martina99

We easily spend 5K out of pocket between medical deductibles, prescription copays, dental and eyeglasses.

lje62

What a mess...
as small business owners, we have been impacted for over a year since Obamacare became the law of the land. Our rates have skyrocketed, out PPO cancelled us but supposedly rolled us into another plan. The hoops they made us jump thru made it impossible to enroll in so we now have a watered down version that isn't user friendly for our daughters who live out of state. Now that there seems to be no hope of repealing, we are struggling to see what our next move is. Our agent told us that we are vulnerable because of the number of employees we have , though the majority of them are dependents of their parents. I wish we were like other people whose companies pay for their healthcare and we just had to choose what plan we want to enroll in now

martina99

I work for a company and no longer get a choice of plans. High deductible. Every time someone goes to a doctor, it's $100 out of pocket. Need lab work? Then at least $300.

S has a chronic condition that needs to be followed up with regularly. H has been limping on a bad knee for a month and a half, he finally went to the doctor today, since ignoring it wasn't working. He has to see the orthopedic surgeon next month. So I imagine that will eat up next year's $5K.

SteveMA

lje62--other businesses have to go through the same thing you do with price shopping plans and figuring out which ones will work for their company. VERY few companies "just pay for their insurance". Most companies do a 50/50 split at best. Nationally rates have increased about 15%. If your rates have gone up more than than, time to educate your employees on responsible use of the plan or switch to a tax qualified high deductible plan with an HSA component. They keep people from going to the ER for minor issues that can be treated at convenience clinics or their regular doctor and keeps your costs down. If you have 5 or more employees on your plan, you can usually offer 2 plans. You base your employee portion on the lower cost plan and then if they want to choose the more expensive option, the employee picks up the difference.

martina99--say you were still on your co-pay plan and your DH had surgery--you would still have to pay some kind of deductible and co-insurance along with your office co-pays, none of which is likely to give you any tax break. With your HSA, you get to deduct however much you put into that each year AND once you meet your out of pocket max, all of your medical costs for the remainder of the year are covered at 100%. So, if your DH has this surgery and you meet your OOP max, your S's visits are free to you the rest of the year. With your co-pay plan, you would still have to meet part of the deductible and OOP max for him AND pay all of your co-pays for the year for visits and medications. Considering your premiums are a lot less, usually, on a CDHP, you are saving money on this plan.

emeraldkity4

I wish the Feds would legalize medical marijuana so I can at least deduct it from my taxes.
I am now to the point where I am taking it at least twice a day along with over the counter meds & tramadol.

Good luck finding a surgeon who will do knee replacement. Mine tells me I am too young even though I need a cane 100% of the time & my cartilage is gone. I guess I didn't complain enough but it is hard to get your point across when you are only in there for 8 min.

SteveMA

emeraldkity4--how many doctors have you talked to? Move to Colorado....

musicmom

Emerald- Is it different out there on the west coast?
DH had NO problem getting his one knee replaced here in NJ at age 57.

emeraldkity4

I'm in Wa.
I think it is just the doc.( I just turned 55, he wants to wait for ten years!) I originally went to him on the recommendation he wasn't fast to operate ( because I was under assumption it would "get better".) I've since has X-rays & an MRI, steroid & synvisc injections ( which was $1,500 but I only paid $15),& acupuncture. Exercise helps somewhat but when your bones are grinding together there is only so much that can do.

I've also gotten a 2nd & 3rd opinion from orthopedic surgeons who are ready to do the replacement, but I prefer the first doc, who specializes in knees.
There are still other Drs I haven't seen yet, & my physical therapist is starting a yoga class for injured folks which I hope will help.

SteveMA

So you have found surgeons that will do the replacement but you choose not to do that. Sorry, but my quality of life is worth more than that. Yes, there are some risks of doing these too young but if you are 55 and walking with a cane the pain for me would be worth doing the surgery. Even by old standards where the surgery is good for 10 years, you have 20 years of a better life vs 20 years of pain. Improvements are being made all the time and it's highly likely that in 10 years you will be able to have one more surgery and have that last the rest of your life. I've watched my MIL suffer like you are and it's just not worth it. She has missed out on so many things with the grandkids because she just is not mobile enough to do them.

emeraldkity4

I am still planning the surgery, but to have the largest most complex joint in my body replaced with metal and plastic, I want to have the best doc I can find for knees.
I don't want a doc who also does toes and feet and everything else.
I also am trying to get as much
mobility as I can ( hence the yoga) before surgery because it doesn't improve function it just relieves pain.
In the next town there is a doc who has pioneered knee replacement surgery without cutting the quadriceps muscle resulting in much shorter rehabilitation time.( generally it is 6-12 months).
But since I will need crutches during that time, I really should get my left hand fixed first( new thumb joint), but I keep forgetting about it since I am right handed & it only hurts when I use it!

MiamiDAP

Surgery is not fun, we have several people in the office, some are better than other afterwards, it all depend on many factors. Recovery is definitely very long, hip seems to be much more than a knee, "hip" kind seem to never stop limping. I hope that I do not need to deal with this, enough is going on in my mouth, just got another implant last week, #6. My dentist said that nothing can beat really bad genes, he is right, the granddaughter is in the same predicament, no implants yet, but by my age, I do not know. I was way too diligent, endured way more than average person would, not many will be up to that at all.
All other pains, I just deal with them. My solution - swim them off. It may work for awhile, then it will not work, but again, with my genes I might not live to experience that.

martina99

Steve, it sure doesn't seem like we are saving money!

On our old plan, the weekly payroll deduction was higher. But office visits were a flat copay per visit, and we were not billed for lab fees, etc. Any money in the HSA went toward dental copays and eyeglasses.

And the cost of the plan has gone up every year..

I suppose the two years we've had the plan, we were disadvantaged in needing enough medical care to pay thousands in deductibles, but not getting past the deductible.

So I suppose it's good that my H hobbled around for a few months and the surgery is pushed to early next year rather than the end of this year.

martina99

And we are blessed with the bad teeth genes as well. Major dental bills every year. My youngest has extreme dental anxiety and needs to be anesthetized for anything more than a cleaning. That is an additional $900 out of pocket every time.

SteveMA

martina99--if you had a co-pay plan you did not have an HSA--you had an FSA--the kind where if you didn't use the money you lost it. An HSA you keep the money forever if you don't use it. Add up what you are saving in premiums compared to a co-pay plan and the tax savings and you will see where you are saving money. If you are saving say $200/pay period--which is about average between a co-pa plan and a CDHD plan, that is over $2000/year. Again, even on your co-pay plan, if your DH has surgery, you would be paying out of pocket for deductibles and co-insurance. Everyone's insurance goes up each year, just like the cost of milk goes up each year.

Your dental costs are separate from your medical costs and have nothing to do with your medical plan, except that you can use both your HSA and a limited purpose FSA if you have one to cover those costs.

We are delaying DD's surgery until after the first of the year too .

BCEagle91

A lot of activity on this thread. Deadline is today and I hope that the servers aren't too slow. Son's deadline was today too. I looked over his selections and just told him that his selections are fine. We have another month to decide on retirement stuff. He has a big chunk of cash now and he needs to think about investments and retirement funds. His employer is switching over to Fidelity which I think is great - and they have a self-directed brokerage but it only allows mutual funds (3200 of them). It would be great if he could do individual stocks, ETFs and bonds too. He didn't have literature on the retirement options - that's available in his web account so he'll have to look it over and get back to me.

Most of the people at work are going with the HMO option. No deductibles and basically the same as the PPO. It will cost $600 more but it will essentially be the same as what I had this year. The HMO uses providers in our regular EPO/PPO choices so there shouldn't be any difference in providers. Other employees think that they will get rid of this option next year because it seems too generous. I'll think about the higher-deductible stuff next year. Hopefully there will be some employees around that pick it this year so we can ask them what they think about it for next year.

I'm glad that I went with comprehensive dental this year (it's a few more bucks biweekly but doubles the benefits). I had a root canal yesterday and insurance covered about 80%. My son used up almost half of my benefits at the beginning of this year for a crown. This was just before he got a job with great dental benefits! I wish I could use some of his! I have a second appointment on the root canal and will then need a crown over it. I'm probably going to try to get it done this year as I like to get teeth stuff done as soon as possible. It would probably be better to have it done early January - might save $800. We'll see how it goes.