Tuesday, February 14, 2017

Why we pay for good health insurance

There's a lot to talk about when it comes to the ACA and health insurance and i'm not going to debate it on the blog. When the law passed, our bills went up...But there is always one thing we have been glad to have as a family, and that folks is good coverage.

I've never had to deal with crappy insurance -- yes its always been expensive, but NEVER was it "I'm going to worry about my bills" crappy, which is why I won't debate the ACA.

I've never been in the position to not have insurance so I don't feel like I can weigh in on the subject. All I know is now, I feel like when I go to the doctor I get answers in that visit. Before, not so much. Tests, long lines and the run around for an HMO plan without real direction. Sure, it was labeled "great" insurance by many when I was in my 20's ---Yes, you read that correctly. At 20 I was working a full time job with benefits while I finished school. --- but I didn't feel like I got the best coverage for what my employer was paying.

(Growing up was different. As a kid, I was on Medi-cal or some state program because we were poor and I don't even remember going to the doctor for anything but vaccinations. I had to go once for a ingrown toe nail that had to be surgically removed and there was the chicken pox... Other than that it was OTC and wait it out...) 

My husband has had crap insurance and we paid our share of a couple hundred dollar doctor visits in exchange for cheaper premiums... and it's not something we will do again now that we are a "family" and I see how often hubs gets sick and needs a doctor to make him better so he's not miserable for a month. Health is health, and I don't want to have to have the "can i go to the doctor" chat. In our house, your sick and want to go, go (and hubs does.. I go for my annual visit and unless there's a chronic issue... they see me next year... but again, that's me and I come from a "power through it" mentality).

The policy we are on now feels more like a traditional HMO with the "approval" wait which we didn't really feel with our Kaiser plan... but that's because it's a different system... but even now, i'm super glad we have it. I love my doctor and little dudes doctors and nurses... and we figured out urgent care and all that.

With my city job, the premiums are steep and if we didn't have help from my employer this would be a different story all together, but oh boy does it cover things -- which is the whole point of this blog article!

Back in 2016 little dude needed to get tubes put in his ears. He was having wayyy too many ear infections and it was doctor recommended. He's been super happy since and HASN'T been sick... even with daycare germs floating, we only had one vomit virus... (Cross our fingers) and one head cold that he got over super fast because of the tubes...

But Holy Cow was that procedure expensive! Like $8,613

For a 30 minute procedure...

Our plan discounts and adjustments where $5,948.25, and our health insurance covered the $2,664.75 making our out of pocket cost, $0.00. They even paid our parking fees at the surgical center...

Yes, we had some follow up appointments and office visit Co-pays... but your talking less than $100

I might be upset at the price increases for 2017 and how they are affecting our paychecks, but boy and I glad that I don't have to pay almost $9k for my son's surgery. 

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