Friday, May 20, 2011

Here's to your health! (And mine!)

Almost every year about this time, my employer changes our health insurance. They do this because almost every year, our premiums increase drastically. It seems like every year, our health insurance costs go up while our coverage goes down. It's a pain in the arse to change insurance every year, but I know the company is doing it to try and save us all a little money.

It got really interesting this year... our new plan, which takes effect soon, cuts our premiums by about half of what our previous plan was. Sounds good, right? Hold on to your cough syrup there, Charlie... the premiums are cut in half, yes, but the deductible more than doubled. From a $1500 deductible (which was pretty freakin' high already) to a $5000 deductible! Once we reach the total $5000 deductible amount, our plan will cover 80% of medical costs incurred. We'll have to cover the other 20%, up to another $950 out of pocket. After THAT, our plan covers expenses at 100% (as long as we stay in-network). So the total combined deductible and out-of-pocket is $5950 for SINGLE coverage. Yikes!!

Fortunately, my employer is generously going to cover a large part of the deductible for us.They'll cover the first $1100 and, if necessary, the second $2500. Each employee will pick up the $1400 in between, plus the $950 max out-of-pocket after the total deductible is met. That's on top of the monthly premiums.

Thanks to my employer kicking in such a generous amount, it's not a bad deal, as long as you only need individual coverage. We considered adding coverage for my husband... He's currently on COBRA until he's eligible for coverage at his new job, which won't be for several months. The premium to cover us both is about the same as what he pays for COBRA, but the deductible would jump to $10,000. Even with the $3600 my employer covers, we'd be screwed if one of us had a major medical issue. The little bit of accessible savings we have would be nearly wiped out. So it seems to make more sense for him to stick with COBRA for now. (His healthcare plan is good, and has a much lower deductible.)

So I finally have an affordable healthcare plan... as long as I don't ever need to really use it! Normal preventive care (annual exams, well-woman exams, mammograms) is covered 100% before the deductible, so there's no problem as long as I stay healthy. But what if I get a breast cancer diagnosis? Or slip and fall in the bathtub and break my leg or something? If not for my employer's financial contributions toward the deductible, it would be hard to cough up the money to meet that deductible all at once. And it would be even harder if we had family coverage with double the deductible. How do people with families afford health care these days? It's ridiculous. And it ain't like the insurance companies and health care corporations aren't making money hand over fist.

A lot of people may disagree with me, but I think this country is in DESPERATE need of healthcare and/or insurance reform. I don't know what the best way to go about it is... I'm not familiar with every detail, but the attempts at reform that have been debated in Congress seem flawed. And because our broken two-party system can't seem to do anything but bicker and fight, nothing meaningful gets done. Nobody wants to compromise, and it's the working class that gets shafted time and again. There's gotta be SOMETHING that can be done to ease the skyrocketing costs of medical care and insurance, isn't there? People shouldn't have to go broke to either get coverage or get treated, or both.

Fingers crossed that whatever plan my husband ends up with is a decent and affordable one. I'm just grateful (and very lucky!) that I have an employer who is generous enough to help cover a lot the costs for MY coverage. But here's hoping neither of us gets a major diagnosis, or gets hit by a truck, or succumbs to an illness that requires even a short hospital stay. It could really put a pinch on our finances!

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