Medical Insurance

[Already Gone]

Does your employer (no names please) pay toward your medical, dental, vision, prescription drug insurance policy?
If so, how much do they pay, and can you take the cash instead?

[M1Ark]

 
I've worked for two utilities in-house and declined medical due to my wifes employer providing better medical.  Each company provided me a whopping $600/year.  It wasn't even cash but in the form of a flexible spending account.  I guess you can also count the $80/paycheck medical payment I didn't have to pay. 

($80 x 26) + $600 = $2680/year savings

[Fermi2]

My wife doesn't work outside the home so I've always chosen medical coverage.

At Fermi I was in an two different HMOs. The one run by Blue Cross SUCKED!!! I think it cost me 55 a paycheck with 15 dollar co pays. The trouble was if you got a referal to a specialist it was only good for one visit. So if you had to see the same specialist 5 times you'd need to see your Primary Care physician 5 times too. It really added up.

The second HMO I was in was AWESOME. I believe it was called HAP. I think it ran me maybe 45 a pay check, with a 15 dollar co pay. They paid the bills quickly, a referal was worth 5 visits to the specialist, and if the specialist needed to see you past that the Primary Care physician would call HAP and that was that.

Overall Blue Cross in Michigan really bit, and DTE Benefits was not of any assistance whatsoever. Blue Cross rarely enforced their negotiated rate and if you called the people from DTE who were supposed to straighten it out they'd say it sounds like an individual problem. DTE also did some sneaky stuff when you signed up each year. For instance if you were a smoker you had to pay more, I don't have a problem with that. HOWEVER when you signed up when they asked Are You A Smoker the DEFAULT answer was yes and was buried below the question. It was the same for Do You Have Other Primary Coverage?

I don't remember what the Opt out price was but I'm thinking it couldn't have been over 1000 dollars for the year.

TVA isn't bad at all. We don't have as many choices as I did at DTE and they're a tad bit more expensive. Not enough to make a difference though. The Base Plan is an 80% Blue Cross plan, it costs me 80 per pay check. My deductible is 300 Ind/ 600 Family after that they pay 80% up to a stop loss of 2500/5000 for 2006. ( I will say I do believe raising the stop loss every year is BS). After that they cover it 100%. I do wish they had an HMO.

I pay a bit more, but Blue Cross Tennessee is spectacular about enforcing their rules, paying their portion, and making sure you understand your obligations when you go to Emergency Rooms and for stuff like surgery. If you ask TVA for help, they get things straightened out. (which I only had to do once, but by the time TVA got involved Blue Cross had realized their mistake, the point is, when I explained the situation to TVA they said ok Mike we got the ball).

My guess is if it was just me and my wife I'd go the CDHP route because she and I rarely get sick and usually when we do we just gut it out.

I know there are those who will say 80% with 80 a pay check is really paying an extra 2600 or so a year BUT when you have kids and major stuff comes up it pays for itself. My daughter had her tonsils out, then a week later suffered a complication. WE'd already paid off her deductible. I had fully figured on paying up to the stop loss. When I got the full bill for her surgery, PLUS an overnight emergency room stay due to the complication it came to around 550, out of a total of more than 15,000.  You really can't beat that.

I'm not sure if TVA offers an opt out. Another thing I think where TVA really was superior to my old company. My first week here we had an HR person explain EVERY benefit plan and help you fill out the paperwork. Same with retirement 401K and moving benefits. Within 2 weeks of me moving to Tennessee I was all straightened out on everything. Realistically I was all set the first day I showed up. By the way, for those of you who have been through Company Orientations I believe TVA probably has the industry standard for the Utility Industry. It really is quite good and lasts about a week. When I hired in at Detroit Edison I showed up at corporate, signed some papers and NO ONE COULD GIVE ME DIRECTIONS TO MY PLANT. The whole orientation lasted maybe 90 minutes. I figured the best way to find the plant was get on I 75 South and look for Cooling Towers and drive towards them.


I know this was a long babble to a simple question! Sorry!!

Mike

[Phurst]

I want to re-energize this thread. I have been considering going back to rent-a-tech mode and want to 'do the math'. One of the biggest expenses can be medical insurance. What does it cost and do any of the companies ( Bartlett, Denuke,..) pay any toward it?

[rlbinc]

Check into HSAs.
I have a Blue Cross Blue Shield HSA with the account held at Mellon Bank.
I'm 50 with a wife, we pay ~ 350 a month.
Our deductible is 10k. The contributions you make are ALL deductible - without that 7.5% of Adjusted Gross Income deal that the IRS requires on itemized returns.
We keep that 10k in the interest bearing account at Mellon Bank. They give you a Debit Card for use. Anything remotely medical qualifies.

HSAs are great. It lowers the cost of catastrophic coverage - anyone can afford treatment for the flu - it's cancer and bypass surgery that causes bankruptcy. That's how these HSAs work.

If you run your own business - your business can deduct Health Care premiums, which lowers the real effect of the premium to closer to 300 a month.

When Doctors learn your first 10k is out of pocket - they are willing to cut you a deal. Last year we had some diagnostics ran that ended up costing us $1700 instead of the $5000 they charge a provider.

Think about it - when the doctor has zero claim paperwork and no chance of rejection - they can risk charging a reasonable fee.

Its not a bad deal. A normal year costs us $4200. A bad year - which we have never had - would cost $14200.  Not quite bankruptcy material.

[MrHazmat]

According to THEM we pay 20% and THEY pay 80% which would be $1040.00 per month for them. But with 5000+ workers I really have to wonder.

[Phurst]

According to THEM we pay 20% and THEY pay 80% which would be $1040.00 per month for them. But with 5000+ workers I really have to wonder.

What do you do between outages?

[RADBASTARD]

The med insurance kills you when you are off.It would not be so bad getting unempolyment if you wern't paying a mortgage  payment for health care but it is a nessasary evil that sux.

[Lorrie Henson]

We had medical coverage and were paying monthly COBRA payments in the summer months, even though the costs was rather high ($815).  Then, the governor apparently passed a state law for "everyone being covered" even if they couldn't afford it.  What that meant for us was the premiums skyrocketed.  We received notification that the payments would be over $1100 a month... during the summer, while unemployed.  We just couldn't afford that, so we went shopping.

We found NASE (National Associated of Self Employed).  They have a menu you can choose from, so the monthly premiums vary from person to person.  We have to pay monthly dues of $40 and our medical premium is $317.  It's not the best insurance, but it's what we can afford right now.  They do pay 100% immunizations and that was important to us.... However, we have a $3000 deductible and that is per person, per incident, which can get costly if a lot of surgeries are needed.

It would be great to have better coverage, but it would cost too much for the 'what ifs', so we choose to pay the lower amount, have some kind of coverage, and pay the higher amounts IF something happens.

NASE's health plan is Mega Life and they are a PCHS.  When traveling, it can be a real pain finding doctors and facilities that are 'in network'... but they are pretty helpful when calling them. 

Good luck!!

Lorrie

[rlbinc]

I know its a rant - but government has no business in Health Care.
I've been in a VA Hospital. Trust me. You don't want government Health Care.

As for insurance - ours is OK, its the best we can get in a corporately and governmentally fettered market.

But think about this for a minute. I breed Bulldogs in my spare time. Bulldogs commonly have Caesarean Sections due to the large heads and small hindquarters specified in the breed standard. ( A human inflicted deformity ) My vet charges me $300 for a C section. On a human, that would be near $25,000. Same procedure. Only breeders assist in the puppy "boot up" process, which amounts to vacuuming out their nose and throats and rubbing them vigorously in a towel until they squeal.

We were discussing this price disparity - and the vet said... "Dogs generally don't have Insurance or Malpractice Attorneys."
I understand there is a huge difference between a vet visit and a doctors visit. But the level of training and competency are quite comparable.
In many cases, I'd take this particular vet's advice before I'd take the advice of some MDs I've had.

If insurance didn't exist - all doctors and hospitals would have to work on market determined price scales. What could the average person afford for this procedure, based on supply and demand? Prices would be much lower than they are now. I have been shocked by the cash prices our doctors have agreed to. 70% off sounds more like a jewelry store than a doctors office, but that is indicative of the markups they must use to account for non-payers, rejected insurance claims, payment processing, etc.

The best possible reform we could have is a free market.

So - when you hear that some candidates favor eliminating the corporate tax cut on medical insurance - that candidate is trying to remove a fetter on the free market. When Gigantic Edison no longer subsidizes insurance, Blue Cross has to attract YOU as a customer of choice with their premium structure.

[Already Gone]

That is a very good point.
When I was working in Canada, I learned that their national health benefit does not include prescription drugs, laser eye surgery, or eyeglasses.  All three of these things are much cheaper in Canada than they are in the US.  If Pharmaceutical companies, Opticians, and Opthalmologists (sp?) want to sell their wares in a country where no deep pocket pays for it, they have to charge prices that people can afford.

[SloGlo]

clicked 'other' on da menu.  currently getting 100% for hmo from da company.  dey don't pay difference four declining it.  butt, ya kin werk as a contractual employee without bennies 'n get about 9-13% more per hour. 

[NJ]

This thread has been dead for some time now and did not see anything in past postings for maybe group insurance through Nukeworker?  There are a lot of us road nomads out there who could use some coverage that doesn't cost a leg and a lung.  COBRA is just too much and on again off again work can cause too much stress and the gamble is too high.  Why couldn't we all just have a group policy for our industry?  Has Nukeworker looked into this?  That would be the best service this site could possibly do for us.  Any ideas out there?
NJ 

[NJ]

Where is that link located?  I'd like to check it out.

[lauriema19]

Yes, we do need a good medical insurance. We just could not afford not to have one and cobra is just rediculous way too high when we are have those time off months.

[NJ]

Mike Rennheck..is this something that you guys have looked into?  This could be the best service you could do for your fellow nukers. With 10 years under our belts... can we look into this?

[HydroDave63]

Mike Rennheck..is this something that you guys have looked into?  This could be the best service you could do for your fellow nukers. With 10 years under our belts... can we look into this?

http://www.nukeworker.com/forum/index.php/topic,5697.0.html

[NJ]

http://www.nukeworker.com/forum/index.php/topic,5697.0.html
These links should be togeather... still not answered

[vikingfan]

i buy my own family insurance coverage through my ins agent ( state farm, through assurant health )for about $300 a month for the 4 of us and a dental discount plan. the plan is a 80/20 plan i took a higher deductible though.

[vikingfan]

here I thought this thread was about medical insurance and its cost and not about what people are making, travel rates and per diem rates ? i know there are threads on here that discuss those issues.

[Phurst]

Thanks for all the info and I want to r-energize this thread with any updates. Who has their own private health care, from who, how much, and are they any good? I looked on-line in a search and the range is wide and difficult to navigate.

[Neutron_Herder]

I'm starting my new career next month after 21 years in the Navy, and the heath insurance stuff is giving me fits!

How did you retired military people handle your medical insurance when you got out?  I've heard some not too positive stuff about medical facilities accepting the Tricare Prime program, especially in areas where there wasn't a large concentration of military people.

I'm leaning towards just going with the Tricare Standard (old Champus) program, and then seeing if the company offers some sort of supplemental insurance that would cover the difference, but I just don't know.  I have some emails in with people at the company to see if I can get info on specifics of the plans offered, but I thought I'd check in with y'all too.

I'm just trying to get all the info I can so I actually have an idea of what to do when I have to pick my plan.  I don't figure I'll have a whole bunch of time to pick one once it's offered, so the more educated I can be going in the better off I'll be.

Additionally...  Would there be any big tax implications associated with employer provided health insurance with all of the health care reform stuff going through Congress?  I'm not trying to start a big conversation about the plusses and minuses of the program itself, just trying to get an idea if any employer based health care is worth it versus just paying the deductibles on my own...

I'm grateful for any information and experiences that anyone has had!

Thanks,
Jay

[Gamecock]

I'm starting my new career next month after 21 years in the Navy, and the heath insurance stuff is giving me fits!

How did you retired military people handle your medical insurance when you got out?  I've heard some not too positive stuff about medical facilities accepting the Tricare Prime program, especially in areas where there wasn't a large concentration of military people.

I'm leaning towards just going with the Tricare Standard (old Champus) program, and then seeing if the company offers some sort of supplemental insurance that would cover the difference, but I just don't know.  I have some emails in with people at the company to see if I can get info on specifics of the plans offered, but I thought I'd check in with y'all too.

I'm just trying to get all the info I can so I actually have an idea of what to do when I have to pick my plan.  I don't figure I'll have a whole bunch of time to pick one once it's offered, so the more educated I can be going in the better off I'll be.

Additionally...  Would there be any big tax implications associated with employer provided health insurance with all of the health care reform stuff going through Congress?  I'm not trying to start a big conversation about the plusses and minuses of the program itself, just trying to get an idea if any employer based health care is worth it versus just paying the deductibles on my own...

I'm grateful for any information and experiences that anyone has had!

Thanks,
Jay

I'm still active duty...but my family is Tricare Standard.  We have a supplement through MOAA that picks up what standard doesn't.  I'm fairly certain that it will work the same after I retire.  I pay $35 a year to be  a member of MOAA and less then $20 a month for the supplement.  There are other organizations that also offer a Tricare supplement. 

[Neutron_Herder]

Well the vision and dental part of the insurance is already taken care of,  at least for now.  We have covered those under my wife's policy from her job, and she's going to be able to continue to work with them once we move...  at least for now. 

I talked to some people that are eligible for both kinds of benefits since my original post, and it turns out that the retired military benefits can only be secondary to whatever benefits that the company offers (if you take the company's medical benefits).  Basically, the new company provides the primary benefits, and the retired military benefits act as a supplement to that.

I'm all about sitting on the fence until I have to make a decision, but I'm just trying to get an idea of what people that are in similar situations have done.  I've heard a couple of different versions of how people have done their insurance, and I'm trying to figure out the most beneficial to me.

The tax thing isn't a huge deal, but they're throwing around numbers like 40% tax on medical benefits exceeding $8500...  I honestly haven't educated myself enough to know if that's $8500 spent (between myself and the company), or $8500 that's covered by my policy.  That's a pretty big deal to me, as my son has chronic medical issues which end up with him requiring a lot of care throughout the year.

I know that I can't plan on anything as far as the new medical bill goes, I'm just trying to plan on the lowest threshold for the highest amount of taxes that I've been able to find.  The whole new healthcare plan is really hard to understand on an individual basis, so I'm just sticking with worst case all the way around.

I'm really not trying to screw the taxpayers (or anyone else, for that matter) over, I'm just trying to maximize the benefits that I've earned combined with the benefits that are being offered to me by my new company...

I appreciate all of the help so far.  Keep it coming!

Jay

[Jr8black3]

20 years is alot of time, been doing it over 25, all ya can do is look back and say I screwed up