Medical insurance- am I being ripped off??

[RStar]

I have Blue Shield from work. A small company of about 40-50 people. I'm over 50, and have my wife on the insurance. I have the HMO 15 plan which has good coverage. Every year it goes up by hundreds a month, and now this year I will start to pay a whopping $1,307 per month if I don't take a lesser plan! And with my wife's health, paying less premiums and more copays may not work at all. With this last 23% increase I won't be able to make it. Do I choose a roof over my head, food on my table, or medical insurance? This is insane!

So, is there anyone else experiencing this? Is our insurance broker ripping us off? He says he can't find anything cheeper, and everyone is experiencing this. Yet I talked to someone who has similar coverage and a similar size company paying half that. Why?

[Kevy Baby]

We are a small company, but we get our insurance through a trade association, which helps keep the price down. Is there some kind of group buying that your employer can get involved with?

[Cadaverous Pallor]

Is the premium based on your wife's condition?

[RStar]

We are a small company, but we get our insurance through a trade association, which helps keep the price down. Is there some kind of group buying that your employer can get involved with?
Yes, we have an HR company (HR Logic, I think) and that is the first question I'm going to ask. I'm not sure if they are getting it through them, or the broker we have had for decades.
Is the premium based on your wife's condition?
No, when buying insurance through a company like this, they don't take that into consideration. It's based on age only.

[BarTopDancer]

We have Blue Shield HMO 30 and we are a larger company. I pay $180 a month for myself but our family plans are ridiculous. I think a lot of companies are getting away from subsidizing the "family" part of the insurance plan. At my last gig (the short term contract one) the family portion for one additional person was $400 a month. Crazy!

I think medical rates are also based on how much people in your company use the insurance. At my last good gig they said our rates were high because there were a lot of people who had a lot of health problems and kept going to the doctor. Not sure if I believe them but that's what they told us.

[JWBear]

Yes, you're getting ripped-off. The whole country is.

[innerSpaceman]

I'm 50, and my employer is paying about a little under $300 a month for standard Blue Cross health insurance. We're not getting any kind of bulk discount - I'm the firm's only employee. So yeah, I'd say you're getting more than typically ripped off.

[BarTopDancer]

Can you get a document broken down by employee and family cost? They may have jacked up the rates on the family portion. Not that you have many options due to your wife's pre-existing condition.

[RStar]

Yes, you're getting ripped-off. The whole country is.

So true!

Ok, this is the rub. The owner of the company decided not to go with the insurance through the HR group because she has health issues that will be pre-existing if she changes. I thought if you are covered from one company and change to another it wouldn't be pre-existing? Also, her Dr won't take the new insurance, which ever one that is (Aetna?), so we are sticking with Blue Shield small groups. People here can't afford the insurance are are cancelling so that the owner can keep her doctor. Nice....

Oh, and we don't have the broker, we are going direct. So we aren't paying a middleman like I thought.

So, for the HMO 15 it's 631 for me plus 676 for my wife! And if I don't pay up, some guy named Franky will come and break my thumbs! :rolleyes:

[innerSpaceman]

And then you won't be able to have them fixed, because your health insurance would have been cancelled for non-payment by then. Vicious Circle.

[alphabassettgrrl]

Ugh. I'd say yes, you're getting ripped off, but if the owner doesn't want to switch to a company that works for everybody I'm not sure what you can do, other than get an individual policy (which has risks that a group policy does not).

[RStar]

So, I guess it boils down to- does anyone else here work for a small company of 50 people or less, get Blue Shield (or Anthem Blue Cross) directly (not through a group) and pay close to those same prices? Or is it just my company?

My other option is that my wife is on SSI Dissability, so she gets Medicare Part A (or is it Medical? I get them confused). I can take her off my insurance, and pay for her Medicare part B & the supplemental insurance through AARP or some such firm. I don't know how much those would cost, and what the coverage would be like. She would also have to change medical groups and drs which would really suck. And less places take Medicare/Medical now. This option makes me nervous....

My last option is to find a new job with better benifits. But that makes me even more nervous in this economy.

[Stan4dSteph]

I'm on Anthem, but it's with a very large company so I doubt my rates would be comparable. Sorry you're having such troubles.

[innerSpaceman]

Well, i consider 1 employee to be less than 50, and - as I said, I get my insurance not through a group, and it's standard Anthem Blue Cross - for (until the rate hike they recently retreated on comes up again) for $280 per month (for me individually, without any other family members covered).

[RStar]

Well, i consider 1 employee to be less than 50, and - as I said, I get my insurance not through a group, and it's standard Anthem Blue Cross - for (until the rate hike they recently retreated on comes up again) for $280 per month (for me individually, without any other family members covered).

Sorry, I didn't mean to make it look as though I didn't see your post.

One of the differences there would be the coverage. In Blue Shield there are different levels HMO 5, 15, 25, 30, & 40. The 5 has the best coverage but the highest monthly premium. The dr office copay is $5, and pharmacy and hospital costs are low or zero. The HMO 40 is cheeper, but the office visits are $40, and you have to pay 40% of hospital and other costs.

I don't recall how Anthem Blue Cross lables the levels, and I'm not sure how to compare what you and I have, but right now I have the HMO 15. My hospitalization is $350 per admittance. When I change to the 30 it will be $500/day!

[lashbear]

Goodness!!

Just a side note from Australia.

My health insurance (through a private provider) costs $135 per month with $200 gap per admittance (up to twice a year - third and subsequent admissions are free), and a Co-pay for Private Hospitals of $50 per day.

Come and live here !!

[RStar]

Goodness!!

Just a side note from Australia.

My health insurance (through a private provider) costs $135 per month with $200 gap per admittance (up to twice a year - third and subsequent admissions are free), and a Co-pay for Private Hospitals of $50 per day.

Come and live here !!

Cripes! I should! But I'd probably end up getting bit by something and promply admitted to the hospital! ;)