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Medical Insurance advice please .

Medical Insurance advice please .

Old Jan 11th 2014, 4:14 pm
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Default Medical Insurance advice please .

Hi all,

I apologise if I am repeating this question. I am sure this has been asked before.
I have recently moved to Colorado in a H1B visa and I am having a little trouble with making a decision with regards to medical insurance.

My employers do offer a medical insurance package where the company contributes towards a portion of my payment but I am finding that my monthly contribution is still pretty high. When I asked my employer he told me the reason why the premium is abnormally high is because there a number of people in the office who are quite unhealthy and have some medical concerns for which they are claiming for.

Is it true that I will be penalised due to the health issues of others?

I always believed that the insurance was based upon your individual situation?

So this leads me to my next question, is it more financially beneficial to me to pay for insurance privately outside of my work policy ? Through kaiser or something like that.

I am 32 years old and my wife is 35. I am the sole provider as my wife is on a H4.

Could you please let me know what you guys have done, and which companies offer the best coverage at the most competitive price?

I look forward to your responses.


Thanks,
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Old Jan 11th 2014, 5:16 pm
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Default Re: Medical Insurance advice please .

The common belief is that Group insurance (that with your employer) is the best option when it comes to health insurance in the US - less restrictions, more coverage, less co-pays deductibles, less premiums because your employer is subsiding the costs.

With group insurance there is no "based on individual situation" - its based on the number of people in the group, and over the years the claims record of said group. Its 6 of one and half a dozen of another - YOU might have an awful health history but you won't be turned down with a Group policy and your costs will be offset by others in the Group who are much healthier, pay their premiums and don't have many claims on the policy.

Having said that, if you feel that your premiums are too high look at the healthcare.gov web site or that of your State and see what coverage you can obtain on that, what your premiums would be for you and your wife and the deductibles, co-pays etc.

It might be that you are just surprised at the cost of your premiums with your employer, but that they are well in line with what people usually pay for their insurance in this country.

If you don't mind telling us, what are your premiums?
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Old Jan 11th 2014, 7:41 pm
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Default Re: Medical Insurance advice please .

Our group plan is through hubby's work, where the premium is tiered according to salary rather than according to one's individual health. So we, as a very healthy family (no conditions, on no meds at all, normal weights, have only had check-ups, immigration vaccines and one kiddie ear infection visit in the last 3 years) are paying much more than a lower-salaried but much less healthy family who might be racking up thousands of dollars' worth of doctor time and meds each year. It's not individualised based on health at all, except that we do get a $1k bung into the HSA once a year for passing all their weight/ blood sugar/ pressure/ cholesterol screening checks.

The premium is around $550 a month for medical and dental; the medical is a high deductible policy that doesn't pay anything anyway until we've paid the first $3k (individual) and $6k (family group) of any bills. So it's really just for major accidents or the sort of illnesses that require hospitalisation.

But it's good insurance otherwise: the admin is excellent, there are tons of in-network doctors around, and I like the security of knowing we can't get booted off or have the premiums raised if we DID develop a condition, or that hubby's company would wade in as an intermediary if the insurance company tried to rip us off in any way (it's a huge multinational, and they really wouldn't want to lose the contract).

I shall wait until the Obamacare dust settles, and run some quotes. But I think that it's about in line with what we'd pay outside of a group plan anyway, as we wouldn't qualify for any of the means-tested rebates.
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Old Jan 11th 2014, 8:18 pm
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Default Re: Medical Insurance advice please .

Try looking at a high deductible plan if you are generally healthy. In practice you end up picking up $00's of medical costs per year even with a regular health insurance, so for the low user of medical services you can save a packet on your insurance premiums, and pay no more out of pocket. Unless you have a substantial claim.... but even 2 days in hospital would turn an HD plan into "regular insurance", covering most of anything you claim for. .... Once you have HD insurance you become eligible to have a Health SAVINGS Account (not to be confused with a Health Spending Account, which you have to spend or lose every year), which operates much like a 401k (personal pension), allowing you to save money pre-tax and use it for medical services and prescription medicines.

Last edited by Pulaski; Jan 11th 2014 at 8:32 pm.
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Old Jan 11th 2014, 8:28 pm
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Default Re: Medical Insurance advice please .

Originally Posted by Pulaski View Post
Once you have HD insurance you become eligible to have a Health SAVINGS Account, which operates much like a 401k (personal pension), allowing you to save money pre-tax and use it for medical services and prescription medicines.
...and, once you're 65, you can spend it on anything and just pay income tax on the withdrawal; for many people this'll be a lower rate of income tax than they would've paid on the money earlier in their life.
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Old Jan 12th 2014, 12:27 am
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Default Re: Medical Insurance advice please .

Originally Posted by Pulaski View Post
Try looking at a high deductible plan if you are generally healthy.
It works out even better if you are not healthy. It's the people who use healthcare more that a yearly physical but less than people with chronic conditions that kind of get the shaft.
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Old Jan 12th 2014, 12:32 am
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Default Re: Medical Insurance advice please .

Originally Posted by Malexi View Post
I always believed that the insurance was based upon your individual situation?
As said, you are on a group plan not an individual one so everyone pays the same regardless of health or age. Theoretically you may get a cheaper plan by switching to an individual plan but the chances are that the plan will not be as good and you will be paying 100% of the cost so it may end up being more expensive. Maybe you can knock of 50% of the premium price by switching but if your employer is paying 75% of the price of your current plan you'll end up paying more.
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Old Jan 12th 2014, 3:07 am
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Default Re: Medical Insurance advice please .

It's hard to give you a useful reply without knowing what premiums your company is quoting you...

I remember being totally gobsmacked at the premiums we paid when we first arrived. They quoted me a figure and I said 'Is that every 6 months?' and they said 'No that's every two weeks...'
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Old Jan 13th 2014, 6:10 pm
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Default Re: Medical Insurance advice please .

We were very naive about the healthcare insurance when we came here in October. I have high blood pressure and although we do not pay extra due to it the cost of my medication was a shock. I think my husband listened to too many people in work before making the choice rather than checking it out himself.
Do your homework before you sign up to anything.
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