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Message
re: Is it time to separate health insurance from the employer's responsibility?
Posted on 10/23/26 at 11:51 am to DCtiger1
Posted on 10/23/26 at 11:51 am to DCtiger1
quote:
None of them could afford health insurance outside of having it subsidized by me.
I think that is a lot of us. Obamacare would cost me about $800/month just to get close to the coverage I currently have
Posted on 10/23/26 at 11:52 am to TDsngumbo
it's a bank, huge disparity between lowest income workers and highest income - those making more than 250k pay the highest, those below 50k pay the lowest
Posted on 10/23/26 at 11:52 am to TDsngumbo
quote:
What in the socialist utopia kind of employer do you work for?
My employer is financial services and we do the same.
When you work for fortune 100s, I expect all of them to do this. Fortune 500s too.
It isnt a bad system. My employer pays $24k for my family plan. I pay $4k. Even though others get a bigger supplement than I do, I am not complaining (other than about the abomination that was the affordable care act).
Posted on 10/23/26 at 11:53 am to TDsngumbo
quote:
If you change jobs, you have to worry about how your new insurance will cover existing conditions
quote:
You sure about that?
I'm having an issue with this. I left for a new job in late May. Previous employer is headquarted in South Carolina so we had BCBS of SC. Had to under the Mrs' plan at her job for June. They have BCBS of Alabama. Got on new company's plan in July. It is with Anthem.
Here's my problem. Among the prescription medicines I take one is Jardiance. With a card my pharmacist told me about I started getting it in February for $0. With the plan with my wife's it was around $15 or something. Now with Anthem it is well over $200 a month.
Blue Cross of Alabama,Blue Cross of South Carolina and Anthem are under Blue Cross and Blue Shield's umbrella in some form or fashion. It blows my mind how under Anthem it is so expensive now. Yum Foods owns KFC, Taco Bell and until last year Pizza Hut. Two years ago when they still owned Pizza Hut I doubt a Pepsi would cost $40 at one place and $4.99 at the other two.
I don't get it.
Posted on 10/23/26 at 11:55 am to Benne Wafer
quote:
the children's hospital that is treating her son for cancer will no longer accept ANY marketplace insurance as of January 1st.
This doesn't sound true.
quote:
someone on social media currently pointing out
Oh.
Posted on 10/23/26 at 11:56 am to theliontamer
My employer pays 2/3'rds of our premium which is about $5,000 a year, I'd rather not have to pay it anytime in the near future.
Posted on 10/23/26 at 11:57 am to I-59 Tiger
quote:
Blue Cross of Alabama,Blue Cross of South Carolina and Anthem are under Blue Cross and Blue Shield's umbrella in some form or fashion. It blows my mind how under Anthem it is so expensive now. Yum Foods owns KFC, Taco Bell and until last year Pizza Hut. Two years ago when they still owned Pizza Hut I doubt a Pepsi would cost $40 at one place and $4.99 at the other two.
I don't get it.
Generics should hopefully be available in 2029 for you.
The discrepancy in pricing is negotiated.
Think of prices like a balloon. Squeeze one end and the other gets larger.
Anthem is on the larger end for Jardiance. Some other drug got priority pricing and someone has to pay the piper.
Posted on 10/23/26 at 12:00 pm to I-59 Tiger
quote:
I'm having an issue with this. I left for a new job in late May. Previous employer is headquarted in South Carolina so we had BCBS of SC. Had to under the Mrs' plan at her job for June. They have BCBS of Alabama. Got on new company's plan in July. It is with Anthem.
Here's my problem. Among the prescription medicines I take one is Jardiance. With a card my pharmacist told me about I started getting it in February for $0. With the plan with my wife's it was around $15 or something. Now with Anthem it is well over $200 a month.
Blue Cross of Alabama,Blue Cross of South Carolina and Anthem are under Blue Cross and Blue Shield's umbrella in some form or fashion. It blows my mind how under Anthem it is so expensive now. Yum Foods owns KFC, Taco Bell and until last year Pizza Hut. Two years ago when they still owned Pizza Hut I doubt a Pepsi would cost $40 at one place and $4.99 at the other two.
I don't get it.
That's not the same as denying a pre-existing condition. I also have a med that was $0 under my old insurance, but under new Ins will be $40/m. It's not a denial of coverage for a condition, but for a specific drug. And for all I know, the drug is $100 out of pocket and the ins is covering $60 of that for me. I don't really know. None of it is transparent.
Also, I went from an employer with Anthem plan to the Anthem plan on the Exchange when I became independent contractor. So both were Anthem. One plan just had better coverage. That's not a refusal to cover a pre-existing condition.
Posted on 10/23/26 at 12:00 pm to deeprig9
Children's Mercy in Kansas. Feel free to search, lots of non social media news stories to choose from.
Probably a ploy for negotiations but what a crappy thing to do to families at their most vulnerable.
Probably a ploy for negotiations but what a crappy thing to do to families at their most vulnerable.
This post was edited on 10/23/26 at 12:02 pm
Posted on 10/23/26 at 12:03 pm to theliontamer
It primarily exists as is because of the way the tax code is written.
Posted on 10/23/26 at 12:03 pm to I-59 Tiger
quote:
I'm having an issue with this. I left for a new job in late May. Previous employer is headquarted in South Carolina so we had BCBS of SC. Had to under the Mrs' plan at her job for June. They have BCBS of Alabama. Got on new company's plan in July. It is with Anthem.
Here's my problem. Among the prescription medicines I take one is Jardiance. With a card my pharmacist told me about I started getting it in February for $0. With the plan with my wife's it was around $15 or something. Now with Anthem it is well over $200 a month.
Blue Cross of Alabama,Blue Cross of South Carolina and Anthem are under Blue Cross and Blue Shield's umbrella in some form or fashion. It blows my mind how under Anthem it is so expensive now. Yum Foods owns KFC, Taco Bell and until last year Pizza Hut. Two years ago when they still owned Pizza Hut I doubt a Pepsi would cost $40 at one place and $4.99 at the other two.
I don't get it.
Each of those 3 carriers could have different PBM's. Also different companies that have the same "BCBS" can have vastly different structures such as Deductibles, OOP, Rx copays, etc....
Posted on 10/23/26 at 12:04 pm to theliontamer
They can't deny for existing conditions anymore.
They may not like it. But if you've had cancer or a long term illness they can't deny you.
BUT. Some issues there is a set time you can get insurance. For chronic Kidney Disease you are forced to Medicare after 30 months. Because the dialysis industry is so big. It's $20,000 a month to do it at home. I don't know how much in center is. No incentive for cure. So much money in treatment. $250 per bag of sugar water. $3500 a month to rent a machine out the 80s. It's a racket.
. But then we have it better than must other countries
They may not like it. But if you've had cancer or a long term illness they can't deny you.
BUT. Some issues there is a set time you can get insurance. For chronic Kidney Disease you are forced to Medicare after 30 months. Because the dialysis industry is so big. It's $20,000 a month to do it at home. I don't know how much in center is. No incentive for cure. So much money in treatment. $250 per bag of sugar water. $3500 a month to rent a machine out the 80s. It's a racket.
. But then we have it better than must other countries
Posted on 10/23/26 at 12:05 pm to Joshjrn
quote:
It primarily exists as is because of the way the tax code is written
Wrong
It primarily exists because FDR hated capitalism.
He put restrictions on employer/employee hours and pay.
So employers got creative in order to attact and retain the best employees. Employer paid health insurance plans was one of the results.
You can thank a socialist for employer paid health insurance.
Posted on 10/23/26 at 12:08 pm to Napoleon
the family owned company I work for (less than 100 employees) pays half our BCBS/ Ala. my share is now 850/mo. for family. It's pretty crappy ins.
coverage has nosedived last 10 yrs. Our first child cost us $200 out of pocket in '97. Hate to think about now.
my wife was an ind contr for a guy who died and she reluctantly bought the business. He paid 100% of employees insurance the Platinum PLus or whatever from BCBS. Best you could get. he let the office mgr pick it. Of course she's gonna pick the best. He also had lots of health issues.
Now she doesn't offer new employess insurance and most don't expect it (they'd rather have the money to blow on a cruise or yet another new car). I think only 2 of the old guard still have the coverage. wife is on my plan.
coverage has nosedived last 10 yrs. Our first child cost us $200 out of pocket in '97. Hate to think about now.
my wife was an ind contr for a guy who died and she reluctantly bought the business. He paid 100% of employees insurance the Platinum PLus or whatever from BCBS. Best you could get. he let the office mgr pick it. Of course she's gonna pick the best. He also had lots of health issues.
Now she doesn't offer new employess insurance and most don't expect it (they'd rather have the money to blow on a cruise or yet another new car). I think only 2 of the old guard still have the coverage. wife is on my plan.
This post was edited on 10/23/26 at 12:16 pm
Posted on 10/23/26 at 12:09 pm to Chad504boy
(no message)
This post was edited on 10/23/26 at 12:10 pm
Posted on 10/23/26 at 12:09 pm to TDsngumbo
Obama wasn't great, but give credit where it's due.
You're right, insurance companies screwed business owners and employees a lot worse before the Healthcare reform act. It also forced doctors and hospitals to modernize their bullshite record keeping.
You're right, insurance companies screwed business owners and employees a lot worse before the Healthcare reform act. It also forced doctors and hospitals to modernize their bullshite record keeping.
Posted on 10/23/26 at 12:09 pm to LSUGUMBO
OOP max is the metric i am most worried about.
.my plan was $5800 when I signed up but they changed it to $8700.
I've already hit it. But that cost me more this year.
I wanted my surgery this year so I didn't have to pay extra. But now it looks like I'll be on Medicare by the time I get it. I have refused to Evergreen look into Medicare until last minute.
Now they telling me to take disability and time off. But I went make enough to pay my insurance if I do that.
So I keep telling people so annual check ups. Feeling fine shouldn't keep you from check ups. Crazy shite can turn up in your 4ps and 50s
.my plan was $5800 when I signed up but they changed it to $8700.
I've already hit it. But that cost me more this year.
I wanted my surgery this year so I didn't have to pay extra. But now it looks like I'll be on Medicare by the time I get it. I have refused to Evergreen look into Medicare until last minute.
Now they telling me to take disability and time off. But I went make enough to pay my insurance if I do that.
So I keep telling people so annual check ups. Feeling fine shouldn't keep you from check ups. Crazy shite can turn up in your 4ps and 50s
Posted on 10/23/26 at 12:10 pm to TDsngumbo
quote:
What in the socialist utopia kind of employer do you work for?
Halliburton used to do this.
Posted on 10/23/26 at 12:11 pm to Weekend Warrior79
quote:
Are you not able to opt out of your employer health insurance and enroll in your own, asking because I honestly do not know.
no, if you have reasonable access to healthcare through your employer, you are not eligible to participate in the marketplace plans.
Posted on 10/23/26 at 12:12 pm to jmarto1
$800 a ninth is what I pay just for the silver plan with dental. I'm fine with 800.
But then I have co-pays, I'm paying for Josiah stays. Clinic visits. Etc. Over $1500 a month. But I'm being billed $20k a month. So I can't complain.
But then I have co-pays, I'm paying for Josiah stays. Clinic visits. Etc. Over $1500 a month. But I'm being billed $20k a month. So I can't complain.
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