We just found out our insurance will no longer cover anyone's spouse who has an opportunity to buy insurance through their company. Some of the people I work with have spouses who work for very small companies that do offer insurance, but at outrageous prices. One of the guys may now be force to pay an additional $300-$400 a month so his wife can have coverage at her current employer.
It seems like every year our cost goes up a little, but the way they manage to keep the cost down is by cutting our benefits. It hasn’t really affected me, since I am a relatively healthy single person who never goes to the doctor, but every year all the people in my office with families keep finding out it is going to cost them more for the same coverage next year.
Posted by FlyingCow (Member # 2150) on :
That's pretty rough.
As a separate story that sort of falls under this thread topic, the company I've just been hired for has (to me) a very strange way of starting benefits.
From the day you are hired, look forward to the first of the next month... then look forward to the first of the following month, which is the day your benefits start.
So, while I should have been hired October 25th (with benefits starting Dec 1st through their rules), they had problems setting up the job in their computer system making my hire date Nov 6th (with benefits starting Jan 1st).
Why should I have to wait 4 more weeks for benefits because they can't figure out how to use their own system? :frustrated:
Posted by Tante Shvester (Member # 8202) on :
The whole system is badly broken, and this country needs real leadership in order to fix it.
I am disgusted.
Posted by zgator (Member # 3833) on :
quote: We just found out our insurance will no longer cover anyone's spouse who has an opportunity to buy insurance through their company.
How can they determine whose spouse has this option unless they are forthcoming about it? Do they have a legal way of doing so?
Posted by Dagonee (Member # 5818) on :
quote:We just found out our insurance will no longer cover anyone's spouse who has an opportunity to buy insurance through their company.
Check with your state's insurance commissioner. This may not be legal in your state.
Posted by SC Carver (Member # 8173) on :
Apparently it’s not illegal. Several of our employees have had to switch to our insurance because their spouse's company won't cover them anymore, according to our HR director.
I wondered how they would know who has the opportunity for coverage elsewhere also.
Posted by striplingrz (Member # 9770) on :
This happened at my employer two years ago. We are still in the same situation.
And to answer your question zgator, at my company, they make you sign an affidavit stating your spouse is not eligible for other insurance. Then throughout the year, they do audits of your claims to ensure what you stated is factual. Not sure how that works, but its how it is done at my company. *shrug*
edit: Oh and btw, we can alternatively opt for paying a premium if your spouse doesn't want to pay for insurance at their employer. Its like an additional $100 a month or pay-period, can't remember. I'll know the first week of November when we go through open enrollment again.
Posted by Mama Squirrel (Member # 4155) on :
FlyingCow-
When did you actually start working for the company? They have to do it based on your first day of work. They have to make it work. It's not your problem if their system isn't working right.
Posted by FlyingCow (Member # 2150) on :
I've been a temp for three months. I am being converted over to a full time employee on Nov. 6th - apparently, due to their screwups, they can't have my first salary day any sooner than that (they need fingerprints, background check, drug test, etc, etc).
So, I'm working for my temp agency at the moment, and getting paid by them. Come Nov 6th I'll be paid by this company, and come Jan 1st I'll have benefits through this company.
Thing is, from Nov 6th to Jan 1st I'll be without benefits - unless I want to pay Cobra for the crappy benefits my temp agency gives (about as bare minimum as you can get).
Posted by ketchupqueen (Member # 6877) on :
quote:Originally posted by Tante Shvester: The whole system is badly broken, and this country needs real leadership in order to fix it.
I am disgusted.
Amen. My husband has insurance for the first time in 7 years, finally.
I've been uninsured for 5.
That's not going to change any time soon; we just can't afford insurance on our own, and his employer doesn't offer coverage for families (it's not a group plan.)
Thank heavens for low-cost state insurance for children. But I wish the whole system wasn't so screwed up.
Posted by pH (Member # 1350) on :
College insurance denied claims for all the specialists I visited over the summer, apparently on the argument that I "graduated" in May.
Commencement was in May, you morons. I didn't FINISH until JULY. MY COVERAGE LASTED UNTIL AUGUST.
-pH
Posted by LisB1121 (Member # 1703) on :
:Jumping out of lurker mode to second Dagonee's comment:
I certainly don't know the law, and can't give you advice, but I would check the law with some other source then your HR department. Don't assume that just because the insurance company is doing it and gotten away with it so far, that it's legal. The company may not even realize that what they are doing could be illegal, or they may have gotten bad legal advice. Or maybe they just think they can get away with it. That's why there's lawyers, to hash out these little details. :-)
Posted by ClaudiaTherese (Member # 923) on :
Health insurance in the US (or, rather, the lack thereof) has been a seething issue for some time. It can't continue like this for much longer, as it has spread to affect people who do have some substantial political voice. On the one hand, it's a tragedy that still more people had to suffer. On the other hand, I am glad it is getting to a point where it cannot be ignored.
For anyone who would ask "but how do we fix it?," I would refer you to a detailed analyses of how other industrialized countries manage healthcare, as well as the literature comparing the efficacy and efficiency of those countries' systems (including basic medical outcomes such as morbidity and mortality rates across the systems).
Also, refer back to "cannot be ignored" above for ongoing motivation to get creative and learn what we can from other systems.
Posted by pH (Member # 1350) on :
You know, the one thing is, I don't think I'd ever be comfortable with the state (or whomever) managing my mental health care. They do have, from what I hear, good free mental health care here, along with cheap/free medication, but something about that sets me on edge. And the feeling is really starting to spread into other health care realms.
-pH
Posted by MightyCow (Member # 9253) on :
I am also mad at insurance. What a racket! I pay huge premiums to get private insurance as a self-employeed freelance writer, and my insurance pays a very low percentage of any expenses, and then several months after paying decides to "disallow payment", forcing me to pay additional expenses.
BLUE CROSS SUCKS.
It's also absurd that as soon as I turned 30, my rates went up a couple hundred dollars a year. How about getting a better actuarial table? I didn't instantly become sickly one day.
Bah, now I'm angry. Time to write some letters to my various governmental representatives.
Posted by ketchupqueen (Member # 6877) on :
pH, I used to feel that way, but when you need it badly enough, you take it where you can get it.
When I was pregnant and because they had delayed the start date of my insurance for an additional month without my knowledge so nothing pregnancy-related was covered as it was "a pre-existing condition", for example. I cancelled the insurance; what good was it doing me? I ended up on Medicaid for the pregnancy. And then this last surprise pregnancy, I wasn't insured at all. Same deal (although I was really, really scared I was not going to qualify.)
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by pH: You know, the one thing is, I don't think I'd ever be comfortable with the state (or whomever) managing my mental health care. They do have, from what I hear, good free mental health care here, along with cheap/free medication, but something about that sets me on edge. And the feeling is really starting to spread into other health care realms.
-pH
I can definitely, definitely understand that concern. It is both understandable and cogent.
However, even though individuals may wish to opt out of the system, I don't think that is a good reason to prevent the provision of that system to other people. That is, even if you don't want to use a state-run system for mental health care, I don't think that necessary entails that one shouldn't be put into place.
(Of course, this is not necessarily what you are arguing, pH -- I was just making my own position clear.)
Posted by SC Carver (Member # 8173) on :
Like I said, it doesn't really affect me very much at this point, not enough to look into a lawyer, but I may pass the suggestion along to some of the people it does affect. I don't know how you fix the big issue. It irritating that they keep eroding our benefits, nothing like paying more for less. And I work for a large corporation with several thousand employees nation wide. If this is the best they can do, I hate to see the bill at a small company.
Posted by mackillian (Member # 586) on :
Health insurance coverage for anyone with a chronic condition is a must have and it's a continuous must-have. Once you ever let your insurance lapse, you're subject to the pre-existing condition clauses.
It seems odd that the panic on losing a job isn't the job itself but the health insurance. I opted-out of my company's health insurance and am covered under Nathan's. If nathan ever loses his job (it's commission and goals-based and goals change monthly, so sometimes it can get hairy), we aren't worried about him not being able to find another job, we're sure that he can. It's the health insurance that's hugely important. The insurance my company offers (and I work for an actual health insurance company) is crap insurance. It's one of the HSA plans and they suck. The insurance is managed through my company's parent company. My actual company has good coverage and as someone who processes claims, we're told to find a way to pay if we can (according to all the documentation). If we deny it and an auditor finds that we could've paid it, we get dinged for it.
The parent company, however, is not good. Not Good.
Posted by Dagonee (Member # 5818) on :
Insurance should not be so heavily linked to employment. The quality - not just cost - of insurance available to those not on a group plan is quite simply not the same. To add insult to injury, the medical costs of those not on a plan are much higher - in some instances 10 times higher.
While a market system might work, we don't have a market system. We have the worst aspects of a market system in a structure that seems perversly designed to exclude the benefits of the market while bringing in all the negatives. It's crazy.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Dagonee: We have the worst aspects of a market system in a structure that seems perversly designed to exclude the benefits of the market while bringing in all the negatives. It's crazy.
Underlined.
Posted by ketchupqueen (Member # 6877) on :
I think it ought to be illegal to charge uninsured patients a rate many times higher than insurance companies get charged without allowing the patient or their advocate to negotiate a price the way insurance companies get to.
Posted by pH (Member # 1350) on :
quote:Originally posted by ketchupqueen: I think it ought to be illegal to charge uninsured patients a rate many times higher than insurance companies get charged without allowing the patient or their advocate to negotiate a price the way insurance companies get to.
$1300 for a Benadryl because the ER gave it to me!
YAY!
-pH
Posted by Samarkand (Member # 8379) on :
What Dag said. And I agree with ClaudiaTherese: it is getting to the point where it will get fixed, because it's starting to effect middle and upper middle class people and they're getting twirked. I am currently having a freak-out fest because I go off my parents' insurance in December, my current job has no insurance, and the new job leads haven't panned out yet . . . argh.
It's really scary - I don't have the money to pay for my allergy meds out of pocket, and without them I get sinus infections which require other meds and doctor's visits, which I really can't pay for, and referals to allergists and CT scans . . . you get the picture. I have to say, it really, really pisses me off. I should NOT have to worry about this.
Hmm. I'm writing Bill Ritter. "Yes I'm voting for you, but FIX THE HEALTH CARE SYSTEM."
I actually think we'll see it on a local/state level first, then states will band together to share costs, then it'll kick in at the federal level. Other theories?
Posted by pH (Member # 1350) on :
I still just can't be comfortable with the idea of insurance for my mental health visits. The medication, okay. Because that could have any number of uses, and there isn't all that much stigma associated with taking antidepressants anymore.
But beyond that, I get severely creeped out. I mean, creeped out to the point that I'd go without sufficient care simply because I can't stand the idea of that kind of invasion of privacy.
-pH
Posted by ketchupqueen (Member # 6877) on :
quote:I still just can't be comfortable with the idea of insurance for my mental health visits.
Um, who usually pays for them?
Posted by pH (Member # 1350) on :
Either I pay for them myself, or my parents pay for them.
-pH
Posted by ketchupqueen (Member # 6877) on :
Oh.
*tries hard to say this in a non-offensive way*
No one in my (mostly upper-middle class family; doctors, lawyers, stuff like that) family has ever been able to afford to pay counseling or psychiatry bills out of pocket.
I thought it was just government insurance that was bothering you there.
And personally, with all the privacy laws in place, I don't really have a problem with insurance paying for any treatment I need.
Posted by pH (Member # 1350) on :
I would have no chance of getting non-government insurance at all without a mental health exception. So no matter what, I'm not going to get coverage, even if I want it. If the government steps in and gives it to me, I still won't take it, even if it means I can't afford to go to therapy.
-pH
Posted by ClaudiaTherese (Member # 923) on :
As that isn't an option for a huge chunk of the population, I support a standard system with national access to medical care (including mental health care). Should you be so inclined and have the resources to seek mental health care external to that system, I personally do not have a problem.
I have more of a problem with multiple layers of access to non-mental-health healthcare and the multiply-tiered system that results. However, there is so much more variability in even what outcomes to measure for mental health that I can't see reaching any sort of consensus on what must be included and excluded as standard of care anytime soon -- not to mention the additional confidentiality concerns, especially in certain situations. I am comfortable with more of a free market approach to this aspect of the system, so long as there is a minimal provision for all.
Posted by pH (Member # 1350) on :
Gah, I've been trying to think of a way to put this...not to get too far into it, but my parents have made some serious sacrifices to be able to support their children, and this worries me more and more as they age.
-pH
Posted by ClaudiaTherese (Member # 923) on :
It is a sobering personal situation, then. I wish you strength and grace in dealing with that.
---
Edited to add: Nonetheless, as their approach is not an available option for so many (even if they had to sacrifice everything to get it, still most people couldn't have gotten to that point, you know?), I think the national provision as a minimum is essential.
How wonderful that your parents loved you so much to make those sacrifices and were in a position to help you as they have. What a blessing in so many ways!
Posted by BaoQingTian (Member # 8775) on :
quote:Originally posted by ClaudiaTherese: For anyone who would ask "but how do we fix it?," I would refer you to a detailed analyses of how other industrialized countries manage healthcare, as well as the literature comparing the efficacy and efficiency of those countries' systems (including basic medical outcomes such as morbidity and mortality rates across the systems).
Also, refer back to "cannot be ignored" above for ongoing motivation to get creative and learn what we can from other systems.
How do we fix it? I know you can't read the tone of my words, but think of it as an honest, hopeful question-not the negative tone that you might imagine someone taking while posted.
If you could direct me to some sites, as well as elaborating personally on what you think the best solutions are, that'd be great.
I do get dejected while thinking about any big issue like this, social security, immigration, etc. I think by and large people (politicians included) come up with some really great solutions, but both sides of Congress seem to be so intent on political power and infighting that if they ever solve anything it would truly be a miracle.
Very few things in life could be as desperate as you or a loved one needing serious medical care, but having no way to pay for it.
My thoughts are that whatever system we choose, it will have to be much more comprehensive than just health care.
Posted by pH (Member # 1350) on :
quote:both sides of Congress seem to be so intent on political power and infighting that if they ever solve anything it would truly be a miracle.
Yes.
-pH
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by BaoQingTian: How do we fix it? I know you can't read the tone of my words, but think of it as an honest, hopeful question-not the negative tone that you might imagine someone taking while posted.
What a delight to read! You are quite eloquent.
quote:If you could direct me to some sites, as well as elaborating personally on what you think the best solutions are, that'd be great.
I can direct you to some sites (see below). I will not elaborate personally, as you say, for two main reasons: 1) it is a dense issue that cannot be encapsulated accurately and briefly, especially as I am swamped with work right now; and 2) I cannot muster the emotional energy and investment to have this conversation again at this time -- not if I want to do the topic justice. #2 is certainly reflective of my own personal and professional failings, and I beg your indulgence for my weakness in that regard.
quote:I do get dejected while thinking about any big issue like this, social security, immigration, etc. I think by and large people (politicians included) come up with some really great solutions, but both sides of Congress seem to be so intent on political power and infighting that if they ever solve anything it would truly be a miracle.
I find myself getting dejected, too. It's important to fight that by taking breaks from solving the big problems when we need to and can, as well as becoming as well-informed as possible about the big problems which matter to us.
If you really care about an issue, you will know it thoroughly. You will review and rereview your own position to assess and address its weaknesses, adapting it to take into account new evidence (which you will continue to actively seek out). You will invite reality to resist your preconceptions by actively seeking out the most tenable and defensible other positions, studying them just as thoroughly as your own, and you will labor to become intimately familiar with both the strengths and weaknesses in each.
Of course, we are all creatures with other competing demands on our time, not the least of which is the need to live our own healthy and balanced lives. However, if you have a passion for something, you will spend the time and the work to know it well: you will do it the honor of paying it the attention it deserves.
Go for it, dude. *smile
quote:Very few things in life could be as desperate as you or a loved one needing serious medical care, but having no way to pay for it.
Agreed.
quote:My thoughts are that whatever system we choose, it will have to be much more comprehensive than just health care.
It is likely more than mere coincidence that health care outcomes disparities so closely track socioeconomic disparities, apparently across all systems of healthcare provision (at least, all that I am aware of).
[ October 27, 2006, 07:49 AM: Message edited by: ClaudiaTherese ]
Posted by DDDaysh (Member # 9499) on :
This is why I LOVE my company, and why I'm trying to get a promotion (even though it means going back to school) instead of looking elsewhere. The company I work for has a parent company based in London. Since the parent company is the one that makes all the benefits, it basically means ours are pretty awesome, at least compared to others.
For one thing, the "premiums" we pay are tiered, so that employees that make less pay a smaller percentage. That means, for me and my son, I'm only paying about $50 a month for a pretty good insurance package. The dental is not included though, and that's probably about another $20 a month.. still not bad. Also, they have like six different plans you can choose from, depending on what deductible you want, how much you want to pay, and who you want to administer it. It's also good, because if you have someone with REALLY bad health problems (like MS or something) and they use up their lifetime maximum through one insurance company, you can switch to another one. It really just makes you feel safer about the future. This is one of the reasons that I could NEVER go back to teaching. When I was teaching I was paying over $150 a month for insurance for me and my son, and they wouldn't let me cover his sister because "technically" his father and I weren't married at the time. (That is another long story about legal issues.) We were having to pay Unicare privately for them. Even though my ex's coverage was ok, and not that expensive (about $50 a month for a reasonable deductable, but with a limit on office visits) to cover my step-daughter was nearly $200 a month. However, since we knew before we got the insurance that she was sick (thankfully not yet diagnosed, so not "pre-existing")we had to pay for a good plan. She ended up having cancer and needing surgery, so it was worth it, but still. It meant that all together we were paying almost $400 a month for insurance. Where I work now, a person making in the highest bracket, insuring an entire family (himself and two or more dependents) with the best insurance plan would still be paying under $300 a month. Oh, and to top it off, you can insure your "domestic partner" as a dependent, whether they're same or opposite sex.
It just is amazing to me that a foreign company provides better benefits than we do to our own TEACHERS. It seems ridiculous. Even worse, my state (Texas) is making it harder for kids to apply for Medicaid, and turning it over to companies to run as an HMO, which means it's very difficult to navigate. You have to have all sorts of referals and things, and so fewer and fewer doctors are accepting it. This is just WRONG. Everyone ought to be able to afford decent health care, espescially children.
Also, it scares me when people talk about not qualifying for Medicaid while pregnant. I don't think the government should be able to turn pregnant women down no matter what, because that puts an innocent child at serious risk. It seems no one thinks of that.
![[Mad]](mad.gif)
![[Smile]](smile.gif)