INSURANCE SUCKS - lets rant about it!!

mbbach · October 2014

So...to say my health insurance blows is an understatement. I'm trying to switch to my husband's (b/c of course his is awesome) but my company pays 50% of my premium so therefore, his company won't let me switch and my company wont let me drop them without proof of other insurance. It's a huge hassle and I am going to have to pay a huge deductable to have this little bundle of joy! So I thought I would share my struggles with you ladies and see if you had any insurance woes that you felt like ranting about.

I figured this was better than "I can feel the baby at 6 weeks!" OR "Im showing but the baby is the size of a raspberry." Oh and who doesnt want ANOTHER thread about bloating

JenGrl8503 · October 2014

The main culprit is probably actually the IRS...they have really strict rules in regard to when you can and can't change coverage...if you've been eligible for your husband's plan all along, then you can't add his or drop yours without a qualifying event (giving birth, getting married, divorced, etc). BUT, you should be able to switch to his and drop yours during open enrollment and since we're all pregnant in 2014 and 2015 and having to meet our deductibles twice at least in 2015 you'd be on his plan.

And I totally get it! My husband works for a nonprofit and our area is struggling financially so our options were either he loses his job or we drop their benefits until the end of the year(to satisfy the IRS requirements they actually had to make him part-time at a higher pay rate so his take home is the same but he had a status change and therefore could drop the benefits)...sooo since we weren't planning on LO3 until 2015, we went with a cheap, really high deductible plan (for us...got the kids good coverage) via healthcare.gov....so everything from now thru the end of the year is pretty much out of pocket.

Currently my internal debate is that the 20 week ultrasound is going to be mid-late December and I'm trying to decide if I can wait 2 extra weeks to find out of its a girl or boy and save money by having it in January so it goes toward next years deductible instead. I know, totally a 1st world problem.

annerz22 · October 2014

I get it! Since DH and I are both independent contractors we have to be on induvidual health insurance. We pay over 1k/month just for our family premium. On top of that we have a decent prices deductible and a large out of pocket max. It sucks. Big time. But luckily we have done well at saving money so we have at least the deductible and a little over half of the OOP max covered.

I'm irrationally annoyed that I will have to meet my deductible twice for this pregnancy (I don't think my first tie screen/NT scan is covered unless ded is paid) since the pregnancy spans over 2 seperate calendar years (14 into 15).

welly01 · October 2014

I'm not looking forward to paying a deductible twice. I got really lucky with DS, who was born in November. Everything was in the same calendar year.

Plus, we are changing insurance plans at work, so next year I think I'm going to be on a high deductible plan. The only good thing is the company gives us a good chunk of money in our FSA account to offset it. Yeah, figuring out insurance sucks.

PlayboyMommy · October 2014

FRAAAAACK! I didn't even think about deductible having to be met twice!

I freaking HATE insurance companies. Loathe with the fire of a thousand suns. Ugh. I actually have "good" coverage and it's still ridiculous. I had to pay for my m/c. How's that for adding insult to injury?

Pintobean39 · October 2014

Don't get me started on insurance. I don't have fertility coverage even though I live in a mandated state(loop hole) Every visit to my RE and all my testing was completely OOP. It only took 3 medicated injectables cycles, 1 IVF with genetics testing and about $40,000 spent to finally reach the point that I'm pregnant.

So insurance should pick up my meds now right??? I need progesterone and estrogen daily or I'll lose this pregnancy. Nope, it's considered fertility drugs which isn't covered. So it's still costing me $400 a week to maintain this pregnancy which includes office visits and blood work. I'll be on this medicine until 12 weeks.

Gets better, I have a high deductible plan of $3750 that I haven't meet this year because everything Isn't covered so doesn't go towards my deductible. So I'll get off this medicine the end of Nov, have to meet my deductible and turn around January have to meet my deductible again.

Fucking insurance, they screw you any chance you get.

Unknown · October 2014

This content has been removed.

trislee · October 2014

ramy3 said:

There are a lot of things about Tricare that are super irritating, but maternity care is not one of them. I never feel so grateful for it as I do when I'm pregnant. Maternity care is covered 100%.

I was having a bitch about the Navy day, and this post gave me some perspective. The maternity coverage really is a blessing.

welly01 · October 2014

coffeeismylyfe said:

So when I got married in 2011, my dad told me he dropped me from his insurance. Great, we just added me to my husband's plan and never looked back. Fast forward to May 2014. We were ttc and wanted to plan a homebirth, so we interviewed midwives, picked one and they ran a vob. Low and behold, my dad never dropped me. Just changed my name (not a clue how he did that without ever seeing my new license or marriage cert) and never told me. We have a shitty relationship and haven't spoken since 2012. I had NO IDEA that my husband's insurance wasn't primary. Now DH's insurance is going alllllll the way back to 2011 trying to retrocatively deny every claim. On top of that my dad's insurance is not working with me at all to try and resolve some of the issues. And my dad still won't communicate with me to try and straighten things out either. Its a freaking nightmare.

Oh my gosh. That is truly awful!! I'm so sorry you're dealing with such a huge headache.

a316b · October 2014

The deductible twice thing is a killer. My work is trying to "encourage" us to move from a BCBS PPO to a High Deductible HSA (BCBS). I'm not sure how I feel about this, especially because I'm looking at that HIGH deductible in 2015 and my "ok" deductible in 2014. Have until Nov 1st to decide...

rideeventing · October 2014

ramy3 said:

trislee said:

ramy3 said:

There are a lot of things about Tricare that are super irritating, but maternity care is not one of them. I never feel so grateful for it as I do when I'm pregnant. Maternity care is covered 100%.

I was having a bitch about the Navy day, and this post gave me some perspective. The maternity coverage really is a blessing.

@trislee Ha! I have lots of bitch about the AF days.

I, too, normally bitch about the military health care system, but am currently very thankful for Tricare after reading these.

If only I didn't have to travel 45 min to 1hr to get to every appointment!

ash413 · October 2014

I honestly can't complain about my company's insurance. My salary a little lower than the national avg for what I do, but they make up for it in benifits. I have a $100 deductible and $1250 OOP max and our portion is just under $300/month for my DH and I.

MrsF0831 · October 2014

a316b said:
The deductible twice thing is a killer. My work is trying to "encourage" us to move from a BCBS PPO to a High Deductible HSA (BCBS). I'm not sure how I feel about this, especially because I'm looking at that HIGH deductible in 2015 and my "ok" deductible in 2014. Have until Nov 1st to decide...

Im on the high deductible this year, we chose it after doing some math. We save more money w the hsa including the amount paid per year and what the deductible is. We'll have to do the math again for 2015 bc even w the pos plans theres always a deductible

tinalovescauliflower · October 2014

I have a confession. I still don't understand how health insurance works. I sort of pretend I do. But all I really know is what my premium and deductible are, and then I pay them. Something tells me I need to bone up on this, stat.

It's actually one of the only things that ever makes me feel dumb. I'm an intelligent woman and yet can't wrap my head around the health care system.

Edited for typos

mmarschk · October 2014

I hate all of these insurance laws and have no idea what to do. In January I get dropped from my parents insurance because I turn 26. And from what I understand I have 60 days before to 60 days after my 26th birthday to find other insurance. My fiancé and I work at the same place, which doesn't offer health insurance and doesn't really pay enough to purchase insurance. So we are looking for different jobs.

SassyPants150 · October 2014

We paid 10k out of pocket total for everything pregnancy and birth related to DD. It was such a crock of shit. It was a complication free pregnancy, vaginal birth (epidural bumped that up but that ish was priceless). Insurance is a joke.

Pintobean39 · October 2014

@mmarschk‌ have you checked with the affordable care act? I saw on the news open enrollment is coming up and that way you could get coverage that starts 1-1-15

@coffeeismylyfe‌ that's crazy that they won't talk to you. Do you have all your dads info? Ss# and group and policy info? I'm on my husbands insurance (as a dependent) and I call them all the time to get information. As long as you are on the policy you should be able to talk to them.

As far as changing your name, you dad didn't need your permission for that or a marriage certificate. I also don't think you can take yourself off by talking to the insurance co. He would have to go to his employer and sign documents to have you removed. Since he holds the policy he has to remove you unfortunately.

zbornak123 · October 2014

I currently have a short term indemnity plan that doesn't cover prenatal care or delivery as far as I can see. My husband is awaiting the three month mark before he can get ins through his employer. But the employer is in the process of changing providers because premiums have shot up. I'm not sure if they will cover any portion of my premium if I jump in with him.

We checked out healthcare.gov last night and looks like I'll be paying anywhere from $240 - $360 a month if I want the good stuff on my own. I'm stopping short of ranting my thoughts on all things healthcare.

My first prenatal appt is later this month so we need to figure this shiz out.

Here's to hoping we all get the coverage we need!

Pintobean39 · October 2014

@zbornak123‌ that $240-360 includes maternity? I've always wondered what insurance cost on the website. If it was comparable to what we've had to pay through employers and is the coverage any good.

zbornak123 · October 2014

@pintobean39 yes maternity included. the one for $360 was 100% covered with no copays for any office visits, no coinsurance for hospitalization/delivery, which is awesome. I live in central PA, it varies from state to state. It prompts you to enter your state and county before showing you plans.

It's pretty easy to browse the plans without filling anything out aside from location. Just click show details and you can scroll down to the prenatal/delivery section on each one.

Pintobean39 · October 2014

zbornak123 said:
@pintobean39 yes maternity included. the one for $360 was 100% covered with no copays for any office visits, no coinsurance for hospitalization/delivery, which is awesome. I live in central PA, it varies from state to state. It prompts you to enter your state and county before showing you plans.

It's pretty easy to browse the plans without filling anything out aside from location. Just click show details and you can scroll down to the prenatal/delivery section on each one.

Actually that's not bad at all. My husbands last employer we were paying $700 a month for shitty coverage.

lakingsfan2015 · October 2014

We have pretty amazing insurance which covers everything and we usually have a very small OOP but we have the worst doctors in our network. With the exception of my OB who I love an adore. The pediatrician gives me the creeps, my husband and I haven't be to the regular doctor in forever. We usually go to the minute clinic if we are sick.

kj808 · October 2014

My insurance is actually pretty good but when I was going through fertility treatments I was annoyed that insurance would cover one IVF in my lifetime but no IUIs. I didn't think that made much sense.

sabriel1 · October 2014

coffeeismylyfe said:

So when I got married in 2011, my dad told me he dropped me from his insurance. Great, we just added me to my husband's plan and never looked back. Fast forward to May 2014. We were ttc and wanted to plan a homebirth, so we interviewed midwives, picked one and they ran a vob. Low and behold, my dad never dropped me. Just changed my name (not a clue how he did that without ever seeing my new license or marriage cert) and never told me. We have a shitty relationship and haven't spoken since 2012. I had NO IDEA that my husband's insurance wasn't primary. Now DH's insurance is going alllllll the way back to 2011 trying to retrocatively deny every claim. On top of that my dad's insurance is not working with me at all to try and resolve some of the issues. And my dad still won't communicate with me to try and straighten things out either. Its a freaking nightmare.
I would think you could fight this on the simple fact that you did not change your name with your dads company or request that. For me, I'm in Ca, when I got married I was no longer eligible under my dad's plan so that stopped it right there.
I have already tried that. They told me that since he is the policy holder, he is the ONLY one that can update any dependent's personal information. So the fact that I wasn't the one who requested the change doesn't matter. That's their answer to everything: I can do NOTHING because I am not the policy holder. Unless he chooses to drop me during his open enrollment (and help me out? Fat fucking chance.) I am stuck on his plan until September of 2017 when I turn 26. Fml.

I don't understand why you are still considered a dependent when you are married, 26, and not dependant financially on your father. That is nuts

mmarschk · October 2014

@Pintobean39‌ I haven't looked in a while but the website is really confusing to me. I wish they had a resource where I could go and have someone explain everything to me while I'm going through the website.

zbornak123 · October 2014

@pintobean39 the $360 would be for me only, not sure what our total payment would be once he gets on his employer plan. I just couldn't tell from my post or your post if the $360 was being interpreted as covering both of us.

Hearing what some others are paying, the premiums I've seen online don't seem that drastic after all.

kac22 · October 2014

DH and I were just talking and calculating yesterday at my Dr's visit. We have a high deductible (which TOTALLY sucks that is resets in Jan) and we have to pay everything out of HSA until the deductible is met. So we had to pay almost $300 yesterday just off my first office visit

chetasu · October 2014

The only reason I don't walk out of my office in a blaze of glory every day, is because of our insurance **le sigh**

@coffeeismylyfe Very weird that the insurance company is still covering you now that you're married. I thought you had to be unmarried to remain a dependent on your parents' insurance. Also, very weird that your dad isn't allowed to drop you whenever. Here, we can drop a dependent whenever, but you have to wait until open enrollment or a life event to add someone.

chetasu · October 2014

@coffeeismylyfe Sorry >:D<

Pintobean39 · October 2014

chetasu said:
The only reason I don't walk out of my office in a blaze of glory every day, is because of our insurance **le sigh**

@coffeeismylyfe Very weird that the insurance company is still covering you now that you're married. I thought you had to be unmarried to remain a dependent on your parents' insurance. Also, very weird that your dad isn't allowed to drop you whenever. Here, we can drop a dependent whenever, but you have to wait until open enrollment or a life event to add someone.

New law is you can keep your kids on your insurance until they are 26 regardless if they are married or not. Normally it's a good thing, except in her case.

mommyofaei · October 2014

trislee said:

ramy3 said:

There are a lot of things about Tricare that are super irritating, but maternity care is not one of them. I never feel so grateful for it as I do when I'm pregnant. Maternity care is covered 100%.

I was having a bitch about the Navy day, and this post gave me some perspective. The maternity coverage really is a blessing.

Yeah even as retiree's on prime our out of pocket is next to nothing.

fitzgirl17 · October 2014

I am an HR professional and pretty proficient in the world of medical benefits. With the Affordable Health Care Act (ObamaCare) you can be on your parents insurance until the age of 26, regardless of status (marriage, in school, other coverage etc.). Most OBGYN office bill a global charge for your services. Minus a few things here and there and it is billed after you have the baby. I am not sure what people are meaning when they say they have to meet the deductible this year and next, unless there are other medical procedures, ultrasounds etc. And once a year every employer has an open enrollment period where you can switch plans or go onto your spouse plan and therefore you can drop yours as that is considered a qualifying event. Hopefully I have answered some of your questions. ALSO before the AHCA I am pretty sure that if you got married or were not in school you could no longer be on your parents insurance. The age limit then was 23. I am not sure the exact date the laws took place as they have been continual for the last several years. So maybe you can play that card. You were not even eligible to be on his and provide your marraige certificate.

jennadesigns · October 2014

For my last pregnancy five years ago I received one global charge, after delivery, for all the care I received while pregnant. I'm still using the same office and not really sure how they do it now. I know that with both my D&Cs I had to pay out of pocket to meet my deductible, but those weren't pregnancies that made it to the end. I'm going to be bummed if I have to meet my deductible this year and next. You also have to consider that if you pay a deductible for each person in your plan, as soon as your baby is born, it's another deductible to meet (unless you've met the maximum out of pocket already). For me, I know this is really going to add up as I have okay, but not great, insurance (which is really frustrating considering I work at a hospital).

annerz22 · October 2014

@fitzgirl17‌ for me since I'm on individual health insurance (no group policy, DH and I are independent contractors) we don't get a global bill. My appointments in office are covered 100% after the initial co-pay but things like the NT Scan/first tri screen and hospital stay are only covered at 80% after I hit my deductible. So my NT scan will be in 2014 and I will pay for it fully OOP and will hit my deductible. Because the plan then "re-sets" on 1/1/15 I'll have to hit my deductible again before insurance kicks in (well the things that require a deductible as some things don't). Because baby is due in May I doubt I will hit my deductible before then so I'll be paying a big chunk for labor and delivery. This is all on top of my $1,300/monthly premium we pay for a family of 3.

I also live in a state with one of the highest cost of insurance so yay for me.

Does that make sense?

fitzgirl17 · October 2014

@annerz22 Yes it does. With my first I had to hit it twice as well, but switched insurances so that is why. But for a majority of people, I think they should be charged a global charge and might have to pay for a few things here and there. I wish it was just standardized for everyone. And I can complain with the rest of them as we have already hit our deductible as we have had a few ER visits and 1 over night stay for my son.

annerz22 · October 2014

@fitzgirl17‌ I completely agree it should be standardized. It's so confusing especially if you change plans or carriers. I think a global charge makes perfect sense.

scubakate · October 2014

I feel very lucky, my insurance premiums cost us $110/month, $750 deductible and $3k out of pocket max. Down side... can't get a tubal

Pintobean39 · October 2014

I got lucky with my boys, this was 21 and 16 years ago. I paid $100 for their circumcision and that's it. Insurance has changed a lot over the years. It now cost more for less coverage.

My insurance is actually not that bad besides the whole fertility crap. It's through a hospital and if we use this hospital we get a huge discount. My husband is a Dr at this hospital and he wouldn't let me use a different one if I wanted to.

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INSURANCE SUCKS - lets rant about it!!

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