March 27, 2014

I’m Going There: Saving on Healthcare

Dec5

My momma used to say, there are three things nice women should never talk about in public, “Money, Religion and Politics.”

Hasn’t that motto been whispered in halls across the land for generations?

Well, I’ll admit, my momma never said that. In fact, our family talks about all three of those topics endlessly, and we all have strong opinions on each one, plus more.

So I am going to broach a topic about which many waver between strong feelings and ignorance.

Yes, I’m going there, with some discussion on how we can save on healthcare.

This quandary with the upcoming changes to our healthcare system has us all in a tizzy, and as the Affordable Care Act website rolled out, it left more questions than answers.

I might not be a rocket scientist, but I’m sure everyone agrees, regardless of where they land on the topic of Obama care, extending its timeline right now ensures tweaks can be made (whether it be to fix a failed website or tighten up legislation.)

Since I can’t speak to whether that will happen, we must be proactive.

Now, the last thing I desire is a political discussion about our specific views on the new health care system. You can browse plenty of opinion posts for that, but what I want to hear about it what you are doing to prepare.

It’s really confusing, and I consider myself pretty savvy when it comes to digging into topics like this.

All I know is that many of us have questions and not only do we not know the answers, the more we read and listen on the topic, the more conflicting facts leave us frustrated.

Recently, my brother received an update that his health insurance policy was changing due to the upcoming legislation. Not only was he losing a vast majority of benefits, but his premium was being raised by $800/month. That’s not acceptable. He was shell shocked.

In the past, we’ve been self employed, so health insurance was a huge issue for many years. We were consistently attempting to navigate our options with providers. Fortunately, we have good health insurance right now through my husband’s job, but their policy is going up, so all employees have to pay additional amounts.

As a mom of five children, who desires to educate myself on topics that will vastly affect my family, I’m so glad that there are qualified insurance pros who are ready and willing to answer the tough questions and walk us through this journey for each individual person and family.

It’s not enough to just throw our hands up and declare, “I don’t understand it.”

I know that’s the easy way, and often, I’m just too tired to worry about it, but we can’t fall into that. We must all be proactive in researching what is best for our households.

As I’ve said before, navigating these waters can be rough without someone to help steer the boat. I trust Dave Ramsey’s group of Endorsed Local Providers, and they are available to help you figure out what will work, simplify the “over my head” verbiage, answer questions and be that sounding board we all need.

Find a local provider now that can give you expert help and find health insurance that fits your budget, while protecting you and your family.

If you’ve already signed up for health insurance independently through the exchanges, don’t forget the tax implications (another topic I wish to ignore because it’s overwhelming.) There are subsidies and credits that you may be eligible for. Be sure to work with a qualified tax professional now to avoid confusion and delays when filing your return, and crazy as it is to talk about, that will be here before you know it.

As you know, I’d love to just pretend it’s not happening, but time is NOT on our side with this situation, so figure out how you can save money now. It can be the most practical Christmas present to yourself. Best of all, it’s absolutely FREE!

Can I be so bold as to ask, how are you handling the health care situation?

Have you already started navigating these waters?


Comments

  1. You are right. It’s overwhelming.

    I keep waiting, thinking something will change, but that’s probably not the answer either. Ours is set to raise.

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  2. We are looking into our options this week ourselves. Thanks for tackling this topic!

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  3. My husband’s deductible was raised by another $8000 and then the cost DOUBLED for the inferior coverage because we have to now pay maternity coverage and pediatric dental insurance for him.

    Absurd. Had to reconfigure our budget.
    His stepdad lost his completely. It’s sad!

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  4. Thank you for addressing this.

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  5. We had this trouble when my hubby left his job to work for himself in September. We had to figure out what all of our prescriptions REALLY cost and how much each out-of-pocket doctor visit would REALLY set us back. So, that was one of the pushes that I needed to research further into a business opportunity that I had been praying about. I read that many people were getting off of blood pressure, cholesterol, anxiety & pain meds after slow progress with supplements from Plexus Worldwide. This is our plan for eliminating certain prescriptions we are currently taking AND supplementing our income while I still homeschool my kids. It’s been a real blessing for us!

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  6. Fortunately, our premium is staying the same but our coverage has been cut dramatically. From a $300 deductible per person to a $2500 deductible. We are eligible for a Health Savings Account so we are putting as much into it as we can afford in an attempt to have the money we will need to meet the deductible.
    their insurance.

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  7. We recently switched to an HSA, putting in the max amt every paycheck. Its still expensive because of the high deductible but then I pay a lower premium. This does save a little money, but healthcare is expensive no matter the route. I try to be more proactive in maintaining my families health, with the first sign of a cold I start them on Vit C and Zinc daily. Good hand washing before meals and after being in a crowd is a must. A good nights sleep also helps in fighting illness.

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  8. Sheila Laurence says:

    I’m probably one of the ‘lucky’ ones, as my employer-provided health coverage is staying the same, and I’m ‘only’ losing the $1200 health care savings account that my company provided in the past (for all employees) and is no longer allowed to do because of Obamacare.

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  9. Im handling it by doing nothing other than throwing my hands up in the air.. Im unemployed and so is my SO.. I lost my job & my insurance due to Obamacare.. Its a lot cheaper to pay cash unless you have some sort of catastrophic illness.

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  10. Our premiums have already gone up $400 per month, while our deductible tripled, (meaning we really can’t afford to use the insurance we now have). To prepare, (although this may not be the kind of thing you were looking for) we are learning about alternative ways to care for everyday medical stuff so we can stay out of the doctor’s offices- as well as building our health, and praying!

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  11. Liza Lee Grace says:

    I consider myself one of the lucky ones – nothing is changing for us. We have fabulous insurance through my husband’s job. We do have a high deductible ($4000), but it’s easily do-able because of our health savings account and company perks. Money goes straight from my husband’s paycheck to the account. The company adds in some each quarter. And our coverage is great. The plan covers just about everything, with few limitations. At least it has covered everything we’ve needed it to! Our portion of the premium has gone up over the years, but not as much as the other plans the company offers. It’ll be interesting to see what jump this next year brings.

    Something worth looking into if possible (I don’t know if it’s doable, given deadlines by the law)…my husband’s company purchases their insurance in June. They get better rates by buying it in the “offseason”. I have no idea if this would work for individuals, but it may be worth asking about.

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    Jen Reply:

    @Liza Lee Grace, Asking about dates is a wonderful tip. Thanks so much for sharing something so practical. :)

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  12. Luckily my husband’s employer insurance is only going up 8% and coverage stays the same. All I know to do about any of this mess anymore is to PRAY!!

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  13. Our premiums have gone up dramatically, but my employer has decided to keep our existing plan & coverage for now. I work for a small business, so if the rates increase significantly again at our next enrollment phase (which is in May), my bosses may drop our health care benefits all together. I’m praying that doesn’t happen. Not sure what else to do in the meantime.

    A couple of my friends have started looking into Christian health cost coops (everyone pools their money & shares each others costs). The costs for the groups they showed me were very reasonable, and the idea seems like it would work well for people who are relatively healthy & have small to mid-level health care expenses. However, it would be pretty risky, IMO, in the event of a catastrophic disease / accident. You could maybe circumvent that by having a backup “catastrophic” health insurance plan for major issues, while using the coop for more day-to-day stuff, but then that might negate the cost savings of using the coop.

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  14. The marketplace or whatever is called is also not an option for us–we will stick with the employer sponsored plan through my husband’s job. Our premiums did go up, but the coverage is the same as it was in 2013 for us. However, that doesn’t mention the changes that we’ve experienced in the last several years. My first baby was in 2006, and our cost was $100 (over premiums). Now, we pay more in premiums, and our 2012 baby cost us $9500 (over premiums).

    We cut other costs to pay for healthcare. Our insurance pays for well visits not-subject to deductible/co-pay, so we go to ALL of our well visits, to cultivate a relationship with our provider. That means that when a child has pink eye, they will talk to us on the phone and advise us without requiring that we come in and be seen (and pay for a sick visit). Well visits also help us to find problems sooner and take care of them when we can do something like a change in diet or lifestyle, before the problem becomes more costly.

    I never thought that I’d make healthcare decisions based so highly on $$, but here I am, and we make the most of it, seeing it as a benefit and an encouragement to live a healthy life and not go to physicians for silly things.

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  15. I do see one silver lining, though: If deductibles are rising, hopefully we’ll all start taking much better care of ourselves in the ways that we can: better nutrition, more rest, and habitual exercise. It may not help with those of us with major conditions or chronic issues, but in some ways I see the explosion of healthcare costs as a natural result of years (decades!) of poor nutrition and couch-potato habits.

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    Jen Reply:

    That is a great point, Melissa. Those who really don’t need it are so quick to rush to the doctor for the littlest of things.. I am very much into preventative and rarely use our insurance, but when I need it (maybe 2 times in 5 years), I am so grateful (like tomorrow with my son’s surgery.

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  16. Reading this makes me thankful to be Canadian, where we have universal healthcare. By no means perfect, but when I read stories of families going bankrupt in the US due to major illnesses I am SOOO thankful.

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    Jen Reply:

    I think that maybe our US news media may hype based on political leaning (unfortunately)since total bankruptcy from illness is so rare. My nephew had a brain tumor last year and they by no means could pay for the expenses. It was amazing all the help that the hospital and doctors gave, plus no deadlines on payment. Just simple payments for how ever long. We are so blessed how well he is doing and the quality care he got, but yes, so many difficult situations coming about right now due to health care. :(

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  17. Not sure what will happen with my husband’s coverage through his employer, but the kids and I are currently enrolled in Medi-Share (Christian medical sharing). Might be a good option for many…

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  18. My husband and I are two of the lucky few who will do better under the ACA than in previous years. My husband’s employer offers a truly ridiculous plan ($25k in coverage per year, an insanely high deductible, no scrip coverage, etc) and wants $650 a month for the two of us. It wasn’t the cost of the premiums that was a problem for us, it was the truly substandard benefits. If one of us were to fall seriously ill or need surgery, $25k would be a drop in the bucket and we’d be on the hook for the remainder. We purchased a “platinum” level plan on our state’s exchange and will pay $26 a month LESS. We are fortunate that we live in a part of the country that went all in on the ACA, and therefore had many insurance companies competing in our state marketplace AND we live in a highly populated part of that state so we had six plans to choose from in the platinum bracket alone.

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  19. Our insurance costs have gone up about the same amount as my husband raises each year (so it isn’t like he actually got a raise in the past 5 yrs). Our premiums have more than doubled and we have to pay so much more out of pocket compared to 5 yrs ago. Gone are the days of everything (like MRIs, Xrays, Labs ect) being covered except the initial exams. This year coming we are taking a different approach. Hubby’s employer gave us 3 options and next year because of what hubby makes I think we will have one “option” to choose from. Anyway we went from choosing the most expensive plan where we just pay small co pays (like $15 for office visits, and $10 and $25 Rx drugs) to the least expensive option where we will now have to pay for EVERYTHING until we meed our deductibles (which are $4000 single $8000 family), this past year it was a $500 deductible which an MRI alone met that. When making this decision I called our insurance to find out how much our maintaince med (hubby on a Statin, me on 2 asthma related) will be.
    We figured it out and for us (youngest kid is 14 yrs old, other 2 are over 18) it will be cheaper assuming nothing major happens to get the cheapest plan and put the max amount into a HSA which rolls over every year and turns into an IRA when he retires, in the past we put it in the use it or loose it account and that was $2500 a year. The employer gave us $500 each in the HSA for hubby and me if we went to the doctor and had him take our weight, height, total cholesterol and waist measurement and I think BP.
    We figure if we need to see a health professional we are going to start using the CVS Minute Clinic at about $80 a visit if it’s nothing major (like the sinus infection hubby gets every year).
    I have Asthma and I try and control it by being dairy free and taking 2 maintenance med one of which is NOT generic and my rescue inhalers aren’t either…but luckily I had my dr give me some RX to get me through for the year in October.
    In the past we just went to where they told us to go for procedures. I finally figured out that our insurance (Aetna) has on their website what the estimated costs of things will be, and what I found most baffling is the fact that even though a “group” that has many offices and hospitals they don’t all charge the same amount. There was a $400 difference between the most expensive place and cheapest even though they are all under the same company for an Xray with contrast on a shoulder. Also I think the fact that my insurance just pays what ever the doctor office puts in for doesn’t make sense either. Like my preventative visit this year should have been free but the office charged me for an officeand they shouldn’t have, my hubby went 3 weeks after me and he wasn’t charged for it and the only difference was I got the Flu shot, which is covered 100% anyway-not to mention because of my Asthma I have a medial need for it, though I’ve never had a flu shot before this year.
    My Asthma isn’t hospitalizing, like it is for others. So if it were we might think differently.

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  20. I am in a weird situation when it comes to the new healthcare, and if anyone here has any advice or knows something I’m missing, I’m all ears!

    I am a healthy 28 year old single graduate student with no children, finishing up my last few semesters at school. I do not have health insurance (my university only subsidizes insurance for students with assistantships, and my department does not award these to second and third year students), and I make TOO LITTLE at my part time job on campus to qualify for any subsidies in the exchanges. Normally I would apply and qualify for Medicaid, but the state in which I currently am living in until April 2014 (Utah) is NOT EXPANDING MEDICAID! So as I’m understanding things, I’m out of luck with getting help to even pay for the cheapest “Catastrophic” plan. It’s outrageous!

    So am I just stuck paying the fine? Am I somehow exempt? It’s all very confusing to me and I’m really not sure what step to take next.

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    JC Reply:

    @Candice,

    If you haven’t already, you might try calling Social Services in your area. Even if you do not qualify for any government assistance, they may be able to direct you to another agency that can assist. You could also try calling your member of Congress. They should have more information about programs that might assist you. Most congressional offices have at least one staffer (or more) that is trained in answering these types of questions. They can tell you the best place to go for more info.

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  21. I’m glad you are tackling this issue! My premium went up $25/month, and I don’t know how or where we are going to budget for the extra.

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  22. Every year my husband’s employer offers wellness challenges throughout the year. If you complete all of the various steps {very easy things} you get a discount on your insurance premium’s for the next year. Each year I have forgot about this until it’s too late. So this year I was on top of making sure we completed each task to get the discount for next year… Good thing we did too.

    We just found out that, with the increase in our monthly premiums, increased deductibles, co-pays, co-insurance, and the fact that it’s now going to cost an EXTRA $50 a month just for me to be on his insurance, it’s going to cost us over $1800 more next year for coverage. And that’s not counting the increase in medication costs. Thankfully by completing the wellness challenges throughout this year, it’s going to save us $1500 next year and eat up most of the increased cost that we otherwise wouldn’t have been able to afford without cutting more of our budget.

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  23. Curious if there is anyone else out there trying to navigate health insurance with a chronically ill family member. My daughter was diagnosed with cancer at the age of 2. For the past 4 years we fought to save her life and and are now left dealing with the long term damages to her body from her treatments. While she was in treatment we had good coverage with BCBS, but were left paying all the copays, deductibles, medications, etc. Those 3 years cost us $60,000 out of pocket WITH our excellent health insurance. It wiped out our savings and put us in debt, but we are thankful she is still here with us and knew we would do whatever it took. Now we face increased premiums, our prescription copays for her monthly meds have tripled, a new tax is being added to every single item we receive from home health care, our scan and lab payments have increased, all our copays have doubled or tripled (she has 9 specialists). I also have a heart condition and autoimmune disease and require specialists and medications. It is hard not to feel like programs like this leave the truly sick behind. We have several friends who are childhood cancer patients and can no longer afford their “last chance” treatments because the new insurance puts the cost out of anyone’s reach.

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    Leighann Reply:

    @Amber, Amber, I’m a little late to the conversation, but have you ever explored if she’s eligible for public assistance through your state Medicaid program? We have several friends whose children have chronic illnesses (including cancer) and they are on a medical waiver through the state government. I’m sure it varies from state to state but worth a call to your social services department or a social worker at the hospital where you daughter is treated. Best of luck to you…

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  24. My husband and I are now self insured. After we both were laid off 2 years ago from jobs with great benefits we had no choice but to self insure for ourselves and our 4 kids. This year we have had total for 6 people $1700 in “billed” medical costs. Our current premium is $480 with a $7000 deductible. So to have medical coverage this year we spent $5760 in premiums to cover $1700 in costs.

    With the “affordable health care act” we will now have a $7200 deductible and a monthly premium of $730! That is $8760 in premiums for 2014. Nothing has changed except the new Obamacare law.

    When I called my insurance company they said they now cover mental health, chiro and pregnancy services. My current policy already covers that. He said that there were policies that were older that didn’t cover that. So my almost double in premiums is paying the cost of “upgrading” their old policies for other people and I won’t see a change in my “benefits” just an upgrade in my costs.

    I understand helping others but the balance here doesn’t seem right. When people are commenting they aren’t sure how they will afford a $25 increase a month and imagine how many others are facing a $300 increase a month – that is huge!!

    I don’t have the answer…our choice is to go uninsured and pay the government fine and put our premium dollars towards a medical “savings” account….. which in our opinion is not a good choice with 4 kids….or find a way to absorb the costs.

    It is disheartening and frustrating.

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    Betsy Reply:

    @Kristin Smith, Our costs are similar. We pay about $6000 in premiums, then a $4500 deductible, and a $10,000 out of pocket limit. So, worst case, we pay $16,000. That would take us several years to pay off (but I feel sure people would work with us, as they have been after large costs the last few years). But to pay the full price of a hospitalization (or even worse, multiple ones) as uninsured would push us over into bankruptcy. We could not afford a $50,000 or $100,000 bout with cancer as uninsured folks.

    So we pay the premiums as a way to protect our futures and those of our children. I don’t want to be penny wise and pound foolish and risk losing everything because we didn’t have insurance.

    If we couldn’t afford the $500/month in premiums, of course, this discussion would be different. I might have no choice but to take the risk. But, for me, the risk is large, and it makes me uncomfortable to have us uninsured.

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    Kristin Smith Reply:

    @Betsy, You said it exactly Betsy!!

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  25. We are blessed to have good insurance through my husband’s job, but premiums, deductibles, and co-pays continue to go up. It costs us so much that we really put off accessing health care. We pay for the good coverage but then can’t really afford to use it.

    And we have been notified that if the projections hold, we will be in the category for 2015 that will require us to be taxed additionally on it. (Haven’t read up on that yet.)

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  26. Ugh. Right now I’m in the “can’t think about it” stage but come January 1st…

    My husband has his healthcare through the VA, my son is on medicaid, and I don’t have anything right now which is scary and a constant step of faith for me. We simply can’t afford it – I’m hopeful that, as screwed up as this system is, it might help me get something more affordable. We shall see.

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