Wow, did I just get a wake up call regarding medical benefits

[NewJeffCT]

Boy, I just got a wake-up call in regards to health benefits. My current company, and my wife's company, both use Blue Cross for health insurance. Since my wife's monthly payments are half of my company's, we use her company's insurance. Neither plan has a deductible, and no maximum as far as I know.

We both got job offers last week from new companies. Her new company would use Oxford and my new one would use Blue Cross. So, I figured that even though the monthly payment was fairly high at this new company, I would be getting basically the same coverage.

Boy was I in for a wake-up call. I went in today for a drug test and to sign some forms. They explained the health benefits to me today:
$350 a month for a family of three ($4,200 per year)
$600 deductible.
$5,000 maximum annual benefit. They pay 80% between $600 and $5,000.

Looking at the numbers, what is the fracking point of even taking the insurance? Unless your bills are between $4,800 and $4,999, you are basically losing money. I guess this company took the bare bones Blue Cross plan. No maternity coverage, well child or prenatal coverage, either.

Yes, I know if they take the $350 per month out of your paycheck, it is pre-tax, but I am still paying a lot for very little.

Hopefully, Oxford is a bit better. But, we definitely have to review it before accepting. I'm glad I didn't officially file my notice yet!

It looks like it may be job lock for my wife & me until we find places with at least decent benefits.

[The Backlash Cometh]

1. Blue Shield is no longer a bargain.

They raised our deductibles to 1200 for every member of the family.

[LynzM]

2. Yup, scary, isn't it?

And sadly, the coverage at the 'new' place seems more like the norm, from what I've seen. This: "Neither plan has a deductible, and no maximum as far as I know." may be almost impossible to find again, anywhere else.

Good luck to you guys with finding jobs you like that have good health coverage!

[Not Me]

3. The level of coverage that any insurer provides is based

on what your employer decides and is willing to fund.
So comparing Blue Cross to Blue Cross, as you are finding is a little like apples to oranges.

[NewJeffCT]

5. I realize that

But, i figured that since this employer was bigger (now, 350 employees, new place is 2,200), I figured the bigger employer would be able to negotiate a better, or at least comparable, plan.

[Quakerfriend]

4. The benefits you and your wife currently have are

becoming quite the rarity.

I, too, got that wake up call several years ago.

[diddlysquat]

6. The point of taking the insurance they offer is in case of

a major health problem. Yes, it is very expensive and you may never really need it but what if you do? All it takes is one accident or expensive illness. We can't afford NOT to be covered.

[NewJeffCT]

8. Unfortunately...

with this plan, the maximum payout if $5,000 per year. So, if one of us had to have surgery and the bill was $20,000, we we have to pay the $600 deductible, 20% of the next $4,400 (or $880) and then every penny over $5,000.

I don't think I can touch my wife again in fear of her getting pregnant! (at my old company, the health insurance I had paid for the whole pregnancy, save a $50 deductible. That was 4 days in the hospital, c-section, all the prenatal screenings & tests, etc)

[prolesunited]

16. You sure you're reading that correctly

They offer NO coverage over $5,000?!?!

Take a second look or talk to HR. That may be maximum out-of-pocket costs, which means once you have paid $5,000 in meeting your deductible and paying your 20% deductibles.

After you meet your maximum out of pocket, they the insurance company, not you, pays 100%. Some policies my have a max, but that usually ranges between $250k and $1 million. I know insurance sucks these days, but I don't think it's sunk that low.

Please ask someone in the company or call the insurance company directly.

[NewJeffCT]

18. I was dumbfounded at the time & asked again

I'm pretty sure that is what she said both times. I will double check with somebody else in this company's HR, though.

edited to add - that I was dumbfounded enough to actually think of walking out right there!

[NewJeffCT]

29. yes, it was

the woman explained it incorrectly to me.

[punpirate]

7. Just one of the ways that...

... lack of a national health plan limits economic growth--this is an object lesson in the way that corporate health insurance prevents job mobility. As benefits contract, it gets progressively more difficult to justify an otherwise better job.

Eventually, it will reach the point that the only options will be staying in a job with marginal benefits as compared with going to a job with no benefits. That seems to be the general trend these days. It's yet another race to the bottom.

[no name no slogan]

13. wait until the corporations raise a bigger stink-- THEN we'll get it

unfortunately, that's how it's happened in most other industrialized nations-- the big businesses got sick of paying for sick employees, so they went to the gubmint to fix the problem.

thankfully, that's starting to happen in this country. corporate America is sick and tired of the rising costs of health coverage. they'll keep hollering until the gubmint steps up to the plate and takes care of things.

unfortunately, it won't happen soon enough for many people :(

[NewJeffCT]

14. you're right, that is what it will take

I've heard that the heads of GM are all for it, after all they got a wave of publicity that it costs $1,600 per vehicle in employee health care costs. Imagine how much more competitive they would be if they could drop their price $1,000 per vehicle and then put $600 per vehicle into R&D for hybrid vehicles?

Doesn't GM have major operations in Canada? Imagine the great publicity they would get if they closed a plant in Canada & opened a new one in Detroit?

If I recall, both GM and UTC lobbied the Canadian government to strengthen their national health care system! (UTC is a major company here in Connecticut and is the parent of Carrier, Otis, Sikorksky and others)

[no name no slogan]

15. You're absolutely right. GM has created many new jobs in Windsor, ON

which is right across the river from Detroit, MI. In fact I heard that more GM cars sold in the US are manufactured in Canada than the are made in the US these days, precisely because it costs GM less $$$ to produce them in Canada. And a very large part of that is paying health benefits for employees!

even if you look at the lions' share of labor disputes in the past few years, almost all of them center on the costs of health benefits. covering rising healthcare costs has been a major sticking point in most labor contracts, and will continue to be so until the federal government pulls its act together and provides the needed coverage and oversight for American workers.

I mean, jeez, it's a freaking no-brainer!!! :crazy:

[NewJeffCT]

17. I know - Canadian labor isn't THAT much cheaper

especially with the dollar as weak as it is these days.

[m_welby]

28. not in this country it won't

I've seen this new health plan scam (err, coverage) close up (I work at a health care company). It's designed to make us (the people) pay. Over the next couple years expect the HSA's (health savings accounts) to get real big and they'll market them like crazy! They pay less and collect more fees for processing paperwork. Unfortunately HSA's are only good if you don't get sick, catastrophic illness will wipe people out. This isn't a civilized nation, this is an 'ownership society'. The best health care system in the world (for those that can afford it).

We should have nationalized healthcare, but what we will get is pay as you go healthcare, which really means you pay or you go.

Corporate america will stop paying, but that doesn't mean the government will start paying, not by a long shot.

[LynzM]

23. It also limits entrepreneurship

If people can't start their own businesses, because they can't afford to buy their own insurance, and hence end up staying in a job they're unhappy with for the benefits, who does that benefit?

[punpirate]

24. Absolutely...

... another good example.

Cheers.

[progmom]

9. holy shit. no maternity or well child???

:wow:

[NewJeffCT]

10. nope

I double checked on that just to make sure. Isn't that like counter-productive?

[progmom]

12. seems like it

wow. this scares the crap out of me.

[anarch]

11. it's the wave of the future for medical "benefits"

It's part of the "we just take your money" program that most major insurance companies are moving towards. You still have to pay for all your medical expenses, but you get a nice little card to put in your wallet.

[SoCalDem]

19. Been there done that.. We were "tied" to a company for YEARS

because our son was "uncoverable" every time my husband got a better job offer..

Universal health care stops this from happening.. the coverage goes with the person, not the employer.

I wish you well.. Talk to employees at the place too.. don;t rely on what the ins co tells you

[NewJeffCT]

20. the woman that told me this was in HR

It was NOT the insurance company. She was giving me the summary.

[SoCalDem]

21. Still, check with an ordinary employee

Most of the true horror stories come out when you talk to people who have used the insurance company and are not "up there" in the hierarchy..

[NewJeffCT]

25. ok, not as bad as I thought

I was wrong, even though I am almost positive I asked the woman again. I checked with a senior person in HR and this is what he told me.

The $5,000 is the maximum out of pocket that I would pay.

Still, I'd have to pay $4,200 for the insurance, plus $600 deductible and then another $880 for the coverage between $600 and $5,000.

[prolesunited]

26. I'm glad it's what I thought

It's a lot, but it will keep you solvent if the worse happens. And that number can jump up there really quick. I just had surgery and between all the pre-op/diagnosis stuff and the surgery, I'm looking at $30k. Luckily, I kept COBRA, No bargain at $520 a month for single coverage, but it sure beats the alternative.

[KayLaw]

22. Yikes!

$5,000 wouldn't go very far in a hospital stay. My m-i-l just spent a few day in the hospital for C. Diff, which is pretty much diarrhea and when she was released there was a bill, after Medicare, for $800. My s-i-l was there and asked what the bill would have been without Medicare and was told it would have been $11,000, and that's just for IV's and basic tests -- no surgery or anything! This system sure isn't working.

[Lydia Leftcoast]

27. Yeah, welcome to the world of "why we need national health care"

Here's my situation:

$272 a month premiums (at my age, that's the best I can do)

$1000 deductible

20% co-pay after the deductible is met

I did the math on various levels of plans, and the others are worse.