Family health insurance now costs $20k per year

I got my last two pairs of glasses from Zenni. One pair was $88, and my sunglasses were $95. Progressives, no line. And I like them better than the $450 pair I got at the local optician.

Shopping around is good for some things.

For surgery…not so much so…

Presumably, you really want this link https://www.warbyparker.com/ rather than the above link that has all of the ad trackers attached to it.

I am thankful that the company that my husband works for offers affordable health insurance. We pay $6500 a year for our family plan, with a $475 per person/$950 family deductible and an out of pocket maximum of $2100 person/$4200 per family. It is a national company, but they are still family owned and take great pride in taking care of their employees. Last year, due to an ankle injury and subsequent surgery, we met our deductible and out of pocket maximum by May. So anything that we needed done, I made sure to get it done before December 31st. My daughter even got a followup ankle MRI on December 31st and skipped going out of town with us to save the costs. Lol. My oldest will join the workforce in January after she graduates with her Master’s, but she is still planning on staying on our plan and paying for the out of pocket costs herself.

But, there are so many things wrong with healthcare billing practices. Several years ago my daughter had an ER visit that resulted in the need for an abdominal and chest CT Scan. Everything turned out all good and she was treated and released. Insurance covered the visit and everything was covered at approximately a 45% reimbursement rate. Fast forward to the end of the year when she went back to the same ER and was diagnosed with pneumonia. They did a chest CT Scan and admitted her. After two nights in the hospital she was released and sent on her way. Insurance covered everything again, but the reimbursement rate was approximately 95%. Of course, this caused my out of pocket amount to be higher. The hospital was billing for tylenol at $60 a pop. Seriously, the line by line itemization was a real eye opener. But, it was paid. The reasoning that I received from the hospital and my insurance company was that the contract reimbursement rates for in patient stays was higher. The hospital knows this and uses the higher reimbursement rates to pay for non medical staff.

I work for one of the few companies left that pay 100% of the health insurance cost. Of course, they’ve now sold and this month we’ll find out how much we’re screwed next year!

Vision coverage is like insuring your car for an oil change. You+your employer pay 100% for 90% reimbursements.

Moreover, it only benefits ~half the younger employees – at the expense of the other half – while it benefits 95% of the older employees. (As the eye lens naturally hardens with age, by 60+, nearly everyone needs corrective lenses; not saying that they have them, but they could use them.)

It’s one of those feel-good benefits that just raises the cost for all. But, fortunately, small dollar so its immaterial to the overall cost of healthcare. (But as a small dollar item, it makes no public policy sense to insure it.)

@bluebayou totally agree about the vision benefit. Waste of money. It covers a portion of glasses, a very small portion, every 2 years. I could save the premiums and have the same amount of coverage. But our vision is bundled with our plan…and not taking it reduces other benefits.

It’s not unusual for larger employers to self-insure (mine did) so in that case it’s just another benefit/helping hand to employees.

H’s company also self insures. Uses the insurance company as a place to process claims. At least that is how I understand it.

We now have a high deductible plan with a HSA. Drug coverage is now a part of the deductible.

Unless you have real problems with your eyes, most people are better off just buying whatever their eyecare needs are where they prefer–Costco, online, Sam’s, Sears, Warby Parker, optician, wherever. I’ve done the math several times and it’s basically pre-paying to limit your choices in getting eyewear for at least the federal plan (which is quite generous). Additionally, you can only get eyewear or contacts every other year–kids sometimes need changes every 6-12 months!

The big expenses are what everyone needs insured–not many of us can afford a 5-6 figure bill without significant help from insurance. It’s also nice that insurers are able to negotiate lower prices than these insane $5/aspirin rates that my D got when she was hospitalized as a toddler. I fought it and was able to get hospital to say yes, it must have been $5 for the whole bottle. (She had a lot of aspirin as part of her treatment.)

Vision insurance does depend. We’ve only had it as an option for a few years. I bought into it last year after some changes. We pay 100% of the premiums, but it’s only $185 for the family for the year. And we get $150 off of contacts each year per person, and then 15% off after that. We have 4 family members with contacts. The glasses benefit is $150 every 24 months, but then you don’t get the contacts benefit. I’m not sure how they are making $$$ off of it.

Our AllState accident insurance so far as paid off as well. It’s $550/year for the family. (We pay 100% of the premiums), but you can get $400 back each year. All you have to do it submit proof of 4 office visits for any reason - dentist, eye doctor, well visits, sick visits, etc. So, it costs $150/year. When a kid broke his arm, they paid us $1000. We did not go to the ER, so it was roughly $500 out of pocket. Same deal for the foot stress fracture - what they paid exceeded the med bills since we stayed out of the ER. Even when my kid got rhabdo, they paid us $800 and the med bills were about the same. At some point I’m sure they’ll make their $$$ off of us, but so far I have no complaints.

@ClassicMom98 - they are making money off folks like me who have vision insurance through my employer but never use it ( no need for glasses or contacts).

That’s how insurance works in general.

Yup. Personally, I would not buy a VSP, but my employer bundles it in as a benefit for everyone employed (no coverage for family members). So VSP makes some $$ off my employer, and that cost, of course, gets passed onto me in some way. :slight_smile:

Ok my kid just qualified for health insurance at his employer. I’ve been paying his COBRA so I feel like I’ve gotten a raise. Now I’m just paying my husband’s retirement health care and my Medicare. Yay kid!

@BunsenBurner at your company, I see how that is. At ours, it’s not bundled into anything, nor are premiums subsidized by our employer. The only benefits our employer pays for are health (50-75% depending on the plan), long-term/short-term disability (50%) and term life insurance (50%) - and only then if the employee chooses to participate in those benefits.

Vision, dental, accident, cancer, etc. are 100% on the employee if they choose to participate. I never did until last year when they changed the benefits and it appeared that we would come out ahead. If they change the benefits, I would drop it.

Your company’s medical insurance benefit does not cover treatment for cancer?

@ucbalumnus it does cover it. From what I understand, and I don’t have it and am unsure of all the details, but this policy is in addition to the health coverage. It helps cover things like out of town travel, and just lets you have extra $$$ to pay for the med bills and related losses.

I think it’s like the accident insurance. Of course, health insurance would cover a kid’s broken arm. But the accident insurance gave us $300 for each x-ray. Since we got them at the orthopedist’s office, the full cost (no insurance paying anything) of an x-ray there is $40. We essentially made $260 with each x-ray. Other reimbursements aren’t as generous, like the doctor visit was ~$250 and they gave us $100. But it was still nice to have. We have a $5000 per person deductible, so the accident $$$ was not paying on top of anything paid by our health insurance - but it will. If my son had already hit the $5K prior to breaking his arm, health insurance would have covered his arm 100% and the accident insurance would still have paid us on top of that. They send checks directly to us.

So I’m guessing the cancer insurance policies are similar. I only half listen during that part of open enrollment though.

@ClassicMom98 could you explain how “accident insurance” covers routine office visits for any reason?

@thumper1 I have no idea WHY, but they do. I guess it’s a selling point to get people to buy in, and then most forget about it. Allstate does not deal at all with doctors. There’s no card to show. When I get an EOB or a receipt from the dentist/eye doctor, I scan it and send it to our Allstate rep. she fills out the paperwork and Allstate mails me a $100 check per visit, up to $400/year.

When we had a broken arm, foot, etc. I had to ask the checkout person at the ortho to print out a diagnosis description for accident insurance. They knew what I was talking about and immediately printed off a ~4-6 page description of what happened. I scanned that and sent it to our rep. She worked her magic and Allstate mailed me a check for ~1000.

Eventually, I’ll probably drop this insurance once my kids are on their own. But for 2 soccer playing, athletic boys, we have had our share of injuries.

They will not pay for anything that happens at work that might be covered by workers comp.

Slightly OT rant …

Great news, a hip problem is slowly, every so slowly, resolving itself. Two different X-rays show it’s not a joint issues. A lower back MRI shows it’s not a spinal issue. I’ve been toying with the idea of another MRI of the specific area. Expected OOP cost - $500.

But…I can spend $500 on an entire weekend attending a seminar on the MELT method. It’s a myofascial release system with proven results in dealing with pain not clearly related to degenerated joints. Included are dinner on Friday, all meals on Saturday and breakfast and lunch on Sunday. Organic, locally sourced - make the local hippies and Woke attendees happy - kind of food. Meditation sessions, yoga sessions, and hiking - also included. Oh, and of course the actual seminar work which consists of 6 separate sessions. Taught by its developer.

It is on a stunningly beautiful campus.

All for the cost of an MRI.

Just a snapshot of what is wrong with this system.