Thursday, February 11, 2010

Crappiest Health Plan Around (or so it feels). How is this fair???

Why is it just when I think we might be ok financially a landslide happens?

When Craig first started working at his current job in 2005 they offered a wonderful Premera health plan. It was so wonderful in fact that when Craig's accident cost about $300k we ended up only paying a total of $5k or less. Then they majorly downgraded us to a KPS high deductible plan 1 month before Eliana was born. Nice timing, huh? With a $3500 deductible we were pretty pissed. Luckily I still had Aetna through Bank of America and the birth didn't end up costing us too much. Well, only 17 months later we have been switched again. This time to Regence with a high deductible plan. Only now it's $5000. I want to crawl in a hole and not come out. The stress and fear of what this means for us is literally right under my skin threatening to make me scream or sob at any minute. My biggest issue is that when we have another baby it'll cost us over $7500 out of pocket. Money we don't have and won't have. The $5000 deductible is only a deductible, meaning once we've met that it's not like everything is all the sudden 100% paid for. We still have to pay at least 20% for everything even after paying the $5000.
I know you're probably thinking, "what about DSHS, Medicare, Basic Health, etc?" Bottom line: we don't qualify for any of that. Yes, it's by a narrow margin, but it's enough that every questionaire comes back, "you make too much". And you can only have $1,000 of cash and/or savings. Well, sorry. I need to have more than that just to pay my mortgage!
I also just learned that the lab work done for Craig is costing us $1200. Plus another $225 for the 10 minutes the dr saw us. Wouldn't a caring dr let you know that a particular lab workup is expensive? I know dr's do not work for insurance companies (although they pretty much do), but even still I think they know a general ballpark of which procedures are cheap and which ones cost a lot. A heads up would've been nice. Instead we have no grocery money for 4 months. Awesome.

It's just so frustrating. I realize that not everyone even has a job right now and I am thankful Craig is working. He was laid off for nearly 3 months 10 months ago and I'd rather not do that again. However it's angering how hard he works and the extra time he puts in (with no overtime pay) to then just have our health plans reduced and reduced and be left with basically nothing. And they didn't even tell us! I had to find out on my own as nothing was sent to us from the company, or Regence for that matter. I almost feel like everyone was hoping we wouldn't notice our already crappy deductible just got worse. I heard things were changed because insurance premiums rose 40%. Why is that? How is that even legal for the insurance companies to do that? I know my anger seems aimed at Craig's employer, but in the big picture it's the whole stupid way that health care is organized in the US. This is not exactly a political blog but I will say that although I am a conservative Republican, in times like these I understand why Obama is trying to reform healthcare. It is absolutely wrong for a hardworking, middle class family to not even be able to afford to go to the dentist, or get eyeglasses, or see a physician should they get an infection, or want to have a baby. Something is seriously messed up!
Oprah had a show about life in other countries and I believe it was Switzerland (or someplace in that region) where they said they pay 50-60% income tax. However, in exchange for that they receive a FREE University education, FREE childcare, FREE medical care, 6-12 months government paid maternity leave,  up to 7 years of 80% pay when you lose a job, etc. We already pay a lot in taxes, I wouldn't mind paying 1/4 more and getting all that stuff in exchange. A huge stress for me is hoping we don't get sick or need to go to the dr. It would be really nice to know we could get medical care without the ensuing crazy bills showing up.

Sometimes I feel like we'd be in a better boat if Craig just quit. Then we'd at least qualify for state health and could have a baby without our house going in foreclosure. We either need to make more money to afford to pay all these crazy bills, or make less so we qualify for help. This 'middle class' thing sure sucks. What a jacked up system we live in!

4 comments:

  1. Hugs Diana. That sounds very awful and stressful! We luckily don't worry about paying for our health care...benefits with the military can be nice...you just have to put up with not having a husband 6+ months a year! It's always something, huh? Hang in there!

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  2. I'm sorry friend. We're dealing with a similar thing. Joe got laid off 2 weeks ago so we lost his health insurance and my work's health insurance is not nearly as good AND this year they raised both what we pay for insurance and the deductible. We also marginally do not quality for Oregon Health Plan (we would if you counted net income but not gross).

    Try talking to Craig's Dr. My OB had me getting ultrasounds every 4 weeks to track growth of the munchkin b/c I am hypothyroid. When I called and told her assistant that DH was laid off and would now have to pay $80-$100 out of pocket for each ultrasound plus 30% of all lab work (and I have to get more lab work than a normal prego, too) so we needed to reduce both to a minimum she said we could reduce the ultrasounds to every 8 weeks AND she'd give us a discount on them.

    We also learned the hard way that you always have to ask exactly what cost for all the lab work (and other procedures) they want to run is...and if/how much is covered by insurance (their office should be able to call to find out for you). How they bill the insurance can make a difference, too (a previous insurance we had, for example, covered "routine lab work" but not "diagnostic lab work.").

    Good luck and hopefully you'll be able to navigate this well!

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  3. Given this horrible experience in your lives, it is beyond puzzling why you would still affiliate as a conservative Republican. Can you not see the GOP is plenty OK with we middle-class drones being pushed to the bring to pay for healthcare? It certainly hasn't been the Democrats who have brought us to this situation, seeing as the country was in GOP hands for eight years as this current situation evolved. Republican leaders care only about two things: legislating their religion into our laws, and protecting their businesses from having to spend one red cent more than necesssary. And thus, you and I get royally screwed. The difference is I saw the absurdity of continuing to believe Republicans care one whit about people like you and me.

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  4. Dear Anonymous:
    There are some truths that I hold to be fundamental and absolute and these truths are why I still affiliate as a conservative Republican. The sanctity of life in any stage and the structure of a family are very important to me. For me there is no separation of church and state. So 'legislating religion into law' is actually completely fine by me. Are there Democrats that vote pro-life? Sure, but they are few and far between. Are there born again Christian Democrats? Sure. For this reason I pay attention to the person and do not 100% of the time vote Republican.
    I believe there are a lot of gray areas, but there are also absolutes and on these truths I will not waver.
    There are also smaller issues that I tend to follow Republican ideals on as well such as immigration/border issues, military/war plans, reducing taxes, etc.
    I respect your decision to not associate yourself as a Republican anymore, however I cannot reconcile the Democratic morals with my faith.

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