Health Insurance Hell

[impy]

It's Open Enrollment time at work, and naturally it's been shrunk down so it's less than twenty days of super fun to sign up. Because who needs a full month to figure this out, right? Right?

Anyway. Because my job is... special... the rates have hiked considerably. Currently I have a Silver medical plan that I haven't used, like, at all. To keep that same plan, it's basically going to cost *does some math* about $15 more a paycheck. Which isn't awful when you look at it like that, but um, I kinda can't afford to lose that. My raise was NOT that much, okay?

So I'm left to figure out what to do. I don't have a doctor that I like (I can think of one that I'm probably not allowed near :P ) so that's not really a concern. I checked and basically the only differences between the various providers is whether or not I'm planning on picking up an addiction and seeking treatment for it next year. Otherwise, the Bronze stuff is all about the same (insanely high deductible, check) coverage wise, but it varies wildly in price. The only other possible difference (not counting which doctors are In Network) is if I needed home health care. One tells you up front how many visits you get (120) the other says see plan details. Which, uh, I kind of am trying to do, guys.

Since all my options are accepted at the three major hospitals around me, and I have no primary care doc that I'm attached to, do I just go with the cheapest option and call it a day? Do I spring for the slightly more expensive Bronze in case I find myself a raging alcoholic by July?


Meanwhile, over in dental, I do have a dentist I like but he's NEVER in network on anything I can get. Possibly in anything they offer us, honestly. This whole dental song and dance is basically just an excuse for this to mock me, really.

The vision has gotten trickier because the more expensive option isn't actually the best as far as I can tell. It's just more expensive. I guess the only reason to choose it is if your doc is available in it and I... am not loyal to anyone at this point so, enh. I'm more likely to go with the place that I last went only because I'm lazy and they should still have my file but otherwise... meh.


Which leaves us with the medical issue, really. What to do, what to do...

Comments

[irishgypsie.livejournal.com]

I used to think PPO was automatically better and would pay more (a LOT more) to have it. But then I did some reading and while PPO often gives you a better selection of doctors (for instance now that I have an HMO I can't see the fabulous OB who got me through my pregnancy because she's PPO only, so if I get pregnant again I'll have to find a new doc). However, the high deductible is a real dealbreaker for me now. When I gave birth my insurance did cover 80%. But my deductible alone was $6,000 so my total bill came to almost $10,000 just to give birth (then the hospital stay for his jaundice was a whole extra bill). It took me well over a year to pay that off. With an HMO there is no deductible, and if/when I give birth again the hospital cost is $500 per day, so if I'm there three days like I was with Ian my total bill is $1500. The actual birth and everything is TOTALLY COVERED - I literally only have to pay the $1500 for the hospital stay. That alone was worth it to me (but also my per paycheck deduction to pay for said insurance is about HALF what the PPO cost.) So...I lose my awesome doctor, but I save thousands of dollars. That decision was not a hard one to make. I highly recommend you look at the HMO options.

[luxken27]

Ugh, I feel you. Our open enrollment shrank from a month to 14 days and become compulsory - as in, if you didn't enroll you wouldn't have coverage at all next year o.O Our rates went up 3% which is - can you believe it - exactly the same amount as our merit raises next year! :D So basically it's all a wash.

I'd say go with the cheapest plan available, especially if you're gonna haveta ante up for vision and/or dental. I'm lucky in that our plan choices didn't really change so I'm not having to drop the doctor I love enough to drive 100 miles round trip to see, but I also suspect that the currently voluntary wellness program is not going to be voluntary much longer...

[snarky-imp.livejournal.com]

Thanks! I wasn't sure if this was one of those things where I thought one route was the correct choice but then someone else with experience would point out that um, the real world doesn't work like that. Basically, without a doctor I would walk through fire for (or pay through the nose for), I might as well save some cash upfront since next year's deductibles are both insanely high.

I really appreciate the advice. *hug*

[snarky-imp.livejournal.com]

Ooh, your job wins on shortest enrollment. Ours has been compulsory for the last few years, so I feel your pain on that. And I am shocked, absolutely shocked, that such a coincidence would happen! I read the notice from one of the higher ups, saying that the difference between this year's and last year's prices would be less than 5% and everyone's replies were pretty much, "Um, show of hands: did ANYONE get a 5% raise? No? So we're all hosed?"

I appreciate the advice on the insurance. The last two years I went through the vision like a fiend to find the best one (the one that basically lets me waltz into the place and say, "Bring me your most expensive frames, money is no object. Also, I'm blind as a bat, so these lenses are going to cost more than some countries make in a year, but all I need to pay is $10. Be a dear and run along now." I've got to get my ass in gear and get another pair this year because next year's options look more limited. Sigh.

Plus side, dropping back to Bronze means that I can keep the more expensive dental, just in case, and still come out ahead. Y'know, so long as I don't get sick. :P

Does your job automatically assume everyone's a smoker in the hopes that you won't check the correct box and they'll be able to charge you more?

[luxken27]

No, my job doesn't automatically assume we all smoke, but it does make you declare your tobacco use so they can fine you $50/month until you quit (they offer, er, compulsory quit programs). Now, obvs this is on the honor system and I was all, "who would actually admit that they smoke?? That's $600/year!" but apparently if you didn't declare it and they later found out that you were a tobacco user, you could be charged with insurance fraud. I'm sure there are people who are willing to risk it on the tiny chance that they will not need emergency medical services, but not me. I don't have that sort of good luck o.O

The wellness program is for us fatties, and considering the private insurance companies are already making it compulsory I am expecting our employer-based options to become compulsory as well, sooner rather than later. I'd rather stay anonymous, thanks, and keep my PHI to myself!

[snarky-imp.livejournal.com]

I'm trying to remember if mine had that period of "declare your smoking!" or just went from no difference to "everyone smokes unless you click the box that says otherwise!" with nothing in between. I think there was that period between, because I kept waiting for my coworkers to get busted because dude, you're on camera smoking outside every hour.

Heh, I avoid a couple of the side things work offers because I don't really want them knowing everything about me, thanks. I'd like to maintain some mystery. ;)