Insurance vent (update)

SciChick

GAH! I am so sick of this. We have a pediatrician that we love and trust. My work health insurance is astronomical in cost. To cover the family would cost nearly $1,000 per month. That's not a typo! So we go through DH's work. We got notification that his insurance is being cancelled at the end of the month. We're looking at the Obamacare plans and most of them just suck. Most of them you have to pay every cent before a $6000 or more deductible is met and then you can have a normal office visit copay. So basically you're paying the insurance premium each month AND you're paying out of pocket for any visits. What the hell kind of insurance is that? Highway robbery is what it is. So to get a more traditional plan it will cost us 4 times the amount we're paying right now through DH's work, though less than $1,000. Afforadable? Yeah, no. 

So since he's being cancelled we have a little more time to try to decide what to do and check out our options. At S's 15 months well baby I discussed this with the doctor - not our regular one because I didn't set it up ahead of time enough - so this was a substitute doc - I asked her if we could do the 18 month appointment at the end of December so we could get it in before the insurance kicked out. No problem she says. We'll just have to come in for the one immunization in January and since it's only 1 shot it'll only be $20. Cool. I call to set up the appointment and they tell me they don't schedule the last two weeks of December. I am so sick of this crap already. We went through this when S was born because DH didn't have the good insurance selected so we had to wait until open enrollment to change it. We got private insurance and it cost us so much money and we never got any benefit from it. I am livid.

Thanks for listening!

Update:

I think I may have found a plan! It is the same thing I described but it covers all of the preventative stuff (well baby visits) at no charge and then the first three PCP visits per person is free and then after that you have to start paying the deductible. So, it's reasonable and gives us what we will use, barring any major injury or anything like that. I am still trying to find out if S's doctor takes this specific plan. Fingers crossed! It will at least give us what we need until we can get something better.

BootsOrHearts

Ugh, that sucks. How tied are you both to your jobs? Is it possible for one or both of you to look for other jobs that have better insurance coverage? That doesn't help you between now and December probably, but longer term that may be a better option. Even if you have to take a small pay cut, you might be saving money in the long-run. Just a thought. 

SciChick

I really can't leave but he will be looking for something else. Hopefully that will solve it. I just don't know how people sitting around a table in a meeting said they thought this would be useful to anyone.

KikiCohen

That is so frustrating I hate dealing with this kind of thing. It makes you sick to think about! I'm not sure what state you live in, but I'm in PA and I know families can qualify for CHIP which is basically free or low cost insurance through the state. Maybe you could look into that for LO. THe rate for just the two of you should then be less.

BootsOrHearts

Insurance really is a nightmare though. There's benefits to a system like Canada's, though the downside is no one has a clue what things really cost. My mother likes to 'demand' certain tests, like MRIs and when I tell her how much those things are costing the Canadian taxpayers, she gets really quiet. :-P

SciChick

Thanks everyone. I checked the assistance programs here and we don't qualify. We qualify for the tax credit on the health insurance yet they are saying we don't qualify for it when it comes to getting lower premiums. I guess it's just as well. You'd hate to be wrong and then owe all that come tax time. 

@mamalamb10 what is the name of that program? It sounds promising. I haven't yet given up hope about keeping our doc but we may have to. They charge $80 per office visit and we can go downtown for free vaccines. As it is S only needs one more next month and then not again until she is 4. So honestly, as long as we don't have anything major happen we don't need much insurance. We're only going to go twice next year for well baby visits and then only as needed so it's a huge cost for not a lot of benefit "just in case." As I said, it's totally highway robbery.

@meagpt22 I can totally relate. We finally got all of the bills from delivery taken care of and every time we feel like we're getting ahead something like this happens. I know I sound like I'm whining but I just don't know how they think this is ok. And I'm pretty upset with my school district as well. They KNOW the family insurance is a major issue and they still won't fix it, despite promises that "they are working on it". Blah, blah, blah. What I do know is that it is impacting whether or not we can have baby #2 and when and that's not ok for me.

SciChick

I have an FSA and we used it all to pay for the bills from delivery. We'll need it again for baby #2 when we get there. I have a hard time paying over $4000 per year in premiums when next year we anticipate only having to spend $200, if we were to pay out of pocket without insurance. S will only visit the doctor for two well baby visits and has only one shot. This is not a good return on investment. It will cost us 2000% what we need. It's not worth it. DH goes to the doctor MAYBE once per year and no one besides me needs medications. 

Wifey xo

Sorry Mama We paid 100% OOP for our IUI's and IVF, and Insurance would not kick in until I was actually pregnant. I understand. The dribbling in of large random bills after my son arrived was insane, and seemed so disorganized. Hope you work something out.

SciChick

Thanks everyone!

SciChick

Aaaand the doc isn't on the provider list. The one he is on is $100 more per month and that plan actually isn't as good so I think we're going to go with the cheaper plan and just go see the doc out of pocket for the well baby exams. S only has 2 visits this next year so overall we'll spend less and still go to the doc. Hopefully DH can find a new job before the second visit in the summer and we won't have to do this for long. This new system is so freaking lame. I did talk to the billing office of the doctor's office and curiously enough they said it's the insurance company who chooses which doctor is on which plan and it's not a situation of being contracted out. At any rate, we'll ride it out for a few months and see what happens.