Monday, November 19, 2012

No end in sight

When does the skyrocketing health insurance costs end? Will it just eventually be that people start going without because they just can't afford it anymore?  Last year the health insurance premiums on the private insurance I have DH and the kids on went up 58%.  This January it will go up another 25%. It keeps going up and I keep upping the deductible and lowering the benefits to try and keep a plan that is within our budget.

Let's talk actual dollars here. Two years ago I was paying $188 a month - for all three of them! Then it took a jump to $266 a month. Last year it went from $266 to $422. Then this past summer the insurance company dropped prescription coverage on the plan (it basically only covered generics with a copay of $15 and a small discount on brand name drugs). With the drop in prescription coverage they lowered the monthly premium down to $408 (big whoop). If I wanted the one plan they now offer with prescription coverage (and not even as much coverage as the old plan) it would cost over $200 more per month than I was paying. Now, effective Jan 1st the plan goes up to $503 per month. So, in 2 years time our health insurance premiums have gone up a total of 167%.  There is something seriously wrong with our health care system and the insurance companies.

As of right now I basically have 3 companies to choose from in my state for individual/private health insurance options. I'm looking into the other 2 (again!) to see what plans they are offering this year and see if I can either get something cheaper or at least more benefits for the same cost.

Currently, I'm spending about $283 a month for Dh's prescriptions (but this keeps changing every 2-3 months as DH keeps trying to find a drug that will help, so it's hard to budget). Three of these prescriptions are generic, yet one costs $83, one cost $66 and one is on the $4 formulary. The name brand drug he is currently on is $130 (for a few months, then I lose the $30 copay discount that is offered by the drug company for the first 3 refills).  So, I need to take that monthly cost into figuring out which is the most cost effective plan and give him the benefits he needs.

I think I found a plan combination today that will cost $506 per month. $3 more than what our current plan will be Jan 1 but, with some key benefits that will bring my other out of pocket costs down. Generics will be $10 copay and brand name drugs will be 50% covered after a $500 prescription deductible.  The plan also has a vision benefit of $150 per year, which we have never had and DH is much in need of an eye exam and glasses. The deductible is very high at $7500 but the first 4 office visits are not subject to the deductible, just a $25 copay. This year was probably one of his highest in medical costs and we still didn't quite hit our $3500 deductible with our current plan.  Knock on wood, but I don't foresee next year being quite as costly as this year. The doctor is about out of options for him to try and I don't see him having to have an MRI (the bulk our our cost this year) again. So, I might as well take the high deductible that has much lower monthly premiums. If I can get those 2 higher priced generic prescriptions DH takes for $10 ea, then I will be saving $129 per month just on those.

I'm going to send in the application for this plan but I'm also now concerned because now DH is probably considered to have a pre-existing condition. The info wasn't real clear on whether that would cause a 9 month delay for the plan to cover pre-existing conditions. The info I could find said "may" be a 9 month wait. I think I'd have to stay stuck with the plan he has, if that is the case, or do some serious thinking of what my out of pocket costs for his fibromyalgia might be if it's not covered.

I'm so tired of paying a $100 or more a month increase every damn year!


  1. Unfortunately I don't see these increases going away anytime soon.

    Everyone thinks insurance companies are evil, that's a given. But one of the big problems is that while insurance co. are private businesses(so they are in this to make a profit and not altruistic), they are HEAVILY regulated by government at the state level. Hubs is in the industry(tho not health insurance). Part of the reason premiums are higher than they need to be is what the companies have to do to meet all the rules and state boards. Every state is autonomous, meaning to write insurance in 1 state a company has to meet different regs. and do didn't things than in another state. Instead of having a nationally recognized process with 1 set of rules for each state, each company has to satisfy 50 different sets of regs. and regulators. The business expense to do so is amplified x 50. A company doing business in all 50 states has to hire a full staff of lawyers, and other employees to deal with compliance issues and it just adds to the cost of doing business and gets passed down to everyone who buys the products. It makes the costs to the insurer so much higher and of course, those costs get passed along to the employers who offer coverage, then in turn to the employees, the ones who buy the coverage.
    And those state regulators have to prove they are worth their government(IE, taxpayer paid)salaries so they are constantly tinkering with regs., meaning more time/effort/money is to be used by the insurance companies to stay in compliance.
    This doesn't even begin to touch upon the other reasons why the healthcare system is broken and the greed of some companies for big profits for it's top management.

    As for the current rise in coverage costs since the signing of Obamacare....On one hand the insurance companies are reacting to the coming Obamacare mandates(or lack of knowing what it will cost them in staying compliant) by offering less coverage for more money, and employers, instead of absorbing the costs, are passing them along to employees. You know it's out of control because the rise in healthcare premiums have outstripped the Inflation rate the last 2 years.
    I have no doubt that businesses are not hiring fulltime and putting whomever they can on parttime status partly just to avoid having to deal with these kind of HR issues.....and then there is the unknown for businesses of what will have to be dealt with once Obamacare is more fully implemented.
    The rest in another comment.....

  2. Part 2 from above...
    Sometimes I think that Obama wants private insurance costs to skyrocket and become unaffordable. This gives him a mandate for national healthcare, forces more people onto it as they lose the ability to pay for private insurance and helps those who still resist to finally throw up their hands and give in.
    All the while Congress and the chosen few "elite" are NOT required to be part of the national healthcare.
    So instead of having a 2 tier system in the US where there are those who have insurance(the non-poor) and those who don't(the poor), we are going to have a 2 tier system in the US where there are those who have low grade insurance(the whole country) and those who don't(the elite who aren't require to participate and can still pay for Cadillac coverage). So nothing really changes, except everyone gets "something" and everyone use to more than "something" get less....except for the ruling class.
    Sounds very much like a socialist communist country, doesn't it?
    We are becoming a Soviet Russia... all standing in lines because of rationed goods and services, and a stagnant economy, with a political elite ruling class, who get the best of everything.
    We are already like that Soviet Russia, only more of us have access to the best(through our jobs), if we have incomes where we can afford it.
    Neither is a good solution.
    I wonder if we took the for profit component out of healthcare....what would that look like?
    And I do think the notion of taking your coverage with you from job to job is a very enlightened concept. Covering pre-existing conditions would be a better but the whole existence of insurance is built upon actuarial tables and the balance of good vs. bad risk need more good risks than bad to make a profit.
    It's just a big mess in the end and I don't see a way out of it without some people being negatively impacted either financially or medically.
    Let's hope that when it all shakes down that we all get a somewhat "fair" deal.
    I know what passes for health insurance now isn't good but I have grave misgivings on what this govt. rule system will turn out to be.

    I hope your family can keep it together and survive the coverage costs until we all get forced into Obamacare and that the new system enhances your lives and ours.

    1. Sluggy - Unfortunately, I think you might be right. It will be interesting to see what comes in 2014, when (I think this is what I read) that health insurance companies will be able to be in all states and I'll have more choices than 3 for private insurance. I really don't believe it's going to any better at all though.

    2. The only difference is that the medicine was free in Soviet Russia...Just saying :)

  3. Our insurance also increased this coming year. It isn't as bad as yours, but it is still an increase. We pay $200 a pay period (times 26 pay cycles), plus $20 co-pay for covered services, and 10% co-insurance. Plus prescription. Limited dental....VERY limited. Vision....hahahaha.

    I have to admit our insurance has been good over the years in paying for Bossy's needs. But it sure comes at a cost.

  4. Mr. Money Mustache had a post on this very topic not too long ago. He was very proud of purchasing individual health insurance for a pretty low rate. However, the comments from people who had been purchasing individual health insurance told stories very similar to yours ... relatively "cheap" in year one, but dramatically rising premiums every year thereafter.

    1. I'll have to find that to read - sounds interesting, especially the comments.

  5. Ahh health insurance an evil necessity. I note with our firms insurance that I have the previlege of paying for health insurance for the extra previlege of paying for all of my health care expenses until the thershold is met. How often do you think we meet the $3,000, with no vision or dental coverage. Those are extra coverages that again comes out of pocket. With the new year I only see a tax increase (which is just inevitable for all tax brackets)and higher premiums for insurance,which means smaller take home pay for all. :(

  6. I was just asking the same questions today! Husband works for the hospital and our insurance still went up $70 a month :(