Health Insurance Can Be a Bitch.

Every time I think I can forget about my health insurance, something comes up and reminds me all over again how much I despise it.  I know it’s important and there’s nothing you can really do to avoid it unless you were billionaire or something, but I’m still gonna bitch and moan about it anyways cuz this is my blog and I can cry if I want to ;)

For those who were following this site this time last year, you’ll remember I waited quite a while to finally deal with it after months of being self-employed.  I had been on my wife’s University plan for the first half of the year, but mid-way through they dropped the coverage of all family members and dependents (d’oh), and I was forced to go out on my own.  In the end though it was solved pretty easily as all I did (thanks to some of your recommendations!) was hit up eHealthInsurance.com and sort through the options available after answering a few basic questions. I poked around a bit, talked it over w/ the wife, and settled on a solid (maybe TOO solid) plan with CareFirst Blue Cross Blue Shield.

And then we had a baby ;) All great things emotionally, but not so much w/ money (as you can tell from my continuously updated Baby Money Tracker! Which will be the subject of a new post here shortly…)  And since we can’t add him to the Mrs’ plan as I just mentioned, it means he had to be added to mine instead.  Which is fine in the long run since it makes things nice and easy – and portable! – for wherever we end up moving to and all that, but getting over the initial shock of seeing my new rates were pretty frightening… you’re about to see them below, jeez…

The crazy part too is that I RARELY even used my insurance at all last year. You wanna know the total number of times I went to see a doctor? One. That’s it. Yeah it’s good I didn’t get all that sick and end up in the hospital any time last year (really good!), and that I’m super covered for the future as well especially now that I’m a parent, but it still pains me to know I spent over $3,000 in total for one simple visit to a CVS Minute Clinic (which are GREAT btw). The whole insurance game is just crazy to me. I know we get jealous of all those countries who have “free” universal health care, even if they’re not 100% top notch as many are quick to point out (I don’t know anything about anything, so I just stay out of the arguments), but I will say it must be nice to at least not have to worry about it all the time.  It’s there whenever you need it and it’s not changing every other month…

Anyways, as you can tell I hate dealing with health insurance.  Life insurance is fine – you rarely have to go in and make a ton of changes, as we talked about last week during the Life Insurance Movement – but this one just drives me bananas. And I know I’m not alone here ;0

Check out my payments over the past 10 or so years, and look how it’s starting to trend. Ugh.

  • $200/mo – what I was paying 10  years ago at my old company
  • $150/mo – what I was paying over the next couple of years through a different company
  • $0.00/mo – what I was paying for at the height of the last start-up I worked for! To say we  had some pretty killer benefits would be an understatement :)
  • $280/mo – what I ended up paying at the end of 2010 when all those benefits got cut and the company eventually went under
  • $292/mo – what I started paying last year when I went out on my own through eHealth (I ended up picking a sturdy Blue Cross Blue Shield plan, even though there were plenty of cheaper ones)
  • $573/mo – what the additional cost was to add Baby $ to the mix (!!!), starting last month.
  • $643/mo – what it will cost going forward starting October 1st!  Ugh….

A 100% increase in the past two months!!! One for the baby, and one for what I can only assume is a normal yearly adjustment? Which will now cost me an additional 75 boners every month I’m insured, freakin’ crazy. And a good reminder of some of the cons of working for yourself to all you out there who’s considering the same! We enjoy a helluva lot of other great benefits like me sitting here in my boxers right now typing this (tmi?), but financially you can really get a foot up your a$$ every now and then. It’s not fun (although sometimes tax deductible).

The only thing I enjoy out of this is the fact I’m providing for my family and supporting my wee one in all future doctor visits going forward :) That does feel awesome.  And that I’m being a good dad to him right from the start – so I can’t complain all the way. And as I already alluded to, we ALSO have a pretty damn solid plan – the reason for such high premiums.

We have a PPO with a $600 family deductible and only 10% co-payments after that.  Along with $25 office visits, and up to a yearly max of $5,000 (total) out of our pockets. So I could easily increase the deductibles and co-payments to save a good chunk every month (roughly $100 for two levels up), but knowing how often babies go to the doctors I’m gonna lay low for a bit and see what happens. Apparently your kid gets whatever terms YOUR plan provides, so if I up all my stuff to save some money, it increases the payouts for the baby too. Which scares me to death…

Now on the PLUS side, I can add as many more babies to the plan as I want without paying a penny more! Haha… WOOT. They screw you for that 1st one, but any others after they can care less ;)  I hope they mean it cuz I’ll be gladly taking them up on that in the future! You better believe it!

Anyone else dealing with health insurance headaches?  Anyone have some awesome (or even worse) plans than myself? Someone make me feel better! Haha… just kidding :) Kinda…

————-
PS: To add my wife to our plan? $150 more and *doesn’t* include maternity coverage. OUCH. I guess that’s where they get you with the “unlimited babies” part?

(Scream photo by CHRISTOPHER MACSURAK)

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35 Comments

  1. William @ Drop Dead Money August 27, 2012 at 5:47 AM

    I feel your pain. The good news is we were able to retire earlier than most people. The bad news is we aren’t old enough for medicare. And if you think they kill you on premiums for having a baby, wait till you see what they do to you just cuz you’re old!

    Like you, I only had one doctor’s visit last year, and that for my physical. Insurers don’t even ask you if you’re healthy or anything like that.

    It’s simple, really. You old? You pay!

    It is crazy. America can beat the rest of the world in putting a man on the moon, but we’re having their lunch eaten by half the world on taking care of our own people. We know how to take care of our athletes, politicians and lawyers. But not our ordinary people.

    Reply
  2. SMB August 27, 2012 at 8:03 AM

    I know what you mean – I’ve only been working for two years and my health insurance premiums have almost doubled in that time and yet I only go to the doctor’s once a year! I’m definitely researching different options come open enrollement season. Perhaps since I’m young, healthy, and rarely go to the doctor, I should switch to a high deductible plan.

    Reply
  3. Brian August 27, 2012 at 8:18 AM

    I am dealing with a claim problem at the moment. Anthem wanted to make sure the little guy wasn’t covered under someone else’s insurance (I have a single policy since it is less expensive to keep me off my wife and his policy). So they processed a claim before inputting the all the correct information. Needless to say they want me to pay for his entire NICU stay ($55,000). Not going to happen since our max out of pocket is $8,000 and we have already spent $6,000 of that. Oh, and they have already approved claims for his bills after that one. They just don’t want to be on the hook for $55K

    In the end I’m sure it will work itself out with a few strongly worded emails and a few phone calls, but I don’t understand why they would even process the claim until they had all the information.

    In the end, my wife’s insurance went from an amazing $12/month (for great coverage) to $400/month (for the same great coverage +babies)

    Reply
  4. Greg@ClubThrifty August 27, 2012 at 9:09 AM

    Ugh! Health insurance sucks. When we started working at a small business, we had to find insurance out on the open market. We had a terrible plan each with our own high deductibles and paid over $800/month for it. The coverage was terrible and the customer service was even worse. (If anybody wants to read about our adventure, we recently wrote about it but I won’t spam you with the link.) Luckily, we’ve moved to a group policy at work through Blue Cross Blue Shield. We still have a huge deductible but at least it is a family deductible. Further, we now qualify for a HSA account, and our scripts are a lot cheaper and baby well visits are free! Bonus!

    If I were you, I’d think about moving to a higher deductible HSA plan. You’ll still get the same discounted rates from the providers, but the actual insurnace will cost you less. Thanks for getting me all riled up for the rest of my day. This topic really gets me going.

    Reply
  5. becca August 27, 2012 at 9:12 AM

    Nothing makes me feel like an adult in a depressing way quicker than health insurance. My insurance rates went up pretty dramatically this year, I had wondered if the industry is girding its financial loins for new rules given all the reform legislation. Like I’m not sure “no maternity care” coverage will be available (*pause* yeah, google says it’ll all change come 2014. Some may scale up before it’s required to see how much it actually costs them. If they’re smart).

    Reply
  6. J. Money August 27, 2012 at 9:31 AM

    @William @ Drop Dead Money – Oh man, I can’t even imagine… we’re all gonna have to deal with it too at some point or another if nothing gets fixed/tweaked!
    @SMB – That’s what a lot of people recommend, but I know the second I do that I’ll be in the hospital like every other week, haha… If you won’t stress out about it though like I would, it may be a good way to go :)
    @Brian – Woahhhhhh that sounds horrible! $55k??? OMG… I def. hope it’ll work out in the end cuz that’s some crazy ass money we’re talking about… and $12 to $400 ain’t much fun either :( It’s a good thing they make babies so cute!
    @Greg@ClubThrifty – Haha, sorry man – had to get it out of my system :) $800 makes me want to vomit even more though, jeez… at this rate I’ll probably even be there in a year or two! Another pro to the wifey going back to work later on ;) We’ll see what happens though… glad at least you’re back on track and have a much better plan in place now, that’s awesome.
    @becca – It’s gonna be wild ride, that’s for sure. Esp. those who are self-employed… we’re gonna have to find a way to bring in more money to make up for it!

    Reply
  7. Budget & the Beach August 27, 2012 at 10:02 AM

    Yup, one of the tougher parts that no one seems to talk about enough when venturing out on your own. Even though freelancing wasn’t my choice, I got on the health insurance search right away. And yes, they seem to raise it whenever they feel like it. I just switched again this year. And the paperwork to fill out? wow! Right now I’m paying 205/month. But the thing is, you need it. That’s all there is. When and if something hits the fan (my 38 year old brother got cancer and had no insurance), then you will be glad you do have it. Tough I know.

    Reply
  8. Stephanie August 27, 2012 at 11:06 AM

    Yikes. Guess I won’t complain too much if my heath insurance premiums go up a bit next year. As it stands right now, my husband and I are covered for $1365/year, with $15 office copays and a $250 individual/ $500 family deductible. Once baby joins us next year, he or she can be added to the coverage for just over $225/year, at least based on our current rates. But we haven’t heard anything about our rates for 2013 yet, so that could all change. My employer is self-insured and just pays the insurance company for administration fees, so I’m not sure whether that will work to our advantage or not. Hopefully the claims for 2012 will be nice and low so they won’t feel the need to increase our premiums. A girl can hope, right???? ;-)

    Reply
  9. Mike@money-mouse August 27, 2012 at 11:08 AM

    Over here in the UK its different as we have the NHS which I think makes things easier for us. We do have the option to go private but not a high percentage of people do this.

    People do go private over here for their treatment if they really want something doing or do not want to be put on a waiting list.

    Reply
  10. Joe @ Retire By 40 August 27, 2012 at 11:18 AM

    Damn, that’s a lot of money to shell out every month. My wife is still working so we were able to jump on her insurance plan. We are paying $150/month. It sucks that health insurance is tied to employment. I don’t know why people complain so much about public healthcare. My parents live in Thailand and they have public healthcare. I guess people doesn’t think about these things until they get sick and go bankrupt.

    Reply
  11. Samantha August 27, 2012 at 11:18 AM

    LMAO@ an additional 75 boners every month

    As always, funny and informative!

    Reply
  12. SavvyFinancialLatina August 27, 2012 at 11:21 AM

    I’m pretty lucky that I landed in a company that covers health insurance. They pay for the monthly premiums, and our plan is pretty good, from comparing to others. I have been taking advantage of it by going to the doctors. Before due to not being uninsured, I would tough it out.

    Reply
  13. Mr. Everyday Dollar August 27, 2012 at 11:28 AM

    Your situation is different with a family but for a single person a high deductible health plan in conjunction with a health savings account can be quite affordable. For me, less than $50 a month. Plus the dollars allocated to the HSA are tax deductible “above the line” and you can even invest them in CD’s, stocks or mutual funds just like an IRA. Pretty cool.

    Reply
  14. My Money Design August 27, 2012 at 12:07 PM

    Ouch! I hear you pain on those costs! I know how much our work pays for people to enjoy health insurance, and it frightens me to think of what a disaster it would be to ever have the same level of insurance if I no longer worked here. Something has got to give or eventually no one will be able to afford being insured.

    Reply
  15. Ginger @ Girls Just Wanna Have Funds August 27, 2012 at 1:20 PM

    So how are you planning to manage the issue of future kids not being covered under the maternity coverage? This was my issue with Individual Plans. I need maternity coverage. Being of child bearing age and all.

    Reply
  16. Jen @ Master the Art of Saving August 27, 2012 at 2:13 PM

    We still don’t have health insurance because it’s so expensive, we’ve been lucky so far…so hopefully that will continue until we finally get some.

    I was always curious how often the premiums go up, sounds like annually with yours. Sorry they’re out to get you. :-(

    Reply
  17. Jenna, Adaptu Community Manager August 27, 2012 at 2:34 PM

    Ugh! I had to do my own health insurance for a couple of years while working for a start up. Definitely glad to be back on the company benefits plan. One good thing was the tax write off though.

    Reply
  18. Brent Pittman August 27, 2012 at 5:18 PM

    We have high deductible HSA. After our son hit 1, his monthly policy dropped by 1/2. So you can look forward to his 1st birthday!

    Reply
  19. Kira August 27, 2012 at 6:19 PM

    Seriously J-Money? This is the second time I have heard you talk about “free” health care. Health care is not free anywhere – ANYWHERE. It is either taken out of somebody else’s paycheck or taxed somewhere else. PERIOD.
    I have an HSA. An HSA that actually makes me look at costs when getting healthcare. Not just costs. Quality vs. Costs. Old Way: Go to Walgreens and pay your $10 “co-pay” while griping about how expensive your insurance is. New Way: Buy Prescriptions at Walmart/Sam’s Club. Pay attention to whether a generic is available. Use tax free money.
    Insurance is so high BECAUSE not everybody buys it. Remember that “Uninsured Motorist Coverage” you have on car insurance? Well – it’s basically mandatory in Health Insurance. Besides the guy who had the $55,000 NIC bill, there was somebody else who had no health insurance, walked in, and got the same coverage for their newborn. And the guy with the $55,000 NIC bill is helping pay for it. Or the insurance company is (which passes on costs to you.) But nobody seems to care since it’s not “their” money.
    I will keep the left/right wing arguments out of this, but the HSA is the best thing to happen to healthcare since generics. And with your rainy day fund, planning for a max $5000 bill in any given year is way better than paying $4000/yr for the “privilege” of $25 co-pays.

    Reply
  20. LB August 27, 2012 at 6:28 PM

    I look and feel like that painting at the beginning of your post today HA! “Too much work and no play makes Homer something something.” – Homer Simpson

    Well isn’t it just raining bills on you lately. I know the feeling with all my hubby’s bills coming in from his hospital stay. Not too bad, but I spread our budget a little thin for school. Oh well, schools important and I am OK with having a crappy budget to work with. At least I get school and other important things.

    As for health insurance I just have to ask: Did you not realize the jump in rate BEFORE you had the kid? Kids need insurance, and kids get sick so did you not check into this before the rate increase? or was it just the suckiness of having to pay it for the first time?

    I have been there before and man was that tough. I feel for you, but crap anything above $300 a month and I am definitely moving to Canada.

    Reply
  21. Brian August 27, 2012 at 8:54 PM

    “Which will now cost me an additional 75 boners every month ”

    I think you meant “bones”….lol.

    Well I know what you’re thinking about :-)

    If it helps any I feel better about my 9-5 now that I see what insurance would cost me if it was not provided through work. Your blog is great BTW! Thanks for all the great info daily

    Reply
  22. ckphoto August 27, 2012 at 9:31 PM

    Don’t assume all work policies are cheaper. I would be paying over $650 a month to have my spouse and child on my company insurance plan. I dropped that plan last year and got them both an individual plan throughout BCBS.

    They each have a $2500 deductible and 20% co-insurance. However, the premiums are $320 a month. With my work plan I am guaranteed to pay $7800 a year. With the BCBS shield plans I am guaranteed to pay $3840 a year. That is a huge savings right there. I also looked at co-pays, etc… Even if we have to meet the full deductible (hasn’t happened yet and my spouse had minor surgery last year), we still save money over the cost of the group health plan.

    It is scary when you start weighing risks vs costs on something as vital as health insurance. But every dollar spent should be evaluated, and this was a case where it made sense to go with private coverage.

    What is worse… when I only need to cover my spouse I will still pay the same amount and my plan only covers ‘family’… it don’t make an exception if you only 1, 2 or 5 people on the plan. So my spouse will stay on BCBS as long as possible.

    Reply
  23. Edward Antrobus August 27, 2012 at 9:31 PM

    I hate health insurance, too. My wife’s company only offers high deductible plans. So we have insurance that we can’t even afford to use!

    Reply
  24. DC @ Young Adult Money August 27, 2012 at 9:43 PM

    “We have a PPO with a $600 family deductible and only 10% co-payments after that. Along with $25 office visits, and up to a yearly max of $5,000 (total) out of our pockets.”

    This isn’t a bad deal. With my HSA my wife and I pay only ~$100ish per month but we both have deductibles of $2,200, out of pocket max set at $3,300 each. So it’s really a “pick your poison” scenario where you can pay high premiums and enjoy that low deductible, or pay low premiums and pay high deductibles.

    In the end it’s a business and protecting you from those catastrophic claims that could bankrupt you. My sinus surgery and septoplasty would be about $20k without insurance :0 http://www.youngadultmoney.com/2012/08/24/the-real-cost-of-sinus-surgery/

    Reply
  25. Wojo August 28, 2012 at 9:22 AM

    Like some of the other commenters, we also have a high-deductible HSA policy, which ran me about $90/month for my son.

    While it’s true that I had to pay out-of-pocket for any unscheduled doctor’s visits, all the numerous well baby visits and shots were all free (preventative care).

    Reply
  26. J. Money August 28, 2012 at 10:44 AM

    Wow. Just realized my new payments are probably equal to others’ mortgages? Pretty crazy…

    @Budget & the Beach – Man, you’re right on that. Nothing we can do about it cuz we need it 100%! Sorry to hear about your brother, that’s sad :( On both accounts.
    @Stephanie – I hope it all goes in your favor! Baby stuff thows it all for a loope, jeesh :)
    @Mike@money-mouse – Okay, yeah that’s what I thought was the case over there – thanks for sharing :) I think it’s absolutely fantastic that everyone is covered there rich and poor.
    @Joe @ Retire By 40 – I know, I don’t understand it either. I think us Americans just like to complain a lot ;)
    @Samantha – Glad you approve ;)
    @SavvyFinancialLatina – Awesome! Yes, most def. take advantage of it and keep yourself nice and healthy :) I’m glad to hear it!
    @Mr. Everyday Dollar – Nice! That’s not a bad deal at all.
    @My Money Design – I know :( I feel like it’s getting scarier and scarier as the years go by… politics get in the way of so much these days.
    @Ginger @ Girls Just Wanna Have Funds – Well the Mrs. still has maternity coverage on her plan, it just wouldn’t be covered if she joined mine without shelling out more money. So we’ll have to see what plan makes the most sense once it’s time for us to start making more babies again :)
    @Jen @ Master the Art of Saving – You don’t have insurance? Aren’t you worried/stressed in case something crazy happened? It freaks me out too much :( I hope you both remain safe until that time too! Don’t go skydiving or anything! :)
    @Jenna, Adaptu Community Manager – Yeah, that is nice actually. A small plus to it all :)
    @Brent Pittman – Oh, really? I wonder if ours will drop too then, even if we don’t have an HSA? Hmmm… that would be something awesome to look forward to!
    @Kira – For sure, I know it’s not FREE in the grand scheme of things, but it gets the point across as people don’t pay directly for their insurance in other countries – even if they pay more in other areas/etc. Didn’t mean to offend you though, so I am sorry if I did.
    @LB – I never researched health insurance for kids until after he was born cuz I knew I didn’t have a choice anyways – he needs it :) Now I could certainly research around more and compare other company’s plans and offerings, but honestly it’s too much work to save a few dollars right now. I’ve got my hands full with everything else now plus the new baby, so I just called them up and locked it in hoping they wouldn’t slam me. And unfortunately they did :( I’ll consider switching by this time next year and see where we’re at… maybe the wife will have a killer job and benefits by then?
    @Brian – Thanks man, appreciate the kind words :) Stop by any time!
    @ckphoto – Woahhh, GREAT POINT! And way to go w/ cutting back too like that, I don’t have the balls for that yet ;) Having a higher deductible and % paid scares me too much at this point, even though I know it would save me hunreds of dollars each month too. Ask me in about 6 months though when I’ve paid half of what you have all year and we’ll see if I’m singing the same tune, haha… thanks again for the reminder, my man.
    @Edward Antrobus – Oh jeez, that sucks man I’m sorry :( Hopefully one day we’ll be making enough where it doesn’t even matter! :)
    @DC @ Young Adult Money – Yikes! So glad y’all had some then – that could have been crazy!!
    @Wojo – Hmm… I’m thinking that maybe I need to re-think this in the near future and see what the fuss is about on these HSA plans… it never really crossed my mind even though I know people love them, but it may make more sense once we’re out of this more scarier time frame with babies when they’re so fragile :) Thanks for stopping by, bud – see you at FINCON I hope?

    Reply
  27. Jen @ Master the Art of Saving August 28, 2012 at 12:37 PM

    Totally, I’m always worrying, stressing, freaking out that something is going to happen. Last time I checked though, it would costs us about $400 for the crappiest plan they had. For a decent one, it was around $700+ a month.

    There are a couple of things we could cut from the budget, but that would only give us around $250/mo. We don’t really spend any money on entertainment or buying stuff, so it’s pretty strict already.

    Reply
  28. Donna Freedman August 29, 2012 at 2:23 AM

    I now pay $512 a month for just me. But as you know, illness can strike without warning. So can the front bumper of a texting driver as you head across the street.
    Witness my gall-bladder surgery a few months back. No symptoms, suddenly a lot of pain, and a couple of weeks later I’m having an organ removed. If it weren’t for insurance I’d have been agreeing to a payment plan for a boatload o’ bucks.
    Not that I was nuts about paying just under $2,000 for my share, mind you. But it beat the hell of the alternative. At least they let me keep those bitchin’ slipper socks. :-)

    Reply
  29. J. Money August 29, 2012 at 9:58 AM

    @Jen @ Master the Art of Saving – Hmm… yeah, def. tough without much income coming in.. are you at least saving some on the side just in case an emergency comes up? Even if it was only $100/mo? That will help you feel better a bit.
    @Donna Freedman – Haha… yes, there’s always that! Don’t forget about your new friendly mini-scars too – they’re always the life of a party :)

    Reply
  30. Jen @ Master the Art of Saving August 29, 2012 at 10:33 AM

    I have a Health & Dental (ING sub-account) that I’ve been putting money in here and there. It’s only up to $600, but it’s better than nothing. I just need to stay focused on increasing the income and things will fall into place. :-)

    Reply
  31. J. Money August 29, 2012 at 12:44 PM

    Oh, great! That’s def. a good start then :) Keep it up! And hurry up and make a million dollars from your blog too, okay?

    Reply
  32. John Egan August 30, 2012 at 6:55 PM

    One good piece of advice is that if you’re self-employed and have recently left a job, stay on your previous employer’s COBRA plan. It’ll save a pretty good chunk of change. Doing your homework and making sure you’ve sufficiently evaluated your options are keys to making sure you get the best health insurance coverage as a self-employed person.

    Reply
  33. J. Money August 31, 2012 at 5:21 PM

    Good one, thx! And sometimes even COBRA is too high if your old employer was giving you a great plan :) My old one would have cost me $800/mo just for myself, so I’d have to go on my own anyways, but you’re right – usually it’s a good thing to consider, even if just temporarily until you find a better one.

    Reply
  34. Cait Young November 26, 2022 at 5:27 PM

    I’m glad to be in good company. We are currently navigating the health insurance system in preparation for pregnancy and I want to scream. I’m finally making decent money, but the extra money we’re making is getting eat up by the monthly premiums ($775!) + out of pocket costs since insurance apparently doesn’t cover much until we meet our $7k deductible.

    Thanks for sharing your experience. Even ten years later, this post hits home.

    Reply
    1. J. Money November 28, 2022 at 9:52 AM

      oh man, you’re bringing back the memories!!!

      you or your spouse should switch and work for the government – their plans are amazing! lol… as soon as my wife got a job there the premiums took a nosedive and having babies cost pennies on the dollar. It’s amazing.

      but yes, without good insurance it’s a night mare. and even good insurance doesn’t always last :(

      hang in there… sending over good vibes!

      Reply

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