I’m sure we’ve done this before, but I can’t find a thread.
Assuming you *have *health insurance, what do you pay (including both your and your employer’s contribution)? What are the basics of the plan?
We’re independent contractors, so we pay out of pocket for our insurance through Freelancers Union. The lowest-level family plan runs us $11,580 per year. (It’s the lowest-level plan, but the math works out such that unless there’s a catastrophic incident, it’s actually the cheapest overall after premiums and doctor visits are accounted for). It’s got a 30 percent co-insurance and $3,500 deductible ($7,000 max deductible). It’s out of pocket max is $36,000. With the exception of name-brand drugs, it covers just about everything and has a pretty wide network.
I’d be interested if we’re in the middle of the pack or, because we’re basically independents, if we’re paying through the nose. Anyone care to share?
You should also state your state, age of adults and any pre-existing conditions since those could be factors in cost.
If you payed last year, many states are getting refunds due to the 20% profit cap in Obamacare. Make sure you check out if you’re due a refund. The average was about $75/person but some states are up to $300? per person. The refunds are on a company by company basis, but if you’re in a state that had a lot of overcharging, then you’re likely due at least a small refund.
I am in Indiana and the family is on the Healthy Indiana Plan.
There’s a bit of a formula, but it works out to 5% of my monthly income. Only make $200? you pay $10. Make $2,000/month you pay $100. Make $20,000 a month (yeah, right) pay $1,000.
Pre-existing conditions: I have allergies and asthma. The spouse has spina bifida, diabetes, arthritis, and carpal tunnel.
To qualify you must have no access to employer-sponsored heath insurance. If your employer offers anything at all, no matter how crap, you can’t qualify for HIP. You must have been in that state, and without insurance, for 6 months.
The upsides: no co-pay for anything but emergency room visits. Go to all your preventive care appointments (they give you a list of stuff you should have done based on your age, gender, and history) and they refund part of the money you paid in the prior year.
Downsides: maximum pay out a year is $300,000. Your list of doctors is basically the Medicaid list, so for finding a primary care guy (which you are required to do or you are assigned one) your choice is limited. Finding a specialist to take your insurance should you need one can be difficult. Oh, and some people will regard you as either poor scum or society parasites for using “their” tax money for your insurance needs (nevermind that we’re paying taxes, too) or both.
It’s not perfect. On the other hand, we do get our medical needs taken care of.
I’m in the UK, so we have the National Health Service.
We pay for that through taxes (see National Insurance) - and this also pays for your State Pension.
(If I remember correctly, I paid about 6 - 9% when I was working full-time.)
I also have optional Private Health Insurance through my employer. It’s free from them, but counts as a taxable benefit, so it costs me about £480 ($753) / year.
The NHS has covered my family for everything from regular doctor’s visits through speech therapy to major operations for cancer.
The only charges were for some prescription drugs, but once you’re 60, even those are free.
(I’ve never claimed under the private insurance.)
I can use free reciprocal arrangements throughout Europe, but need insurance to visit the US (usually $1,000,000 worth of cover.)
I’m a retired federal employee and as such, I got to continue my Blue Cross/Blue Shield coverage. I pay $430/month and the feds pay the rest (I’m not sure how much.) This covers me and my husband under the Standard plan.
I don’t recall the specific amounts or percentages, but we have a copay for all prescriptions and doctor visits, an annual deductible of $5K, I think, and we get the best coverage if we use doctors and facilities in “The Plan.” I just found out how important that is - I had a procedure recently that was done in an out-of-plan surgical facility, and I think about $1200 is going to fall on me. Upon further reflection, I suspect the doctor who did the procedure has an interest in the facility… anyway, in the future, I won’t fall for this.
The biggest thing about my coverage that ticks me off - thru the gov’t, you either get single or family plans, so whether it’s just a couple (like my case) or a family of 12, the premium is the same. Seems to me, the more you may use, the more you should pay. I really shouldn’t complain, tho. In the past 8 years, my husband has had 5 spinal surgeries, and our total out of pocket was a tiny fraction of the actual costs. We’d have been screwed without insurance.
I’m not sure what happens when I hit medicare age - my spousal unit is younger than I and he’s under my policy. I should probably ask some questions about that.
253€/month. I’m self-employed, so I’m both employer and employee and I pay a fixed amount rather than one based on salary, but the plan is country-wide (Spain). If I worked for a company, I’d pay 7.5% of my base salary and my employer would usually pay exactly as much; I say “usually” because there are some special employment regimens where the company pays less.
I work overseas for a big US based corporation and I pay $408 per month for myself, the missus, and daughter for medical insurance. The company pays just over $1,100 per month. Living/working overseas makes our situation a bit different than most. There is a local clinic that we use for normal visits, shots, and prescriptions that costs us nothing,
For more serious issues they will stabilize the person and medivac them to South Africa, then to the USA. We get two company paid RNR trips per year so we can visit our family doctor and schedule any medical procedures then. We pay a $25 per doctor visit in the US and any other costs our covered by insurance. There is a deductible based on the family size but I don’t recall what it is.
See, this is why I cannot justify paying for health insurance. If I am exposed to $36,000 out of pocket in one year, insurance is useless to me, because I will have to declare a medical bankruptcy anyway. The outcome is really no different than having no insurance at all. I am much better off paying out of pocket for everything, because the last quote for such crappy insurance was $700 a month.
I expect ‘catastrophic’ insurance to protect me from catastrophe. Anything less is just a bad value.
I pay $39.69 every two weeks. That’s for a decent policy with a $1500 out of pocket cap, no co-insurance for wellness services (physicals, mammograms, pap smears, etc.). The best thing about being a corporate wage slage.
Federal contractor. $185.12 every 2 weeks, but my employer pays $157.35 of that, so $27.77. It’s the “high deductible” plan; I pay the first $1500/year out-of-pocket, after that I pay nothing.
Work for a large health insurance company and pay about 500ish a month for a family HRA plan covering me, my wife, and our 6 kids… Its pretty standard-ish (medical, vision, dental and prescriptions) and I have more taken out for flex spending to cover deductible stuff. With the 6 kids its worth every penny.
I recently had to drop my health insurance. I was paying around $1,400/month, and that cost was rising around $100/month every 3 months. I figured that I would either go bankrupt buying health insurance or through some illness, and I’d take my chances that the pre-existing condition clause is not overturned. So, I’m hoping to be able to buy government-sponsored insurance in the Fall.
No insurance company will have me, due to my pre-exisitng condition.
Self-employed. Mr. Athena and I pay around $580/month for coverage.
It has a $3850 deductible per year. Before the deductible is met, we pay 100% of everything. After the deductible is met, they pay 100% of everything. Very simple.
We do have to go in-network for that, but I have yet to find a doctor who is not in-network. The worst we’ve run into is that an in-network doc & hospital sent some labwork to an out-of-network lab and we had to pay about $300 for that. No big deal, it was on a $5000 bill that my insurance paid the rest of.
My only complaint about it is that the premiums go up by $50-$100/year. When we started the plan about 5 years ago, it was $270/month. And we can’t shop around because I developed a pre-existing condition during these 5 years that has made me uninsurable. I’m really hoping that the bit of Obamacare that makes it so that insurance companies cannot deny coverage based on pre-existing conditions stays in effect.
Primary Care Physician visits are a $10 co-pay, all other doctors/clinic visits are $20, no referral needed.
For treatments/surgeries/hospitalizations…I don’t pay much…here’s what the website for my benefits says:
So near as I can tell, there technically isn’t an out-of-pocket maximum, though I’d only pay at most $750 a year for in-patient treatment, but in theory there’s no limit for my co-pays for ER visits, ambulance rides, or out-patient surgery. But in practicality, I can’t ever see that going over $1000…and even that’s a stretch.
Mt dental doesn’t cost me a single penny from my paycheck (employer pays $40 a month,) and that gets me two cleanings/check-ups and one set of x-rays per year with no co-pay, and I have deductibles and maximum amounts for procedures like fillings, crowns, etc…
I also pay nothing fro my paycheck for my vision plan, and it gets me one eye exam a year with a $20 co-pay, but I get no help with lenses, frames, etc…
I have $67 deducted from each biweekly paycheck for coverage for my whole family. I don’t have the numbers in front of me, but I’m pretty sure my employer pays the bulk of the cost.
I’m in California, and I happen to work for a large healthcare organization. That’s part of why our coverage is relatively inexpensive, but I’ve had similar coverage from other employers in the past. I’m always somewhat shocked at how much some people pay for healthcare. We only have to pay a copay ($10 for a doctor’s visit, $5-15 for prescriptions, and I think $50 for a hospital stay), and insurance covers everything else.
I pay $305 per month for Pre-existing Condition Insurance. It is part of Obamacare, and boy, am I grateful. I couldn’t get private insurance at any price.
I’m 37, self-employed, and I pay about $200/month for health insurance with a $3500 deductible and 0% coinsurance after deductible. This is an HSA-eligible (Health Savings Account) plan, so I use the tax advantages of that, too.
Family of four - two kids. $9.5K/year in premiums, $5K deductible, 20% afterwards, max out of pocket, I think 9K - so the total max per year is around 18.5K.
For my wife and me, both retired but not yet eligible for Medicare, $1,100 per month. That’s with exactly the same coverage she had when she was working.
