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huge variance in health insurance

October 18th, 2017 at 03:20 am

Have you noticed the large variance of health insurance people have in the US? That even if you work and have employer provided health insurance there is a huge variability for what different companies pay and offer?

I mean there is huge variability in how much you pay of the premium. There is variability in whether you have a HDHP or more traditional HMO/PPO. There is more variability in your deductible. Also even within insurance companies depending on what you buy you have different levels of providers. Meaning some plans have more providers than others. It's crazy extent that that is so much variability that until you are in the plan you really can't evaluate how good it is.

Until this job DH's medical insurance was premium. We knew that from talking with friends. Now we are definitely still good but it's not cadillac good. It's still probably covered by the company 90% and 10% us. But the coverage is not as extensive we have Aetna versus BCBS for starters. And less providers take Aetna. But we can't really evaluate much more except it seems like there are higher deductibles but we never seem to have to pay for the deductible.

Would it be worth it to decouple insurance from employment? I think it would be very fair. I'm not sure we would come out ahead considering what it would cost us to insure ourselves. However I know we would likely self-insure and buy a cheap catastrophic plan and pocked the cash from the company. Of course that's assuming the company even gave us the cash from what they are saving for paying for health insurance.

I really question if companies really would give their workers the money from not having health insurance? Do you think they would? Or would decoupling health insurance just profit companies and make workers poorer?

6 Responses to “huge variance in health insurance”

  1. LuckyRobin Says:

    Some companies do offer the money to employees, but not all do. And you have to show proof that you are buying an insurance plan with the money.

    I really do not think there is any such thing as a cheap catastrophic plan anymore when you are covering a family. For singles, yes, but not really for families, not if you make too much to qualify for the subsidies.

  2. Elle Says:

    The value of employer plans is spreading the risk. The larger the insured pool, the lower the overall cost as you'll have lots of healthy people and few really sick people. 80% of expense goes to the 20% of insured.

    When you buy your own insurance you are the pool. You don't get a low premium because there is no risk sharing.

    My employer has over 14000 employees across the system. We self-insure. My OOP premium is $70/month and they pay $348. My hubby's employer has 25000 across the system. His OOP is the same but the employer pays $740 just for him. To me, this is outrageous and gouging!

    I take our high deductible w/HSA plan. Hubby doesn't have that yet but I'm hoping. I'm building up my equity in that account for future healthcare costs-I pay my OOP direct and leave this asset to grow. It's pre-tax and currently law says it's tax-free when used. We'll see if that stands up for the next 3 decades.

    Until we have insurance reform or universal healthcare, i don't see a solution to insurance costs because insurance is a for-profit business.

  3. creditcardfree Says:

    I don't know. But need to point out in reference to Elle's comment, that health care is also a for-profit business, as are pharmaceutical drugs. A true free market will make for profit companies compete for your business. Competition helps the consumer get the item they want at the price they are willing to pay. Subsidies of any kind (and they happen in many ways) mess with the true free market.

  4. PatientSaver Says:

    People like Bernie Sanders are pushing for healthcare for all as healthcare should be a basic human right. Right now it's not. Why shouldn't we all be eligible for Medicare-like plans? Seems to work pretty well for seniors and I've never heard a single one complain about their Medicare plan.

  5. LivingAlmostLarge Says:

    Medicare you can't take away. Not one complaint. People also seem to like medicaid and Tricare for the most part. Not all but I'm not sure how happy the military would be if we took it away.

    Robin we bought cheap health insurance for a year and it sucked. We didn't go to the dr because we made too much for subsidy but bought the cheapest crappiest thing we could find. Not exactly smart I know and we took the kids but DH and I wait until the last possible minute and did everything and the minute we got back on employer provided we went to the dr. So I can easily sympathsize with people about buying crap and not using it.

    Ellie I was thinking that without employer provided coverage the pool would be everyone. That everyone has to buy insurance from the companies who compete for our business and everyone has skin in the same game. Right now we do not have skin in the game since some of us are covered by employer provided coverage.

  6. Elle Says:

    unfortunately if we each buy our own policy we are not a pool. A pool is a single negotiated contract.

    I've done insurance contracting. It's not fun and they are not interested in what makes sense. I wasn't asking for margin. I was asking for breakeven on cost.

    The only large single pool is a universal healthcare plan.

    and I agree, capitalism doesn't really have a stronghold on insurance. The subsidies the coupons, the "maybe you won't have to pay for it if you can' afford it" drug commercials......they all screw with insurance coverage.

    On Medicare/Medicaid/Tricare: there are PLENTY of complaints. Day 1 hospitalization is 100% OOP cost. Drug coverage can be expensive and then there's the "doughnut" hole od 100% OOP before you get to 100% coverage. MC pays a premium for Part A and Part B.
    Then you have an option for Part D which you also pay for. There is nothing easy about navigating MC.

    Finding a doctor who has room in her/his practice for another patient is tough! The payments are very low. I once asked my doc how much of his practice could be this population and he could still make a reasonable living. 33%. He has to cover his overhead, his office nurse, his biller/coder, his transcriptionist. You can't do that if you see 2 of these patients in one hour and collect only $50 from each visit. i asked this particular doc because he lives an average middle class lifestyle not the lifestyle picture most people have of docs.

    I don't have a magic answer but I am a firm believer that insurance reform is a major part of the solution. Had this discussion with an attorney patient one day. He stated this is a legitimate solution from the legal perspective along with Tort reform. You have no idea how many frivolous lawsuits cost millions in malpractice judgments unless you're on this side of healthcare.

    My bottom line: buy the insurance you can afford and hopefully you have the savings to cover the gap to coverage.

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