Moved MPSIMS --> IMHO.
twicks, who’s currently uninsured, nerve-wrackingly enough
I’m a 28 year old guy with no health problems. I buy my own insurance: $70/month premium with a $5000 deductible.
I am the only insured, age 63, $3350 yearly premium, $3500 deductible, no copay, 50% co-insurance, $5000 max out of pocket. HSA eligible and annual physical included (thanks to the ACA).
So, the most I will pay is $8350 per year.
Only me, $75.00/month HMO for medical, it also has vision and dental on separate plans. I have no clue as to my company’s cost.
My husband’s active duty and I’m pregnant with twins. We pay $12.69 twice a month for dental, but other than that, our health care isn’t taken out of his paycheck. Our catastrophic cap (max out of pocket amount) is $1k per family, but they cover things like emergency room visits, so we’ve never come close to hitting it. The only time I have to spend money is I visit someone out of the network or for a few prescriptions that aren’t completely covered. In two years, I’ve spent $135 on non-dental medical care and prescription drugs. With how much some of you are paying, my husband’s paycheck doesn’t seem as small.
Canadian, but I have a supplementary plan through work that covers prescriptions, dental, optical and upgrades like massages. 
$60 a month.
I pay $150 a month for myself only, full coverage and no deductible.
I pay $160/month for Blue Cross/Blue Shield for myself. It’s not through my employer, I’ve bought it straight from the insurance company since I was 23 (and unemployed). It’s pretty awesome insurance, for the most part everything is paid for 100%. It will only cover 90% of some procedures/specialists, but my yearly out of pocket limit is $1,500 I believe. Lifetime benefits are capped at $10 million, so unless I need more than a few dozen organ transplants I should be set.
It was only $74/month when I first got it, so it’s more than doubled in cost in only 7 years or so, but the cost increase seems to have leveled out. I’ve never taken health insurance offered through an employer, the cost benefit has always been small or nonexistent, and I avoid hassles when switching jobs.
Federal Employee. Every 2 weeks, here’s the breakdown -
Health: Blue Cross Blue Shield Family Standard: 198.48
Dental: MetLife Family: 30.64
Vision: BCBS Family: 11.29
It didn’t matter whether or not there were pre-existing conditions or our ages.
Retired military and now on Medicare, so nothing for medical coverage. I pay about $800/yr for dental, which really isn’t worth it.
I pay nothing for medical, 12.66 per month for dental. My employer pays a total of 12,505 per year for the two combined. The only out of pocket are small co-pays for prescriptions. It covers me and my daughter.
Work for the state and we just did our sign up for the next fiscal year. Pay nothing for medical with a $500 deductible. Pay $39.04/month for Dental and $12.00/month for Vision. Don’t know what the prescription copay is as I rarely get prescriptions.
Individual, non-smoker
My annual contribution: $546
My employer’s annual contribution: $4,248
Coverage Details:
General Medical Expenses
Annual deductible In Network
$800 Individual; $2,400 Family
Out of Network
$1,000 Individual; $3,000 Family
Primary doctor office visit In Network
$40 copay
Out of Network
60% covered after deductible is met
Specialist office visit In Network
$50 copay
Out of Network
60% covered after deductible is met
Out-of-pocket maximum: Individual/Family includes deductible In Network
$3,300 Individual; $7,400 Family; deductible included; copays not included
Out of Network
$6,000 Individual; $13,000 Family; deductible included; copays not included
Lifetime coverage limit In Network
Limit does not apply
Out of Network
Limit does not apply
Inpatient Hospital Care
Hospital copay In Network
Not applicable; 50% reduction in benefit if stay is not preauthorized
Out of Network
Not applicable; 50% reduction in benefit if stay is not preauthorized
Hospital semi-private room In Network
80% covered after deductible is met; 50% reduction in benefit if stay is not preauthorized
Out of Network
60% covered after deductible is met; 50% reduction in benefit if stay is not preauthorized
Inpatient physician and surgeon services In Network
80% covered; after deductible is met; preauthorization required
Out of Network
60% covered; after deductible is met; preauthorization required
Independent lab In Network
80% covered; after deductible is met
Out of Network
60% covered; after deductible is met
Outpatient Care
Outpatient surgery In Network
80% covered after deductible is met
Out of Network
60% covered after deductible is met
X-ray and lab in physician's office In Network
80% covered after deductible is met
Out of Network
60% covered after deductible is met
Emergency room In Network
$150 copay; waived if admitted
Out of Network
$150 copay; waived if admitted
Urgent care clinic visit In Network
$50 copay
Out of Network
$50 copay
Ambulance services In Network 80% covered after deductible is met; Out of Network 60% of eligible expenses after deductible is met
Durable medical equipment In Network
80% covered after ded is met; diabetic pump/pump supplies cov under med; needles, syringes, test strips carved out to CVS Caremark; cranial bands ltd to $600 per lifetime in/out-of-network comb
Out of Network
60% covered after ded is met; diabetic pump/pump supplies cov under med; needles, syringes, test strips carved out to CVS Caremark; cranial bands ltd to $600 per lifetime in/out-of-network comb
Prescription Drug Expenses
Prescription drug vendor CVS Caremark
Prescription drug Web site www.caremark.com
Prescription drug member services phone number 1-888-797-8912
Annual prescription deductible Not applicable
Retail generic $10 copay; 30 day supply
Retail preferred brand 25% coinsurance up to $75 per prescription; 30 day supply
Retail non-preferred brand 50% coinsurance up to $150 per prescription; 30 day supply
Mail order generic $25 copay; 90 day supply
Mail order preferred brand 25% coinsurance up to $187.50 per prescription; 90 day supply
Mail order non-preferred brand 50% coinsurance up to $375 per prescription; 90 day supply
Top
Coverage
Standard PPO
Preventative Care
Annual physical exam In Network
100% covered
Out of Network
60% covered after deductible is met
Well-woman exam (includes pap) In Network
100% covered
Out of Network
60% covered after deductible is met
Well baby care In Network
100% covered
Out of Network
60% covered after deductible is met
Immunizations (child) In Network
100% covered
Out of Network
60% covered after deductible is met
Mammogram In Network
100% covered
Out of Network
60% covered after deductible is met; office visit copay may apply; subject to Reasonable and Customary limits
Allergy tests and treatments In Network
No copay unless a doctors visit is billed; otherwise, 100% covered after applicable copay based on provider type
Out of Network
60% covered after deductible is met; if office visit is billed
Routine vision exams In Network
One per calendar year
Out of Network
60% covered after deductible is met; limited to 1 per calendar year in and out-of-network combined; exam for the treatment of disease or injury to the eye 60% covered after deductible is met
Hearing evaluations In Network
Covered; part of routine physical exam
Out of Network
60% covered after deductible is met
Family Planning
Fertility services In Network
Covered; copay applies for diagnosis, testing, non-invasive treatment; 80% covered after ded is met for hospital service, diagnosis and non-surgical treatment; IVF/artificial insemination not covered
Out of Network
60% covered after deductible is met; hospital service, diagnosis and non-surgical treatment; IVF or artificial insemination not covered
Office visit: Pre/postnatal In Network
$40 copay initial visit only; 80% covered after deductible for all subsequent visits
Out of Network
60% covered after deductible is met
In-hospital delivery services In Network
80% covered after deductible is met
Out of Network
60% covered after deductible is met
Mental Health and Substance Abuse Care
Mental Health: Outpatient coverage In Network
Copay based on location of service rendered; preauthorization required for outpatient facility care
Out of Network
60% covered after deductible is met; preauthorization required for outpatient facility care
Mental Health: Inpatient coverage In Network
80% covered after deductible is met; preauthorization required
Out of Network
60% covered after deductible is met; preauthorization required
Detox: Outpatient coverage In Network
80% covered after applicable copay/deductible based on location of service
Out of Network
60% covered after applicable copay/deductible based on location of service
Detox: Inpatient coverage In Network
80% covered after deductible is met; preauthorization required
Out of Network
60% covered after deductible is met; preauthorization required
Rehab: Outpatient coverage In Network
80% covered after applicable copay/deductible based on location of service
Out of Network
60% covered after applicable copay/deductible based on location of service
Rehab: Inpatient coverage In Network
80% covered after deductible is met; preauthorization required
Out of Network
60% covered after deductible is met; preauthorization required
Medical Therapy
Acupuncture In Network
80% covered after deductible is met; not covered unless performed by MD, DC and includes covered medical diagnosis
Out of Network
60% covered after deductible is met; not covered unless performed by MD, DC and includes covered medical diagnosis
Chiropractic In Network
$50 copay; limited to 80 visits per calendar year, in and out-of network combined; combined with physical, occupational, speech therapy and post-cochlear implant aural therapy
Out of Network
60% covered after deductible is met; ltd to 80 visits per calendar year; in and out-of network combined; combined with physical, occupational, speech therapy and post-cochlear implant aural therapy
Outpatient physical therapy In Network
Covered; limited to 80 visits per cal yr; in/out-of-network combined; copay based on location of service rendered; combined with occupational, speech, chiro and post-cochlear implant aural therapy.
Out of Network
60% covered after deductible is met; limited to 80 visits per calendar year; in and out-of-network combined; combined with occupational, speech, chiropractic and post-cochlear implant aural therapy
Outpatient speech therapy In Network
Covered; limited to 80 visits per cal yr, in/ out-of-network combined; copay based on location of service rendered; combined with physical, occupational, chiro and post-cochlear implant aural therapy
Out of Network
60% covered after deductible is met; limited to 80 visits per calendar year, in and out-of-network combined; combined with physical, occupational, chiropractic and post-cochlear implant aural therapy
Outpatient occupational therapy In Network
Covered; limited to 80 visits per cal yr, in/out-of-network combined; copay based on location of service rendered; combined with physical, speech, chiropractic and post-cochlear implant aural therapy
Out of Network
60% cov after ded is met; ltd to 80 vis per cal yr, in/out-of-network combined; copay based on location of svc rendered; combined with physical, speech, chiro and post-cochlear implant aural therapy
Care at Alternate Sites
Noncustodial home health care In Network
80% covered after deductible is met; unlimited; preauthorization required
Out of Network
60% covered after deductible is met; unlimited; preauthorization required
Prescribed care in noncustodial skilled nursing facility In Network
80% covered after deductible is met; limited to 60 days per year, combined in and out-of-network; preauthorization required
Out of Network
60% covered after deductible is met; limited to 60 days per year, combined in and out-of-network; preauthorization required
Hospice care In Network
80% covered after deductible is met
Out of Network
60% covered after deductible is met
Nothing for medical or dental. I don’t know how much the company pays. $20 copay for doctors visits, $100 for the ER, $100 per day hospital, $1500 out of pocket max per year.
This, only I pay $40 per month for the whole family. I have a $25/year deductible for prescriptions.
currently $700/month on my ex-employer’s group COBRA, which is about to expire. In light of that,
[partial hijack]
looking thru the various HIPAA plans in my state (California), none have reasonable premiums + low copays + low maximum out-of-pocket.
Would anyone know of national or state organizations, clubs, or associations that offer health insurance? Freelancers.org is 1 example.
Replies much appreciated.
[\partial hijack]
Now that I’m on Medicare (YAY!), I’m just paying about $98/month for my supplemental insurance. Of course I’m still paying a small fortune for prescriptions and copays, especially when I get into that insanity called the “donut hole.” But hey, it’s better than the preceding 15 years without any insurance at all.
Not asking anything personal, but a lot of medications are available in generic form, and many big stores offer prescriptions for $4/ month & $10/3 months. Some of the big ones to look at are Kmart, Target, Costco, Walmart and Walgreens.
About this for us, too. With a 10K deductible. Takes care of preventative stuff and one (or two?) doctor visits a year. Beyond that it doesn’t kick in until one of us gets hit by a train.
Wow! All these US answers just make me want to scream! My husband and I are American expats living in Hungary. He’s got dual citizenship and he’s working for an international company here. His health insurance is paid via payroll taxes and I don’t know how much that is. I am not a citizen so I have to pay into the system. My insurance costs us 5,000 HUF (Hungarian forints) a month, or about $25 (US Dollars). There are no co-pays, no deductibles and no caps. Everything medical is covered, including annual mammograms and other women’s check-up stuff.
Prescriptions are not covered by insurance, but they’re not expensive either. For my HRT, I pay 6,000 HUF (about $30) for a 3-month supply. I have no dental insurance, but I pay less here for my dental work than I was paying in the US when I had dental insurance.
I tore some knee ligaments in January attempting to learn to ski, and my leg brace cost us about $50 (I googled it; it sells retail for about $400) and I pay nothing for my twice-a-week physical therapy.
I LOVE universal healthcare and do not understand why the US is so resistant to it.