Change of health insurance

Rebjane

Super Moderator
Well, we have been very lucky so far having good health coverage. We have a plan which covers 100%; we have lots of co-pays for drugs, specialists and lab test, sputum cultures, etc. But overall it has been ok, few glitches here and there but I turn on my inner b*itch and things have gotten straightened out. Hubby's company is now only giving 2 options one is an 80/20 plan the other I guess is worse. He was going to get the info for me today since I'm the one who deals with all the health insurance stuff. He thought after the $3000 was met(he wasn't sure this was the #) that after they would pay 100%. Anyway, we were having a heated discussion about this; Maggie listening in. Of course, the company wouldn't be doing this unless they would be saving $ and passing off some of the expense to the employee(us). Of course, we will always hit the initial payout. So now I've got numbers flying through my head of all our costs. Sammy's orthodontic payments($1200) a year. I am concerned; this sucks. I work per diem at a hospital and I do not get benefits; now I could certainly look into what insurance I could get at the hospital I work at and see if it's better. Which would mean more hours for me, more stress, less time with kids. I was saying to my hubby; but Maggie is doing so well part of that reason is cause I'm around being the drill sargent. Anyway, this is more of just a vent and to hear how others have dealt with this 80/20 plan(we've never had this before) and I don't deal with change well. After my hubby and I finished our "discussion", Maggie asked if we were going to break up and what were we fighting about. Great! SO I said sometimes parents have loud discussions and we are not breaking up; I said our fight was about money.
 

Rebjane

Super Moderator
Well, we have been very lucky so far having good health coverage. We have a plan which covers 100%; we have lots of co-pays for drugs, specialists and lab test, sputum cultures, etc. But overall it has been ok, few glitches here and there but I turn on my inner b*itch and things have gotten straightened out. Hubby's company is now only giving 2 options one is an 80/20 plan the other I guess is worse. He was going to get the info for me today since I'm the one who deals with all the health insurance stuff. He thought after the $3000 was met(he wasn't sure this was the #) that after they would pay 100%. Anyway, we were having a heated discussion about this; Maggie listening in. Of course, the company wouldn't be doing this unless they would be saving $ and passing off some of the expense to the employee(us). Of course, we will always hit the initial payout. So now I've got numbers flying through my head of all our costs. Sammy's orthodontic payments($1200) a year. I am concerned; this sucks. I work per diem at a hospital and I do not get benefits; now I could certainly look into what insurance I could get at the hospital I work at and see if it's better. Which would mean more hours for me, more stress, less time with kids. I was saying to my hubby; but Maggie is doing so well part of that reason is cause I'm around being the drill sargent. Anyway, this is more of just a vent and to hear how others have dealt with this 80/20 plan(we've never had this before) and I don't deal with change well. After my hubby and I finished our "discussion", Maggie asked if we were going to break up and what were we fighting about. Great! SO I said sometimes parents have loud discussions and we are not breaking up; I said our fight was about money.
 

Rebjane

Super Moderator
Well, we have been very lucky so far having good health coverage. We have a plan which covers 100%; we have lots of co-pays for drugs, specialists and lab test, sputum cultures, etc. But overall it has been ok, few glitches here and there but I turn on my inner b*itch and things have gotten straightened out. Hubby's company is now only giving 2 options one is an 80/20 plan the other I guess is worse. He was going to get the info for me today since I'm the one who deals with all the health insurance stuff. He thought after the $3000 was met(he wasn't sure this was the #) that after they would pay 100%. Anyway, we were having a heated discussion about this; Maggie listening in. Of course, the company wouldn't be doing this unless they would be saving $ and passing off some of the expense to the employee(us). Of course, we will always hit the initial payout. So now I've got numbers flying through my head of all our costs. Sammy's orthodontic payments($1200) a year. I am concerned; this sucks. I work per diem at a hospital and I do not get benefits; now I could certainly look into what insurance I could get at the hospital I work at and see if it's better. Which would mean more hours for me, more stress, less time with kids. I was saying to my hubby; but Maggie is doing so well part of that reason is cause I'm around being the drill sargent. Anyway, this is more of just a vent and to hear how others have dealt with this 80/20 plan(we've never had this before) and I don't deal with change well. After my hubby and I finished our "discussion", Maggie asked if we were going to break up and what were we fighting about. Great! SO I said sometimes parents have loud discussions and we are not breaking up; I said our fight was about money.
 

Rebjane

Super Moderator
Well, we have been very lucky so far having good health coverage. We have a plan which covers 100%; we have lots of co-pays for drugs, specialists and lab test, sputum cultures, etc. But overall it has been ok, few glitches here and there but I turn on my inner b*itch and things have gotten straightened out. Hubby's company is now only giving 2 options one is an 80/20 plan the other I guess is worse. He was going to get the info for me today since I'm the one who deals with all the health insurance stuff. He thought after the $3000 was met(he wasn't sure this was the #) that after they would pay 100%. Anyway, we were having a heated discussion about this; Maggie listening in. Of course, the company wouldn't be doing this unless they would be saving $ and passing off some of the expense to the employee(us). Of course, we will always hit the initial payout. So now I've got numbers flying through my head of all our costs. Sammy's orthodontic payments($1200) a year. I am concerned; this sucks. I work per diem at a hospital and I do not get benefits; now I could certainly look into what insurance I could get at the hospital I work at and see if it's better. Which would mean more hours for me, more stress, less time with kids. I was saying to my hubby; but Maggie is doing so well part of that reason is cause I'm around being the drill sargent. Anyway, this is more of just a vent and to hear how others have dealt with this 80/20 plan(we've never had this before) and I don't deal with change well. After my hubby and I finished our "discussion", Maggie asked if we were going to break up and what were we fighting about. Great! SO I said sometimes parents have loud discussions and we are not breaking up; I said our fight was about money.
 

Rebjane

Super Moderator
Well, we have been very lucky so far having good health coverage. We have a plan which covers 100%; we have lots of co-pays for drugs, specialists and lab test, sputum cultures, etc. But overall it has been ok, few glitches here and there but I turn on my inner b*itch and things have gotten straightened out. Hubby's company is now only giving 2 options one is an 80/20 plan the other I guess is worse. He was going to get the info for me today since I'm the one who deals with all the health insurance stuff. He thought after the $3000 was met(he wasn't sure this was the #) that after they would pay 100%. Anyway, we were having a heated discussion about this; Maggie listening in. Of course, the company wouldn't be doing this unless they would be saving $ and passing off some of the expense to the employee(us). Of course, we will always hit the initial payout. So now I've got numbers flying through my head of all our costs. Sammy's orthodontic payments($1200) a year. I am concerned; this sucks. I work per diem at a hospital and I do not get benefits; now I could certainly look into what insurance I could get at the hospital I work at and see if it's better. Which would mean more hours for me, more stress, less time with kids. I was saying to my hubby; but Maggie is doing so well part of that reason is cause I'm around being the drill sargent. Anyway, this is more of just a vent and to hear how others have dealt with this 80/20 plan(we've never had this before) and I don't deal with change well. After my hubby and I finished our "discussion", Maggie asked if we were going to break up and what were we fighting about. Great! SO I said sometimes parents have loud discussions and we are not breaking up; I said our fight was about money.
 

Ratatosk

Administrator
Staff member
Prior to Select Choice, we had a plan where we could choose our provider and once we met our deductible, everything was paid 100%. The deductible at the time was a $200 for a single policy.

We switched to select choice - which is 20/80 in network and 10/90 with a MUCH higher deductible. When we first started, it was nice because we were young, no kids and we didn't have major medical expenses. One office call a year and I paid a $10 copay or something nominal. That was how they sold it to us -- those who don't have many medical expenses would save a LOT more money. I think my annual pap and bloodwork was covered 100%.

But then I had my tonsils out and I noticed sure I met my deductible, but then I needed to meet co-insurance before everything was covered 100%. Even with DS we usually come NO WHERE near meeting the deductible and coinsurance amounts. Oh and because we have to choose a provider locally -- going to the CF clinic in the city is out of network and a much higher deductible and percentage out of pocket.

But this is the only plan we're offered thru work -- DH and I work for the same entity.. And unfortunately, our HR person is a nosey busybody who makes snide comments about those of us who may have higher medical costs -- that WE'RE bringing up the premiums costs each year. So I try to stay under the radar regarding the insurance issue. It's not just us we have one coworker awaiting a kidney transplant, a few with cancer, heart attacks, accidents....
 

Ratatosk

Administrator
Staff member
Prior to Select Choice, we had a plan where we could choose our provider and once we met our deductible, everything was paid 100%. The deductible at the time was a $200 for a single policy.

We switched to select choice - which is 20/80 in network and 10/90 with a MUCH higher deductible. When we first started, it was nice because we were young, no kids and we didn't have major medical expenses. One office call a year and I paid a $10 copay or something nominal. That was how they sold it to us -- those who don't have many medical expenses would save a LOT more money. I think my annual pap and bloodwork was covered 100%.

But then I had my tonsils out and I noticed sure I met my deductible, but then I needed to meet co-insurance before everything was covered 100%. Even with DS we usually come NO WHERE near meeting the deductible and coinsurance amounts. Oh and because we have to choose a provider locally -- going to the CF clinic in the city is out of network and a much higher deductible and percentage out of pocket.

But this is the only plan we're offered thru work -- DH and I work for the same entity.. And unfortunately, our HR person is a nosey busybody who makes snide comments about those of us who may have higher medical costs -- that WE'RE bringing up the premiums costs each year. So I try to stay under the radar regarding the insurance issue. It's not just us we have one coworker awaiting a kidney transplant, a few with cancer, heart attacks, accidents....
 

Ratatosk

Administrator
Staff member
Prior to Select Choice, we had a plan where we could choose our provider and once we met our deductible, everything was paid 100%. The deductible at the time was a $200 for a single policy.

We switched to select choice - which is 20/80 in network and 10/90 with a MUCH higher deductible. When we first started, it was nice because we were young, no kids and we didn't have major medical expenses. One office call a year and I paid a $10 copay or something nominal. That was how they sold it to us -- those who don't have many medical expenses would save a LOT more money. I think my annual pap and bloodwork was covered 100%.

But then I had my tonsils out and I noticed sure I met my deductible, but then I needed to meet co-insurance before everything was covered 100%. Even with DS we usually come NO WHERE near meeting the deductible and coinsurance amounts. Oh and because we have to choose a provider locally -- going to the CF clinic in the city is out of network and a much higher deductible and percentage out of pocket.

But this is the only plan we're offered thru work -- DH and I work for the same entity.. And unfortunately, our HR person is a nosey busybody who makes snide comments about those of us who may have higher medical costs -- that WE'RE bringing up the premiums costs each year. So I try to stay under the radar regarding the insurance issue. It's not just us we have one coworker awaiting a kidney transplant, a few with cancer, heart attacks, accidents....
 

Ratatosk

Administrator
Staff member
Prior to Select Choice, we had a plan where we could choose our provider and once we met our deductible, everything was paid 100%. The deductible at the time was a $200 for a single policy.

We switched to select choice - which is 20/80 in network and 10/90 with a MUCH higher deductible. When we first started, it was nice because we were young, no kids and we didn't have major medical expenses. One office call a year and I paid a $10 copay or something nominal. That was how they sold it to us -- those who don't have many medical expenses would save a LOT more money. I think my annual pap and bloodwork was covered 100%.

But then I had my tonsils out and I noticed sure I met my deductible, but then I needed to meet co-insurance before everything was covered 100%. Even with DS we usually come NO WHERE near meeting the deductible and coinsurance amounts. Oh and because we have to choose a provider locally -- going to the CF clinic in the city is out of network and a much higher deductible and percentage out of pocket.

But this is the only plan we're offered thru work -- DH and I work for the same entity.. And unfortunately, our HR person is a nosey busybody who makes snide comments about those of us who may have higher medical costs -- that WE'RE bringing up the premiums costs each year. So I try to stay under the radar regarding the insurance issue. It's not just us we have one coworker awaiting a kidney transplant, a few with cancer, heart attacks, accidents....
 

Ratatosk

Administrator
Staff member
Prior to Select Choice, we had a plan where we could choose our provider and once we met our deductible, everything was paid 100%. The deductible at the time was a $200 for a single policy.
<br />
<br />We switched to select choice - which is 20/80 in network and 10/90 with a MUCH higher deductible. When we first started, it was nice because we were young, no kids and we didn't have major medical expenses. One office call a year and I paid a $10 copay or something nominal. That was how they sold it to us -- those who don't have many medical expenses would save a LOT more money. I think my annual pap and bloodwork was covered 100%.
<br />
<br />But then I had my tonsils out and I noticed sure I met my deductible, but then I needed to meet co-insurance before everything was covered 100%. Even with DS we usually come NO WHERE near meeting the deductible and coinsurance amounts. Oh and because we have to choose a provider locally -- going to the CF clinic in the city is out of network and a much higher deductible and percentage out of pocket.
<br />
<br />But this is the only plan we're offered thru work -- DH and I work for the same entity.. And unfortunately, our HR person is a nosey busybody who makes snide comments about those of us who may have higher medical costs -- that WE'RE bringing up the premiums costs each year. So I try to stay under the radar regarding the insurance issue. It's not just us we have one coworker awaiting a kidney transplant, a few with cancer, heart attacks, accidents....
 

Allisa35

Member
I can totally sympathize with you. I don't deal well with change at all. My husband switched jobs back in April so our ins. changed. We actually still have the same ins. company but the policy is different. Before they paid 100% (except for durable medical equipment) and now we are on a 80/20 policy. It was a major adjustment for me. It's still a good policy; it is an HMO and we have a co-pay for the dr. visit and have no deductible and unlimited lifetime coverage amount. Well, this past week we just got the enrollment papers for this next year. There is a memo stating that due to the high costs of the HMO plan, they will no longer offer that plan starting in 2010. So we will have to be on the PPO plan starting 2010. I was upset and starting freaking out. The PPO is still an 80/20, but we will have a $3,000 deduct. and have a 5,000,000 lifetime coverage amount. And the out-of-pocket will go up from $3,000 to $4,500. Needless-to-say, I am not a happy camper. So, I know what your feeling (lol)!!
 

Allisa35

Member
I can totally sympathize with you. I don't deal well with change at all. My husband switched jobs back in April so our ins. changed. We actually still have the same ins. company but the policy is different. Before they paid 100% (except for durable medical equipment) and now we are on a 80/20 policy. It was a major adjustment for me. It's still a good policy; it is an HMO and we have a co-pay for the dr. visit and have no deductible and unlimited lifetime coverage amount. Well, this past week we just got the enrollment papers for this next year. There is a memo stating that due to the high costs of the HMO plan, they will no longer offer that plan starting in 2010. So we will have to be on the PPO plan starting 2010. I was upset and starting freaking out. The PPO is still an 80/20, but we will have a $3,000 deduct. and have a 5,000,000 lifetime coverage amount. And the out-of-pocket will go up from $3,000 to $4,500. Needless-to-say, I am not a happy camper. So, I know what your feeling (lol)!!
 

Allisa35

Member
I can totally sympathize with you. I don't deal well with change at all. My husband switched jobs back in April so our ins. changed. We actually still have the same ins. company but the policy is different. Before they paid 100% (except for durable medical equipment) and now we are on a 80/20 policy. It was a major adjustment for me. It's still a good policy; it is an HMO and we have a co-pay for the dr. visit and have no deductible and unlimited lifetime coverage amount. Well, this past week we just got the enrollment papers for this next year. There is a memo stating that due to the high costs of the HMO plan, they will no longer offer that plan starting in 2010. So we will have to be on the PPO plan starting 2010. I was upset and starting freaking out. The PPO is still an 80/20, but we will have a $3,000 deduct. and have a 5,000,000 lifetime coverage amount. And the out-of-pocket will go up from $3,000 to $4,500. Needless-to-say, I am not a happy camper. So, I know what your feeling (lol)!!
 

Allisa35

Member
I can totally sympathize with you. I don't deal well with change at all. My husband switched jobs back in April so our ins. changed. We actually still have the same ins. company but the policy is different. Before they paid 100% (except for durable medical equipment) and now we are on a 80/20 policy. It was a major adjustment for me. It's still a good policy; it is an HMO and we have a co-pay for the dr. visit and have no deductible and unlimited lifetime coverage amount. Well, this past week we just got the enrollment papers for this next year. There is a memo stating that due to the high costs of the HMO plan, they will no longer offer that plan starting in 2010. So we will have to be on the PPO plan starting 2010. I was upset and starting freaking out. The PPO is still an 80/20, but we will have a $3,000 deduct. and have a 5,000,000 lifetime coverage amount. And the out-of-pocket will go up from $3,000 to $4,500. Needless-to-say, I am not a happy camper. So, I know what your feeling (lol)!!
 

Allisa35

Member
I can totally sympathize with you. I don't deal well with change at all. My husband switched jobs back in April so our ins. changed. We actually still have the same ins. company but the policy is different. Before they paid 100% (except for durable medical equipment) and now we are on a 80/20 policy. It was a major adjustment for me. It's still a good policy; it is an HMO and we have a co-pay for the dr. visit and have no deductible and unlimited lifetime coverage amount. Well, this past week we just got the enrollment papers for this next year. There is a memo stating that due to the high costs of the HMO plan, they will no longer offer that plan starting in 2010. So we will have to be on the PPO plan starting 2010. I was upset and starting freaking out. The PPO is still an 80/20, but we will have a $3,000 deduct. and have a 5,000,000 lifetime coverage amount. And the out-of-pocket will go up from $3,000 to $4,500. Needless-to-say, I am not a happy camper. So, I know what your feeling (lol)!!
 

grassisgreener

New member
Been there too! I remember being totally blind-sided when DH's company held a huge meeting (all employees, served dinner, the 9 yards) only to announce the HUGE changes in insurance. It changed from $15 co-pay to $15% and $30 to $30%, etc. Of course people all around were complaining about their allergy medication and birth control pills, etc while I about puked when I realized what it meant for us! It was right before Christmas and we were in the process of building a new house so we FREAKED out! That was 4 years ago.

Hang in there while you get things figured out and try not to let it make you fight because fighting won't change it. You guys will get through this! I got on the phone and made a million phone calls, found a LITTLE help and then we sucked it up and adjusted our budget, cutting out alot of little things that added up. Since then we have changed insurances when my DH changed jobs so we are "okay for now" of course I wonder when another insurance bomb will drop!
 

grassisgreener

New member
Been there too! I remember being totally blind-sided when DH's company held a huge meeting (all employees, served dinner, the 9 yards) only to announce the HUGE changes in insurance. It changed from $15 co-pay to $15% and $30 to $30%, etc. Of course people all around were complaining about their allergy medication and birth control pills, etc while I about puked when I realized what it meant for us! It was right before Christmas and we were in the process of building a new house so we FREAKED out! That was 4 years ago.

Hang in there while you get things figured out and try not to let it make you fight because fighting won't change it. You guys will get through this! I got on the phone and made a million phone calls, found a LITTLE help and then we sucked it up and adjusted our budget, cutting out alot of little things that added up. Since then we have changed insurances when my DH changed jobs so we are "okay for now" of course I wonder when another insurance bomb will drop!
 

grassisgreener

New member
Been there too! I remember being totally blind-sided when DH's company held a huge meeting (all employees, served dinner, the 9 yards) only to announce the HUGE changes in insurance. It changed from $15 co-pay to $15% and $30 to $30%, etc. Of course people all around were complaining about their allergy medication and birth control pills, etc while I about puked when I realized what it meant for us! It was right before Christmas and we were in the process of building a new house so we FREAKED out! That was 4 years ago.

Hang in there while you get things figured out and try not to let it make you fight because fighting won't change it. You guys will get through this! I got on the phone and made a million phone calls, found a LITTLE help and then we sucked it up and adjusted our budget, cutting out alot of little things that added up. Since then we have changed insurances when my DH changed jobs so we are "okay for now" of course I wonder when another insurance bomb will drop!
 

grassisgreener

New member
Been there too! I remember being totally blind-sided when DH's company held a huge meeting (all employees, served dinner, the 9 yards) only to announce the HUGE changes in insurance. It changed from $15 co-pay to $15% and $30 to $30%, etc. Of course people all around were complaining about their allergy medication and birth control pills, etc while I about puked when I realized what it meant for us! It was right before Christmas and we were in the process of building a new house so we FREAKED out! That was 4 years ago.

Hang in there while you get things figured out and try not to let it make you fight because fighting won't change it. You guys will get through this! I got on the phone and made a million phone calls, found a LITTLE help and then we sucked it up and adjusted our budget, cutting out alot of little things that added up. Since then we have changed insurances when my DH changed jobs so we are "okay for now" of course I wonder when another insurance bomb will drop!
 

grassisgreener

New member
Been there too! I remember being totally blind-sided when DH's company held a huge meeting (all employees, served dinner, the 9 yards) only to announce the HUGE changes in insurance. It changed from $15 co-pay to $15% and $30 to $30%, etc. Of course people all around were complaining about their allergy medication and birth control pills, etc while I about puked when I realized what it meant for us! It was right before Christmas and we were in the process of building a new house so we FREAKED out! That was 4 years ago.
<br />
<br />Hang in there while you get things figured out and try not to let it make you fight because fighting won't change it. You guys will get through this! I got on the phone and made a million phone calls, found a LITTLE help and then we sucked it up and adjusted our budget, cutting out alot of little things that added up. Since then we have changed insurances when my DH changed jobs so we are "okay for now" of course I wonder when another insurance bomb will drop!
 
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