Health Insurance

PolitiSUCK
1

plenty of threads on here on this topic but I need some other clarification.

I had some, let it lapse, in hopes my employer was going to offer it in the form of a raise since I will have been at this company 3 years in January.

That has slowly, ok blunty, been stated as not the case. So until I find something that will pay for my hard work and offer some benefits (probably going to go to school for something, have really considered the Line Work program at ECC…but i really don’t want to sell the bird right away), I need something to hold me over. However if any of you need home improvement work done, the company does great work, and a building spree could change his mind?..ok doubtful.

For how small the company is at this point (1 other full time employee, myself, 2 brothers as owners and the son) and the extra time and help I’ve done, I can see why Obama wants to slap a penalty on small businesses like this.

Heck they use the “banked” overtime system, and only once did I actually recieve time and a half for working over the clock. The only positive right now, at least I’m working.

I need some answers from the health insurance guru’s on here.

I need to know what to budget myself at.

Healthy New York looks to be my best bet at around $170 a month (no problem affording that). I guess there are several major companies that offer the “healthy ny” policy. My question, why do the prices vary so much by carrier for the same package and care?

Does anyone know of a policy, similar in price, that I can get w/o bothering with the Healthy NY stuff.

Mainly I want health insurance for the unknowns. I could be at home and I let the sawzall get out of hand…or a jackstand kicks out and takes out a testicle…Cancer! That kind of thing.

Should I just hold out until Obama’s idea gets passed in some form or grab it now, that could be till next year I suppose before they get a happy median.

Rock and a hard place, Rock and a Hard place. Internet bitching actually feels kinda good.

2

I can’t help with you any specifics but I do know that waiting for health insurance from the federal government is the worst thing you can do, while having no coverage now. It will be a long while before anything is implemented (if it is at all).

Def. find something that at least covers you for the big stuff, like you mentioned.

3

x2

If Congress were to pass a public option don’t expect to see it implemented until at least the end of 2010 if not later.

If you are going back to school see if there is some insurance that they offer.

4

$170 per month is not that bad dude.

I get insurance through my work, and it is 45 bucks every two weeks for independent health, or 21 bucks every two weeks for a $500 deductible empire blue plan…

5

I had healthy NY had no issues with it paid my bill and was all set. went to the ER once after a crash on the bike was like 100 for the visit.

6

Wow $170 a month? I pay $84 a month for single male and its pretty good coverage with Excellus. We don’t have that full rewards with the spending account beyond going online and doing the questions and stuff and can get you like $200 in spending last time I checked every 6 months.

I just really wish I we had more options to send it. I never go to the doctor and only require a checkup every 5 years so its such a waste of money. I wish I could use it to spend on things like a gym membership and such.

7

shit Ed, $170/mo is not bad actaully… you can get more expensive premiums through employer plans believe it or not.

Post cliffs on the explanation of benefits of the healthy NY program and see if it has any Fucillo pitfalls.

You’re gonna want SOMETHING though, and sooner then later. Xrays are ~1800 a film, MRIs are 3k or so iirc… not too mention pain meds while your crushed tecticle heals.

8

Thanks for the replies. Seems like a good option. Did a little more reading and hunting for info.

The rates from Univera (choose them because they have the doctor I’ve always gone too listed and Independent health was much higher) are ~$210 w/ drug coverage, ~$150 w/o.

Then they have a high deductible plan that is ~$170 w/ drug and ~$116 w/o. It involves opening some sort of health related savings account that is tax deductible…which if I was a good saver would probably be a good idea.

I’ll be looking into that further. Basically it seems like the “emergency” or “fire” insurance, and puts you in the seat to cover all the small stuff.

How I understand this, w/o drug coverage,
If I go in for a cut that is infected. I have to pay for the anti-biotic that would kill the infection.
If I go in for a broken leg, I have to pay for the pain killer.

I always hear how expensive prescription drugs are, so maybe I’ll go with the prescription drug plan on the non-deductible, with deductible it doesn’t seem to matter one way or the other really, your still paying out of pocket until you meet the threshold.

Here’s the benefit pkg pdf:
http://www.ins.state.ny.us/website2/hny/english/hnybp.pdf
Services Covered by Healthy NY

• Adult preventive services consisting of mammogram, Pap test, prostate cancer screening,
physical examinations every three years and adult immunizations
• Preventive and primary health care services for dependent children including routine well-child visits and immunizations
• Inpatient hospital services consisting of daily room and board, general nursing care, special diets and miscellaneous hospital services and supplies
• Outpatient hospital services consisting of diagnostic and treatment services
• Physician services consisting of diagnostic and treatment services, consultant and referral services, surgical services (including breast reconstruction surgery after a mastectomy), anesthesia services, second surgical opinion and a second opinion for cancer treatment
• Emergency services
• Outpatient surgical facility charges related to a covered surgical procedure
• Diagnostic x-ray and laboratory services
• Pre-admission testing
• Maternity care
• Home health care (up to 40 post-hospital or post-surgical visits per calendar year)
• Physical therapy (up to 30 post-hospital or post-surgical visits per calendar)
• Diabetes equipment, supplies and self-management education
• Therapeutic services including radiological services, chemotherapy and hemodialysis
• Blood and blood products furnished in connection with surgery or inpatient hospital services
• If the prescription drug benefit is selected, prescription drugs obtained at a participating pharmacy
($3,000 annual maximum per person)

http://img.photobucket.com/albums/v348/BigEd2006/misc/co-pay.jpg
co-pay.jpg779×271

Services Not Covered by Healthy NY

• Mental health services, including but not limited to treatment and medication for ADHD,
depression and anxiety
• Alcohol and substance abuse treatment
• Chiropractic coverage
• Hospice care
• Ambulance
• Dental care and vision care
• Durable medical equipment

9

Call your car insurance company and see what they have to offer you as well. I took out a tiny extra policy through State Farm that covers ANY emergency room stuff 100%. I already have full medical through work, but the lady told me to get this because it lowers the amount for each of cars by almost $40 each/annually. What the policy does is that it cuts you a check for whatever the emergency room visit is for, EVEN IF IT IS ALREADY PAID FOR by other insurances that you have. I know that this won’t apply in your case, but other people might be interested. The policy costs $99 a year but it knocked off around $120 a year spread out over my 3 cars, so essentially I got it for free. You have 2 vehicles too, so maybe it is something to look into.

10

I have a single, high-deductible plan with an HSA (Health Savings Account) and for my personal situation (single, great heath) it’s was best option IMO. Even if I had to pay my whole deductible the cost would still be less expensive than an HMO.

Basically the difference between an HSA and an HMO is that with an HMO you pay them regardless if you’re sick or not. With an HSA, if you don’t get sick you’re money stays in the savings account until you actually need it for something and earns interest. And if you keep contributing to it, you can invest it as well.

Also, most HMOs have maximum benefits you can receive. If you get cancer and need $4 million in care, your HMO might have a cap of $1 million so you’re left to pay the remaining $3 million. With an HSA, there is no maximum benefit.

Actually what you’re supposed to do is pay for all your medical needs, even down to small things like cough drops and pain killers with your HSA card and keep the receipts. You can then deduct these items from your taxes at the end of the year :tup:

11

very informative, thanks.

12

Wish i could help, but i can’t…all i want to comment is that last year for like 4 or 5 months i had a lapse in my coverage…and going nearly a half a year knowing i had no coverage was terrifying.

13

I want to add a question to this informative thread.

I hear a lot about generic drugs and how cheap they are but my question is, are there generic alternatives for most of the common prescription drugs?

This doesn’t apply to me as I am fully covered but I am just curious.

14

they make generics for common drugs… YES

I dont get it

15

Depends on how long they’ve been out. When they’re in patent, only the name brand one is made and the drug company can bend everyone over. When it expires, then a generic comes out.
Generic Viagra in 2011 :angryhump:

16

hmm

I don’t think you can deduct since the HSA is already untaxed.

The lady who explained our HSA/high deductible was a fucking idiot though…One time she said you can use your HSA for OTC drugs and the next month she said you couldn’t.