Health insurance Question HELP

[Boyd R]

With rising costs I was forced to drop or insurance 1 1/2 years ago and self insure under a catastrophic plan. $5,000 deductable, then 100% up to 3,000,000 and my out of pocket $51 a week with a health savings account attached. Every 6 months both the premium and deductible go up with cost of living. YES DEDUCTIBLE also, now at $5,600.
Su and I have had our worst year ever medically and our total health care costs including prescriptions, and insurance cost for the year has been right at $5,500 for the year.

She has the opportunity to get insurance through her employer.
It is the Cigna Gold plan. $1,000 deductible 20-80 after that. Our out of pocket woul be $87 weekly. If we would have had this insursance this year our total out of pocket was right at $6,100
Her insurance comes with $10,000 life for her, She also has that Aflac Cancer policy already, not tied in with this. $10 every two weeks.
Mine comes with Pay at the door price reduction in dental and vision.

Part of the kicker to this is employer contributions. I could take the $200 a month of contribution and give myself a raise. Her employer would kick in $142 a week. No way to know if they would consider that in her next raise. Or even look at it as she is now to expensive to keep around and would look for ways to terminate or demote.

For those of you that study you insurance policies and have a good grip on them what do you think we should do?? I hate this kind of stuff and gives me a severe headache.

[CarolU]

I can't advise you what to do Boyd, I think I'd talk to my CPA and see what they say. With those figures, it certanly appears you'd be money ahead to cancel your insurance and put that money in savings for when/if. Especially since Su has catastrophic with her policy.

The new Health Care rules with the IRS allow you to put money in a special savings account that is tax free to pay out-of-pocket costs with. Also, anything over a certain amount out-of-pocket in medical bills (and I seem to remember it as $500) is tax deductable. Talk to your CPA about both.

Self-employed people and small businesses really need to combine forces and lobby for insurance reform for individuals. Those prices are rediculous.

[paintedhorizon]

Def. take it Boyd. However, know that since you are coming from an individual policy to a group policy, you may have a waiting period for whatever medical problems you have had

[Boyd R]

Carol I think you are backwords
We have the Catastrophic now
Su has the opportunity to to get 80/20 coverage.
We currently have a health savings account, You have to have a catastophic plan to have an hsa. the Max you can have in it can equal only your deductable. it draws 4% interest but has fees associated with it so they basically steal back your interest. I am thinking about dropping it.
Also on medical expenses I beleive and I may be wrong the threshold is 7 1/2 % of your adjusted gross income. So for us we would be able to dectuct once we get to $3750. Plus I am paying my premium after tax.

Now if I spend the max on my catastrophic, to get to 100% coverage I will be at $8252

With the normal 80/20 I would have spent $5524. A savings of only $3273
but still owe 20% on anything else incurred.

Our biggest risk is Cancer and have that covered under the Aflac cancer policy. Which is seperate from both of these and is only $5 a week.

This to me is a no brainer to stay with catastrophic but yet I feel like the 80/20 is what I am suppose to do. It is almost like only knowing to ride english and someone throwing a western saddle on my horse.

[GeorgeGuns]

I spent a couple years working for a health insurance company, and my dad has great experience withit too:
IMO you ought to keep things as they are. The deductible may be lower with Su's work plan, but 20% out of pocket can really add up tremendously and leave you with astronomical bills should something terrible happen and hospitalizaton or very expensive medications is necessary. With your current plan, you know what your ceiling cost is, and can plan for that.

The only other option I would think of is looking at yet more indivicual plans that may taylor to your needs, ie: I don't and won't need maternity care, or child care, and some companies are starting to look at this. The drawback to changing though is that you now have pre-exisiting conditions, and MANY companies won't cover squat for pre-existing conditions for anywhere from 90 days to a year! Read your plan or prospective plans thoroughly - don't go by the simple handouts that HR gives, ask to see the whole plan book.

Su should be able to get the Life independantly of the health insurance, its two different matters. $10,000 isn't much for life insurance, might not even be worth it. I'd be much more concerned about getting a good disability plan, both short and long term. IMO, unless the employer has a really killer Life insurance plan, its worth it to shop and get that independantly too. Points to consider for life insurance are Term vs Whole, and wether or not you can borrow against the policy - most will let you borrow up to the amount (or a percentage) you have paid into it already, some will let you borrow against the amount of the policy. Some life policies also will pay out early in the event of a catastrophic and definately terminal illness: this can be really important if hospice care becomes necessary as most plans have inadequate hospice coverage.

Hope this helps!!

[motorgypsy]

My gut feeling is that catastrophic is the major worry. As long as you have a plan to take care of your deductable on that plan at least you know you can't be bankrupt by a major health problem with catastrophic. Our plan was the reverse and if you ran up a huge bill you really could lose everything to pay for catastrophic illness. Catastrophic is the type of plan Hilary Clinton was trying to get the country to underwrite so that private individuals could afford health insurance for anything other than major catastrophic but we all know where that went along with our surplus. But that was our big worry and of course long term care if we ever need it. Good luck!!! It is indeed a headache!