Friday, October 17, 2014

Our Unfiltered Healthcare Numbers

We received our annual healthcare renewal letter today. I don't typically share details about our finances, but this is kind of a big deal. There are a lot of exaggerations and bending of facts to suit personal opinions. This isn't about my personal opinion. This is about the choices my family, and many others, will be making in the coming days.
First, I should explain that my husband works for a very small company that isn't large enough to have any sort of group rate policy. We pay for 100% of our insurance. Because of that, we have a very high deductible and try very hard not to need a doctor.
I made a picture of the price and benefit changes that were sent to us today.

There are a couple of things I'd like to point out. We were told that our premiums might increase some, but so would our benefits. As you can see here our deductible will decrease by $3,000. However it is still $7,000, which is a good bit more than what we spend on average on family healthcare costs. 

You'll also notice in the picture that we will now have prescription coverage. Yeah! But wait, there is that sneaky add on that it doesn't kick in until we meet our new $7,000 deductible. Boo! So, it really might as well still be no coverage at all.
The next upgrade is that I will now be covered for "Essential Health Benefits". These vary from state to state, but I am having a lot of trouble finding out what they are specifically above what we normally have. I know it covers mental health coverage (a total joke if you look at what is actually covered), maternity (no one in my house needs that), breast reconstruction, and then "others" that no one can seem to promise specifics on. 

Now we get to the math. For these new add-ons that we probably will never get to use and certainly didn't ask for, we are paying a pretty large price. To be exact, it is $526.18 per month more. That adds up to $6314.16 per year more. The total we are out of pocket for this is $9,413.28. Before we get real use out of it we must first meet the deductible. That puts us at $16,413.28 per year out of our pocket. 
We are not wealthy people, but we end up with too much income to receive any break or credit, but not enough that we would want to add an extra $500 a month payment for anything. I think most people probably arrange their budget so that even if they are well off they don't have $500 extra that they are willing to throw at something that has no added benefit. 
We are now looking at our options. We will talk to an agent, we will investigate every avenue we can find, but tonight the numbers just don't add up. There is a very good chance we will end up uninsured. 

1 comment:

Bob Vineyard said...

Your situation is not unusual. All individual plans issue in GA (including those issued in 2014) are being cancelled and transitioned to the newer Obamacare plan designs.

Many lines of coverage are not moved above the deductible. While it may SEEM like you don't have Rx coverage, you do since meds on the plan formulary are discounted and apply toward your out of pocket and in most cases, your deductible as well.

While it may not seem like much, adding on the Rx was a big deal. The old plan did not cover ANY Rx, not even generics. That is fine until your health changes and need medication ....... some can run several hundred, or even several thousands per month.

If you have a family plan the $7,000 deductible is for the family, not per person. Other than for renewals, 2015 plans and rates have not been released to the public by order of HHS. Since you had a $10,000 deductible before you could probably save a few $$$ by increasing the deductible to something in the $12k range for 2015.

The EHB is mandated by the government and includes a range of benefits like "free" preventive care and screenings, maternity, "free" birth control, pediatric dental and other shiny new things. All totaled there are something like 120 things the old "substandard" plans did not have that are required on the new Obamacare plans.

You can't avoid it (unless you want to pay the fines). This is our brave new world.