous, especially when a doctor sends a letter stating there’s no reason to not cover him.
My husband and I have a private health insurance plan through Assurant Healthcare, paying $185 a month. Our plan is basic and suits our needs just fine for now. We secured the insurance through USAA but I was dissapointed that there isn’t an option for maternity coverage. Looking forward to reading GRS suggestions on this!
I have full medical, dental, and vision through my employer (University of California) for just myself, and I pay $21.21 monthly for the medical and do not pay anything for dental or visual.
My employer pays $496.50/month for my medical, $22.38/month for my dental, and $13.58/month for my vision.
For my medical insurance I have a $15 copay for doctor’s visits, $50 copay for the ER, and $5-$20 copay for prescriptions (depending on name-brand or generic).
My medical coverage is restricted to a smaller group of doctors, which is a recent change and was unfortunate because I had an AMAZING family physician that wasn’t covered under the new plan (I’d have to pay twice as much to stay on the plan by which she was available). Other than that very personal complaint, I am very happy with my medical coverage across the board.
My dental insurance is fantastic (For example, for a root canal I am responsible for only $75). It’s a shame that more people don’t have dental coverage– everything dentistry-related is so expensive without insurance!
I’ve never used my vision insurance, but nearly all of my coworkers use theirs.
We are self-employed and get coverage through BCBS of Oregon. The costs keep going up, up, up every year very steeply. We have had to move to higher deductible plans to keep it “affordable” even though it is a tough bill to pay each month at $550 for our family of 3. Our son is on the best plan of the 3 of us with a $2500 deductible with vision coverage and $25 copay. I have a $2500 deductible plan without vision and $35 copay. My husband is the oldest (cost goes up with every year older someone is!), and has the worst plan of all, a $10,000 deductible plan without vision and $35 copay. All of our plans are limited to four office visits per year with the copay. Good thing is that preventative is covered for all of us at 100%, and the first few hundred $ of lab tests are covered at 100% as well. Rx are covered at $10 each for generic. Can’t help but say I wish we had a National Health Plan as some people cannot even afford the worst individual plan and go without…
I don’t advocate this but this is how we managed.
Husband and I are in our mid 50’s. Husband is self employed. We had health insurance for 1 baby and during a random 2 yr. period. We were in process of switching insurances (without coverage) when our son broke his arm, requiring surgery/pins etc. The whole procedure was $10,000 including interest. It took us 8 yrs. to pay off completely.
Otherwise, we never could afford health insurance.
Hence, I studied alternative health. We ate healthy, exercised, got our sleep, took vitamins, chose to be vaccinated, never used antibiotics for any sicknesses (not even tylenol), used alternative remedies exclusively, used Chiropractics for sports injuries and random aches, etc. We had 2 surgeries (including that broken arm), a couple ER visits, tons of stitches, 3 sets of braces, contact lenses/glasses, exams for overseas travel and the occasional curious symptoms.
We paid out of pocket for everything. however, the hospitals/dr. ALWAYS cut the bill in half when they knew we were uninsured. We have never asked for a discounted bill.
The most major incident would be son’s malaria. All our children were high school and college athletes and were very active.
I suppose you could say we were mighty lucky/blessed. But we were diligent about good health! After reading the posts it appears we saved ten’s of thousands of dollars! I don’t quite know how to think about that.
Again, if we could have afforded health insurance we would have it.
Now, we believe we should purchase catastrophic. Haven’t purchased it yet as we still cannot afford it.
My husband is self-employed and I am a stay-at-home mom, so we pay for independent health insurance. We pay $410/month for us and our daughter. Our deductible is $5000 per person/$10,000 per family.
The trickiest thing for us in shopping for insurance was finding coverage for maternity since we will have at least one more child. Most plans don’t cover it, and those that do usually require a 24 month waiting period. We were fortunate to find a plan with BCBS where we’d had their coverage through an employer previously. So, they kind of considered it a pre-existing condition and waived the waiting period with an increase in premium (of course).
We have employer-sponsored health insurance and pay about $550/mo for a family of 5. We have $35 copays for most visits. I didn’t pay a cent for my hospital birth but paid for every penny of my homebirths.
I’m eligible for my employer’s plan, but is is less expensive for me to pick it up on my own. Especially when you consider that I receive a $100/month stipend from my employer if I can prove I have alternative coverage.
So it is $85 per month for medical and dental, with a $35 office visit co-pay and $5000 deductible. I recently raised the decutible from $2500 to $5000 after the premiums increased from $130 to $180 per month for the lower deductible plan.
European Country with mandatory healthcare here. Contribution is 8.2% of salary, deducted by my employer. (If I had children, they would be covered for free.)
Vision and basic dental is included.
I pay 10 Euros per quarter for doctor’s visits + a roughly 10% co-pay for prescription drugs.
Private Insurance, we use a broker to find it, not sure if that is the best option because I think they push what is best for them. When your busy though you go with what works.
Family plan for 4 through Golden Rule Insurance. $382/month, deductible is $3500
$35 copay for the doctor (maximum of 4 visits per year per member)
Only generic prescription drugs are covered with a copay of $15
$100 copay for the emergency room.
70% coinsurance until we meet the yearly out-of-pocket maximum of $5,000
Not sure how good they are on customer service, we haven’t really had to use it yet. Thankfully we are a healthy family.
Golden Rule is a scam. Look it up, and get something else. Their “customer service” consists of trying to dump you when you get really sick, and denying claims.
Live in Los Angeles. Employer plan, I pay $550 a month for Aetna PPO for myself and my 3 sons. Also pay $60 for dental & about $12 for vision. Husbands company pays for his. Have deductibles to meet. Can’t wait for the follow up on this.
Self employed Blue Cross for $83.46, no dental.
I’m stunned at what people are paying. I could get group coverage through a contracting company I’m dealing with. The only problem is the cost of the group plan is more than Blue Cross Blue Shield’s most expensive individual plan.
I live in Indonesia.
I am 35 years old and I recently bought a health insurance. The yearly premium was USD1000. I think it will increase around USD50 per year. It is a complete coverage for treatment, hospital stays, operation, etc in Indonesia, Singapore, Malaysia and Australia,
The max payout per year is USD 650,000.
Insurance is offered through a union retirement package, we are paying about $1500/mo for married couple w/o children. Deductible is $800, copay is 20% of UCR. No dental, optical.
We took the highest deductible we could & our premiums are still outrageous. Luckily we’re pretty healthy & have had no major accidents or illnesses.
Health insurance is neither complicated nor boring. Please stop that attitude.
Here’s my take
My health is not something I’m willing to take a risk with. I can go with a high deductible plan but I know from going most of my life with no or limited access to health insurance resulted in me becoming apprehensive to the doctor to skip the cost. Say you get sick with something and it takes several visits to finally diagnose what you have and then several more visits to finally completely treat it? If you are on a high deductible plan you would not want to keep going having to shelve out the money each time and instead hope that everything was caught the first time.
Due to this, for me, I would rather be more generous with health insurance even though I am young (24).
I live in Australia, and I pay $236 a month, For top hospital/dental and a few others things. For my entire family 2 parents and 2 little kids. More kids costs nothing extra.
We also have the government system (medicare) which covers all health care. Which is great in emergency situations or major things like cancer. But with not so emergency things ( hip replacements ect.. ) it struggles.
Once I was laid off, I purchased my own health insurance with a $5000 deductible. After paying close to $200 a month for 2 years, I missed a payment after my unemployment benefits expired and the health insurance dropped me like a bad habit. I just haven’t had the money to find new health insurance and keep hoping I’ll be hired as a permanent employee soon and my lack of insurance will be a distant memory. My second hope is that my boyfriend will be hired on as permanent at a job that allows domestic partners insurance coverage.
We pay $390 a month for a family of three through DH work. Our max out of pocket is $2500 a year but if we just go in check up or when we get sick, we just pay $10 copay. We pay the family rate so if we have more kids, we pay the same per month. It does go up about $30 a year right now. Most things are covered at 90%, then the deductible paying kicks in.
We have a little bit of vision coverage each year (covers my eye exam and half a year of contacts). We get a group rate through work for dental, but pay $60/month for the family plan. Still have to pay part of amounts for fillings/work, but check ups are covered.
We had individual insurance last year and for a mom and son, paid $200/month, with a $5000 deductible. We are pretty heathly so we took a risk on a higher deductible since it was just for a year before a job change.
My husband and I are married, from Florida, and our insurance comes from his work. He is practically self-employed. His father owns a clock repair business, and my husband is the only other employee. When his dad retires it will be his business.
They have shopped around and selected a high deductible HSA from BCBSFL. His “company” pays about $100/month for his coverage, and we pay an additional $120/mo to add me to the plan. Our deductible is $10,000. We are in our mid-twenties. We are both healthy. The coverage does not include dental or vision benefits.
Pros: Once we pay out of pocket for things and meet our deductible we’re covered. After meeting that deductible a few years ago after a freak heart issue that required my husband to be hospitalized (when our take-home was not even $45K that year) we didn’t have to fight to have anything covered. Luckily he is fine and there is no follow up care.
Cons: It’s expensive. I know that the first $10K in the bank isn’t “really there”- it’s to cover medical bills just in case. It puts added stress, especially toward the end of the year. Our deductible resets 12/31. I worry that something will happen right before the new year, and carry over, leaving us $20K in the hole.
I work part-time in a library system and recently was promoted to another part-time position that replaced a full-time one. I don’t have access to health insurance through my employer. I love my job now, and am waiting for someone else to leave so hopefully I have their pay and benefits (including free healthcare).
We haven’t looked into private insurance because I have a pre-existing heart condition. It is not a factor in my life but because I had surgery it still counts against me. I am not sure how Obama’s restructuring of healthcare would affect our situation and payments.
Great topic. I’d like to see something similar related to 401k’s or ‘retirement savings’.
I envy those who get coverage through their employer. It’s been 15 years since I had employer-sponsored health coverage. I have purchased private plans all that time, and premiums have quadrupled (of course I have also bumped up in age brackets a few times). In my part of Oregon, there are few insurers and I have switched a few times when premiums were favorable. Currently Assurant Health charges me – a 41 y.o. female – $220/month for a $7500 high-deductible with no eye, dental , or drug coverage. I have had an HSA from the beginning. With my HSA savings account, I chase the best rates and lowest fees and I would appreciate a discussion on those because it is very time-consuming to research current information on HSA account holders. All told, I have spent tens of thousands on insurance premiums and have actually NEVER filed a claim. Why? With all available money going to health insurance, I cannot afford health CARE. The US system is infuriating.
I’m retired and get my health insurance from the U.S, Federal government (my former employeer). I have a choice of a variety of plans. I have Kaiser HMO with my share about $210 a month. The government pays about another 2/3 of the cost. Reasonable co-pays. No dental.
I am a complete outlier here. My employee pays 100% of all health care premimums including Blue Cross/Blue Shield PPO, dental, vision, long-term care, etc. I pay no months. They also contribute $6,000.00 a year into an FSA for co-payements, drugs, contacts, etc. (Yes, *they* are paying this, not me.) This, I know, is truly rare, and I’m very grateful to have this for this time. This job is probably only going to last for 2 to 5 years, and then I’ll be back to the HMO paying what many are here.
My husband is self-employed, so we pay for our insurance. We have a PPO with BCBS Texas. For a family of 5 (60,59,22,22,20) our premium will be $1,082 as of January 1. $5000 deductible, $300 prescription deductible (but has a cap, so we end up paying full price later in the year). No dental or vision. I had breast cancer in 2005 and my husband has restless legs, sleep apnea and acid reflux, so even when the kids are on their own we’ll be paying a lot.
I pay $400 a month for a family plan, I get a $200 a year discount for partictipating in wellness activities. My deductible is $2500 per person, after that is met everything is 100 percent covered. I get 1100 in a HSA account, and I put another 3800 in an FSA to cover medical expenses. I usually met my deductible by July. I have some chronic health problems. My plan is through my employer and we lost our eye coverage in 2010. Then I pay $40 a month for dental and another $80 a month for braces and cash for the eye doctor.
For a single mom I wish I didn’t have to pay so much but after reading through the other comments my plan doesn’t seem to bad. I do wish eye and dental were included.
I don’t have health insurance. I changed jobs in April and my company makes new hires wait 4 months to be insured. A month later that job imploded, and I started over at a new place in October. I hope to be insured by February. It sucks and it’s really scary.
Individual plan at $138/mo with a $2500 deductible. PCP visit is $30, specialist visit is $60. Great medical plan with vision included, and dental extra (though included in the $138) through my employer. I’m early 50s. I’ve only recently become eligible, and am so thankful for this excellent insurance. Previously, I was self-pay at ~$400/mo for me and my husband with TERRIBLE coverage and $15,000 yearly deductible! My husband has chosen to go with “temporary insurance” which runs around $100/mo for basic coverage and gives little coverage. Thankfully, we’re both in excellent health.
I’m on an individual plan. I am the only employee of a church (I’m the pastor). I pay $285 for me, my wife, and baby. Its an HSA. No copay, they send me a bill. It actually pays a ton of stuff before requiring a deductible including all of the well baby visits at $150 each!
I’ve been a huge fan especially since our denominations health plan is over $1,000 a month for a family. I just can’t justify that premium when I don’t use near that much in health care. That and I need every tax break I can get as a pastor. Above the line deductions on HSA contributions are great!
After reading all this, I’m very glad that I live in Canada and also have excellent supplemental health care from my employer (at no cost to me for the insurance itself – lots of dental coverage, massage therapy, physio, drugs, etc). I’m generally in pretty good health, but 12 yrs ago I had cervical cancer. Since it was a very small amount and “microinvasive”, I didn’t need to have chemo or radiation, just close followup every 6 months for 3 or 4 years. My total cost was limited to the cost of parking at the downtown cancer hospital and the local hospital that my gynecologist works out of of. Our medical system here isn’t perfect, but it’s pretty good.
I choose not to carry insurance for myself, my wife, and my four children. Instead I pay $320 per month to be a part of a health cost sharing plan called Samaritan Ministries. I pay for anything under $300. Anything over $300 is covered 100% up to 250k.
Cheers
California Resident, Self employed. I pay about $80 a month for a HSA PPO plan with a $10,000 deductible.
Every year for the past 3 years my health insurance premiums have risen 30-50% each year. Each year I would simply choose a cheaper plan to keep the monthly cost around $50. But as of this year, I am now at the cheapest plan available on the market, so I have to eat the increase to $80 or go without insurance. What really troubles me is what I am going to do if this trend continues. A 40% increase every year is going to lead to some serious problems.
Heh! The magic of compound interest! Savings at 1%, insurance at 40%, that’s how we Get Poor Quickly!
We are self-employed. My husband is covered by Medicare and a supplemental plan. My state provides coverage for uninsurable persons and I am on this Blue Cross plan with a $2500 deductible and a discounted pharmacy provision. I pay $762/month and it goes up about $90 annually. When I reach my deductible, then it goes to a 80/20% split if you use a BC provider. Dental care is not covered. With my premiums this high, my costs for medical needs exceeds $1000. per month
I pay $572.72/month for our family of three, with my employer covering the remainder (which is another $1,100/month or so). This is for a 100% coverage plan for almost everything, with 90% coverage for a few “out of network” things, but it’s a blue cross/blue shied PPO, so in practice nothing is ever out of network and we never pay anything but the $15 copayment (my wife spent three days in the hospital affer having a pulmonary embolism and we paid a total of $0. The birth of our daughter cost the same). Even if you do manage to find someone out of network, there’s a $2,000 annual maximum on out of pocket payment. The plan also includes 100% of all care received while abroad, which is an interesting perk.
This is honestly the best health plan I’ve ever seen and one thing that makes me reluctant to leave my current job. Vision and dental are separate. Both are inexpensive, with the vision coverage being pretty good and the dental coverage being pretty mediocre, but they’re switching to delta dental for 2012, so hopefully they’ll be better.
I have my own dogwalking business here in Alameda, California and have to pay for my own. I have Kaiser with a huge deductible of $1500 a year and within three (3) years went from paying $280 a year to $385 – with no changes in my health and I have an active, healthy lifestyle. My boyfriend has his own individual policy too and pays more, we’re both just 45. His is more, but really mine is the same if you add in the $1500 deductible. My problem is that having this plan makes me not want to go to the doctor. Also, unless you grill your doctor thoroughly to the point of being a miserable patient, they have NO idea (they said they’ve complained about this to Kaiser too) what any procedures or tests will cost. I hate having to blatantly be a “poor” patient, in both sense of the word.
This makes no sense and could be easily remedied with a software program for each patient attached to the files. After all, eventually someone in billing DOES know. LOL.
I used to work (2000-2003) for a company handling small business health insurance – our customers were insurance agents and each of the 9-12 health carriers we had at the time. Very few people know this, but since I was in marketing, I had to write ads to our agents/brokers on changes in the plans. Each Carrier (ex. Blue Shield or Aetna) would submit double-digit rate increases to the Dept. of Insurance every couple months, which somehow (apparently the DofI has limited power) became single-digit rate increases. EACH one did this every couple months of say, 3-6% for someone of this age, in this zip code – mind you, these are all for small businesses with employees from 2-50 and I only know for that market. So, rates went/go up and up and…up. I would like to think the state departments of insurance would have say as to their rates? I think if they were given power to raise/reduce rates per age rate/zip code, then our states could (maybe slowly) start lowering rates with each and every Carrier and then, we would have sane rates for everyone.
Just my thoughts. After all, the first time I was told to write something about how Blue Shield was raising rates by 3.5%, I asked my boss how do I write anything positive about this!?! He said, “it’s only being raised by 3.5%.”
I hated what the carriers do to people and on a side note, they waste tremendous amounts of paper on all the brochures and literature they made us throw out every 3 months.
Usually a carrier was only making a change to one or two sentences on 2-3 pages in a 50 page brochure. Well, they don’t tell you what changed. They mail you all new literature and expect you to have boxes and boxes of these on hand. So, I had to dig through each new one finding the change and writing about it for our insurance brokers/clients. Which was fine. It was my job and I was happy to do it.
Problem was, it made our warehouse people throw out dozens of full boxes of brochures each week. Couldn’t be helped. The carriers state how much health care costs – well, this is one cost that could have been fixed with an email to us, so we could print out change slips for each brochure. Or better yet, they could keep their plans the same for a whole year. And, they don’t. Most small businesses don’t have any clout and neither do us paying our own way.
Thank you for this forum.
P.S. – I stopped reading these replies after too many were from Canada and not the US> too depressing to hear about how you have it made (and you do) – when we have very limited options here in the U.S.
I am self employed and living in Japan. Here people pay into one of several versions of the national health insurance system. Health insurance premiums are calculated based on my city income tax and the number of people in my household, all of which works out to about 6% of my annual income. I think there is an insurance premium cap of about $5000 per year as well. For minor treatments and checkups I pay a 30% copay. Major treatments and inpatient are fully refundable. Treatment prices are significantly lower than the states because the government negotiates prices with the doctor and hospital associations every few years. For example, to get my teeth cleaned costs me about $10 dollars and my yearly physical costs me about $15. I can choose my doctor and clinic since all doctors in the country accept the national health insurance and generally the quality of service is quite high.
You are so fortunate. This sounds like the perfect system and I love the fact that you have the choice of which doctor to see, a choice often absent in other public health systems in the world.
I work for a local small business in the US that does not offer health coverage or any money towards health care. Health insurance is important to me because when things go badly in my family, they tend to go SUPER badly. So I purchased my own health insurance.
This was hard in and of itself because I don’t make very much money and have had acid reflux for many years (insurers don’t like this). I was rejected by 3 companies before being accepted by ODS for their cheapest policy.
I pay $71/month, I get 4 doctor’s visits with a $25 copay per year. I recently had some blood work done and insurance covered most of it as well as most lab work. I think my last visit cost me in total (all lab work and blood work) about $60.
In general my coverage isn’t bad. I can afford a yearly check-up and I know if I get sick I can go see a doctor without bankrupting myself. I don’t have eye or dental coverage, which I would like but can’t afford. I wish my employer would pay part of it, but since I’m the only one there who has their own health insurance it’s not really on their radar.
I’m unemployed and I pay $550/month for medical insurance (no dental) in California. Its been a big drain on my resources. But I couldn’t find a cheaper medical insurance.
So I’m thinking of either finding a job in the near future, or just not get insurance coverage for 2012.
I am a little shocked at how much the few here are paying that are on medicare. It seems to be $300 a month total. I was thinking it would be about half that. Any other thoughts on this.
My husband and I pay $75 for a basic Medical policy through BCBS of FL. It pays for doctor appointments and medications. We think it’s great. If our needs change, we could change the policy, but right now, it’s working for us. We don’t have health care coverage through my husband’s job. The Rx coverage is pretty good, and we also have a Rx discount card through Walgreens for the top tier stuff that our BCBS policy doesn’t cover, and that helps out a bit.
I don’t have health insurance. I tried to get some when I moved to Massachusetts but gave up after weeks of trying, out of frustration. My attempts to get information about insurance coverage online only resulted in me being added to various junk-mail lists. My plan is to wait until (a) my employer decides to make insurance available, or (b) this country decides to become sensible and socialize the insurance. In the meantime my fallback plans are (a) don’t get sick; (b) self-insure by saving money; (c) use emergency rooms; and (d) if necessary, go back to british columbia for treatment of long-term illness.
I am the Controller for a small (55 employees) manufacturer here in South Carolina and I bid out our insurance plan every year.
In order to get sufficient participation levels, we have had to pay approx $200 per month to provide every employee with single coverage. That gets you a $5,000 deductible but it does have doctor co-pays and a pretty good prescription benefit with it. So it is basically catastrophic coverage with a few benefits for routine things.
About 1/3 of our employees opt up to a $1,500 deductible plan we offer. (Same benefits, different deductible.) That costs an individual about $40 per month extra. To cover an employee and spouse at this “higher” level is about $350 a month extra for the employee. And to cover a family will set you back around $465 per month! That’s all above and beyond the $200 already paid by the employer!
I’ve already seen a lot of good for the employees come from so-called “Obamacare”. And I’m looking forward to the changes coming in 2014. I only hope we get to see them.
Mike, You sound like a very caring employer and it must be such a relief to your employees that they are covered so well with medical insurance.
Traditional Medicare. $110 a month engrossed out of my Social Security benefit, plus about $80 a month for Medigap insurance plus about $25 a month for drugs. No dental. Rates go up every year.
Before I was laid off my job, I paid about $30 a month for an EPO that covered just about every doctor in town with just a $10 copay (no deductible except for the ER), including the Mayo, where my longtime doctor practices. The Mayo does not take Medicare assignment (few doctors with good track records do), and so it costs a ton of money just to go in for routine care.
[You know, JD, that pop-up that slides out from the right-hand side of your comments pages is really an annoying distraction.]
During a period when my employer, a state university, offered only Cigna, an outfit that NONE of my doctors would do business with, I bought an MSA. Huge rip: expensive, big deductibles, and the bank charges on the savings account (in those days only a few banks could do MSAs) were extortionate.
Speaking of huge rips, I found that when you buy your own dental insurance, that’s what you get. Between the deductible and the many things it won’t cover (just about everything), you’re better off to put about $40 or $50 aside in a sinking fund to cover routine care and build a good emergency fund for bigger bills.
“[You know, JD, that pop-up that slides out from the right-hand side of your comments pages is really an annoying distraction.]”
It really is, especially if you’re looking at the site on your phone.
I’m from Barbados. The company that I work for, provides health insurance for all staff. The plan covers medical, dental and vision costs, each with a deductible. Most companies here provide health insurance – some cover the full costs, whilst others pay a portion and the employee pays the difference.
I am 39 years old and live in Maine. It costs me about $411 each pay period (biweekly) to cover me, my husband and my 8 year old son through my job as an ophthalmology technician. We have Harvard Pilgrim PPO with a $2k family deductible/$1k individual. This is up from last year when we paid $398 a pay period for the same coverage. We don’t have dental coverage and so we use a dental clinic when needed, although my son sees a pediatric dentist as he is autistic and has behavioral issues.
Our insurance is covered by my husband’s employer. Our coverage is good, probably because he works for the city, and we pay about $130/month. I appreciate that it comes out automatically so it’s not something that we have to factor into our personal finances.
I have employer sponsored coverage for a family of four (in Ca). One of my kids has a chronic disease that requires frequent dr office visits, labs, and testing like MRI, bone scan, or ultrasound. I prefer PPO so we can see drs I like and not have to deal with referrals of an HMO.
I chose the HDHP with a $2400 deductible for the family. I pay $89.54 every pay check, x26= $2328.04 annually for the premium.
My employer pays $1440 into a health savings account to be used towards the deductible. I pay all costs up front until the deductible is met then the plan pays 100%. When you subtract the employer contribution from the deductible my part is $960.
So total annual cost in CA PPO for family of 4 is $3288.04.
Last yr was my first yr trying this HDHP and I really like it. Met the deductible by March and never had to pay anything after that. Previously with a traditional PPO paying 10% and office copays etc our annual expenses for health care were over $10K. Of course, I understand that I am very fortunate and realize it works well for us since we have the income available to pay the deductible up front.
This is an important thread. I AM PASTING MY INFO BELOW. I AM INTERESTED IN KNOWING THE SYNOPSIS OF ALL THESE COMMENTS HERE WRITTEN AS A POST ON THIS BLOG AS WELL. THANK YOU.
I am employed by Federal GOvt USA in NYC.
Blue Cross Blue Shield Plan. Reportedly the best plan available out of the ones available to us.
For single PERSON biweekly premium is , Govt Share $168.77 and individual pays $56.25 biweekly.
For employee and spouse, Govt pays $395.21 and individual pays $131.73.. It is the Basic Option premium above I mentioned.
I think preventive dental services are covered. I missed on enrolling for the vision plan separately this coming year 2012. I go to my home country and get my eyes and dental work checked. (b’coz I have good trust in my doctors from there due to personal relations than interest in saving money on insurance here in USA!)
Thankfully no emergencies there yet like emergent tooth removal etc…
Pasting the link for 2012 FepBlue benefits:
http://www.fepblue.org/benefitplans/2012-sbp/bcbs-2012-RI71-005.pdf
Will look forward to the author’s blog on this interesting comments from the readers.
I work for a medical center that self-insures their employees. Insuring myself alone (the family plans costs more obviously) costs $170/mo for full medical + dental+vision, plus I usually spend another $1000/yr on uncovered prescription drugs and co-pays. I feel very lucky.
Even though the full coverage plan is an awesome deal, the center also offers a slightly cheaper plan with more limited coverage & a very high deductible. Puzzlingly, many people choose this plan even though it is a bad deal. Then they end up shocked & financially wrecked when they need an operation, have a baby, their kid breaks her arm, or they need emergency care.
Our premium for employee plus spouse coverage is $770 per month. My husband’s employer pays $500 of that. It is Blue Cross/Blue Shield PPO.
Our co-pay to the primary care doctor is $25 and $35 to a specialist but our PCD is the gatekeeper. Our prescription plan is $50 deductible and then a tier of $10/$25/$35 for co-pays. I think our deductible for (which doesn’t count co-pays) is $2000. For an emergency room visit, there is a $100 co-pay.
We are covered for a basic eye exam but not glasses. For dental, we pay a $40 per month but it is more like a discount plan than real insurance. I get frustrated because I have a long history of kidney stones so I know when I am passing one but my PCD makes me come for a visit and pay for a urinary specimen check before he will allow me to see the urologist. On the other hand, he is willing to come to the house if you are really sick and then go to his office to pick up samples and bring them to you. This may not be available to all of his patients, just ones who live near his office. We have had to sit down with our kids and convince them not to go with the cheapest plan as they graduated from college and started work but show them what their out of pocket costs would be if they had a worst case scenario. I know that people say “well, I’m young and healthy” but you can be in a serious car accident with someone who is under-insured and we know plenty of young people who have come down with cancer. Even the flu can be a serious problem for a young person. Our neighbor’s 20 something son got that h1n1 flu several years ago, was uninsured and his hospital bill and rehab bill was huge. He was put into a coma and was strapped into a lung machine and another machine to help him from moving. He almost died.
Wow there is a big range of costs. I am currently a grad student. I pay $2010 for one year of coverage. It includes a $500 allowance for prescriptions but only from the school pharmacy. No dental or vision. Max lifetime of $1 million and $500 deductible in network. I hate it since I had a better plan when I worked at a hospital but other options aren’t great in the range I can afford. I also get no coverage for hearing and I need that (although no one covers that).
I have health insurance from my employer (individual coverage):
$31.57/month for medical
$40/month for dental
Free vision
Free prescription
Health care credit of $15.51/month
Health care discount of $25/month
Total monthly premium: $31.05
I have no idea what the health care credit and discount are. I think it might have to do with being a non-smoker, but I never saw an explanation; it just started showing up on my pay statements.
Medical is partially subsidized by the employer, but I don’t know how much of the premium they pay. I have a $500 deductible and the insurance covers 70% of in-network costs; out-of-pocket maximum is $3500. Dental is a group rate but not subsidized by the employer. It covers 100% of preventive and diagnostic care, 80% of basic restorative (e.g., fillings), and 50% of major restorative. I have never used the vision or prescription plans, so I’m not sure what they cover.
I’m a freelancer in WA state who pays for my own individual plan. I have medical and limited vision through Regence and dental through Dental Health Plus. I pay $317/mo for medical and I can’t remember my dental costs off hand. The medical insurance is an 80/20 split for in-network costs.
My husband is active duty enlisted (USAF.) His complete health care is covered. My medical is covered, one eye exam a year and no dental – same for my son. Maternity care costs were covered.
I’m a 48-year-old unemployed single female with pre-existing conditions in California. I have a good individual plan ($1500 deductible)but pay $600/month. How did I get this plan since I have a pre-existing condition no health insurer will touch? I worked at a Fortune 500 company, left voluntarily and then exhausted my COBRA group health insurance coverage after 18 months. Once COBRA ends after 18 months, you can enroll in an individual plan which offers similar benefits. This is due to HIPAA, which is federal law. At least in the state of Calif, you must pay 200% of the regular premium. Thus, if you’re in good health, you pay $300/month on the open market. If you have to go thru HIPAA due to the fact that you’re uninsurable due to pre-existing conditions, you pay $600/month.
Beginning in January of this year, I went on an individual plan after leaving my full time job to start my own business. I currently pay $145/month for health and dental coverage with BCBS of OK. They do not cover a pre-existing condition (which is unlikely to be a problem for me) and I have a $5,000 deductible. For me this policy is peace of mind in case something catastrophic happens. As a bonus, it paid for my two regular dental exams/cleanings and annual doctor’s exam. I found the plan through AAA.
Paid $1700 cash for a root canal, dental fill, and crown. I’m 29 healthy and haven’t needed to see a doctor for a problem since 2005. I have a misdiagnosed preexisting condition from when I was in the Marines that is making it very hard to get any kind of insurance. I had a military doctor diagnose me with ulcerative colitis in 2005 but once the issue was resolved within 2 weeks of medication I haven’t had an issue since. I haven’t taken any meds since 2005 and I saw a VA doctor earlier this year to try to get the diagnosis reversed. The VA says I don’t have ulcerative colitis so I don’t get any help from them but because it shows up on my medical records I haven’t been able to get affordable insurance. If anyone has any suggestions I’d be glad to hear them.
I pay $140/mo through work for HMO coverage for just myself. $5 copays for most everything. I have to stay in-network, but I’ve had no issues doing so. I have rheumatoid arthritis, IBS and bunions so it works pretty well for me.
Thank you.
This is very informative as I’m at a job I’m not sure I like but it has outstanding benefits, that are hard to consider letting go of. I’m surprised actually to hear how many people pay for employer-provided care. When I was in graduate school, I had catastrophic, high deduct from BCBS and used student services for routine stuff. That was 2003-5. It was affordable enough for working part time. I was in my early 40s and in excellent health, which only means I didn’t have to pay much out of pocket.
I’m 51 now, still excellent health, and but also realize that could change on a dime.
US Citizen here. I get coverage for myself and my family (2 adults/2 kids) through my employer. I pay $250/month for this and I am not sure what my employer pays. There is a $2k out of pocket deductible for my family from the insurance (Blue Cross Blue Shield HMO) and last year we got hit with it all which sucked but this new employer (I switched jobs in November) will pay 75% of that which is very awesome!
I have an individual policy with Anthem BCBS. When I first got it, it cost me $160/mo for a $3k deductible and no copays. It has increased in price twice, and now I’m coughing up $230 for what is lousy coverage and not nearly worth it for a healthy person, but I’m afraid to go without.
I’m in the US, and I’m currently on COBRA. My health ins history:
On parents’ plan until I graduated college at 21. Got independent insurance (anthem) for $100/month. Became full time employee at my company, so they picked up my tab mostly, so I paid $92/month. Had a major medical event a few years ago, so I am no longer qualified for independent health insurance and must either take really poor limited liability insurance or go the COBRA route. (I was laid off last month)
My portion of the COBRA plan is $350/month.
With the exception of the limited liability plan that was recommended to me, all the plans had 100% wellness care and 80/20 otherwise. I was quite lucky. And with a nearby university hospital, I also get great care.
I’m a little late to the game, but I do pay for my own health insurance through one of the major companies. I pay $153 a month for coverage. It’s actually pretty good — I get $1k of office visits a year (and even an ER doc fee counts as an “office visit”), am allowed one discounted trip to the ER, and I have a $5k deductible. After that deductible, I am covered 100%. The only big downfall is that I have no maternity coverage. My husband and I would like to have a baby in the next year or two, so I am hoping to move into a job with coverage soonish.
I have medical/dental/vision covered at no cost for myself through my employer, with a $250 deductible. If I were to add my spouse and 2 kids it would be over $900 per month. There’s no way I can afford that, so I have the kids on my dental through work at $55 and have purchased a high deductible ($3500) medical plan (no vision) through a health insurance company in my area for $422 per month (it just went up from $385 per month) for the spouse and 2 kids. It does offer 6 office visits each person per year, with no deductible applied, and generic prescriptions at $15 copay.
Interesting question. My answer got really detailed, so I posted it to my blog:
http://foundryintheforest.wordpress.com/2011/12/18/how-much-do-you-spend-on-health-insurance/
Greetings,
I’ve been rejected three times by three different health insurers for private individual coverage because of a preexisting condition. Out of desperation I formed a general partnership with my own husband so that we would qualify as a “business” in the state of California. Now we have guaranteed-issue group coverage, which we would not be able to purchase if we did not qualify as a “business.”
Right now I pay $404/month to cover myself and my husband under separate high-deductible HSA-compatible plans through Kaiser Permanente. I also save an additional $254/month into a personal health savings account. The premium costs increase 10% each year, so I expect my premiums to cost $444/month next year.
Our insurance covers annual checkups. Beyond that, we each have a separate $2800 deductible before our insurance starts paying for medical coverage. The health savings account helps pay for those costs, and I can use my personal account to help pay for the medical/dental bills of my spouse as well as myself.
It’s not an ideal situation, because businesses require a minimum of two people to qualify for the purchase of guaranteed-issue group coverage in California. If one of us died, the survivor would lose his or her health insurance.
The Affordable Care Act gives me some hope. I do not qualify for its PCIP pools, because I have had health coverage during the past six months. I’m not complaining, though. I plan to purchase individual coverage for myself and my husband on the exchanges when they go online in 2014.
J
My husband and I are in Silicon Valley and have an individual insurance plan through Kaiser Permanente. We don’t have dental or vision coverage. He is a contractor at a company and I’m self-employed.
It costs us $485/month for a family plan. We each have a $2k deductible and, IIRC, there was something about coinsurance (which I have to admit I didn’t really pay attention to), with a total out-of-pocket max of something like $5 or $6k. I had to get my appendix out a few months ago, and the whole thing cost us about $2300 out of pocket, which we were really happy about, all things considered.
My husband’s company wants to hire him as a permanent employee. They will cover his insurance costs entirely, but if I go on his insurance, my coverage will cost nearly $400 just for health. I have to research this to see if it’s actually a better plan than what I have now. So far, it’s sort of unclear. (Is there any sort of benefit to being in an employer group other than cost that I should be taking into account?)
Once we have our first child, our health/dental/vision coverage will be $340 a month with a $75 deductible per person and then 100% for everything in network. However, if I quit work, we will have to move to my husband’s insurance which is $650 a month and a higher deductible. It’s a shame because it really makes me feel as if I have no choice but to continue working…
J.D., if you are looking for more sources of information about any upcoming health insurance topics I would love to help out. While I know many people turn to the internet first, I can share some information that may not be on the internet necessarily and offer alternate options that people may not have thought of for securing their health insurance.
I’ve been a health insurance broker in NJ for the past 8 years so can share some information that that will help specifically people in the 20-30 age range to get more affordable coverage and also anyone else finding themsevles without coverage.
If I can be of help, please let me know. Thanks!
Mike
I have a high deductible plan with BCBS which pays 100% over 5k. I don’t pay any premiums and my company puts $2500 into my HSA. Basically the maximum I could pay on medical is $2500. If my medical bills come up to less than $2500 during the year then I’m actually getting tax-free money from my company.
For dental again I pay zero premiums and get 100% coverage on cleanings, xrays, and routine fillings. If it’s major work anything over $1000 is covered 100%.
I get coverage from Blue Cross/Blue Shield offered through my employer. We have basic coverage with $30 copays, relatively cheap glasses unless you need special things, and pay between 0-70% for any care beyond regular doctors visits. Plus a 1000 deductible.
Big cons are the fact that the prescriptions are barely covered. And when my child broke an ankle I had to pay 600 out of pocket. 300 of that was beyond the deductible.
All that for about $79 a week for the whole family.
5-600 a year.
We live in Switzerland. All insurance here is private and individual, with a mandated basic package and optional extra-cost coverage (for example, semi-private room vs. ward).
Premiums depend on age. I am 59 and my wife 55. Together our premium for both basic and optional coverages is US$750/month.
I just bought health insurance (sunlife)that covers women’s typical health risks, such as cervical/breast cancer. It feels good to have this kind of insurance because ur confident that what ever happens in the future you are secured. FYI, my insurance also have investments features for my retirement(my principal purpose of buying this insurance, actually).. It costs $1,400 p.a. just enough for my spare cash..
I carry the insurance as my husband is currently unemployed. My employer (<300 bed independent hospital) works hard to manage costs to keep health benefits affordable for employees and to provide options rather than "one size fits all" and I appreciate their efforts. As a half-time employee (striving for full time, but that's another story), the choices were high, medium and low deductible. I did the math and surprised myself by going with the low deductible ($435/mo for family). The total cost difference between high and low for me was $4000 for the year, based on best estimates of expenses.
This new way of managing health expenses has forced me to examine choices and needs, and not to assume a test or prescription is necessarily the right choice just because the doctor said so. I now have a bigger stake in the game.
This is such an interesting topic and is really making me think and wonder… I know it’s late in the commenting, but I’d love to know what *percentage* of your income you pay in health insurance. I realize this can be tricky to calculate, if it is deducted automatically from your paycheck. Also, some people have their employer kick in part of the premium, so if your portion and the employer portion are added together, what is the total premium?
I’m finding myself floored by the huge amounts some folks are paying each month. And so I’m wondering if you must have an awfully high salary, to be able to support such an expense.
It would also be interesting to know what folks pay out of pocket as a percentage of income, or the total healthcare costs of insurance and out of pocket (up to the deductible, co-insurance, out of network, prescriptions, the whole shebang)…
How are healthcare costs rising, relative to incomes increasing? And how close are people to being at the point of not being able to afford health insurance? Where you have to make choices between food/shelter/basics vs health insurance. JD, I apologize if this is veering off-topic. It is info I’m interested in, but maybe you are saving it for a future post?
I guess our insurance takes around 33% of our income.It leaves us with $1,222 bring home a month.
$260/Month for Family Coverage through employer – $2K Deductible – split by company & me. 80/20 after that. $6K Out of Pocket Maxiumum
I think a ‘Summary post’ of the replies would be helpful.
I am not Canadian, just US citizen. My employer pays for my health care plan, but my wife is unemployed so we pay for hers. We both are on a high deductible plan of $4,800 that costs about $340/month in premiums, plus we set aside $120/month pre tax into a health savings account and my company also puts in $120/month. We are both young so we don’t access that money often, just to pay for doctors visits and prescriptions (that are low cost) so the account has grown to where we can afford to pay the entire deductible, emergency savings would cover the rest to the maximum out of pocket costs for the plan year.
Pros (for us): We keep what we don’t spend, premiums are lower than traditional plan, no referral requirements or prescription requirements (I can see who I want when I want without a battle with an HMO)
Cons: Financial exposure while growing HSA, pay all costs up to deductible, splits the emergency savings picture a little.
My expenses are that I work in a job that pays a little less than what I could otherwise make, and I don’t get to work from home. For that trade-off, I get paid health insurance, plus dental and optometry services, and a pension. My job may not be everyone’s sexy dream job, but it pays the bills nicely.
Health insurance is mission critical to me, since despite my fairly healthy lifestyle I do indeed have BRCA2 gene, (which is a cancer gene, guys and you are not off the hook) and I will without a doubt develop some form of cancer some day.
I’d love a post about how to get health insurance when you have a relatively minor, pre-existing condition.
The best example of how this can be a really difficult situation is Dooce (a.k.a. Heather Armstrong, dooce.com), who has suffered from depression and was thusly rejected from most every health insurance she applied for.
A lot of people have some ongoing “illness,” which can make individual health insurance either impossible to get or void when it comes to payment.
Every state has an insurance plan for the uninsured. Contact your state government and ask. It will be rather expensive, but it is worth it.
We have chosen the high-deductible plan from my employer. I consider it to be excellent insurance. For a family of four, we pay $0 in monthly premiums, our deductible is $3000, and then we pay 10% until we reach our annual out-of-pocket max which is $5000. Preventative care is covered 100%. In good years, we might end up paying nothing for health care, and even in the worst of years, we pay at most $5000. All of this comes directly from our HSA, which I fund to the max each year. Note that this does not include dental or vision. We have separate dental and vision coverage, which is ok but not great.
As self-employed attorneys, my wife and I are able to obtain coverage through the state bar association. Our family coverage runs us about $630/ month. It’s a high-deductible plan, $10,000 deductible, which pays everything over that. Had some issues with them paying certain expenses related to her pregnancy, but worked that out, b/c well, we are attorneys. Mainly were internal errors, not policy decisions.
Of course as soon as we started our HSA last year the interest rate on the account was slashed precipitously (3% to .5%, now .3%). We have some yearly expenses related to the baby and my wife, but those don’t come too much that it made sense to raise the deductible all the way to $10,000 and take advantage of the HSA instead of staying at $2,800, where they wanted over $900 + a month.
$630 a month plus potentially $10,000 in expenses does seem high to me, but then again it is a deductible expense. As long as we spend only say $1000 in yearly expenses, the total then of $8500 a year isn’t awful, about 8% of our combined income. If we have to spend all $10,000, it would come to about 15%, too much IMO.
DH and I have coverage through my employer. It is a PPO plan meaning we pay a copay for almost all services. There are medium-low deductibles; above that some services are 100% covered and others are 80/20.
We pay roughly $600/mo for this coverage. I do not know how much my employer contributes but my belief is that their contribution is less than $200/mo. The firm coverage is good for general medical, vision, and dental.
We want to change to an self-coverage plan with a high deductible, which would cost us less than $350/mo, but because DH is over 50 he has to pass a physical and when we had to make the decision to join the group coverage, we didn’t have enough time to get that done.
We are both in very good health which makes mandatory coverage even more annoying than expensive … since joining the firm in April I’ll have paid $4800 over the year and neither of us has been to the doctor even once. $4800 for nothing. Nice.
Health insurance information is one of the few glaring omissions I find on the GRS blog.
The US health insurance situation is changing fairly rapidly (at least for people who aren’t covered by an employer’s policy), and I would like some guidance.
I am a solopreneur and neither me nor my husband have health insurance. The estimate I got for high deductible coverage for the both of us is $385 per month.
I am loath to spend that much if I have no assurance that the insurance company will actually come through for us once one of us gets sick or seriously injured.
Previously I was on an plan through my employer that covered medical, dental and vision. While I was working, it cost me about $66 per month.
I am currently unemployed and am on the COBRA plan through my employer, so I can have the exact same coverage as I did when I was employed. However, now it costs me $330 per month.
My husband is self-employed and has an individual plan through the same insurance provider as I do, found through ehealthinsurance.com. Medical-only costs about $230 per month.
UPMC PPO, roughly $1100/month premiums, of which we contribute about $330 and my employer covers the rest. We had traditional old-school health insurance (i.e., not managed care) through my husband’s job, but we switched to mine because his was roughly $5000 a year more and cost us slightly more out of pocket besides. We have been happy with the coverage.
Coverage for myself, significant other, and 2 children is $900 per month through my employer here in the US. $30 co-pays for basic doctor visits & routine things. We pay 80% of all other costs, up to $5,000. After $5,000, the insurance company pays everything.
$900 per month works out to be about 22% of my total yearly income I use just for health coverage. I am completely against the government having any say or control of my healthcare so I am happy to pay this. They’re building a brand new hospital in my town right now, and my Children’s Hospital is phenomenal.
Hi, I’m a United Kingdom citizen (or Great Britain if anyone doesn’t recognise that title). We have a National Health Service. This is paid for by taxation. It is entirely free at the point of delivery for all people. This includes General Practioner services (this may be Family Doctors in other countries) to advanced hospital care. If a person requires a prescription from their doctor, it costs £7 (roughly) per item. People above 65 don’t pay for this. There is also the option to buy a prepayment certificate for either 3 months or 12 months to pay for all of prescription costs. As an example, I have asthma and eczema. I require 4 separate drugs per month. The yearly total for this would be £336, with a prepayment certificate I get it for about £150. Dental and eye care is also subsidised, apologies I don t know the details of this.
I get my insurance through my employer- a large financial institution. I chose the mid-range PPO that was offered (No deductible and 90% coinsurance in- network, $300 deductible and 70% coinsurance out-of-network) plus premium dental coverage and basic vision. There is no co-pay for yearly physicals and women’s health exams. For this, I pay only $57 per month. Generic prescription drugs cost me $5/ month, but anything name-brand is very expensive.
My office has a doctor on staff that we can go to without making any sort of payment, so I am able to go to him for things like allergic reactions, trouble sleeping, etc. This is one of my favorite benefits and I know I’m very lucky!
I’m young (24) and generally very healthy, so this plan might seem like more than I really need but I’ll never dip below this level of coverage if I can help it. This year, my doctor sent me to the emergency room to treat dehydration. I was in bad shape, but I went to the ER mostly because the doctor said I needed an IV. I was there a total of 3 hours and I saw the doctor once, for maybe 30 seconds. I was given an IV with fluids and anti-nasea medicine and they ran a few blood tests. My total bill ended up being around $160, but without insurance, I would have paid an additional $2000 (this is what my insurance supposedly “paid”- I’m not buying it)! Imagine if I had something really wrong with me or if I needed expensive tests!
I pay about $80 biweekly and I budgeted $800 for my FSA. I have gone over that by a little bit (it could be more, but I am getting my contacts refilled after Jan 1). I upped it to $1100 for the next year because I have to get the contacts, plus I am interested in new glasses. We are trying to get pregnant, so it should probably be more, but since we’ve been trying over a year I don’t feel so confident anymore and didn’t want to up the FSA.
Anyway, my insurance through my employer is the top of the line, a PPO/personal choice. (I’m am in the US, btw.) I can go to any doctor I want, never need a referral. Only need pre-certs for certain procedures. Specialists are a $20 copay, primary is $10. Surgery is $100. I think ER is $500 but I am fortunate to not have to know that (knock on wood). I have decent prescription coverage. I do not have vision insurance at my current job, unfortunately, but when I did I found I saved about $70, which I didn’t feel was a great savings. My dental insurance is covered by my employer.
I had cancer at the age of 23 and was extremely lucky to have similar, top-of-the-line insurance. It has been a while since my treatment, but I don’t recall paying much in the way of co-pays and I never had a hospital bill. Thank god for that. I would recommend good insurance to anyone at any age because you truly never know what might happen, even to an extremely healthy young person.
We have health insurance through the National Guard. About $190/month for really great coverage. They only have two brackets, single or family, so when our first arrives next summer it won’t change any. Definitely some tradeoffs with serving in the military but the insurance is a big reason why I still do. My civilian employer has insurance also but it’s more expensive (to me) for less coverage.
Oh gee, I live in Massachusetts.. I’m a part-time nursing student (which somehow translates into 50 hours/week). I work 2 days a week, making about $100 each day. I qualify for Commonwealth Care, which is Massachusett’s low income healthcare. I pay $0/month, and pay about $10 per doctor visit, $50 to the ER. My birth control is free, and I’m not on any other medicines. I am grateful to live in MA because I don’t know how I would be able to afford it otherwise. My job doesn’t offer it, even if I was full-time, and my school doesn’t either, since I’m not enrolled in enough credits. Even if I was offered it through school, the health insurance is $1,000 for the year and not offered to be broken up into monthly payments. In addition, the health insurance isn’t as good, nor does it come with free dental & vision like Commonwealth Care does.
My husband and I have retiree insurance in the USA. Our premium just went up to slightly over $600 per month/each. The deductible is $2,500 each with an out of pocket maximum of $5,000 annually. We are looking at other options but the research looks like the older you get the more insurance companies can charge. It’s over a year out before one of us qualifies for medicare.
How much do you spend on health insurance? $347 a month
Where do you get your health insurance coverage?
I have an individual plan for myself and my daughter. My employer only offers family coverage for $800 a month or individual. So I had to get a plan myself.
What sort of coverage do you have?
I have a $10,000 deductible, $30 copays. It’s horrible and sucking me dry!
Spanish- 180 euros a month just for my wife, I and my son..
well worth it..
Great conversation in the comments for this article. I encourage the group to consider all forms of cost for consumers of health care:
1. Financial cost (out of pocket expense for insurance premiums, deductibles, etc)
2. Time cost (the additional time people spend in order to save on financial cost such as waiting periods)
3. Pain/Emotional cost (the anxiety and strain one goes through when they face complexity in insurance benefits, or confusion in using the health care system.
The true costs of health care (and health insurance) in any country is the total of the 3 categories. Sometimes we ignore the hidden costs.
J.D.
My family pays $825 per month. That’s health insurance coverage for my wife and I, and our four children. I’m 34 years old and my wife is 31. Our kids are 10, 9, 5, and almost 1. We have a $1,000 deductible with office visit and prescription copays. Except for me. Personally I have a $2,500 deductible with copay benefits.
Sincerely,
Jared Balis
I am currently covered by COBRA … paying $862.10 per month for my wife and me. We have pre-existing conditions (my wife just had back surgery this week) so I’m not sure what we’re doing after COBRA expires “if” the Obamacare program gets shot down by the SCOTUS.
The $862.10 covers a $2000 annual deductible with maximum $6000 annual out of pocket after 20% copays.
I live in Maine and we have no competition for individual insurance if you are buying it on your own. It’s Aetna Blue Cross/Blue Shield or nothing. I was fortunate and got in on a group program offered to individuals by the state. It was meant to address the problems individuals have getting insurance and is subsidized, for low income people, to help pay for the premiums. Unfortunately, I don’t qualify for that. I am currently paying over $700/mo for health insurance! For those who are complaining about paying $160 I have no sympathy! I have the highest deductible I can get and this is the cheapest plan available to me. This is a real issue in this state. If you aren’t employed or your employer doesn’t offer insurance (which is happening more and more), you are SOL unless you have enough $$ to buy your own. If I didn’t have expensive monthly prescriptions I would bag it and put the money in a health savings acct I made for myself.
my law firm has charge me for Health Insurance Cover fees, in which i have not arroved to canada, please i need your advice, am i to pay the health insurance or it is the responsibility of my employer to pay the fees, please i need your help.
Company sponsored- $5oo a month(i pay 250 bi-weekly) 30$ copay for regular doctor, $50 for specialist, $150 ER..$170 copay for MRI, No dental and we can get a free pair of eyeglasses every 2 years. This is for 2 adults (one smoker) and one teenager. also we get up to 1500 a year for any money spent on copays, aspirin, band aids, etc,, as long as we get the receipts..