Vent. Insurance from work with high deductible

amother

Sun, Dec 29 2024, 2:57 pm

So I'm incredibly grateful that we get insurance from DH work. They cover a decent amount of the premium - we only have to pay $100 a month.
I am so grateful.

But the only insurances offered all have high deductibles. (Around 3500-4000 per family).
And because we're eligible for insurance through work, we're not eligible for any marketplace subsidies or cheaper insurances or lower deductibles.

It's so frustrating. We spend so much on Dr visits, medicines, therapy because we have to pay full price until we hit the deductible.

This is just a vent.
But the insurance situation here is insane.

amother

Aconite ↓

Sun, Dec 29 2024, 3:01 pm

insurance is insanity. We also get through my husband's work. I don't think we pay anything monthly but our deductible is even higher. the thing is a lot of our therapy is out of network so wasn't worth upgrading to a plan that we would have to pay for but get a lower deductible. insurance in america is pretty messed up.

amother

Dustypink

Sun, Dec 29 2024, 3:05 pm

We have what’s considered decent or good insurance. We pay $1000 a month and have a low deductible.

That’s just the way it is, low premium means high deductible. There’s barely any insurance that would come out to less.

amother

↑ Aconite

Sun, Dec 29 2024, 3:09 pm

that means you are paying at least 12,000 on medical expenses before you even step foot at a dr. is everyone you see covered by your insurance?

amother

Pansy

Sun, Dec 29 2024, 3:11 pm

amother Aconite wrote:

that means you are paying at least 12,000 on medical expenses before you even step foot at a dr. is everyone you see covered by your insurance?

How did you get to that total?

sweetpotato

Sun, Dec 29 2024, 3:16 pm

How much is covered once you meet your deductible? What is your out of pocket maximum?

Honestly what you’re describing sounds very decent and expected. If you only pay $100/month for premiums, and your deductible is $4k, then you’re paying about $430 a month per year to get insurance benefits. This is not at all considered a lot to pay for a family. I pay about $450 a month (my employer covers the rest) and we have a $3k deductible on top of that, and this isn’t considered outrageous.

High deductible vs high premium, it often comes out more or less even and is just different ways to pay. I like my high deductible plan bc I have an HSA and put money in it pretax that I use to pay the out of pocket expenses.

amother

Calendula

Sun, Dec 29 2024, 3:19 pm

I have the same. It’s annoying not the worst. I’d be more annoyed paying a high monthly premium.

Does your company offer an HSA? It’s an amazing savings account - you put pretax money into it and invest them in the stock market, and can take money out of the account to cover medical expenses without paying any income tax on the money you take out. The account is only an option for people on Hugh deductible health plans.

amother

Wisteria

Sun, Dec 29 2024, 3:29 pm

I have a marketplace plan and pay around $300 just for myself to be covered and my deductible is 3k-just for myself. My out of pocket is 9.5k for myself. You have a decent plan. And you are definitely better off than the marketplace unless you want to pay thousands a month for coverage. It all evens out at the end. If you take a marketplace plan you’ll have to take a very expensive plan to get a lower deductible. 3k for a family is considered very low for a family. That would mean around 1.5k single.

amother

Silver

Sun, Dec 29 2024, 4:27 pm

That is actually very good insurance.

Your actual medical expenses - deductible plus premium are about $430 per year - you didn't mention whether you have co-insurance or co-payments after your deductible.

Many people have premiums of $1500 or even more for their family and have a high deductible as well. Is this $4000 for the family because assuming it is for the family it is actually very low per person.

amother

Obsidian

Sun, Dec 29 2024, 4:34 pm

Thats very cheap! That’s only about $5k total out of pocket for you for health insurance for your whole family! You are lucky! I doubt you would be able to get ANYTHING for cheaper than that through the marketplace.

We also get insurance through work. It’s also partially covered. We still have to pay $700/month for the premium and like $8k deductible! That’s more than $16k on just health insurance.

amother

Crystal

Sun, Dec 29 2024, 4:51 pm

That sounds like really good insurance! We pay $9k in premiums for basically no deductible and that’s considered an excellent plan. And with a high deductible (that I don’t even consider so high some plans are $8k) you’re eligible for an HSA which is much better than an FSA.

amother

Raspberry

Sun, Dec 29 2024, 4:53 pm

Calculate:
Premium+deductible+ copays= how much is costing per year

Do you have the option if not taking insurance from work and getting into another plan?
From what you described,it doesn't sound like there are many cheaper options.

amother

Lightgray

Sun, Dec 29 2024, 4:54 pm

Op, Is it a HSA plan? Even if the employer doesn’t offer to fund an HSA account you can still take advantage of it doing it yourself if the insurance plan itself is a HSA plan

amother

Cantaloupe

Sun, Dec 29 2024, 5:04 pm

amother OP wrote:

So you're basically paying $400 per month for your family. Reframe it that way.

amother

Amethyst

Sun, Dec 29 2024, 5:18 pm

That’s a great deal. I’m paying over 15kper year in premiums and have a 7.5k deduction… through work. It’s enough to have me looking for work at another company that may have better benefits or pay more… but that’s how it is everywhere.

amother

RosePink ↓

Sun, Dec 29 2024, 5:22 pm

amother Aconite wrote:

that means you are paying at least 12,000 on medical expenses before you even step foot at a dr. is everyone you see covered by your insurance?

No, it means she pays 5,200 before she is covered.

amother

↑ RosePink

Sun, Dec 29 2024, 5:25 pm

I have the same costs and I think it's a great plan! So many people pay more than the total out of pocket amount just in premiums.

It really comes out cheaper than many higher premium lower deductible plans.

amother

Lightpink

Sun, Dec 29 2024, 6:39 pm

When I first offered it I hated it until I did the math and figured out bec of the lower premium I did better even with the high deductible plan. And we do have a lot of medical expenses. If I get a huge co pay as a lump sum in the beginning of the year typically I can pay it off over the year. We get to 20% very fast at which point our co pays are low. Then we hit 100% and everything is free and we really try to take advantage of every medical expense then. I think it is better than all our copays in the past.

Does your company offer an hsa. It allows you to use money pre tax toward the co pay. Which is very helpful. My employer also gives toward our hsa account.

It takes some reframing of medical expenses but most ppl do better this way.