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How Can This Possibly Be Just?

by Ian on November 16, 2006

I just got a notice from our health insurance company that our health insurance is going up 20% next year. For $600 of month ($7200 a year), I will have a $5,000 deductible for my family. This year, we had to pay over $5,000 in medical bills because some stuff was out of network.

Our health insurance costs have gone up 100% ($300 a month) in the last three years. Of that amount,  $100 a month is because we had two more kids.

Does anyone have any suggestions (apart from giving up our kids for adoption) of where to get reasonably priced insurance? This is our greatest monthly expense after our mortgage, even more than food!  If we have one semi-major injury in a year we are going to be paying over $13,000 out of pocket for medical costs for the year.

You constantly hear about how many uninsured people there are in the country but they never break it down by how many don't want insurance, how many are really too poor and how many are average people who have to make a choice between insurance and food.

{ 8 comments… read them below or add one }

Christine the Soccer Mom November 17, 2006 at 8:04 am

Ian,

We are covered with Hubby’s insurance at work, so I can’t tell you what the coverage is like, but if you are a Knight of Columbus, they have insurance. Not sure what the options are (Hubby is a brand-new Knight at the moment), but the Knights might be able to help.

Sorry I can’t offer more information, but it might be worth looking into.

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aquinasandmore November 17, 2006 at 9:04 am

KofC has great life insurance but not health insurance.

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Patrick Kinsale November 17, 2006 at 10:12 am

The high cost of health care is one of the great scandals of our time, both for its high cost on those who are self-employed, and its high cost on businesses that provide coverage for their employees. I’m paying more than $1,500 a month for my family on COBRA, but it is pretty complete coverage. This is an area where Catholic hospitals should lead the way in providing affordable health care not just for the poor, but for those who cannot otherwise afford insurance.

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Carol Koster November 20, 2006 at 3:15 pm

Participate in your employer’s Flexible Benefits Spending Account. Estimate how much you think you might spend on medical costs in a year. Then submit that amount to your employer to be escrowed into a Flexible Benefits Spending Account. Each paycheck an equal amount gets depostied to this fund _before_ income taxes are deducted. As you incur medical expenses you submit receipts to the Flex Ben management agency your employer contracted with. Then you get reimbursed for those expenses. The upside is since pre-tax dollars are escrowed, you save money on your Federal and state income tax payroll deductions, too. The downside is if you don’t spend the money in the Flex account by the end of the plan year, you lose it. Ask your employer for more details. Also, try switching to generic prescriptions, not all medications have generic equivalents but if some or all of your does, it can save a lot of money. Ask your doctor if generic prescriptions instead of name-brand drugs are right for your medical condition. Exercise more, eat more healthily, watch portion control at meals. Look in your employer’s handbook or next years health insurance plan book for “wellness” incentives, which might lower your premiums. Stay “in network” as much as possible rather than going out of network (doctors, specialists, therapists, medical equipment providers, dentists, vision providers, phramacies, etc.), and see if primary care physicians can treat what ails you rather than specialists, which cost more co-pays. There are usually incentives to stay “in network” rather than going out of network. Buy over-the-counter medications, some used to be prescription-only and retain prescription strength and can be cheaper than the newest or current name-brand prescription meds. Get an allergy skin prick test if you suffer from allergies, and get on allergy shots, sometimes insurance will pay for this as a “wellness” healthcare activity if it means someday you’ll see a doctor less and buy less Rxs. For vision insurance if your eyeglass prescription doesn’t change that much year to year consider getting glasses every two years, or reuse old frames when possible. Sometimes with vision insurance there are incentives for lasik laser surgery, or there are incentives to not get new frames every year, or incentives to get a basic but serviceable style of frame rather than the high fashion frames. Might mean you start reading fine print more, sacrificing a bit of higher quality or style more, visit specialists less, try generic Rxs more (if they don’t work for you you can always switch back). Claritin used to be a Rx allergy non-drowsy once a day pill, which went over the counter. Clarinex is the new Rx only version of it, on our health plan costs $85/3-month supply from husband’s employers’ contracted mail order pharmacy. Well, Claritin name-brand over the counter for a 30-day supply is about $11 at Wal-Mart (90-day equivalent is $33-$34 or so, sure beats $85!) and the store-brand of the same drug, for 30-days is $2.68 (90-day equivalent $8.04, and definitely beats $85/90-day supply)! Shop around, ask your doctors, read teh fine print in your employee handbooks and employee insurance handbooks. Get your past receipts out, and figure out ways to save on this or that. Also, sometimes you cna save money by using a mail-order pharmacy. My husband’s employer contracts with AnthemRx.com. Sometimes it’s suggested to buy Rxs from Canadian pharmacies. Good luck! Also, try radio talk show host Clark Howard’s website, he is a nationally syndicated radio talk show host about personal finance, helps to save money, avoid scams and rip-offs, and get bang for the buck. He has a website chock full of other suggestions. Try it, and you can listen to his show on the site, too, at http://www.clarkhoward.com . Good luck!

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Bob Morgan November 21, 2006 at 9:24 pm

No doubt this is a huge expense and only rising year after year. Are there any groups you can join to take advantage of group health benefits? Doesn’t Catholic Marketing Network have some type of plan? How about the Christian Booksellers Assn? One earlier poster had a helpful idea though alone not an answer and that is using Medical Savings Accounts … especially for the amount of your deductible. If you could have that $5000 in a MSA, at least it would be pretax. I think there is some type of MSA still available for the self employed.
Good Luck! I will pray for you.
Bob

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aquinasandmore November 21, 2006 at 9:30 pm

Thank you all for your comments.

We have individual health insurance because for a company our size, every employee has to get the same plan and that would actually make our costs higher for the same coverage.

We have an HSA but have barely been able to save money at all let alone contribute to the HSA.

We don’t have prescriptions and almost never visit the doctor so generic prescriptions don’t help but we would do that if we needed them.

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Renee November 22, 2006 at 8:50 am

We are self-employed, and have similar circumstances. Every 6 months our premiums go up and we haven’t even made any claims. We have 3000 dollar deductible, and after that 80/20 coverage if it is in network.
This summer we had to take our oldest to the emergency room for a deep sliver, and the bill was 1000 dollars!!!
The one thing that helps us is when we have medical bills, we talk to the billing supervisor and explain we are basically self pay, and negotiate the price ourselves. Insurance companies negotiate all the time, so we give it a go. Usually we save at least 10 percent, or we set up a very reasonable payment plan. I do live in fear of a chronic illness or serious medical need. It would financially ruin us.

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Kristin November 27, 2006 at 1:30 pm

Maybe this is a site to check out? I really don’t know much about group health insurance, but I’ll pray for you.

https://www.ehealthinsurance.com/ehi/Alliance?allid=Pot23751&type=SG&sid=MMH3-3851469

It definitely seems unjust — and that you should be punished for having more children!

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