Anyone's health insurance getting worse and worse?

[NYMama]

We just got our benefit info for 2007 - the insurance premiums keep going up, and the copays are getting worse at the same time.

I have to pay copays - $25 for primary care docs/ Pediatrician visits, $45 for specialist visits, plus 10% of total charges for each visit. ER visis - $200 plus 10% of charges, URgent care visit $75 plus 10% of charges.

Prenatal - it's $25 initial copay, 10% of charges for each visit. Then for delivery, it's $150 copay per day, plus 10% of overall charges.

One of my coworkers figured out that a mammogram will run her about $150 per pop, MRI's are way up there, etc.

Our prescription coverage is terrible too.

AND I WORK FOR AN INSURANCE COMPANY!!!!!!!!!

I know I should be thankful to even have health insurance, but come on!! Is anyone else experiencing major changes for next year?

[tatteredtoo]

Yikes, if we had those rates, we couldn't afford health insurance at all.
This is the first year that we've had this company, as hubby's work changed providers last year so we had to change, too. We won't get any word on changes until next month so I can't really answer yet. I just hope they don't do anything drastic.
-Tina

[JasmineHG]

i'm not ucky enough to be working at the moment for open enrollement- but- i have sh*t my pants when i've gotten the bill from the hospital that i worked at!!! I went to my ER- and my bill was outrageous...i was like, hello- i work here!!!!! It is awful, the only way to catch a break is to be unemployed and have the government pay for crap. I have a poor, make that very poor, attitude about the division of medical costs. Needless to say we are struggling with our bills but my neighbor didn't pay a dime for anything, and gets all her baby formula for free...GRRRRRRRRR

[NYMama]

I hear ya about the division of health insurance. One of my coworkers used to work in medical billing and she was saying that you basically are paying for the uninsured. Hospital's charge insurance companies way more than they should in many cases, to offset the costs of care for the uninsured. But then the hospitals still try to get as much as they can from those who are uninsured - it's not like the bill collectors stop calling thos patients, and their credit is then destroyed. I know hospital's aren't getting rich from all this either, many are going bankrupt.

In New York, they have some good programs out there for working people who fall in certain income categories - Healthy Kids, Family Health Plus, etc. And it's good that these families are getting help with insurance and getting good coverage. But then it's us folks who don't fit into the income guidelines who are getting squeezed. When you have to start thinking, do I really need to have this bone set or this eye re-attached - it's going to cost me $x.00, there's something wrong...

[peanut]

We have Healthy NY and it is a joke. We don't have anymore prescription coverage for me because they have a maximum of 3,000 per person. Then they do not cover home health at all. We pay over $400 dollars a month and don't get much of anything at all. We still have co-pays ($20 a visit) and for hospitalization we have to pay $500 per visit. We tried to qualify for medicaid for pregnant women for me, but we make too much because I get disability. We have hardly any money and I have to keep going into the hospital because we can't afford the meds that would help to keep me hydrated. I think that we should just chuck this system and do a socialized medicine plan - that way everybody would have the same regardless of their ability to pay, we are already paying so much for it we may as well be able to use it.


Lora

[NYMama]

We had Healthy NY for a year too, so I could stay home w/ Matthew for a bit. But fortunately, we were "Healthy New Yorkers" that year and rarely needed to use the insurance. I always worried about what would happen if we really needed the insurance for something serious b/c it wasn't comprehensive coverage. Then the premiums went up and I had to get back to work so that ended that. At the time, I had Matthew on Healthy Kids. His coverage was great and the premiums were real low.

I've never had wonderful insurance, working mostly for not for profit agencies before. But now it's getting awful even in the for profit sector...
I have to sock so much money away this year in our flexible spending plan for medical expenses. At least then the money taken out is tax deferred...

I'm thankful I'll be through most of this pregnancy by the time our new coverage kicks in. If all goes well w/ delivery and it's a vaginal delivery, I'll probably opt to leave the hospital after one day instead of 2 and save some dough. And then there's the fees for all those newborn doctor's visits...

Who knew an LMSW married to a blacktop contractor wouldn't ever be rich!

[teddi]

CA has pretty great programs. Better than NY. Programs for families and kids with incomes up to 300% of federal poverty guidelines (in some counties). There's Medi-Cal, CMSP (in certain counties), Healthy Families, Healthy Kids, CA Kids (for "illegal" aliens), and AIM for pregnant women.
There's even a program for people who get denied medical insurance because of health problems (though it ain't cheap but it's something!)

I'm really lucky that I have the coverage I do- when DH lost our medical / dental this year I was able to JUST qualify for a ONE year plan that for being private pay- is relatively cheap. Rx's cost $10 generic $20 name brand. Dr visits are $25. ER is I think $50. Kids plan is only $24 a month for ALL three kids, and their coverage is even better than mine.

Unfortunately, we will be feeling the squeeze next year. I will get medical thru my job for me (covered 100%), dh will also get 100% for him from his job. I will say, at least my plan will be *stellar*. $10 dr visits, $15 name brand drugs- so IF I had another HG pregnancy, I would be so fortunate.

The kids, we will probably end up paying about $400 a month to insure. The kids, who are healthy and young.

Kaiser is a huge HMO out here. They have their downfalls and all, but I have to say, it is wonderfully simple (your monthly premium gets paid, you almost NEVER see a bill). I had a hugely expensive pregnancy, and I paid about $30 for the breast pump rental, and $100 hospital stay bill, and $20 for 30 Zofran pills (cheap cheap cheap by comparison). I think Kaiser spent close to $100,000 on the last pregnancy/birth.

In all that the ONLY time I saw a bill- was last year when I had to take an ambulance ride. Never seeing a bill. That's so stress free, I know I have been so blessed.