Insurance Sucks!

atraveller · June 2014

I rarely go on any real rants, but the letter I got over the weekend really got under my skin. It was a letter from my insurance provider alerting me that they are filing a request with NY State Dept of Financial Services (DFS) to approve changes to my premium rates for 2015 and if approved the change will be 17.03% - they don't say increase or decrease, but its pretty obvious that will be a 17% increase. WTF!!!

This brings me back to my entire issue from day one with the affordable healthcare act. I am not anti-insurance, nor against everyone having access to it. I love the idea of universal health, etc....but Obama's plan didn't quite work out to what it was originally sold to the American public to be and the biggest problem with it is he left yet again way way too much power in the hands of the insurance companies, while at the same time dictating to the American people that we must get insurance or be penalized. So... while yes there are many people in lower income brackets or with very large families that benefited from AHA and I don't begrudge them the right to insurance, many others of us, who are in middle income brackets or contractors without employer provided healthcare got screwed. Between my husband and my salary we are not eligible for subsidies under AHA. We are far from rich, but we make more than the minimums, so we have to pay full premiums - and since he works in a small business that is small enough it doesn't have to provide him with healthcare and I'm a sole proprietor who gets some money towards healthcare from my main employer but not full coverage, we are stuck with out of pocket for our monthly premiums. But we were managing with that - then AHA came along and the plans I was getting through my local chamber of commerce went away and I got stuck going on the exchange - where I was able to get a plan for the same premium I was paying before this new act, but for a plan that had less coverage and many more copays - so ultimately AHA has cost me more money, not saved me anything. Sure, I could go on lower premium high deductible plan, but I did the math and that kind of plan would ultimately cost me more.

Net-net - sure some restrictions were put on insurance companies around not excluding anyone for pre-existing conditions or creating unnecessary sign up waiting periods, but no significant limitations were put on them in terms of premiums or services for their premiums -so they basically cut services or created copays for services that were covered in full before in order to show lower premiums and "SEEM" like they were being reasonable. It's such crap and the only people who lose are us, the folks who need insurance. There is no way that NY State should approve my insurance companies request to raise premiums by 17% only one year after instituting this plan - it's outrageous and will put me in a situation where I'll have another almost $1200 in out of pocket costs before even getting to the copays - but I know they will because that is how it works. So I'll have to start researching in November (right around the time when I'll be knee deep in maternity leave and a newborn and I'll just have so much time on my hands, NOT) if there are other plans I can switch to which have lower premiums but similar services. Such crap, I tell ya.

I apologize if I offended anyone that is getting real benefits out of the AHA. Again, I'm not against the premise of it, but against the fact that it wasn't really set up right and also against the whole mandated part of it - forcing people to have health insurance or be penalized in what is supposed to be a free country, is not a good thing in my mind. My DH goes to the doctor once a year and this year, we decided to just suck it up and pay the penalty for him but next year he'll have to go on insurance and pay way too high premiums for insurance he will barely use. There really should be a pay as you go type plan with nominal to no premiums but that doesn't exist.

Okay, rant over - thanks for letting me vent gals!

bumpuser10309732 · June 2014

How infuriating! I feel for you. We were always really broke in the first part of our marriage and I tried to be responsible and purchase what insurance coverage I could afford and I'm still paying for a gall bladder surgery I had 5 years ago. My brother had a baby around the same time (no insurance) and since it was his low season (he's a contractor) he came out owing nothing. It really really pissed me off. Then on the other side of it, my oldest brother struggled with chronic migraines which cause his depression to become severe and a lot of the treatments that were approved weren't helping him at all and things were escalating with his depression. I can't tell you how many arguments my mom got into with the insurance companies because they wouldn't cover this or that. SO SHITTY! You shouldn't have the power to decide on something like that for a person. Healthcare costs are so out of control.

lrobi13 · June 2014

That is rough. I am sorry that your pocket has been hit hard by the changes. I hope you can find a solution.

My job has decent coverage for me and I will add lo to it but it is too costly fro DH to be added so he is own he own as well (works for a small family business that doesn't have it). He has been told that his current plan will not be available next year so I am sure he will take a big hit. He is toying with the idea of saving his money and just paying the $99 fine and just pay cash for whatever medical services he needs (not my favorite idea)

bennikki · June 2014

Ugh, this is my worst nightmare realized. I fully expect a letter like that coming in the mail for me. My one ray of hope is that we're in MN, so Dr's are paid on salary not treatments, so they're able to control costs somewhat (this doesn't apply to elective treatments such as cosmetic surgery or fertility treatments). I know our monthly premiums will go up annually due to inflation/cost of living, but I'm used to the 2%-5% increase. If we had kept our pre-ACA plan, we would have seen a 50% increase, so like you we opted for a lower premium with less covered from the exchange. It's such a nightmare!

Like you, I fully support universal healthcare, but what we have is not universal healthcare, not even close, and the fact that there were a ton of politicians and their supporters walking in our local parade this weekend carrying signs that said "Thank you Senator Blah-Blah, my sister now has health insurance!" I wanted to scream, "you guys are ignorant idiots!"

staryb · June 2014

I realize that the ACA isn't working for everyone but I am very thankful for it. I was shopping for private insurance before the marketplace opened because we knew we wanted to start a family soon and almost all of the plans that covered maternity had 9 month waiting periods before coverage would even begin. They also either had very high premiums and/or deductibles and we just couldn't afford it. DH is fully covered by his job but to add me on would have been almost $400/month. When I got pregnant I still didn't have insurance and if it weren't for the ACA I wouldn't have been able to get it. My premium isn't bad, all of my costs have been very reasonable and I haven't paid for a single OB appointment. We also make too much to qualify for any subsidies even though we have very little expendable income, but we are definitely better off than we would have been.

I do agree that it's extremely annoying to hear about people who are paying a lot less or nothing at all because they are lower income when so many hard working people are struggling. The system is definitely flawed but it is working for some of us and I think it's a step in the right direction.

atraveller · June 2014

lrobi13 said:

That is rough. I am sorry that your pocket has been hit hard by the changes. I hope you can find a solution.
My job has decent coverage for me and I will add lo to it but it is too costly fro DH to be added so he is own he own as well (works for a small family business that doesn't have it). He has been told that his current plan will not be available next year so I am sure he will take a big hit. He is toying with the idea of saving his money and just paying the $99 fine and just pay cash for whatever medical services he needs (not my favorite idea)

- I believe you are in NY too, so doubly understand. Glad you have good work coverage - that is really truly the best solution.

Re: Your DH - just an fyi on the penalty - something we researched and found out - it turns out it is the $99 or whatever it is or 1% of your income, whichever is higher (And if you file taxes jointly it's 1% of combined income) - so we are paying a penalty on 2015 taxes for DH not having insurance for 2014 that is 1% of combined income. We had our accountant double check this and it is the case. For next year - 2015, I believe that number goes to 2% - to be billed on 2016 taxes. Just figured I'd let you know that - so if your DH is planning on going off insurance you have all the facts. (and yes it doubly sucks).

Maggie6424 · June 2014

I hate insurance companies. As if they don't make enough already, they think they are entitled to take more money from us just because it's something most of us need. I like my Kaiser, but I hated BCBS.

Raesofsunshine1 · June 2014

My insurance is terrible also. Im not sure how much it will be once little one gets added on later.

I heard on NPR that rates are expected to increase even more than expected because a lot of young people are just paying the fine instead if paying insurance premiums. It was supposed to help lower costs if more younger, healthier people signed up. It is aggravating and while I realize something has to be done, I dont think this is it yet!

lrobi13 · June 2014

atraveller said:

lrobi13 said:

That is rough. I am sorry that your pocket has been hit hard by the changes. I hope you can find a solution.
My job has decent coverage for me and I will add lo to it but it is too costly fro DH to be added so he is own he own as well (works for a small family business that doesn't have it). He has been told that his current plan will not be available next year so I am sure he will take a big hit. He is toying with the idea of saving his money and just paying the $99 fine and just pay cash for whatever medical services he needs (not my favorite idea)

- I believe you are in NY too, so doubly understand. Glad you have good work coverage - that is really truly the best solution. Re: Your DH - just an fyi on the penalty - something we researched and found out - it turns out it is the $99 or whatever it is or 1% of your income, whichever is higher (And if you file taxes jointly it's 1% of combined income) - so we are paying a penalty on 2015 taxes for DH not having insurance for 2014 that is 1% of combined income. We had our accountant double check this and it is the case. For next year - 2015, I believe that number goes to 2% - to be billed on 2016 taxes. Just figured I'd let you know that - so if your DH is planning on going off insurance you have all the facts. (and yes it doubly sucks).

We are actually in Louisiana but thanks for sharing about the penalty. That would sting a bit but may still be less than paying premiums and out of pocket costs!

atraveller · June 2014

lrobi13 said:

atraveller said:

lrobi13 said:

That is rough. I am sorry that your pocket has been hit hard by the changes. I hope you can find a solution.
My job has decent coverage for me and I will add lo to it but it is too costly fro DH to be added so he is own he own as well (works for a small family business that doesn't have it). He has been told that his current plan will not be available next year so I am sure he will take a big hit. He is toying with the idea of saving his money and just paying the $99 fine and just pay cash for whatever medical services he needs (not my favorite idea)

- I believe you are in NY too, so doubly understand. Glad you have good work coverage - that is really truly the best solution. Re: Your DH - just an fyi on the penalty - something we researched and found out - it turns out it is the $99 or whatever it is or 1% of your income, whichever is higher (And if you file taxes jointly it's 1% of combined income) - so we are paying a penalty on 2015 taxes for DH not having insurance for 2014 that is 1% of combined income. We had our accountant double check this and it is the case. For next year - 2015, I believe that number goes to 2% - to be billed on 2016 taxes. Just figured I'd let you know that - so if your DH is planning on going off insurance you have all the facts. (and yes it doubly sucks).

We are actually in Louisiana but thanks for sharing about the penalty. That would sting a bit but may still be less than paying premiums and out of pocket costs!

Whoops, mixed that up - someone told me they were in NY- ahh, monday pregnancy brain at its finest

. And I get you on the penalty. That's why we did it this year - we determined it was less than the alternative. Not sure what we will do this coming year. Still thinking on it.

atraveller · June 2014

Raesofsunshine1 said:

My insurance is terrible also. Im not sure how much it will be once little one gets added on later. I heard on NPR that rates are expected to increase even more than expected because a lot of young people are just paying the fine instead if paying insurance premiums. It was supposed to help lower costs if more younger, healthier people signed up. It is aggravating and while I realize something has to be done, I dont think this is it yet!

I hear you - that's why I'm looking into Childhealth plus for my Lo. I was told by a bunch of people now that its accepted by most doctors, and you can get it even if you make a lot of money, you just pay full premiums - but the full premiums are still less than the average family add on premium AND best part - no copays. Little hidden secret.

RE: the whole reason for raising rates - I think you're right - but there in lies the problem in my opinion - there should have been a mandate that insurance companies have to keep prices steady for at least 2-3 years AND even once they do increases they be 5% or under. For them to complain - not enough people signed up, so we need to raise rates is BS - my money is on the fact that the heads of BCBS, MVP, Signa, etc.....make more money than they can spend in a lifetime and they could easily eat the cost of less people signing up. Okay, Im stopping...I just really despise insurance companies.

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