What are your health insurance stats?

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Topic Author
GraduateStudent
Posts: 75
Joined: Tue Oct 14, 2014 10:50 pm

What are your health insurance stats?

Post by GraduateStudent »

I'm curious: what do other Bogleheads pay for their health insurance?

Here are the details of my employer-sponsored plan:

Premium: $283/month for family of three
Deductible: $250 per individual/$750 family maximum
Co-insurance after deductible: 10% paid by me / 90% paid by Plan
OOP Max: $1,500 individual / $4,500 family (100% coverage after this limit)
Geography: I live in the Greater Boston Area.
Age: My wife and I are both 31, son is 0.4.
Dental and vision separate

Questions:
1. Obviously there are more than four six important details here. But do these four parameters provide a reasonable starting point for comparison between plans?
2. Would (the collective) you please share your details? I'm curious to know what types of plans the Bogleheads bunch use.
Last edited by GraduateStudent on Sat Jul 01, 2017 2:50 pm, edited 2 times in total.
Life after grad school is great.
mhalley
Posts: 8776
Joined: Tue Nov 20, 2007 6:02 am

Re: What are your health insurance stats?

Post by mhalley »

This will be all over the map as it depends on your zip code and your company, and of course employment. I pay $2008 a month as a retiree at age 62 for me and the wife for a 7k deductable non hsa plan. :oops:
Traveler
Posts: 849
Joined: Fri Aug 30, 2013 9:07 pm

Re: What are your health insurance stats?

Post by Traveler »

Premium: $3/month for one person
Deductible: $1800
Co-insurance after deductible: 20% paid by me / 80% paid by plan
OOP Max: ~$3200 (100% coverage after this limit)
HSA available - no contribution by mega corp employer
Dental and vision separate
Topic Author
GraduateStudent
Posts: 75
Joined: Tue Oct 14, 2014 10:50 pm

Re: What are your health insurance stats?

Post by GraduateStudent »

mhalley wrote:This will be all over the map as it depends on your zip code and your company, and of course employment. I pay $2008 a month as a retiree at age 62 for me and the wife for a 7k deductable non hsa plan. :oops:
Interesting that zip code matters.... where do you live?
Life after grad school is great.
runner3081
Posts: 3925
Joined: Mon Aug 22, 2016 3:22 pm

Re: What are your health insurance stats?

Post by runner3081 »

HDHP (no employer contribution to HSA)

Premium: $40/month for full family coverage (3+)
Deductible: $1,700 per individual/$3,400 family maximum
Co-insurance after deductible: 20% paid by me / 80% paid by Plan
OOP Max: $5,000 individual / $10,000 family (100% coverage after this limit)
Geography: I live in the Phoenix area
Age: Doesn't matter for employer sponsored plans.
Dental and vision separate
BarbK
Posts: 257
Joined: Sun Nov 22, 2009 11:27 am

Re: What are your health insurance stats?

Post by BarbK »

Premium - $1300 per month - Retired ages 64,60 - no ACA subsidy
Deductible - $6350 each ($12700 combined)
includes HSA
Florida
aristotelian
Posts: 8928
Joined: Wed Jan 11, 2017 8:05 pm

Re: What are your health insurance stats?

Post by aristotelian »

runner3081 wrote:HDHP (no employer contribution to HSA)

Premium: $40/month for full family coverage (3+)
Deductible: $1,700 per individual/$3,400 family maximum
Co-insurance after deductible: 20% paid by me / 80% paid by Plan
OOP Max: $5,000 individual / $10,000 family (100% coverage after this limit)
Geography: I live in the Phoenix area
Age: Doesn't matter for employer sponsored plans.
Dental and vision separate
Mine is similar to this except higher deductible, I think about $6k and premium is $50/month. My employer contributes $6750 to the HSA. Not sure how long that will last as it is a new program.
sawhorse
Posts: 3600
Joined: Sun Mar 01, 2015 7:05 pm

Re: What are your health insurance stats?

Post by sawhorse »

GraduateStudent wrote:
mhalley wrote:This will be all over the map as it depends on your zip code and your company, and of course employment. I pay $2008 a month as a retiree at age 62 for me and the wife for a 7k deductable non hsa plan. :oops:
Interesting that zip code matters.... where do you live?
Obamacare premiums vary enormously by geography. Even two adjacent counties can have premium differences of more than 30%. At the state to state level, the differences can be several times. I think it's due to different state regulations as well as the number of companies serving the area, as that determines the amount of market competition.

Interestingly, some of the highest cost of living states, such as Massachusetts, have some of the lowest premiums, and some of the lowest cost of living states, such as Wyoming, have some of the highest premiums.
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Thrifty Femme
Posts: 537
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Re: What are your health insurance stats?

Post by Thrifty Femme »

Here are the details of my employer-sponsored plan:

Premium: $0/month for a family
Deductible: $2,600
Co-insurance after deductible: 20% paid by me / 80% paid by Plan
OOP Max: $6,000 family (100% coverage after this limit)
Geography: Mid-west
Age: Average age of adults is 41.5
Dental and vision separate

My employer contributes $1,000 to my HSA.
Last edited by Thrifty Femme on Sat Jul 01, 2017 6:54 pm, edited 1 time in total.
Joeko
Posts: 24
Joined: Sat Jun 10, 2017 8:29 am

Re: What are your health insurance stats?

Post by Joeko »

Premium: 1,100 / Mth
Family: 54, 50, 21
Deductible: 10k /15K Family
Coverage: Not Much
ACA Bronze Plan - no subsidy
Texas
Topic Author
GraduateStudent
Posts: 75
Joined: Tue Oct 14, 2014 10:50 pm

Re: What are your health insurance stats?

Post by GraduateStudent »

Early results of this thread show basically a bimodal distribution in premiums between those with employer subsidies and those without:

Premiums: 0, 3, 40, 50, 283, 1100, 1300, 2008

mean ( 0, 3, 40, 50, 283) = $75
mean ( 1100, 1300, 2008 ) = $2,154

I bet many of you already knew this, but I didn't :)

Of course we're still a bit undersampled.... I'm especially interested to hear more from folks WITHOUT employer subsidies, although all responses are welcome!
Life after grad school is great.
Topic Author
GraduateStudent
Posts: 75
Joined: Tue Oct 14, 2014 10:50 pm

Re: What are your health insurance stats?

Post by GraduateStudent »

Early results of this thread show basically a bimodal distribution in premiums between those with employer subsidies and those without:

Premiums: 0, 3, 40, 50, 283, 1100, 1300, 2008

mean ( 0, 3, 40, 50, 283) = $75
mean ( 1100, 1300, 2008 ) = $2,154

I bet many of you already knew this, but I didn't :)

Of course we're still a bit undersampled.... I'm especially interested to hear more from folks WITHOUT employer subsidies, although all responses are welcome!
Life after grad school is great.
Seasonal
Posts: 2477
Joined: Sun May 21, 2017 1:49 pm

Re: What are your health insurance stats?

Post by Seasonal »

sawhorse wrote:Obamacare premiums vary enormously by geography. Even two adjacent counties can have premium differences of more than 30%. At the state to state level, the differences can be several times. I think it's due to different state regulations as well as the number of companies serving the area, as that determines the amount of market competition.

Interestingly, some of the highest cost of living states, such as Massachusetts, have some of the lowest premiums, and some of the lowest cost of living states, such as Wyoming, have some of the highest premiums.
Your first paragraph suggests the typical reason given for the results in your second paragraph. There tends to be more competition in states such as Massachusetts than in states such as Wyoming. The increased competition results in lower prices.
misterno
Posts: 525
Joined: Sat Mar 08, 2014 7:55 am

Re: What are your health insurance stats?

Post by misterno »

Joeko wrote:Premium: 1,100 / Mth
Family: 54, 50, 21
Deductible: 10k /15K Family
Coverage: Not Much
ACA Bronze Plan - no subsidy
Texas
what is the OOP on this?
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bottlecap
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Joined: Tue Mar 06, 2007 11:21 pm
Location: Tennessee

Re: What are your health insurance stats?

Post by bottlecap »

When I find out how little some people pay for low deductibles that most wouldn't even consider "insurance", I get sick.

Let's just say that my relatively young, healthy family could buy a fairly nice new car every 2 years with the premiums (similar to Joeko, but we're younger). The deductibles are about 60% of the yearly premiums. We never hit the deductible, unless we have a baby, and then we just touch it. Yay!

We get far better prices at doctors offices during the stretches we don't have insurance.

Before the federal government took control of the market in our state our premiums were less than a third of this for what worked out to be better deductibles. It couldn't have hit our family at a worse time.

Between threads like this and news articles about how any change to the law will cost prostitutes more in health care (true story last week on CNN), I will eventually need anger management and/or have a heart attack, so I will eventually get some use out of it.

I'll keep you posted should I be so lucky!

JT
awval999
Posts: 1254
Joined: Fri Apr 08, 2011 10:17 pm

Re: What are your health insurance stats?

Post by awval999 »

I work for a health system.
So the health insurance (of course you have to use the health systems' hospitals and doctors) is generous.
As the above poster pointed out, this really isn't even insurance, it's simply health coverage.

Premium: $200/month Self+Spouse
Deductible: $0
Co-insurance after deductible: There is no co-insurance; everything is covered after co-payment. ($0 PCP, $35 specialist, $150 ER, $150 hospital admission, $150 birth of child)
OOP Max: $1,500 individual / $3,000 family (100% coverage after this limit)
Geography: Midwest
Dental and vision separate
txranger
Posts: 103
Joined: Sun Jun 11, 2017 9:14 am

Re: What are your health insurance stats?

Post by txranger »

Expat -- live in se Asia
About $540/ mo for worldwide covg except for US,$200 deductible young family of 3. $2.5 mln cover. Includes maternity care. No dental. Has some vision cover. I buy separate travel ins when go back to the states.
Any other expat stats pls post tnx
Edit -- includes all oop but does nt cover a few meds for some pesky reason.
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VictoriaF
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Joined: Tue Feb 27, 2007 7:27 am
Location: Black Swan Lake

Re: What are your health insurance stats?

Post by VictoriaF »

I pay $116.70/month for a GEHA HDHP, self only. GEHA then sends $62.50/month to my HSA account.
My annual deductible is $1,500. Once every few years I combine several procedures to exceed the deductible. Most of the time, I have virtually no out-of-pocket expenses. i don't use any prescription drugs. I use vitamins and supplements at an average cost of $60/month.

I also pay ~$50/month for a dental insurance.

I am a Federal retiree and live in the metropolitan Washington DC area. I am not eligible for Medicare yet.

Victoria
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Joeko
Posts: 24
Joined: Sat Jun 10, 2017 8:29 am

Re: What are your health insurance stats?

Post by Joeko »

Our OOP is the same as deductible as long as it is in Network. There is no maximum OOP if we go out of Network.

We pay all non preventive cost up to Deductible then the Insurer takes over. I haven't been to the Doctor in 2 years, partly because of cost and mainly because I am in good health.
Dottie57
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Location: Earth Northern Hemisphere

Re: What are your health insurance stats?

Post by Dottie57 »

Premium: $100 very 2 weeksq
Deductible: 1300 in network. 2600 out of network
Co-insurance after deductible: 20%
OOP Max: $3900 in network. 7800 out of network
Geography: twin cities
Age: I am single at age 60
HDHP PLAN. EMployer contributes $400 a year. I contribute the rest up to the max.
hicabob
Posts: 3263
Joined: Fri May 27, 2011 5:35 pm
Location: cruz

Re: What are your health insurance stats?

Post by hicabob »

60yo male.
insurer/provider ... Kaiser Permanente
plan .... ACA Bronze/HSA - California
premium ... $640/month (no subsidy)
$6000 deductible.
mhalley
Posts: 8776
Joined: Tue Nov 20, 2007 6:02 am

Re: What are your health insurance stats?

Post by mhalley »

If you go to healthcare.gov the premium varies by even the county you are in. I live in WV.
lowndes
Posts: 108
Joined: Tue Jun 06, 2017 4:30 pm

Re: What are your health insurance stats?

Post by lowndes »

Premium: $1100 paid by me, $1300 paid by employer (family of five)
Deductible: $1500 per person, $4500 for family. $6000 max out of pocket (plus deductible so really $10500)
State: Texas
Age: 33 year old male
Plan: PPO
Shallowpockets
Posts: 1892
Joined: Fri Nov 20, 2015 10:26 am

Re: What are your health insurance stats?

Post by Shallowpockets »

Some people here have some real good plans. They should ride them as long as they can. Some of these plans seem so good that if these people become unemployed the financial hit of losing that insurance would be a huge.
In fact, reading these replies makes me wonder why all the fuss is out there about medical insurance costs. But, of course there is a whole world of insurance not at all reflected in these replies. Seems that employer covered insurance is the sweet icing on an otherwise badly baked cake.
Even the expat in SE ASIA is paying $540 month, which is extravagant in contrast to some posts. This is the first time I have heard a true figure from someone living overseas. In light of recent threads involving non US healthcare and its "benefits", and moving out of US just for healthcare considerations.
hudson
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Joined: Fri Apr 06, 2007 9:15 am

Re: What are your health insurance stats?

Post by hudson »

xxxxx
Last edited by hudson on Sat Jul 15, 2017 8:33 am, edited 4 times in total.
theplayer11
Posts: 1491
Joined: Tue Jul 22, 2014 8:55 pm

Re: What are your health insurance stats?

Post by theplayer11 »

53 year old, self employed, self pay-$11.6k/yr for family plan, 11k ded. Thankfully, tax ded and max out HSA
highdesert
Posts: 69
Joined: Sat Nov 28, 2015 11:50 am

Re: What are your health insurance stats?

Post by highdesert »

$595/month premium (self only; I pay $238, employer $357)
$600 deductible
$3000 OOP max
25% copay for most services after deductible
atfelt
Posts: 10
Joined: Fri Dec 09, 2016 11:56 am

Re: What are your health insurance stats?

Post by atfelt »

Employer Plan:

Premium: $114/month for family
Deductible: $2,800 individual/$5,600 family
Co-insurance after deductible: 10% paid by me / 90% paid by Plan
OOP Max: $5,400 individual / $10,800 family (100% coverage after this limit)
Geography: Midwest
Age: My wife and I are both 34.
Dental separate, basic vision included.

My employer contributes $1,200 to my HSA.
jlcnuke
Posts: 434
Joined: Thu Mar 16, 2017 10:26 am

Re: What are your health insurance stats?

Post by jlcnuke »

Work HDHP plan:

Premium: $338/year for single individual
Deductible: $2600 in network, $5k out of network
Co-insurance after deductible: None if in network, 30% out of network.
OOP Max: $2600 (this is met when deductible is met) in network, $10k out of network
Geography: I live in the Greater Atlanta Area.
Age: 40
Dental and vision separate

For the family plan, the premium goes up to $650/year, and the family deductible/out of pocket max doubles (though each individual person in the family still has the $2,600 cap).

For either, employer contributes up to $1,300/year to HSA (as long as you put in $500 to get the $500 company match).
Carson
Posts: 726
Joined: Fri May 09, 2014 3:26 pm

Re: What are your health insurance stats?

Post by Carson »

OP, our plan stats are remarkably similar. However, one caveat - ours is a grandfathered plan that does not cover preventative or routine wellness care.

Premium: $241/month for family of four
Deductible: $250 per individual/$750 family maximum
Co-insurance after deductible: 10% paid by me / 90% paid by Plan
OOP Max: $1,000 individual / $3,000 family (100% coverage after this limit)
Geography: Chicago
Age: 35/40 + 2
Dental and vision separate
30-something personal finance enthusiast, just get getting started on this whole portfolio thing.
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Gamma Ray
Posts: 487
Joined: Sun Feb 01, 2015 8:16 pm
Location: Bouncing between FL and NYC

Re: What are your health insurance stats?

Post by Gamma Ray »

I am not sure how much relevant this thread to anyone else because there are hundreds of insurance companies and even with their Gold/Platinum/etc tiered plans, nothing matches 1:1 My gold is not same as your Gold even for same insurance company in a different state.

Does anyone know if the new law (without going into politics, just the facts please) forces companies to standardize their plans to make comparison across companies easier?

Just to answer OP's question, my finances and work is based out of NY.
$622/mo for individual and wife so $1244/mo goes to health insurance. My company pays for $620, I pay the rest.
$260/mo for son's insurance with State sponsored plan.

When I tell my friends overseas that we pay near $20,000/yr in healthcare after copays/etc for a young family with no history of major illness (knock on wood..).. their jaws drop.
Here is my plan details, i hope it helps you


Image
Bogled4Life
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Re: What are your health insurance stats?

Post by Bogled4Life »

My husband retired from a public school district in 2014. Here's our current retiree health insurance info:

Family Plan Premium: 7/1/2016 - 12/31/2016 = $1,281 or $213.50/month (school district's share for the period $7,260)
Family Plan Premium: 1/1/2017 - 6/30/2017 = $1,306 or $218.67/month (school district's share for the period $7,399)
Deductible: $50 subscriber & $150 family (me & 1 child)
In-Network Office Visit - PCP: $0
In-Network Office Visit - Specialist: $0
Coinsurance after deductible: 20%
OOP Max: $400 subscriber & $1,200 famly (100% coverage after this limit)
Geography: Central NY
Age: dh 58, me 56, ds 20
Dental and vision separate
Last edited by Bogled4Life on Wed Jul 05, 2017 7:50 pm, edited 1 time in total.
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Edie
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Re: What are your health insurance stats?

Post by Edie »

Employer-based coverage, I would need a large raise to cover cost of benefits if I changed jobs (the reduction in straight premium cost to me with new employer from my previous employer was over $8,000, and I had worse coverage there). I am -very- aware of how lucky we are to have such great coverage.

Premium: ~$51 every 2 weeks for family HDHP
Deductible: $2600 in network, $5000 out of network (everything is family based, there is no individual limit)
Co-insurance after deductible: 10%, this might be 20% for out of network, not sure
OOP Max: $4,000 in network / $10,000 out of network (we hit OOP max in network every year, some years earlier than others)
Geography: Southwest
Age: Late 30s me, early 50s spouse, two nearly 20 year olds, 17 year old and 15 year old.
Dental and vision separate

Our insurance actually works out to be a net income of $107 dollars if we used zero services throughout the year, since employer contributes ~$1440 to the HSA. I contribute to max out the rest of the family limit. I have a calendar reminder set to make spouse open another at age 55 to contribute the extra $1000, assuming nothing changes.
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Gamma Ray
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Location: Bouncing between FL and NYC

Re: What are your health insurance stats?

Post by Gamma Ray »

Edie wrote:Employer-based coverage, I would need a large raise to cover cost of benefits if I changed jobs (the reduction in straight premium cost to me with new employer from my previous employer was over $8,000, and I had worse coverage there). I am -very- aware of how lucky we are to have such great coverage.

Premium: ~$51 every 2 weeks for family HDHP
Deductible: $2600 in network, $5000 out of network (everything is family based, there is no individual limit)
Co-insurance after deductible: 10%, this might be 20% for out of network, not sure
OOP Max: $4,000 in network / $10,000 out of network (we hit OOP max in network every year, some years earlier than others)
Geography: Southwest
Age: Late 30s me, early 50s spouse, two nearly 20 year olds, 17 year old and 15 year old.
Dental and vision separate

Our insurance actually works out to be a net income of $107 dollars if we used zero services throughout the year, since employer contributes ~$1440 to the HSA. I contribute to max out the rest of the family limit. I have a calendar reminder set to make spouse open another at age 55 to contribute the extra $1000, assuming nothing changes.

$100/mo with those relatively low deductibles and money saved in HSA? That's amazing, not to mention $4k OOP max? Wow.
LiterallyIronic
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Joined: Sat Dec 05, 2015 10:36 am

Re: What are your health insurance stats?

Post by LiterallyIronic »

My plan covers my four-month-old baby and me. An outrageous $418/month (of which my employer pays $375). Individual deductible is $4,500 with a family deductible of $9,000. Have access to HSA.

My wife is on a separate plan - one that isn't through work. Can't risk losing my job and not having health insurance available for my baby. Insurance insurance, if you will. Hers is $100/month. Individual deductible is $7,500, family deductible is $15,000, and maternity deductible is $7,500.

I'm early 30s; wife is late 20s. No medical history whatsoever. Utah.

Note that our health insurance setup turned out to be completely worthless, as we paid $12,000 earlier this year to have the baby. This makes me extremely bitter that my sister, who has been on Medicaid and WIC for the last ten years is having a fifth baby, which will entirely be paid for by Medicaid.
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fizxman
Posts: 324
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Re: What are your health insurance stats?

Post by fizxman »

HDHP plan: Work puts in $500/year

Premium: $60/every two weeks for individual
Deductible: $1500 in network, $3000 out of network
Coinsurance after deductible: 20% in network, 40% out of network.
OOP Max: $4000 in network, $10,000 out of network
Geography: Central PA
Age: 37
Dental and vision separate

Two other things:
1. If a person you want to put on the plan (spouse or child) can get insurance through their own employer, they cannot get on this plan. This stinks because my wife pays over $200/every two weeks for her insurance.
2. Rx copays don't kick in until the deductible is met unless it's a preventative therapy drug. I don't know how common this is in other plans or how often it comes into play in this plan since I don't have any prescriptions but it seemed rather draconian to me.
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seed4great
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Re: What are your health insurance stats?

Post by seed4great »

Premium: $302/month for one (employer's part is separate)
Deductible: $400 per individual/$1200 family maximum
Co-insurance after deductible: 10% paid by me / 90% paid by plan (in network)
OOP Max: $2,000 individual / $4,000 family (100% coverage after this limit)
Geography: San Jose, CA
Age: 50
Dental and vision separate
The greatest lesson in life is to know that even fools are right sometimes.
remomnyc
Posts: 855
Joined: Mon Jan 04, 2016 4:27 pm

Re: What are your health insurance stats?

Post by remomnyc »

For a family (individual deductible and OOP Max are 1/2 of family plan)
Network/Non-Network
Premium: $0
Deductible: n/a / $6,000
Co-Insurance: n/a / 80%/20%
OOP Max: $6,000 / $15,000
Co-pay: $20 office & $40 specialist / subj to deductibles and co-insurance
Geography: NY, NY
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flamesabers
Posts: 1824
Joined: Fri Mar 03, 2017 12:05 pm
Location: Rochester, MN

Re: What are your health insurance stats?

Post by flamesabers »

Premium: $47.82 for myself
Deductible: $150
Co-insurance after deductible: 15% paid by me/85% paid by plan (in-network providers)
Co-insurance after deductible: 20% paid by me /80% paid by plan (out-of-network providers)
OOP Max: $1,000 per fiscal year
Generic medication is free if I use the plan's home delivery program. Otherwise the cost is $10 for getting a prescription filled at a retail network pharmacy.
Vision is included.
Dental is separate.
itstoomuch
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Location: midValley OR

Re: What are your health insurance stats?

Post by itstoomuch »

Single:
Medicare A @$108/mn
Medicare Advantage F+D @ $120/mn. with $3200/a deductible (highest available), $25/visit copay.
No dental or vision.
Rev012718; 4 Incm stream buckets: SS+pension; dfr'd GLWB VA & FI anntys, by time & $$ laddered; Discretionary; Rentals. LTCi. Own, not asset. Tax TBT%. Early SS. FundRatio (FR) >1.1 67/70yo
musselpoint
Posts: 27
Joined: Wed Dec 10, 2014 3:45 am

Re: What are your health insurance stats?

Post by musselpoint »

Insurance purchased through the Marketplace, Bronze HSA:

Premium: $585/mo for single individual (I will not be eligible for a subsidy this year)
Deductible: $5500 in network, $11,000 out of network
Co-insurance after deductible: 20% if in network, 50% out of network.
OOP Max: $6550
Geography: Western North Carolina.
Age: 48

I am healthy (touch wood) but if I am unlucky enough to contract a chronic or acute condition, moving back to my native country which has a sane and humane healthcare system is absolutely an option. I cannot fathom how I could continue to afford insurance on the private market through age 65.
ETadvisor
Posts: 320
Joined: Tue Jul 04, 2017 1:37 pm

Re: What are your health insurance stats?

Post by ETadvisor »

GraduateStudent wrote:I'm curious: what do other Bogleheads pay for their health insurance?

Here are the details of my employer-sponsored plan:

Premium: $283/month for family of three
Deductible: $250 per individual/$750 family maximum
Co-insurance after deductible: 10% paid by me / 90% paid by Plan
OOP Max: $1,500 individual / $4,500 family (100% coverage after this limit)
Geography: I live in the Greater Boston Area.
Age: My wife and I are both 31, son is 0.4.
Dental and vision separate

Questions:
1. Obviously there are more than four six important details here. But do these four parameters provide a reasonable starting point for comparison between plans?
2. Would (the collective) you please share your details? I'm curious to know what types of plans the Bogleheads bunch use.
Premium: $98 every two weeks for family of four
Deductible:$5,700
Co-insurance: 20% after deductible
OOP Max: $9,500
HSA contributions by employer $1,600
Dental and vision separate
book lover
Posts: 183
Joined: Thu Aug 23, 2012 4:01 pm

Re: What are your health insurance stats?

Post by book lover »

Exchange Plan( Anthem)
Monthly premium two people: $392
Deductible per person: $200
Max out of pocket per person: $850
jmw
Posts: 103
Joined: Thu Jul 02, 2015 2:01 pm

Re: What are your health insurance stats?

Post by jmw »

US Employer Corporate POS Plan:
Premium: $182 for a family of any size ($2800/month if paying 100%)
Deductible: $200 per individual/$600 family maximum for OON, 0 deductible for in-network and HMO
Co-insurance after deductible: $15/10%/30% (HMO/PPO/OON)
OOP Max: $1500/$2000/$3000
Geography: Northern California

Grandfathered Catastrophic Health Insurance:
Premium: $30
Deductible: $25,000
Co-insurance after deductible: $0
OOP Max: whatever the primary plan will pay
Geography: anywhere in the US

Foreign Country's National Single Payer Health Insurance:
Premium: $35
Deductible: $0
Co-insurance after deductible: $3
OOP Max: not applicable
Geography: inside of the foreign country only
Interesting Exclusions: cancer, US style hospital room with solid walls
Interesting Inclusions: dental
djscal
Posts: 41
Joined: Thu Feb 02, 2017 2:42 pm
Location: Southern California

Re: What are your health insurance stats?

Post by djscal »

Here are my benefit stats - I realize that I'm pretty lucky to still have these Cadillac benefits that cost me next to nothing:

Health:

US Fortune 50 Mega Corp PPO Plan (health plan provided by BCBS):
Geography: Southern California
Deductible: $400 per individual/$1200 family maximum in-network / $800 / $2400 for out of network
Co-insurance after deductible: 10% after deductible in network/40% after deductible out of network (Office Visit & procedures in network / OON)
OOP Max: $2200 individual $6600 per family in network / $4400 individual $13200 per family for out of network
Hospital Stay: 10% copay in network / 40% out of network
Premium: $47 per pay period or $1222 per year for myself and my son (26 pay periods) / my wife is covered by her employer since I would have to pay a not insignificant working spouse contribution to put her on my health plan
Company pays: $14,300 / yr for myself and son

There are also HSA plans offered with a 0 employee premium and a large employer contribution - but the prescription coverage deductible is too high in the HSA style plans for it make sense for me to enroll in an HSA plan. So for now I'll stay with the PPO.

Prescription coverage (express scripts - what a horrible company):

No initial deductible
Retail Generic: In Network - 10%, member pays minimum $10, maximum $50 per prescription
Out of network - 10%, member pays minimum $10, maximum $50 per prescription
Retail Formulary: In Network - 25%, member pays minimum $35, maximum $125 per prescription
Out of network - 25%, member pays minimum $35, maximum $125 per prescription
Retail Non Formulary: In network - 35%, member pays minimum $50 (no maximum) per prescription
Out of network - 35%, member pays minimum $50 (no maximum) per prescription
Mail order generic 10%, member pays minimum $25, maximum $130 per prescription, 90 day supply
Mail order formulary brand 25%, member pays minimum $85, maximum $310 per prescription, 90 day supply, member pay the difference rule applies if generic available
Mail order nonformulary brand 35%, member pays minimum $125 (no maximum) per prescription, 90 day supply, member pay the difference rule applies if generic available
Premium: $0 for myself and my son

Dental:

PPO Plan (Delta Dental):
Annual Deductible: $50 individual / $150 per family for in network & $75 per individual / $225 per family for out of network
Preventative: no charge in network / 20% copay after deductible for out of network
Orthodontia: 50% copay in or out of network and $2000 max per individual per lifetime
Basic Services: 20% after deduct in network / 50% after deductible out of network
Major Services: 40% after deduct in network / 50% after deductible out of network
Maximum benefit per year per individual: $2000
Premium: $0 for entire family / wife declines dental coverage from her company since it has a cost and my company will cover her for free
Company pays: $1510 / yr

Vision (Davis):

$20 copayment in network / $50 copayment out of network
2 pairs of glasses every 2 years
Contacts 100% up to $150/yr
Premium: 0 for myself and my son

Mental Health (Value Options):
10% copayment in network / 40% out of network (office visit / detox / substance abuse / inpatient / outpatient etc)
Premium: 0 for myself and my son
Last edited by djscal on Fri Jul 07, 2017 5:19 pm, edited 1 time in total.
JGoneRiding
Posts: 1973
Joined: Tue Jul 15, 2014 3:26 pm

Re: What are your health insurance stats?

Post by JGoneRiding »

Those quoting really low premiums, it that because you are not quoting employer portion ? Or not quoting aca subsidy? Bec that would seem to unfairly scew it.
Jackson12
Posts: 1022
Joined: Tue Oct 06, 2015 9:44 pm

Re: What are your health insurance stats?

Post by Jackson12 »

GraduateStudent wrote:I'm curious: what do other Bogleheads pay for their health insurance?

Here are the details of my employer-sponsored plan:

Premium: $283/month for family of three
Deductible: $250 per individual/$750 family maximum
Co-insurance after deductible: 10% paid by me / 90% paid by Plan
OOP Max: $1,500 individual / $4,500 family (100% coverage after this limit)
Geography: I live in the Greater Boston Area.
Age: My wife and I are both 31, son is 0.4.
Dental and vision separate

Questions:
1. Obviously there are more than four six important details here. But do these four parameters provide a reasonable starting point for comparison between plans?
2. Would (the collective) you please share your details? I'm curious to know what types of plans the Bogleheads bunch use.
Dreading retirement cost but maybe they'll be lower. For now :

Family co- pay medical plan, pre-fax with employer contribution. Premiums are $599.00 monthly.employer contributes $800. Disabled son, over age 26, is covered too.

Hospital ER visit: a flat $200 fee.
Most doctors visits cost $20 to $30

Dental insurance ( we use every bit of it: $95 a month, pre-tax, for $3000 of annual coverage.

Vision insurance :$15.14 a month - covers eye exams and a pair of glasses for each of us. We each get a pair a year because our prescriptions keep changing. Glasses and even eye exams are very expensive so the insurance is worth it.

FSA: $215.66 pre-tax

Deductible $2500 , $5000 family, but we use very little of it. Co- insurance. Deductibles count towards out of pocket limits. Most costs are covered and very little goes toward the deductible
Last edited by Jackson12 on Thu Jul 06, 2017 8:51 am, edited 2 times in total.
Jackson12
Posts: 1022
Joined: Tue Oct 06, 2015 9:44 pm

Re: What are your health insurance stats?

Post by Jackson12 »

mhalley wrote:This will be all over the map as it depends on your zip code and your company, and of course employment. I pay $2008 a month as a retiree at age 62 for me and the wife for a 7k deductable non hsa plan. :oops:
Will this be significantly lower at Medicare age? Or? I'm trying to calculate those expenses as we near 65, etc
User avatar
rosylenm
Posts: 127
Joined: Mon Aug 29, 2016 5:51 pm

Re: What are your health insurance stats?

Post by rosylenm »

what do other Bogleheads pay for their health insurance?

Here are the details of my employer-sponsored plan:

Premium: $802/mo (paid by employer/0 paid by me)
Co-pays & Rxs: $5.00
Deductible: none
Co-insurance after deductible: none
OOP Max: $1,500 individual
Geography: Bay Area
Age: 42
Dental paid by employer ($43.00/mo), vision covered by medical

I was considering the HDHP offered (so I could max HSA), but was persuaded by ED to continue with grandfathered health plan and contributing to FSA. I might reconsider in a couple of years if the HSA administrator changes.
Last edited by rosylenm on Wed Jul 05, 2017 10:18 pm, edited 2 times in total.
itstoomuch
Posts: 5343
Joined: Mon Dec 15, 2014 12:17 pm
Location: midValley OR

Re: What are your health insurance stats?

Post by itstoomuch »

Jackson12 wrote:Will this be significantly lower at Medicare age? Or? I'm trying to calculate those expenses as we near 65, etc
^Depends.
Depends on what the greater Public tells our elected legislators :oops: .
We're treading carefully here :confused .
Rev012718; 4 Incm stream buckets: SS+pension; dfr'd GLWB VA & FI anntys, by time & $$ laddered; Discretionary; Rentals. LTCi. Own, not asset. Tax TBT%. Early SS. FundRatio (FR) >1.1 67/70yo
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