do you like your medical insurance?

[LivingAlmostLarge]

I have fabulous medical insurance. Ridiculously great benefits. We've chatted with our neighbors and friends and our benefits are superior in price and coverage.

Pretty much everything covered. I have 24 chirovisit, vision and dental basic coverage, we pay extra for more coverage $7/month for vision and dental!

Found out to take home my baby it will be $0. It cost $10 for the initial office copay but nothing else since or afterwards. Private room included. It's ridiculous.

My DH pays for us both $100/month for vision/medical/dental premiums. I got glasses and contacts last year and this year I get it again to explain our benefits.

I've broken a foot, ACL, etc. I've never paid for a single thing than office $10 copay. I didn't pay for either knee brace or foot cast or crutches.

I admit I'm spoiled by our medical insurance. At my DH's last place we paid $0 copay to boot. And it was even cheaper monthly, but it's likely gone up because of rising costs.

It costs according to the benefits statement we get $24k/year for the company to pay for us. I am sure we'd be screwed if we moved to a socialized system or had to pay taxes on our benefits. I'm not even sure we could afford to buy this great insurance.

But do you like your employer provided coverage?

[MonkeyMama]

Employer provided insurance? No - never. I worked for a large international firm for a few years, and a couple of mom and pop shops. Have never been offered anything in the realm of decent or reasonable.

Anyway, I could pay something like $800/month to add all my dependents to my boss's plan, and have the pleasure of high deductibles, etc. I considered at least taking the "free insurance" for myself once I had my children, but I read all the fine print and it isn't good coverage in the least.

What I am happy with is our private, non-profit HMO plan. I have had it since I graduated college. Right now we pay $550 per month + $3k per year deductible (possible anyway). Anything preventitive is covered (for the most part - like the kids have annual checkups which I believe are "free," coming up).

My perspective is different. I know private insurance is insanely expensive, and I find our plan to be reasonable.

IT's easy to get in to see a doc - I've never had to wait more than a few hours to get in (good urgent care to bypass emergency, etc.). They have a good advice line for having young kids. We call often and it's either "check for this, but everything should be fine," or "HOw soon can you get here - appointment in 15 minutes?" The emergency room at our current location is also pretty decent. Seems to be a fluke more than anything.

Which reminds me, we bide our time so much in the Bay Area, we have gone to their urgent care more than once with the kids - another reason we like it I guess. No searching for doctors when something "urgent/non-emergency" happens.

We only switched to HDHP in 2008. BEfore that we would never see a bill and never pay a dime above our premiums. No paperwork, ever. VEry easy to swith doctors, get referrals, etc. I was happy to pay more and know I Would never get any 4-5 figure surprise. We didn't pay anything for pregnancy or L&D. Which is why I could stomach higher premiums - you lve at the doctor when you are pregnant - figured we got our money's worth.

Most people I know with private insurance pay more and get less, so I am happy. We currently have no cap on our benefits, & our out out-of-pocket can not exceed our deductible. TOo good to last, probably. No paperwork since everything is within HMO. THough with the HDHP we sometimes get bills now. (Ugh - what an extremely inefficient system - as most medical billing must be. I am waiting for a bill from 18 months ago still - must be some kind of statute there).

**This is the truth - if I worked somewhere with better benefits - it would come out of my paycheck somehow. I think people lose sight of the big picture. I hear the funniest things from people about how horrible my employer must be, etc. He's got like 10 employees - what better can he offer? I am sure I could get decent benefits and a smaller paycheck if I preferred.

[DebbieL]

Well, I'm in Canada, so yes I have fantastic medical insurance. I am very happy with our system here. I pay $54/month (the maximum). If you are low income or unemployed it is free. Some provinces it is free for everyone. Still, I think $54 is cheap. I have never had any issues with the quality of care I've received.

I also have extended medical through my school (I'm in college part-time). This covers 80% of the cost of any prescriptions. It also covers alternatives such as chiropractor visits, massage, physiotherapy, psychologists, etc. My dental is also covered through school. I'm very pleased with the extended dental/medical through school (costs me $100/year for medical and $100/year for the dental).

[LivingAlmostLarge]

It's standard for the industry. It definitely come out of the salary but it's not since it's not taxed right now! I'll change my tune when it's taxed.

[atomicrc11]

My health plan at work has been great. I pay $300/month and the company kicks in $1000. Co-pays are $15 for appointments, $50 for ER if you aren't admitted and $350 co-pay per pregnancy. Drug co-pays are $5 for generics, $15 for preferred name brands and $45 for non-preferred drugs. I've had overall great care and it really has been worth it. It covers pretty much everything with no life time limits on benefits. I also pay about $30/month for dental. Certainly not a Cadillac plan, but I wouldn't want anything less in the new plan being put forth by the current administration.

[LivingAlmostLarge]

This is definitely one reason why in the US people find if hard to leave jobs for starting their own business.

[MonkeyMama]

It's standard for the industry. It definitely come out of the salary but it's not since it's not taxed right now! I'll change my tune when it's taxed.

True - I get the feeling my profession pays well, but no one cares about benefits. ? It's just been not a great experience. Though I Also understand most small employers don't even offer benefits (because they can't get group deals). Something like 75% don't, statistically.

As for the taxes - no doubt the best tax deal is if employer pays, or pays on your behlaf. BUT there are decent tax breaks regardless. If you pay enough - you get to itemize on your tax return (with medical and dental we itemize plenty). Better than nothing. Though I know we don't get a FICA break on our health insurance.

[MonkeyMama]

This is definitely one reason why in the US people find if hard to leave jobs for starting their own business.

No doubt about it.

BUT, on the flip side, I think on some level people are used to "employer provided coverage." Few ever check their options. While everyone was griping about our subpar insurance coverage at my first job, I got my own private plan for a mere $10 extra per month (no doubt cost less in the end since I had no co-pays, etc. & it was far superior medical care).

I have just never really understood the whole "reliance on employer thing." My healthcare is important to me. I don't mind paying for it. I understand many people can't afford it. BUT I hear upper middleclass people all the time say they can't afford $10k a year. Truth is they just don't want to pay for it. They can certainly afford it.

My biggest pet peeve is people putting down my employer for lack of insurance. There is no way I would have such a high salary or such high retirement benefits, elsewhere. So yeah, it's my pet peeve when people get hung up on the cost. For me, it's such a small piece of the pie. (Not aiming at commenters in the thread - but in real life people have said some really stupid things about my situation).

I work with smart people though - I think they all have private insurance.

[LivingAlmostLarge]

I do think it depends on what you are getting. We're lucky because we get the benefits without being taxed on it. It's something the company pays for us and isn't taxable income. Someone suggested getting the cash and buying cheaper insurance?

Well I'd pay taxes around 40% on the income so we'd get 60% to shop with. What could I buy? Definitely not something nearly as comprehensive. So I'll take the perk and slightly less salary. If it was a sucky plan, I'd rather have the cash and buy something just as cheap for less.

[zetta]

No doubt about it.
My biggest pet peeve is people putting down my employer for lack of insurance. There is no way I would have such a high salary or such high retirement benefits, elsewhere. So yeah, it's my pet peeve when people get hung up on the cost. For me, it's such a small piece of the pie. (Not aiming at commenters in the thread - but in real life people have said some really stupid things about my situation).

I work with smart people though - I think they all have private insurance.

You are also young and not dealing with any major pre-existing conditions. My aunt is 60 with a history of kidney stones and type II diabetes -- she's much better off getting the group rate through a large employer than she would be trying to buy her own in the private market. I also know someone who got some kind of cancer in his mid-40's that required a bone marrow transplant. No way is he ever going to be able to afford coverage through private insurance.

[swanson719]

We have Tri-care, and aside from jumping through the hoops for coverage like everyone else, it's good for us. We pay $3 a month for generic scripts, and $9 a month for brand name. The re-curring ones are mail ordered and have the monthly price for a 3 month supply. Dental is $12 a month for family coverage. Life insurance is included for $30/mo for me for $500K and $10/mo for DW for $100K, which are the max allowed.

My biggest complaint is that there are times that Tricare doesn't pay the full amount billed by the hospital and we get bills. We've never ended up having to pay them, but there is a lot of hassle with it having to be a go between for the hospital and insurance with the social worker for the hospital and case manager for tricare because they aren't on the same page. I imagine this happens in other insurance as well. From a cost standpoint, it's impossible to beat, though the administrative end is lacking.

[LivingAlmostLarge]

Definitely sometimes I have to call my insurance who didn't pay the bill and I got the entire cost. But then it's taken care of.

[Goldy1]

A lot of people are happy with their employer based benefits. MAybe some of these people have "secure" jobs also,but most people don't. Not everyone works in the medical field or for a secotr not at high risk. The problem is that some people only think of themselves and take it for granted ie I get bennies from my spoues's job so don't tax me so other people can get help, screw them if they lose thier life savings due to getting laid off and sick. Just don't make me wait over 2 weeks to get an apt.
It cold happen to a lot of these people too.
I used to get Cadilac care for no co pays but the employer each year gave lower coverage for more out of pocket.
As health care continues to increase, those fees will be passed down. Maybe our kids won't be so lucky as to get married to someone with a "secure job" or have thier own.
50 million uninsured and counting.

[DebbieL]

You are also young and not dealing with any major pre-existing conditions. My aunt is 60 with a history of kidney stones and type II diabetes -- she's much better off getting the group rate through a large employer than she would be trying to buy her own in the private market. I also know someone who got some kind of cancer in his mid-40's that required a bone marrow transplant. No way is he ever going to be able to afford coverage through private insurance.

That is the kind of thing that would keep me up at night if I lived in the US. I am very grateful for our universal health care (and contrary to what many in the US seem to think, it really is a very good system here for the most part - I've got no complaints).

[LivingAlmostLarge]

Goldie, absolutely that's what it is.