Another Insurance Vent

Posted on: Wed, 08/15/2007 - 6:04am
ctmartin's picture
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Joined: 07/30/2007 - 09:00

I just saw the post down below about insurance companies and EPIs and it just got me wondering about insurance in general and what kind everyone has.

You see, we have an individual policy. It is relatively inexpensive ($220/mo), but provides us NOTHING (except for well baby and 1 wellness visit for hubby and i each, paid at 80%). otherwise, we have a $5000 individual ded (with a $10,000 family ded). this was never a problem before, as we really only had minimal healthcare expenses.

well, back in april i had a miscarriage which required a visit to the emergency room. after that, i realized the need for better coverage and starting doing some research. well, i didn't get very far when my daughter had her first peanut reaction.

i was in the process of completing underwriting with my current insurance company in order to switch to a lower ded. well, of course, now i had to add her allergy and ... surprise, surprise, we were denied due to a "change in medical condition."

so we are STUCK in our current insurance! thieves!! what do you all do, and how do those who have to pay out of pocket do it (HSA?) now that we have our epi and realize, GOD FORBID if/when we have to use it this also requires a trip to the emergency room, i don't want to have to stop and think about how much it's gonna cost. do most of you have insurance through you or your spouse's employer or individual policies? which companies?? cost??? any info/comments appreciated!

Posted on: Wed, 08/15/2007 - 8:52am
pitterpat's picture
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Joined: 02/04/2006 - 09:00

We have insurance through dh's company. Luckily, it is really awesome insurance...to the point that people at the doctor's office call to double check because they say "no one has a $10 copay these days." Very lucky, I know, because we used to have to pay $1000+ per month for an individual policy with BCBS. They start out nice and affordable, but go up and up every year until they price you out. They paid for stuff, ok, but I had to be on the phone with them constantly. I thought that was normal. Sorry I don't have any good solid answers, but I wanted to offer something.
Can you not get insurance through an employer? Can you change jobs to do so? Unfortunately, it seems that's the only way to afford it.
Good luck.
Patty

Posted on: Wed, 08/15/2007 - 10:16am
chanda4's picture
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Joined: 12/14/2006 - 09:00

We filed bankruptcy 4yrs ago because of medical bills...and we HAD insurance!!! My hubby was back at the same job again(his turn over is often being in the car business)....so we coulnd't handle the $5000 deductable again, not with ur 4 kids's problems. So we went on our own and got an HMO policy(which I don't mind, you have to ask for referrals, but we have NO deductible now...which saves us thousands and thousands!). I couldn't get myself covered though(Kaiser isn't all that good) and they wouldn't cover 2 of my kids(the older 2's) RX(because of pre-existing conditions)....so we have basic HMO coverage with no prescription for $374 a month(for hubby and 4 kids). ER is $150 each visit(unless admited)....so I can deal with this, better then the $7800 ER visit(from 3yrs ago) that I still owe(because of the deductible!!!!)
Insurance sucks(IMO)....with the 6-7 companies we've had over the last 10yrs....not one has been wonderful, not even close!!!!
------------------
Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, seeds(all-sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut(also avoiding legumes), trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-4 (peanut, tree nuts, milk, soy, egg, beef and pork, cats, dog, guinea pig, hamster, grass, mold, dust mite and EE)
Savannah-1 1/2 (milk, beef and egg, dog(avoiding peanuts, tree nuts, strawberries, seeds, legumes and corn)

Posted on: Wed, 08/15/2007 - 10:34am
mom2boys1975's picture
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Joined: 07/19/2007 - 09:00

We have ins through dh's work. Our portion is $200 per month. We have a $600 deductable, $20 copay for gp, and $40 for for specialist.
Through dh's old employer we paid about the same but didn't have a deductible and specialists were $30.
I have friends without insurance so yes I realize how lucky we are.

Posted on: Wed, 08/15/2007 - 12:53pm
ctmartin's picture
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Joined: 07/30/2007 - 09:00

thanks to you all for your replies! i am just so at a loss right now as to what to do. my husband is a freelance photographer who also works in the restaurant industry. we just found out (because we never really explored the option before) that his restaurant does offer BCBS. it is sooo expensive, though ... $480/month for the 3 of us! we may just have to do it, though, b/c our only alternative is sticking with what we have, and, since our daughter was diagnosed with PA, the ded just seems too high for us now. thanks again.

Posted on: Wed, 08/15/2007 - 1:48pm
PinkPoodle's picture
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Joined: 06/12/2007 - 09:00

ctmartin-I think $480 is a little higher than average for a family plan (doesn't matter whether you have 1 child or 6---same cost), but if the coverage is much better, I think it is worth it.
Our insurance coverage hasn't been perfect, but I liked Tufts a lot (though they recently changed their policy limiting the # of epis) and Harvard Pilgrim. BCBS (at least the one in MA that we had--they have so many different plans) was a bit ridiculous about covering DD's asthma medication (MD had to appeal it). They did cover ER visits, office visits ($10 copay), etc..
Tufts was great because my 1st pregnancy was high risk and I was on bedrest for some; they sent a nurse once a week AND a housekeeper ("to help with housework, shopping, etc.). I can see how the housekeeper would have been a necessity if I had older children, but this was my first baby. They were great throughout the pregnancy--from the first visit to the MD (2 days later they sent a congratulations note and What to Expect When You're Expecting). I thought it was a very nice touch [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
About 18 months ago a nurse called and introduced herself as my DD's casemanager (she called to offer this voluntary service because DD's asthma diagnosis). She sent DD a packet about asthma geared toward young children. Every once in a while she'd call to check on my DD and every once in a while DD would get a new book or coloring book about childhood asthma (one was about sports, one was about warning signs, etc.). DD was diagnosed with pneumonia and they called every day. I'm sure they save money in the end by providing this patient education, and even if that is there motivation, it still felt very nice to be on the receiving end.
We now have Oxford...haven't had to use them much yet.

Posted on: Wed, 08/15/2007 - 10:39pm
seanmn's picture
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Joined: 10/01/2003 - 09:00

We had Medica prior to BCBS and they were a great company.

Posted on: Wed, 08/15/2007 - 10:52pm
Sarahfran1's picture
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Joined: 12/01/2006 - 09:00

$480 a month seems like a bargain to me! Our plan (BCBS PPO, family coverage including vision, dental and prescription) is $1100 a month. My employer pays a good chunk of that--my share is about $350, then we pay an additional $300 in various copays each month (DS has significant health problems and gets monthly infusions of gammaglobulin; we're paying 10% of that cost, plus a $20 copay each week for speech therapy).
So I'd go with the $480 a month plan--it's worth it to be a part of a group plan that can't drop you when your health status changes!
Sarah

Posted on: Thu, 08/16/2007 - 4:05am
Christabelle's picture
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Joined: 10/03/2004 - 09:00

Our insurance plan is pretty awesome for coverage. I can't complain. We have a minimal co pay and get about 8 epi pens at the beginning of each school year. For that I think we pay around $20.

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