Saturday, February 1, 2014

Health Insurance Under ACA

Here's a short video where, a few days ago, a local news station filmed an employee meeting, in a small town near Pittsburgh, where the people working in this small business found out how the ACA has affected their personal coverage(monthly premiums and co-pays and deductibles).

Nobody in that room looks very happy about the financial changes, do they?
I can imagine this scene was being played out at many businesses in January.

I really feel for "Judy" in this clip.  She's about my age and her premiums went up by $431 per month from last year to $1360 a month this year, plus her Deductible went up to $4K a year.

This means with just premiums, she is paying $16,320 a year and if she actually uses her medical coverage up to the deductible, she will have spent $20,320 minimum on her health care.  After that huge yearly expense, then she gets the added joy of paying for co-pays, co-insurance and the %s of health related expenses that she will still be responsible for.
And you know, working at a small body shop business, "Judy" is not earning big bank.....

We paid $5892.12 in premiums last year for our insurance.  Add in another $1,158.56 for Vision and Dental premiums and it comes to $7,050.68.   Hub's employer does chip into help on the cost of the premiums so it could be worse on that score if he worked elsewhere.  Heck, we could be paying as much as "Judy" will this year if not for the largesse of Hub's employer!

You can tack on another $2K for last year's deductible, another $1500(at least)for prescription copays, and other OOP we paid of $2,967.99 and our direct medical expenditures for 2013 came to $13,518.67.

Our deductible went up in 2014 to $3K, and like I found out earlier this month, our prescription plan is NOT exempt from meeting this deductible(meaning we use to not have to meet it with money spent on rxs)so we are going to be paying through the nose toward this deductible right from the start.
But when we crunched the numbers of a high deductible plan with lower premiums versus a lower deductible plan with higher premiums, this coverage will be lower overall for us.....we think.

But it is still going to be more expensive by far than last year's plan.  Between the premiums and that $3K deductible we are already $9,285.00 in the hole for healthcare before we receive ANY benefits on the coverage.

Since we(or rather me)uses out coverage on a regular basis throughout the year for my chronic conditions, that means we need to come up with $3K pretty much in the first few months of the year, since I'll be getting drugs, having office visits and using durable medical equipment every month from Jan. 1st onward.

We have the cash set aside in savings(plus are dumping salary into a HSA) to cover this $3K right away(though I hate the thought of using the after tax basis savings if there isn't enough in the pre-taxed HSA by the date a deductible has to be paid)so we don't have to worry about not being able to go to the dr., get medicine, have tests done, etc. until after we've received enough paychecks this year to cover those costs.

Imagine someone who has little to no emergency fund having to meet a deductible amount like this(let alone pay out hundreds in premium money from their paychecks)when there is little money leftover each pay after you pay the fixed bills(including those premiums), taxes, the utility bill and put food on the table.

Just another reason why we all need to live BELOW our means and put away as much as we can for emergencies and the unavoidable unexpected costs in life.




  1. This video absolutely breaks my heart. It just BAFFLES me that people (myself included, but not as high as these individuals) pay so much each month that covers absolutely nothing until an outrageous deductible is met (i.e. for me, I pay 100% *no co-pays at all, until I reach my deductible.. then it turns into 80/20 before I reach my annual deductible). But nonetheless, I'm so incredibly grateful to work for a company that has the ability to cover a large chunk of the cost.

  2. My daughter works for and is insured by NYU, and I hope this does not adversely affect her. I think not. The other two children work for school systems. I wonder if all this will affect them negatively. It is scary to hear these stories.

    1. NYU is a HUGE entity, supported by NY tax dollars. NY taxes are among the highest in the country so that school system has large pocket in which to subsidize employee insurance coverage rates. But I don't know what kind of "deal" employees get from this employer but it's probably highly subsidized(and NYU prolly gets large discounts from insurers too).

  3. We are the only country in Western civilization that doesn't have universal health insurance. I think this is wrong, especially as we are so much richer and allegedly a Christian country.

  4. This makes me so mad! We pay $90 a week and Den's company picks up the majority of the tab on this one. And the kicker is the doctors that we have to use treat us like shit because they lose money on our kind of insurance. So we pay for this crap and don't use it because they walk in, say you have a head cold or are depressed and take the co-pay with never treating you. It is absolutely pointless to go to the doctor. This is just a new tax.


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