yakky
Oldies but Goodies
Posts: 794 
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Post by yakky on Dec 23, 2014 0:45:28 GMT -5
Okay, so I'm trying to renew my health insurance. I have found a plan that looks like it would work for me on the washingtonhealthplanfinder website. It shows me a deductible of $750 with an out of pocket limit at $1100. Perfect. So I click for more information on the plan an fit sends me to the "exchange" link and guess what? Now the deductible for this same plan is showing up at $2500.  ?? And an out of pocket of $4100. WHAT?! I'm so frustrated. Every single plan I look at has a conflicting deductible from one website to another (but connected and definitely the same plan!). Has anyone else ran into this??? I plan to call in the morning. Tomorrow is my deadline for renewing too... grrrr |
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justju
Oldies but Goodies
Posts: 93
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Post by justju on Dec 23, 2014 2:41:09 GMT -5
Sounds stressful.
We live in one of the most expensive insurance areas (there really is some dreadfully unique driving round here - and I've gone from loving driving to hating it)
Will you be able to pay monthly?
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paliz
Oldies but Goodies
Posts: 746
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Post by paliz on Dec 23, 2014 7:04:55 GMT -5
It's all frustrating. My suggestion would be do a full "application" on the market place and see where that takes you. I find the quotes to be misleading.
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yakky
Oldies but Goodies
Posts: 794
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Post by yakky on Dec 23, 2014 17:39:03 GMT -5
I called to renew today and found out the "skinny" and it looks like we should still get the $750 deductible! :clap:
And, the saga of last year (when I thought I had a $250 deductible and it changed in the spring to $2500 and they wouldn't budge saying that I had always been on the $2500 plan).... well, it continues. I checked my insurance account today (before renewing with premera) and saw that my account summary indeed says I have a$250 deductible this year. I talked to the excellent rep, Rachel, and she got everything switcheroo'd in the computer and it looks like I might be getting some refunding from the year!!! Potentially significant!
Also, the different between the 2 deductibles were explained - and made sense.
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Post by kidsandpets on Dec 23, 2014 18:17:34 GMT -5
I called to renew today and found out the "skinny" and it looks like we should still get the $750 deductible! :clap: And, the saga of last year (when I thought I had a $250 deductible and it changed in the spring to $2500 and they wouldn't budge saying that I had always been on the $2500 plan).... well, it continues. I checked my insurance account today (before renewing with premera) and saw that my account summary indeed says I have a$250 deductible this year. I talked to the excellent rep, Rachel, and she got everything switcheroo'd in the computer and it looks like I might be getting some refunding from the year!!! Potentially significant! Also, the different between the 2 deductibles were explained - and made sense. Great!  |
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Post by tammyof3 on Dec 23, 2014 21:00:48 GMT -5
I called to renew today and found out the "skinny" and it looks like we should still get the $750 deductible! :clap: And, the saga of last year (when I thought I had a $250 deductible and it changed in the spring to $2500 and they wouldn't budge saying that I had always been on the $2500 plan).... well, it continues. I checked my insurance account today (before renewing with premera) and saw that my account summary indeed says I have a$250 deductible this year. I talked to the excellent rep, Rachel, and she got everything switcheroo'd in the computer and it looks like I might be getting some refunding from the year!!! Potentially significant! Also, the different between the 2 deductibles were explained - and made sense. Great! AWESOME!!!!! Unexpected refunds are always welcomed |
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btid
Oldies but Goodies
Posts: 139
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Post by btid on Dec 24, 2014 10:45:17 GMT -5
I am going to look into a Christian insurance like Samaritan. I am very frustrated too. Currently we have a catastrophe only insurance with $15,000 deductible and we have had it for 12 years. I really like it but the premiums are increasing over 50%. GRRRR!
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yakky
Oldies but Goodies
Posts: 794
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Post by yakky on Dec 25, 2014 1:04:57 GMT -5
Yikes, btid!!! I hope you can find something better for your family!
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Post by tammyof3 on Dec 25, 2014 21:00:50 GMT -5
I am going to look into a Christian insurance like Samaritan. I am very frustrated too. Currently we have a catastrophe only insurance with $15,000 deductible and we have had it for 12 years. I really like it but the premiums are increasing over 50%. GRRRR! After this year we will never do one of those. We went from the frustrated we paid so much for insurance to very grateful to have it. Our medical bills with the insurance rates this year hit $1M. If I remember right those type of policies would not have put a dent in our medical bills. The true part of medical insurance is you never know what is around the corner. If our son stays healthy with not flare ups his medical bills will be $300k every year from now on. If he has a flare up it will be even more. |
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btid
Oldies but Goodies
Posts: 139
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Post by btid on Dec 27, 2014 10:37:10 GMT -5
I am going to look into a Christian insurance like Samaritan. I am very frustrated too. Currently we have a catastrophe only insurance with $15,000 deductible and we have had it for 12 years. I really like it but the premiums are increasing over 50%. GRRRR! After this year we will never do one of those. We went from the frustrated we paid so much for insurance to very grateful to have it. Our medical bills with the insurance rates this year hit $1M. If I remember right those type of policies would not have put a dent in our medical bills. The true part of medical insurance is you never know what is around the corner. If our son stays healthy with not flare ups his medical bills will be $300k every year from now on. If he has a flare up it will be even more. The thing is, the way ours is set up, we'd have to pay $15,000 max. So our insurance is just like yours. Do you not like the HSA's? I LOVE them! LOVE them!! We have had ours for over 12 years and have a bunch saved up because it is tax free!!!!! So you can put this year its $6550 for a family and its just like an IRA so you get interest on the account so the $15,000 is not a big deal whatsoever, because we have saved up for 12 years and we always contribute the maximum that the government will allow, but the premiums make me angry angry angry. Our insurance is just like yours, but we would pay $15,000 the most out of pocket. If we did switch over to Samaritan, I have heard that they will exclude pre-existing conditions. But I have not looked into it at all. None of us have any health conditions except me, I have anxiety that I say a nurse practitioner for recently. So who knows they may not accept us. |
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Post by tammyof3 on Dec 27, 2014 15:05:39 GMT -5
After this year we will never do one of those. We went from the frustrated we paid so much for insurance to very grateful to have it. Our medical bills with the insurance rates this year hit $1M. If I remember right those type of policies would not have put a dent in our medical bills. The true part of medical insurance is you never know what is around the corner. If our son stays healthy with not flare ups his medical bills will be $300k every year from now on. If he has a flare up it will be even more. The thing is, the way ours is set up, we'd have to pay $15,000 max. So our insurance is just like yours. Do you not like the HSA's? I LOVE them! LOVE them!! We have had ours for over 12 years and have a bunch saved up because it is tax free!!!!! So you can put this year its $6550 for a family and its just like an IRA so you get interest on the account so the $15,000 is not a big deal whatsoever, because we have saved up for 12 years and we always contribute the maximum that the government will allow, but the premiums make me angry angry angry. Our insurance is just like yours, but we would pay $15,000 the most out of pocket. If we did switch over to Samaritan, I have heard that they will exclude pre-existing conditions. But I have not looked into it at all. None of us have any health conditions except me, I have anxiety that I say a nurse practitioner for recently. So who knows they may not accept us. We have an HSA and it is very well used! LOL We have always complained about how much we have paid and our deductibles and out of pocket max. I have looked into the Samaritan type of plan a few years back but basically it is not insurance and they have a lot of exclusions. Basically had we done it this year even though we were perfectly healthy at the start of Jan 1 they would not have covered our bills b/c they didn't have the money to cover the expenses. My son's hospital bill was $450k not including all his treatments. He was playing basketball and excited about a super bowl party on the weekend and Thursday they were telling us to not expect him to live through the night. It is crazy how quickly your life can change! DS now has procedures that he has to do 4 times a year that are $35k each time. Plus all his check ups with his specialist. We also pay $2400 a month for his IGG treatments. |
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sarahw
Oldies but Goodies
Posts: 136
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Post by sarahw on Dec 27, 2014 16:24:35 GMT -5
Janice posted this on H@H a little while back:
So far there's been nothing about Samaritan Ministries that I didn't like. It has met our needs very well. I find it to be simple and a real blessing to our family.
Julie gave a great synopsis of how it works. Basically the $300 per instance is like what regular insurance would call your deductible. You're responsible for the first $300 of each medical situation. However, that $300 must only be paid for the first three medical situation in a year. If your family experiences four or more medical needs in a year, then the $300 is able to be shared. So, if you want to put all of that into regular insurance jargon...your yearly deductible should be no more than $900 ($300 x 3 medical situations).
You choose who your provider will be. There are no networks or anything like that to worry about. You would tell your provider that you are "self-pay." A lot of times that results in large discounts since you're not going through insurance.
I like that they allow, and even encourage, homebirths and the use of midwives. They actually waive the above-mentioned $300 if you use a midwife for homebirth. They allow you to share the cost of all your prenatal vitamins and the first three months of any prescription that is needed for your pregnancy.
Samaritan Ministries is really good about helping you find ways to lower your costs. They share options for getting lower-priced prescriptions and will help find ways to lower costs for some medical needs.
I really like that we send our monthly share to another family. I know that our money is being used by people that need it. My children like drawing pictures to send along with our monthly share. It is an extra opportunity to teach our children about helping others.
It does say that they are rare instances where there's not enough money to cover all the needs for the month, but we haven't encountered that. Actually, the last three months there has been MORE money available than needs submitted, so our monthly share was decreased by 8% each month for the last three months.
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Post by tammyof3 on Dec 27, 2014 21:18:51 GMT -5
It basically boils down to you want health insurance for when something truly goes wrong or help paying the "little" medical bills.
We looked at the Samaritan b/c it sounds so nice and the monthly "payment" is so tiny compared. Even the yearly coverage for help with the big bills sounds nice. Though their fine print says they will not pay out more than 50% of what is in the funds from the yearly.
This year was our oh crap medical year. The most we have done until this year was a few ear tube surgeries. We have never even had a broken bone other than a nose once.
Jan - resulted in ds1 having an ambulance ride and 3 days in the hospital with surgery for a broken tib and fib of the right leg. Ambulance was $1k and hospital/surgery was $20k.
Feb and March consisted of doctor follow ups, wheelchair, boot, crutches and such that equaled a couple thousand and lots of xrays to make sure things were healing.
Feb - was when life stopped for a while and ds2 was taken from the doctor's office to children's local to be transferred Dallas Children's to ICU and a nurse in the room 24 hours for 3 days with them saying not to expect him to live through the night. We then received the diagnosis and he had to do multiple blood transfusions, 5 sessions of plasmapherises and other transfusions and a round of chemo.
This resulted in a bill of about $400k and about 20 doctors billing us. The children's ambulance was also $6k.
Mar - DD got a set of ear tubes which was just $3k.
DS2 also needed another round of chemo $15k. He also needed his two rituximab treatments that are $35k each one b/c it is still new and expensive.
DS2 also sees about 4 doctors for Mar - June and his specialist visits are $3k each time with blood work.
June DS2 starts seeing a nero doctor as well due to headaches over $5k
Aug DS2 sees the specialist eye doctor. He has 2 cataracts due to steroid drugs so those are being monitored.
Aug is when he also needs his next two rounds of treatments at $35k each.
If we had gone with Samaritan b/c it did sound good we would have to file bankruptcy for this year.
DS2 will need the $35k treatments now 4 times a year for life. Oh and I forgot he $2400 a month treatment we started in August as well. Combined that with $3k doctor visits from now on.
I just want to tell the other side of the coin how life can change so quickly and when you think you pay so much it might become a true need to have that health insurance policy.
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Post by tammyof3 on Dec 27, 2014 23:45:55 GMT -5
I think I have said so much negative about Samaritan - sorry about it. Still working through the craziness of this year medically and the realization of how much our medical bills will be every year:( I love the idea of it!
Even with Obamacare insurance I am wondering if any company is sustainable with multiple families like our family is now with these huge ongoing medical cost. Insurance companies use to only cover $1-2M for the life of the policy. This means before Obamacare that we would not be covered after this year. I am not sure what we would have done to keep ds alive!
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?? And an out of pocket of $4100. WHAT?!
