Health insurance problems

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On Thursday, the bad news I've been dreading for the past 6 months finally came in all at once. My wife's employer is no longer offering health insurance and we just got the renewal rates from my employer.

My employer is dropping down it's contribution towards the plan and rates have gone up significantly (over 20%). Our high deductible plan is now going to cost in the ballpark of $1,100/month or around $13,000/year.

My wife is pregnant and it looks like the birth will happen until Jan 3 or 4th. We originally had hoped that the OB could induce on Dec 29, to help make things more affordable (in and out of the hospital before the end of the plan year). It doesn't look like this is an option any more.

We really don't have room in our budget to pay that much per month. The plan has a high deductible, so we'd have to pay $1,100/month plus making repayments to the hospital (they want $300/month for 18 months). We already paid for our prenatal care, $2,500 which drained our HSA account.

I can always go to the VA but if I drop our family plan, my wife and kid will no longer be covered under anything. No private plan will insure a pregnant woman. We make too much for Medicaid and she's ineligible under our state's high risk pool because she hasn't had a 6 month lapse in coverage and is eligible for a group plan through me (it doesn't matter that it's too expensive).

Things are really bad right now. I currently work about 60 hours a week and am happy to have a job but my wife was cut down to 30 hours and is in a high risk pregnancy.

We really don't know what to do. It seems like our options are:

1) Keep the current family plan and pay for it by eliminating retirement contributions and taking out a second mortgage.

2) Drop insurance entirely and pay the hospital in cash and hope to God that nothing bad happens. If the baby winds up in the NICU or there are other complications, bankruptcy would always be an option. The worst part of it all is that the price I was quoted for a vaginal delivery was close to 2x more expensive w/out insurance.

3) Get a divorce and remarry after the baby is born and the medical expenses have been worked out. She'd be eligible for Medicaid if it weren't for my income.

I'm getting an ulcer and can't sleep from the stress of all of this. I can't be the only one in this situation. What has everyone else done?
 
Is COBRA an option on your wife's insurance? Not sure if that is cheaper than the deductible on yours, but perhaps it is a short term option until other insurance can be obtained?
 
Unfortunately, it's not an option. She's currently on my plan and our worst case fall back solution was to switch to her work's plan. But the plan is being done away with entirely and didn't include maternity coverage to being with (she works at a small business with 5 people).
 
There is no easy answer to your problem, it looks, from my limited view that your locked into paying the $1000.00 a month till the baby is born.

Then perhaps looking at a higher deductible plan.

you may have to quit your retirement contributions for a while till things settle down for you.

when it comes time to pay the hospital, sit down with their accounting department, and ask them for help. They would rather collect some money every month or week, then to get stiffed or send it out to collections.

If your a member of a local church, explain your situation and see if support is available.

Talk to the other folks at work and see how they are going to get by.

And on a last note, I live in MN and I work with a fellow that has a $5000.00 deductible plan and he pays in the mid $800 range for coverage for his wife and daughter and himself.

I pay almost $800.00 a month for my coverage. Until this year I never used it. But boy oh boy did I use it!

I hope some of this was some help, I will keep you and your family in my thoughts and prayers.
 
First take a deep breath and relax. Nothing bad has happened yet. I know, easy for me to say, but over my life, I have wasted a lot of time worrying about bad things that did not happen. I found it is easier to deal with bad things that do happen than to stop worrying about things that might happen.

Can you keep the health insurance until the baby is born and drop out mid-year when everything looks okay? Shop around for a cheaper policy after she is out of the hospital? Or consider putting some portion of the $1100, whatever you can into a your own medical fund. Then if something bad happens, turn it over to the doctor and negotiate a payment plan.

In the meantime look forward to the baby and enjoy every minute with him or her.
 
What is supposed to be a blessed event turns into a nightmare over insurance. And there are folks that think we don't need health insurance reform.

John
 
KB, why can't that early induction happen around the 29th? I'd continue to pursue that one by all means possible! I can't see why a medical staff wouldn't work with you on that one. Man I totally feel for you. I'm in a similar situation, 3 small kids and a 4th on the way this June. I've got a good paying job with OK family medical coverage, but there is no way I could swing even CLOSE to $1K/mo for medical coverage!! My wife has to work around my shift-work and I've got all I can do to pay for our very basic lifestyle. At $1K/mo I'd have to go without a medical plan and hope for the best. There ain't no such thing as debtor's prison.

Joel
 
"3) Get a divorce and remarry after the baby is born and the medical expenses have been worked out. She'd be eligible for Medicaid if it weren't for my income."


I think someone could come after you if you tried that in the 9th month!

Originally Posted By: JTK
At $1K/mo I'd have to go without a medical plan and hope for the best. There ain't no such thing as debtor's prison.
Joel


+1
BEST OF LUCK with your high-risk pregnancy and any complications you've encountered. We are sending a prayer to kb01 and Family.
 
Originally Posted By: JTK
KB, why can't that early induction happen around the 29th? I'd continue to pursue that one by all means possible! I can't see why a medical staff wouldn't work with you on that one. Man I totally feel for you. I'm in a similar situation, 3 small kids and a 4th on the way this June. I've got a good paying job with OK family medical coverage, but there is no way I could swing even CLOSE to $1K/mo for medical coverage!! My wife has to work around my shift-work and I've got all I can do to pay for our very basic lifestyle. At $1K/mo I'd have to go without a medical plan and hope for the best. There ain't no such thing as debtor's prison.

Joel


Same here pure insanity. The only good thing about working where I work (fortune 500) is that the insurance is only 75 dollars per month for a $500 annual deductible plan. I pray for you guys, that is absolutely terrible. Take care of the family and stress about the money afterward.

The hospital will negotiate with you, just go down there and THANK them for the great service that they did your family, and ask them for MERCY. Set up a meeting with one of the directors, and thank them profusely for their great care and services!

If you do it exactly like that, they will help you out. I've heard this scenario on dave ramsey's radio show at least a dozen times in the past year.
 
Originally Posted By: John_K
What is supposed to be a blessed event turns into a nightmare over insurance. And there are folks that think we don't need health insurance reform.

John


This is a result of the 'reform'. Insurance companies are being forced to do things and they are raising rates in anticipation.
 
Originally Posted By: JustinH
... The only good thing about working where I work (fortune 500) is that the insurance is only 75 dollars per month for a $500 annual deductible plan..


That is a good deal Justin. Mine is ~$200/mo, then a $550/person deductible, then 80% is covered with a yearly max out of pocket of $3K per person ($6K/family max). So I guess worst case scenario for me would be 'only' $3550 for the new baby. What ever amount of my tax return doesn't go to VISA is getting saved for that. Good times man. Given what I'm reading here, I'm grateful for what I have.

Joel
 
I really, really hate these stories.

KB my thoughts are with you and your family. We wish you well. Money comes and goes, but hopefully, your family will be "forever".

If it was me, I would drop retirement contributions and do everything you can to *not* pull that second mortgage.

If all else fails, dump your insurance and pay cash.
 
These stories make you think that the run away cost of health care and high insurance premiums along with employers dropping coverage (which is essentially a pay cut) are going to make everyone poorer. It's like people can't afford to have a child. Maybe that's the plan.
 
Originally Posted By: rshaw125
Originally Posted By: John_K
What is supposed to be a blessed event turns into a nightmare over insurance. And there are folks that think we don't need health insurance reform.

John


This is a result of the 'reform'. Insurance companies are being forced to do things and they are raising rates in anticipation.



Yes. Their shake down plans were being disrupted. They had to advance their calender before the door closed.

Business doesn't change. It reacts. This is nothing but business. Anyone who thinks otherwise is mistaken. We're the only ones held hostage by some emotional grip on the sanctity of life.

"How do you put a price on a human life?"

Ask the accountant at the insurance company ..the hospital ..the physicians boards. They do it easy enough ..and to the maximum amount that they can.
 
Originally Posted By: rshaw125
Originally Posted By: John_K
And there are folks that think we don't need health insurance reform.

John


This is a result of the 'reform'. Insurance companies are being forced to do things and they are raising rates in anticipation.

Pretty much. Health costs are pretty much unfordable for us as a nation bc of Dewey Screwem and Howe LawF irms and the extraordinarily expensive equipment drop retirement contributions. You can't be without health insurance.

Originally Posted By: mechanicx
It's like people can't afford to have a child. Maybe that's the plan.
Were I starting out again, that would be my plan for sure.
 
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As part of my work I see situations like this all the time (yesterday, for example, I was looking at an account where the bill was around $110k and the insurance paid $7,500 leaving about $100k as patient liability).

There are really crummy insurance plans out there and KB01 has one of them. I am guessing he works for a small employer....

The most financially prudent choice would be option 3 - divorce and Medicaid. But it is an emotionally difficult choice and most people do not do it. If OP's wife doesn't go on Medicaid, as a low income person she may qualify or charity care. Not-for-profit hospitals have to provide certain amount of community benefit care so if she has low income, even if above Medicaid maximum, she may still be eligible for charity care.

The OP may try to find a hospital whose mission is to provide care for the poor like Catholic care or any other religious hospital.

It's a tough situation and unfortunately, until all the provisions of the health care reform kick in in 2014 (provided the newly elected bums don't overturn it), things like this are going to happen.

Good luck.
 
Originally Posted By: rshaw125
"Divorce and medicaid". You mean get someone else to pay your bills. The taxpayer. I think this is also called mooching.

Well, if the system is that stacked against him, I wouldn't blame him at all...
The insurance companies don't exactly play fair so why should he?
 
Originally Posted By: IndyIan
Originally Posted By: rshaw125
"Divorce and medicaid". You mean get someone else to pay your bills. The taxpayer. I think this is also called mooching.

Well, if the system is that stacked against him, I wouldn't blame him at all...
The insurance companies don't exactly play fair so why should he?


Spin it anyway you want it is what it is.Someone else working to pay your bills.
 
Originally Posted By: rshaw125
Originally Posted By: IndyIan
Originally Posted By: rshaw125
"Divorce and medicaid". You mean get someone else to pay your bills. The taxpayer. I think this is also called mooching.

Well, if the system is that stacked against him, I wouldn't blame him at all...
The insurance companies don't exactly play fair so why should he?


Spin it anyway you want it is what it is.Someone else working to pay your bills.


True but isn't that what is happening when your employer cuts your health insurance and pays you a rock bottom low salary despite your productivity and worth? You are just paying his bills on his luxury items. No one is playing fair anymore, that goes for employers, health care, health insurance etc.
 
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