Wednesday, August 10, 2011

Insurance Woes

With my birthday coming up soon, it is once again time to learn what my health insurance premiums will be for the coming year.  My policy renews automatically each year and I have nothing to do but make sure that the premiums are ALWAYS paid on time.  As long as I stay paid-up, the insurance company cannot drop me as a customer although I've become expensive for them.

Since I am self-employed, I have an individual health insurance policy.  I obtained it 11 years ago when I shopped for the very best coverage available to me.  At the age of 32, my monthly premiums were $151 for a 'preferred provider' plan.  My copays are $25 for any doctor's visit; my coinsurance for covered services is only 10%; my deductible is a small $100; and my out-of-pocket maximum for medical care is $2500.  My prescription coverage is limited to $1500 each year, however.

Over the years, my insurance premiums have increased at varying percentages.  Last year the increase was 8.4% and this year it is 7.7%.  In 2009, the increase was 31%.  That was outrageous!!

So this coming year, my monthly premium will be $503.  That's a total of $6036 for the year.  I have to earn $9000 to cover that expense after taxes.

I was curious about what my same policy would cost a new customer, so I ran a simple search on my insurance company's website.  For a medically underwritten plan such as my own, a perfectly healthy person would be charge $516 monthly.  Just a tad bit more than I pay now.

My insurance company also offers HIPAA insurance plans for people who may be on a COBRA extension of group coverage and need to transition to an individual policy.  The HIPAA plans are much more expensive because they bypass medical underwriting and will cover patients with pre-existing conditions.  The HIPAA version of my same insurance plan carries monthly premiums of $1260.  

Can you imagine paying $15,210 each year for insurance coverage?!!  I can't.  This is the most expensive plan offered by my insurance company.

Looking at numbers like that just reinforces how important it is that I DO NOT LOSE my health insurance coverage no matter what.  It would be too risky to switch to something else.  I'm locked in for the long haul.

Maybe it helps to think of the $503 monthly check as not just current medical coverage, but insurance against having access to insurance for years to come.  At least that helps me feel somewhat better about the cost.

How about you?  What is your monthly health insurance premium and what does it cover?  What are your copays, coinsurance, deductibles, out-of-pocket maximums, and other coverage/restrictions?


  1. Omg!!! Yes. I am in cobra and pay $271 with a $40 copayment. If I don't get a job by mid next year I will be in that $1200 category. The thought scares me because I can't afford that and will have to just be without.

  2. I'm one of the lucky ones--I'm on Medicare. It's very easy to support cuts to Medicare until you rely on it.

    Before Medicare took over, I was paying over $800 per month for private insurance (as part of a group.) I woke up the other day and realized that if I had to apply for health insurance coverage now, I could be denied--I've taken medication for migraines.

    A few weeks ago I met someone in an RV park. After he told me about his two kidney transplants, we got embroiled in a political discussion. After I determined that the government had paid for his new kidneys and is still covering the costs of his medical care, I gained a new understanding of politics: The government should make cuts, until it cuts me.

  3. Hi - ya, insurance woes for sure. I pay $446.00/month for now. I am eligible for Medicare on 11/1 this year. I chose Medicare as my supplemental insurance and Connecticare as my primary with the zero dollars premium option. My social security disability will be tapped $115.00/month towards Medicare. I have an access/free program for the Avonex. Also, my husband pays $446/00/month too. We will be in better financial shape once I am on Medicare, not much, but some.It is all so awful.
    Love Gail

  4. I work with an organization that helps patients receive medical care at an affordable rate. While we cannot take away the expenses completely, we try to lessen the burden as much as possible. Visit our website for more information on our efforts, and to learn what you can do to help us, help so many.

  5. I'm on Medicare, but also a stae program, that is cutting out my primary care Dr next year so I must change, I pay nothing, I DO pay $5 co pay for any Dr appt and all of my one spasticity drug--deductible is like $350, THEN I pay for dental ins., honestly...I am not sure...$15/month and $1,000 deductible or some nonsense. My PARTNER is on Medicare, pays $400/month for total coverage through university retirement ins. SHE has many expenses though. How anyone on Medicare alone gets any quality medical care is beyond me. Almost her ENTIRE SS goes to health care. I voted for Obama to FIX this for "the little people." HA! Next.

  6. I work for private industry and contribute $330.55 per month for my health and dental insurance. It's for me and my boyfriend. There is a $3000 deductible per person out of pocket deductible, but I believe that if that happened, the employer will chip in $2500 of that. I pay $20 per regular doctor visit and $30 for specialist and scripts are $7 - 75 depending. I get help from ENBREL support for the $50 per month copay.

    I believe I'm very lucky with my benefits - they've not always been this generous. I also work hard and struggle with staying at this job, and when I have my worst days, I remind myself that the benefits are so good and I need them!!

  7. Lisa, I'm on Medicaid and I pay nothing for it.

    In return I get virtually nothing for it. I'm "in line" for an emergency colonoscopy that the doctor wanted me to have back in's August now.

    I guess the only positive thing about Medicaid is if they "approve" of the drug, it's copays. And if you can find a doctor that accepts Medicaid, no copays.

    If I had private insurance I would have had my colonoscopy in June.

    Even the doctor admits that.