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Private Health Insurance Update – Changed Again

It’s been 6 months since I’ve tackled the private health insurance issue and renewed with Celtic.  I just received a letter letting me know of my new premium choices for August 2013, so it’s time to play the game again. Since they are once again raising the rates on crappy coverage, we are actually switching companies this time.  So I went back to esurance.com and spent an hour looking at our options and getting us signed up for a new policy that will work with our doctor.

Current Policy with Celtic

  • $5000 individual deductible / $10,000 annual family deductible
  • $6000 additional family annual coinsurance maximum ($16,000 a year maximum out of pocket)
  • 20% coinsurance
  • Two $35 doctor’s visits per year and the 20% coinsurance thereafter.
  • Basic vision coverage provided and saved me about $150 a year.
  • Total was $357.24 a month.   It will rise to $421.71 per month.

New Policy with Humana

Humana 80/5000

  • $5000 individual deductible / $15,000 annual family deductible
  • $7000 additional family annual coinsurance maximum ($17,000 a year maximum out of pocket)
  • 20% coinsurance
  • Six $35 doctor’s visits per year and the 20% coinsurance thereafter.
  • Better RX rates.
  • No vision coverage.
  • Total cost will be about $267 per month.  I’ll eat that $150 a year of vision coverage loss that I could have saved with the other plan to save $925 over the next 6 months.  :-D

Why I Chose It

Honestly, I have come to the conclusion that most health insurance policies suck and just are there to cover the OMG moments of life.  I’m just trying to keep our costs as low as possible while limiting our maximum out of pocket per year to $20,000 or less.  Having low cost basic coverage like some $35 doctor visits is nice too.  In the end, I am not expecting miracle coverage.  I just like basic coverage and knowing that we won’t go bankrupt because of a major fall or something.

Oh, and on a side note, having my birth control covered 100% now has meant a savings of about $840 a year.  Yeah, the NuvaRing is freaking expensive usually.  So, yay for that at least!

If we ever want to have a kid, it looks like there are just hardly any policies available that would cover the prenatal stuff and delivery.  BUT, they all cover the baby wellness visits and immunizations.  Weird.  So I called around, and if we use cash and have a normal pregnancy, it will cost about $5000-$7000 for all the prenatal visits and stuff and the delivery.  It’s usually like $20,000 or more, but hospitals and doctors really love not having to deal with insurance companies, lol.

I think all of that is moot right now since I am not kid-ready, but all knowledge is worth having.  :-D

What kind of plan do you have?

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15 comments to Private Health Insurance Update – Changed Again

  • I agree that most of the plans suck but its better to have something rather than nothing. Especially since we have kids there is no choice. It looks like you will be saving a pretty penny going over to Humana. Seems like every year the premium gets higher and higher for us. We have a larger deductible as well to help lower the monthly cost.

  • My employer pays 80% for drugs and dental and provides a small amount yearly that we can use for glasses or massage or counselling.

    Luckily the Canadian government picks up most of the health care costs and when I am a senior the individual provinces pay a large portion of drug costs.

    The various levels of government would also give me a monthly income if I was permanently unable to work.

    New moms can take 1 year off and receive a percentage of their pay from the government.

  • Interesting! This is a very timely post since I will have to start looking into insurance soon.

  • I have coverage through my company – they pay about $600 for all three of us (we pay no premiums), and it includes maternity, vision and dental (companies can really work out good deals!).

    It is possible to have cheaper maternity care IF you have a normal healthy pregnancy. If I had no insurance, my midwives would have been $3500. In the metro DC area – I suspect that would be cheaper in Houston (I paid a $20 co-pay for my entire pregnancy).

    That being said – there are so many things that can go wrong during pregnancy – if you look up the statistics, it’s amazing the human race continues to survive. If you end up on hospital bed rest, you’re looking at a potential 30k-50k+ hospital bill just for hanging out in bed for a few weeks. Those prices are also for “normal” vaginal delivery – if you need a C-section for any reason, add another 15-30k on top of that. If there’s any chance you might get pregnant (or want to), bite the bullet and get the maternity coverage add-on.

  • Michelle

    As an FYI. I had a baby via c-section at a major Houston hospital (had planned on a normal birth though). And our bill (before insurance) was $35,000 for me and the baby!

  • I have a high deductible plan through my employer, costs around $275/month. We don’t plan on getting sick, but I just found out that some basic brand medication would require me to pay out of pocket.

    I started to think more about it and there are a few important things that I care about/will care about in the next few years:

    basic medical visits
    reasonable prescription costs
    prenatal/delivery costs
    having good hospitals in-network

  • Oh man…scary costs. Sucks that medical insurance costs so much, yet the only time it really kicks in is during a catastrophe. I have Aetna through my company. I don’t directly pay for the insurance but it’s part of my salary + benefits total package compensation. So I do pay for it. It’s been really nice so far. Benefit of working for an international corporation.

  • Hmm… I have no vision coverage as well. For me, it’s such a pain since glasses/contacts/appointments are so expensive! Apart from finding sales on contacts, I’m guessing you’re planning on paying for these expenses out of pocket?

  • My employer covers the majority of my health insurance costs. I pay $273 a month and the employer pays $364 a month. This is for a PPO plan where I can see whatever doctor I want whenever I want and have at least 70% coverage of the bill. Dental and Vision care are another $8 a month in total.

    Today I was listening to the Fresh Air program on my local NPR station and the host was interviewing a former insurance exec about a new book he’s released, and his take on the Affordable Care Act. The state insurance exchanges start in October this year, and that would mean you may have more options. The interview was really fascinating and delved into the criticisms of the ACA. I highly recommend listening to it. http://www.npr.org/2013/07/11/200443445/former-insurance-exec-offers-an-insiders-look-at-obamacare

  • My work just switched everyone to a high deductible plan with a health savings account as of July 1st. I guess I’ll see if I like it or not the first time I get sick and end up needing to go to the doctor. Thankfully the deductible is only $1500 and routine wellness care is included.

  • I’m always surprised at how americans are stressed because of healthcare…
    It motivated me to write a post about our “socialized” healthcare system in Europe :)
    In short, we pay 500€ per month for 2 adults and 1 baby. Doctor visits cost few euros. Staying in hospital for whatever reason is 150€

  • PW

    Just an FYI

    all medical insurance policies will be mandated to cover maternity care starting 1.1.2014. You may want to check into those policies as they become available on the Exchange/Marketplace Oct. 1.2013 for a 1.1.2014 effective date. See the mandated coverage list below. Once on the Exchange/Marketplace you can look at the plans and costs.

    How will my benefits be impacted by the law?

    Every plan sold or renewed in the individual and small group market after January 1, 2014, must include all the benefits in a “benchmark” plan – a plan chosen for the state based on coverage currently available in the state – and will cover services in the following categories:

    Ambulatory patient services
    Emergency services
    Hospitalization
    Maternity and newborn care
    Mental health and substance abuse disorder services, including behavioral health treatment
    Prescription drugs
    Rehabilitative and habilitative services and devices
    Laboratory services
    Preventive and wellness services and chronic disease management
    Pediatric services, including oral and vision care

  • retired

    Since Tx will not have its own health care exchange, Texans can shop for the benchmark coverage outlined in Obama care at http://www.healthcare.gov . Our govenor and state can set up a healthcare exchange with a 12 month notification to the national exchange.
    We are retired. We get a subsidized high deductible plan from our former employer and established a health savings plan. If we use the network doctors all costs are limited and pre negotiated. So far, we pay less than $500 per year for insurance and run about $6000 in out of pocket expences for the 3 of us this year.
    I had my first child under a medical university study program and paid $500. No doctor or hospital would see me without insurance unless I put up a $500 retainer 30 years ago. I did’t have $500. Other 2 girls were delivered normally for less than $2000, paid by insurance. Bed rest can be monitored from your home usually. Midwives were 2/3 what docs charged, as they have a doc on call in most cases. Best to stay away from c sections. Every pregnancy is different, but I find staying away from the docs the last trimester really helped reduce stress and costs. Every pregnancy I was advised I would probably be induced. Avoiding inuced labor made the whole experience much better, and safer, I believe.
    USA has one of the worst pregnancy statistics in the world, and one of the highest c section rates ….not sure we wouldn’t be better off without our present pre natal and maternity care.

  • @Thomas, yeah, it is good to have at least something. Good luck!

    @Jane, cool beans.

    @Michelle, eSurance, baby!

    @Daniel, I see baby stuff! ;-)

    @SavvyFinancialLatina, ooh, love it when the employer covers it all as part of your overall package! :-)

    @Lisa E., well our current coverage is until the end of this month, so over the last 4 weeks, I did my annual wellness checkup, went to the eye doctor to ensure my prescription is the same and I got the contacts stuff out of the way, and I had my annual dental cleaning. So I’m good for another year or more for vision for sure, and I know I can get a basic appointment at the eye doctor at Sam’s Club for about $50-$75. Contacts will run me about $200 a year and glasses will run me about $200 every 2 years.

    @Linda, thanks for the link!

    @KK, I’ve heard great things about HSA’s, hope you like it!

    @Julien, nobody likes bragging. ;-) Glad you love your benefits though! :-D

    @PW, thanks for the info, I will take a much closer look at new policies in another 6 months. :-D

    @retired, thanks for the link! I think your health insurance kicks butt. :-)

  • ISABEL

    Interestingly, my friend and I were talking just the other day about the costs of actually having a baby (she is due any day now) and she told me that in Texas you can get Medicaid no matter how much you make for the pregnancy and delivery. Something to think about. :)