health care benefits

[kasia]

anyone care to share what their plans are like? this is the first time ever that i'm getting benefits, so i'd like to know how mine compares.

[Faithless]

anyone care to share what their plans are like? this is the first time ever that i'm getting benefits, so i'd like to know how mine compares.
First time ever, and how long have you been employed with the current comp? :frown:

I siphon off my wife's hospital benefits plan. Almost a 100% coverage.

We've had two kids and aint had to worry about the $10K-$20K price tag.

I've a bunch of sick leave and it's all acruable.

[kasia]

First time ever, and how long have you been employed with the current comp? :frown:

I siphon off my wife's hospital benefits plan. Almost a 100% coverage.

We've had two kids and aint had to worry about the $10K-$20K price tag.

I've a bunch of sick leave and it's all acruable.

i've never had a real job =p all of them were just externships/internships/clerkships.

so dental, vision, etc.? nice.

i wonder what i can get. contacts, glasses, lasik (?), my teeth bleached, etc. you think?

[Faithless]

i've never had a real job =p all of them were just externships/internships/clerkships.

so dental, vision, etc.? nice.

i wonder what i can get. contacts, glasses, lasik (?), my teeth bleached, etc. you think?
That's all in your comp's set plan and whatever else you can negotiate.

With wifie's medical, dental is covered 100%.

Eyecare, too, as far as I can tell, because I only go for checkups. No glasses.

[kasia]

That's all in your comp's set plan and whatever else you can negotiate.

With wifie's medical, dental is covered 100%.

Eyecare, too, as far as I can tell, because I only go for checkups. No glasses.

o damn. i thought i could maybe get an extreme makeover for free =p

[myself808]

My advice, stay away from HMO care. if you can. No health plan will pay for *non-medically necessary* procedures, no plastic surgery, lasik or anything cosmetic of any kind unless doc says so, same with dental. no teeth whitening, gold caps or fillings. vision usually provides a $ limit. you can get either contacts or glasses paid for, unless you have 20/20 vision, but if you want designer frames, colored or disposable contacts, you will have to pay the difference.

[lethal]

I had an HMO, so for regular doc visits the co-pay was $15 bucks. Co-pay on scripts was $10.

Dental care was covered at 80%, so I paid 20% except for regular check-ups and cleanings, which were fully covered.

I had no vision coverage.

There was a flex plan under which you could put pre-tax income in and be reimbursed for health care expenditures from. These expenditures included contacts, glasses, eye exams, contact lens solution, pretty much anything medically related. The purpose of this plan was to lower your gross income for tax purposes saving you money on taxes at the back end.

[Chris]

I have HMO, 10 dollar copay, 50 Hopsital, 250 emergency.

Dental 90% covered with check up and clearing coverd.
No Vision.

Flex paln as well.

[rice cracker]

I don't even know. I just pay $10 for medicine and I think $15 for appointments. My dental check ups are free, but for things like fillings and other oral sugery I'm not sure what I would have to pay. I'm so unhelpful :(

[nifer]

i have a PPO (blue cross personal choice) for health/vision and aetna HMO for dental.

i pay about 60$/month for the two combined.

basic health is pretty decent, i can go to any doc (any most specialists) i want w/o a referral. i think my copay is 15$. rx's are 15$ for brand, 10$ for generic. i went to the emergency room once, the bill came to about 1600$, i only had to pay 25$ :biggrin:

vision is lacking. free eye exam, 60$ frames, 50$ lenses. i just spent almost 500$ on my new pair of glasses and that's the total AFTER my health coverage.

dental is ok. i need to go to a doc in network. cleanings and amalgum fillings are covered, i'm not sure about anything else

[Green_Jade]

I miss my student insurance.. my dr. visits were covered.. and most diagonostic tests.. although they only covered MRIs upto 1000 bucks..grumble.

...kinda on topic with this post..anyone know of a cheap short term medical insurance?

[Oblivious]

i've got shitty ol' HMO. LOL
my company pays for it, so no monthly fee for me. :biggrin:

80% for dental. (Metlife)
$15 copay for doctor visits. (Blue Shield - Access + HMO Plan 15)
$15 for presciption drugs.
vision - i don't know yet. still gotta go. :tongue:

get PPO if you can afford it. :wink:

[nifer]

I miss my student insurance.. my dr. visits were covered.. and most diagonostic tests.. although they only covered MRIs upto 1000 bucks..grumble.

...kinda on topic with this post..anyone know of a cheap short term medical insurance?

look up COBRA. i'm not too sure how "cheap" it is though, but it is short-term

[kboy75]

Well, I used to work in a healthcare IT company. I didn;t actually do healthcare, but i learned the different between various plans.

I mean, let's be practical.

As much as people harp on HMOs, I feel like they are just doing that because they've just heard a lot of bad stuff about the "big bad HMO". If you are a young, healthy person, an HMO is your most cost-beneficial option, most of the time.

I for one, had an excellent health plan at my last job, and I liked the freedom of a PPO, which really was not that much more outta my pay check. I did have a couple of minor health issues, so it was worth it for me.

If your employer uses a major healthcare provider, it is most likely just fine for your needs, especially as a young 20 something. When you start to scrutinize is when you get older and actually start having to USE all of the services. Half of the stuff you see on there (your plan)... you will probabaly never even come close to using.

If you have a specific need, like dermatology, orthadontia, etc. look into a medical spending account benefit that your employer may provide and what may qualify. it is pre-tax, so it is deducted from your gross income.

For me, what is important in a health plan is:

- freedom to go to any specialist w/o a referral from a primary care physician.
- low co-pays for office visits and prescriptions drugs
- dental and vision

that's about it. I guess you can include a low deductable for more serious stuff, but chances are you will never use this benefit if you are relatively healthy.

[Faithless]

look up COBRA. i'm not too sure how "cheap" it is though, but it is short-term
Good suggestion.

Here's a link to some facts. One problem might be the timeline for qualification:

COBRA duration (http://www.cms.hhs.gov/hipaa/hipaa1/cobra/duration.asp)

[Green_Jade]

Good suggestion.

Here's a link to some facts. One problem might be the timeline for qualification:

COBRA duration (http://www.cms.hhs.gov/hipaa/hipaa1/cobra/duration.asp)

sniff.. I knew about COBRA, not that it helps me any..since I've yet to have a full-time job.

grr.. i should move to Canada and become a citizen.

[Faithless]

sniff.. I knew about COBRA, not that it helps me any..since I've yet to have a full-time job.

grr.. i should move to Canada and become a citizen.
Awwww. :frown:

It's curious that the health care industry can provide some pretty mediocre to poor benefits. Outside of the hospitals and what not, you see where the smaller outfits don't do as a good a job for their employees.

(I'm thinking of the home care nurses and the like.)

[moJo]

i have Kaiser for medical, SafeGuard for dental (though i can switch to Delta at the next open enrollment), and VSP for vision.

i had PPO most of my life, when i was under my dad's plan. i liked that a whole lot better than what i have now. having a doctor to go to instead of heading to a big medical building in a crappy-parking part of of the city. also, being able to go to specialists directly was nice.

[iris]

I definitely know I'm getting screwed. I'm getting a 50/50 Health Plan from my company and no dental. What is fair is 80/20.

[teaz0r]

doctor visits and prescriptions is 100%
if i'm admitted to a hospital, they pay
for my room at a private hospital.
i dunno about surgery. i forget.

i can get contacts, clear ones but not coloured.
dental, but not cosmetic dental work.

[Faithless]

I definitely know I'm getting screwed. I'm getting a 50/50 Health Plan from my company and no dental. What is fair is 80/20.
That does suck.

Is everyone else in the same boat (figuratively)?

[iris]

That does suck.

Is everyone else in the same boat (figuratively)?

In my company? Yes. I don't know what I can do about it. I just hope I don't get majorly sick.

I'm going to bring it up at the next company meeting and let it be known that I don't think it's fair and it should be adjusted.

[lethal]

Oh, the firm paid all the premiums at my last job. I'm sure it came out of my salary somehow, but it lowered my tax burden then.

I'm not sure how other places work.

[Faithless]

In my company? Yes. I don't know what I can do about it. I just hope I don't get majorly sick.

I'm going to bring it up at the next company meeting and let it be known that I don't think it's fair and it should be adjusted.
What's a person to do, except fight a little for it, when there's leverage, or seek a better benefitted job.

Do you work for a small company?

The New York Times put out an article, talking about the increasing cost of health care. Small companies really feel the pinch.

Soaring Health Care Costs Leave Little Companies in a Bind (http://www.nytimes.com/2004/02/24/business/businessspecial/24ANDR.html?ex=1078290000&en=cd5a41e239faf810&ei=5062&partner=GOOGLE)
...
Among small-business owners, health care costs are issue No. 1, and the reason is simple. While those costs are rising at double-digit rates for almost everybody, leading to higher numbers of people without insurance, they have climbed even faster than the average for small companies, which were already less likely than large employers to offer any kind of health insurance.

Only about 47 percent of small companies offer health insurance, according to surveys by the National Federation of Independent Business, an advocacy group in Washington — though the figure is significantly higher, above 70 percent, for companies with more than 20 employees. By contrast, 98 percent of businesses with more than 200 employees offer coverage.

A survey of 2,800 companies by the Kaiser Family Foundation last fall found that insurance premiums increased 15.5 percent in 2003 for those with fewer than 200 employees and 13.2 percent for larger enterprises.
...

But those are just stats.

Does your employer have some sort of benefits plan committee? Is it possible to look at alternatives?

One article on the web talks about exploring a "high deductable health insurance plan":

http://www.journal-topics.com/columns/thisway040204.html
As an example, consider a family of 4, two adults age 40 and 2 children, using a traditional PPO with a $1,000 deductible for each person up to a maximum of $3,000 for the entire family. The cost of this type of policy was approximately $542 per month last year. If this same family looked at a deductible plan of $3,500 deductible for the entire family, the cost of that policy would be $376 per month. This is an annual savings of $1,860 per year, which more than covers the additional $500 deductible required.

Just one example. Not necessarily the best.

[Chris]

pinning...

[artsfartsyjanet]

How soon after all of you started working do you get health care benefits? Day one? After your first or second paycheck?

[Faithless]

How soon after all of you started working do you get health care benefits? Day one? After your first or second paycheck?
We negotiate it to happen right away for those who qualify for bene's -- as long as a provider is picked, or else the default is given.

Don't tell us your new job isn't giving them to you right away.

[artsfartsyjanet]

We negotiate it to happen right away for those who qualify for bene's -- as long as a provider is picked, or else the default is given.

Don't tell us your new job isn't giving them to you right away.

haha..no, it's right away. i was just wondering. the benefits stuff is new to me.

[Green_Jade]

I had to wait three months for my coverage to kick in.. but it's pretty good.

I think it's a PPO, the group plan calls it Choice Plus, but from the benefits, it sounds like a PPO.

I can go see whoever I want w/o a referral, $20 co-pay for PCP/Specialists, $35 for Urgent Care, and $50 for Emergency most other major medical is covered %100 in network with prior approval. Of course, no dental except accident related stuff and all mental health needs prior approvel from a 'mental health designee'.

Now if I can only see all the specialists I need to see in one place..I'd be set.

[hooligan]

full time research assistant, health, but i have to work 6 months to get dental and vision.

[kasia]

full time research assistant, health, but i have to work 6 months to get dental and vision.

do you know what your dental and vision cover?

[hooligan]

do you know what your dental and vision cover?
No, I don't, but it's with the general PPO that covers all of UCLA. I'll let you know January 3rd when I go sign my contract.

[artsfartsyjanet]

do any of you consult anyone else about what is the best benefit option for you? or no?

[nola]

What kind of services does one get with Choice Plus Preferred Provider?

[artsfartsyjanet]

all these plans are confusing... not sure which is right for me.

what kind of questions do you ask yourself before choosing a plan?

i need time to think about all this before work on monday.

[nifer]

full time research assistant, health, but i have to work 6 months to get dental and vision.


wow.. you work in academia and have to wait 6 months for full benefits? :eek: usually non-profits offer great benefits to counter the less than stellar salary... at least that's what i've experienced ;)

[Hanuman]

I used to have a PPO and I felt their coverage was much better, though I think I had to wait 6 months for it to kick in.

Now I'm on GHI and Blue Cross/Blue Shield. It's been ok so far, $10 co-pay for doctor visits. I chose this plan, because I'm the type of person that rarely goes to the doctor unless something is very wrong with me, so I thought this plan would be fine for me, especially cause this plan costs me nothing a month. Their are other plans that would give me a little better coverage such as lower dedectables on hospital stays and all that. I'm thinking of upping my coverage, but with my employer we can only do that in the small window of November 1st to December 1st, so now I have to wait to next year.

Vision and Dental are covered by the union plans, so they allocate 1 doctors exam every 6 months and either contacts or glasses every 6 months. I'm not sure how extensive the dental is.

[Faithless]

all these plans are confusing... not sure which is right for me.

what kind of questions do you ask yourself before choosing a plan?

i need time to think about all this before work on monday.
What did you go with?

Anybody ever hear of Consumer Driver Health Plans (CDHP)?

[hooligan]

wow.. you work in academia and have to wait 6 months for full benefits? :eek: usually non-profits offer great benefits to counter the less than stellar salary... at least that's what i've experienced ;)

I don't get a "stellar" salary. Yeah, waiting 6 months does suck, I wanted to get my eyes checked. It turns out I signed onto Kaiser's HMO and I need to look into that some more.

[Faithless]

anyone care to share what their plans are like? this is the first time ever that i'm getting benefits, so i'd like to know how mine compares.
Quoting the same post again.

I think being able to compare your employer's healthcare relative to others (in the same industry) is probably a worthwhile endevor (whether you can do anything about it or not).

http://www.chcf.org/

If the business forum could use another sticky, it might be one about good resources for examining/comparing healthcare costs.

According to another link (http://www.chcf.org/documents/insurance/OnlineInsuranceTA.pdf) on that site, there are websites that examine the quality of some healthcare plan providers:

http://www.ahrq.gov/ (Agency for Healthcare Research and Quality)

http://www.ncqa.org/ (National Committee for Quality Assurance)

[Chad]

Blue Cross Blue Shield and don't have a dental plan. I don't ever go to dentists anymore since this one tried to rip me off a few thousand. I don't think dentistry is really necessary unless I get some infection. I'm missing two teeth on my lower jaw but they weren't very important ones. I think a lot of people live without dentists, so I can too.

[Faithless]

Blue Cross Blue Shield and don't have a dental plan. I don't ever go to dentists anymore since this one tried to rip me off a few thousand. I don't think dentistry is really necessary unless I get some infection. I'm missing two teeth on my lower jaw but they weren't very important ones. I think a lot of people live without dentists, so I can too.
Well, if you believe that whole thing about preventive maintenance, then you got to go to the dentist for regular check-ups to reduce plac and lessen those "pits" that can lead to all-out tooth decay.

I've actually asked my dentist to schedule me three visits a year.

[Hanuman]

Speaking of which, I just got told I'm going to have to have all four of my wisdom teeth removed....My insurance covers that, but to be put under, I'll have to pay out of pocket for the anesthia, what kinda horseshit is that?

[deez nuts]

Speaking of which, I just got told I'm going to have to have all four of my wisdom teeth removed....My insurance covers that, but to be put under, I'll have to pay out of pocket for the anesthia, what kinda horseshit is that?

bring your own anesthesia.

ye ol bottle of jim bean.

[kimpossible]

Speaking of which, I just got told I'm going to have to have all four of my wisdom teeth removed....My insurance covers that, but to be put under, I'll have to pay out of pocket for the anesthia, what kinda horseshit is that?


That's actually not bad if all you have to pay for is anesthesia. My anesthesia was covered but the procedure was only 50% covered. Good luck with it. I had all four teeth done at once. Had a week full of Ensure and rice gruel diet after that.

[Arex]

Speaking of which, I just got told I'm going to have to have all four of my wisdom teeth removed....My insurance covers that, but to be put under, I'll have to pay out of pocket for the anesthia, what kinda horseshit is that?Local anesthetic should be fine. My girlfriend had three of her wisdoms removed in one sitting and she was awake the whole time. Although I guess it depends on how impacted they are.

Of course, this is coming from the guy who was put under to have four of my pre-molars removed back in high school.=)

[tommyhtown]

That's actually not bad if all you have to pay for is anesthesia. My anesthesia was covered but the procedure was only 50% covered. Good luck with it. I had all four teeth done at once. Had a week full of Ensure and rice gruel diet after that.

A little over a year ago, I paid a little less than $300 total to have four of my wisdom teeth removed. And anesthesia was used. After that, I had SlimFast, Ensure, Campbell and Soup-in-Hand for almost a week.

I'll be out of my COBRA coverage at the end of the year. I have to start looking for insurance now and also start reading up on preexisting condition, continuation/discontinuation period of coverage, and HIPPA.

[TB4000]

About to use this Blue Cross next week for dental work, and may use it again to get some more contacts. When you get down to your last pair, these bastards burn.