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Health Insurance upon finishing residency

maxpower75

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  1. Attending Physician
    Hello all, I am currently a final year Nephrology fellow looking at jobs, I found a pretty good job offer that I am currently considering. I was kind of suprised when I was looking at the health insurance, I was curious if this kind of cost was the norm, the employee only cost is relatively cheap ($35.31 biweekly), if you include your wife it is $273.20 biweekly, the whole family plan is a total of $411.94 biweekly.
    Being a resident I am kind of ignorant regarding health insurance costs, is it fair to assume that you will pay about 10K/yr for health insurance premiums? I was curious if I could get some insight if this was pretty standard, or If I need to do more research on this topic.
    I thank you in advance!
     

    OldPsychDoc

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    1. Attending Physician
      Hello all, I am currently a final year Nephrology fellow looking at jobs, I found a pretty good job offer that I am currently considering. I was kind of suprised when I was looking at the health insurance, I was curious if this kind of cost was the norm, the employee only cost is relatively cheap ($35.31 biweekly), if you include your wife it is $273.20 biweekly, the whole family plan is a total of $411.94 biweekly.
      Being a resident I am kind of ignorant regarding health insurance costs, is it fair to assume that you will pay about 10K/yr for health insurance premiums? I was curious if I could get some insight if this was pretty standard, or If I need to do more research on this topic.
      I thank you in advance!

      Welcome to the REAL (non-student) world...
       
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      gng930

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        Wow, that jump when you include your wife is pretty significant ($200+ biweekly). Consider just buying it for yourself and doing some outside shopping for your wife and kids. When I was looking at HMOs for myself while taking off time from school, it was definitely less than $200 per MONTH (~$160 IIRC) for Kaiser which (surprisingly) has the highest satisfaction rate among HMOs.
         

        f_w

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          Sounds about right for a group policy. Doesn't the employer kick in some pre-tax money on this ?

          You are a physician. You might want to consider an HSA based high-deductible plan. You only pay insurance on the stuff you really need to insure and you pay the other things out of your HSA with afaik pre-tax money (but at insurer negotiated rates, not list-prices).
           

          Winged Scapula

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          1. Attending Physician
            :eek: Do you smoke like 10 packs a day? That's insane.

            No, I'm a non-smoker, never smoked, never been treated for substance abuse, never had a moving violation, who takes no medications, has had no major surgeries, no genetic diseases and with no health problems other than migraines.

            My employer provides it, and this was the cheapest plan that had some sort of hospital coverage...as it is, its only 80/20.

            You'll be suprised when you head out into the real world...this is is why a lot of working Americans don't have health insurance. Not because they can't afford it, but because they don't want to. The rate also goes up as you get older. If I was under 30, it would be cheaper.
             

            Winged Scapula

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            1. Attending Physician
              Sounds about right for a group policy. Doesn't the employer kick in some pre-tax money on this ?

              My employer pays for all of it now, but when I become partner then it will be my debt. And yes, it is a group policy.

              You are a physician. You might want to consider an HSA based high-deductible plan. You only pay insurance on the stuff you really need to insure and you pay the other things out of your HSA with afaik pre-tax money (but at insurer negotiated rates, not list-prices).

              I don't have a choice...I get what my employer offers. Frankly, I don't have time to shop around for a better policy. However, even the above has a $1000 deductible and as I noted, is not the best plan (ie, mammos only every 2 years, despite the fact that the current recommendations are q 1 yr).
               

              docB

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              1. Attending Physician
                For everyone leaving residency I suggest you ask for a letter from the company that provides your benefits stating that you have been insured continually for however long you have been covered. It becomes important when you have to go out and buy insurance on the private market. Insurers can exclude pre-existing conditions like hypertension. If you have been insured and can prove it (the letter) you can avoid having your pre-existing condition excluded. Most insurers will know what you mean when you ask for such a letter. Mine just sent it to me when I left the UC plan. Unfortunately for me it didn't help because NV insurers can pretty much do whatever they want.
                 

                Winged Scapula

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                1. Attending Physician
                  For everyone leaving residency I suggest you ask for a letter from the company that provides your benefits stating that you have been insured continually for however long you have been covered. It becomes important when you have to go out and buy insurance on the private market. Insurers can exclude pre-existing conditions like hypertension. If you have been insured and can prove it (the letter) you can avoid having your pre-existing condition excluded. Most insurers will know what you mean when you ask for such a letter. Mine just sent it to me when I left the UC plan. Unfortunately for me it didn't help because NV insurers can pretty much do whatever they want.

                  Very important.

                  My current insurance denied me coverage for my migraines because I didn't supply them evidence that I have been continuously covered. I HAVE the documentation from my previous insurers but never knew what it was for...now I know.

                  Now I just have to get around to sending them to my current insurer. Devils.:oops:
                   

                  gng930

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                    No, I'm a non-smoker, never smoked, never been treated for substance abuse, never had a moving violation, who takes no medications, has had no major surgeries, no genetic diseases and with no health problems other than migraines.

                    My employer provides it, and this was the cheapest plan that had some sort of hospital coverage...as it is, its only 80/20.

                    You'll be suprised when you head out into the real world...this is is why a lot of working Americans don't have health insurance. Not because they can't afford it, but because they don't want to...

                    The thing is that I did have to take off 2 years from school when I worked at a job with no benefits. I had to do my own insurance shopping and saw reasonable plans that had high deductibles/copay but would basically take care of you in case of major illnesses. Even the most expensive Kaiser plan isn't much more than $200/month, even for someone in their early 30s. Now I'm not saying it shouldn't be a problem for the average American household to pay that x4. I'm just saying $450/month seems excessive especially if it's being offered as part of a "benefits" package. My parents are in their 50s, have both had cancer, one with multiple risk-factors for heart disease, and I'm POSITIVE they don't pay that much COMBINED for health insurance.

                    I wonder if us working in a hospital where exposure is such a huge risk has to do with the ridiculous cost.
                     

                    f_w

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                      The jump from 'employee only' to 'employee+spouse' is the result of the employer being able to subsidize up to 90% of the premium for the employee without having to report this subsidy as employee income. For spouse and family coverage the rules are stricter.
                       
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                      gng930

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                        You might want to ask them about that.

                        I don't need to; I was the one who filled out their last benefits renewal package. $140/month covers my parents and sister. And seeing as how they both had surgery to resect their cancers and didn't need to sell their house to pay for it, I'd say they're pretty well covered.
                         

                        f_w

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                          I don't need to; I was the one who filled out their last benefits renewal package. $140/month covers my parents and sister. And seeing as how they both had surgery to resect their cancers and didn't need to sell their house to pay for it, I'd say they're pretty well covered.

                          Is that individually purchased health insurance or is that an employer or union subsidized plan ?
                          (you mention 'benefits renewal', that would indicate that the balance of the $1200 that this coverage costs on the open market is paid for by an employer or union)
                           

                          gng930

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                            Is that individually purchased health insurance or is that an employer or union subsidized plan ?
                            (you mention 'benefits renewal', that would indicate that the balance of the $1200 that this coverage costs on the open market is paid for by an employer or union)

                            Yes it is part of my mother's employer's benefits package as is Winged Scapula's. My original question was concerning him/her paying so much for a employer-subsidized health plan. Why are 3 people (2 above 50 y/o with a medical history) combined paying 1/3 the premium of a 30-year-old with a pristine medical history.
                             

                            f_w

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                              Y Why are 3 people (2 above 50 y/o with a medical history) combined paying 1/3 the premium of a 30-year-old with a pristine medical history.

                              Mh maybe because one employer is more generous than the other ?

                              Physician practices are often a bit different from regular companies in that regard. Once you become partner, you pay your entire health insurance out of your share of the overhead, policies for employee physicians tend to reflect that structure.

                              Also, health insurance for employees is one of the largest expenses for small companies. If your employed physicians are part of the same company as your ancillary staff, you may have to offer them the same deal as the staff (depends on your state). If you give free family health insurance to fred, you recently married associate physician, you also have to give free family insurance to Yessenia who is running your front-desk ( and her 6 children).
                               

                              Winged Scapula

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                              1. Attending Physician
                                Yes it is part of my mother's employer's benefits package as is Winged Scapula's. My original question was concerning him/her paying so much for a employer-subsidized health plan. Why are 3 people (2 above 50 y/o with a medical history) combined paying 1/3 the premium of a 30-year-old with a pristine medical history.

                                First of all I am closer to your parent's age than I am to 30.:p

                                Secondly, I never said I paid that much for the insurance. My employer pays the entire amount for me. Once I become partner, then yes, I will be responsible for the cost myself and I will likely choose a different plan (not because of the cost per se but because I think their coverage stinks).

                                Nonetheless, costs vary wildly depending on employer contribution and group size. Large offices and corporations often get cheaper health insurance simply due to the number of employees they cover. This is why I got great coverage as a resident with only a small personal contribution (lie $32 a month). Small offices do not have that bargaining power and therefore the monthly cost is more. As f_w points out, it is one of the largest costs to small business owners.

                                I suppose the cost would be lower if I chose a $2500 deductible, but since I am not paying the monthly cost it didn't seem to be prudent to me to choose the plan which would have me pay more out of pocket. Health care in some states is more expensive than others as well. At any rate, I saw the Mercy Care cost table and for a female my age, it ranged from about $300 a month to mid 400s (higher costs associated with lower deductible, better script plan, etc.) So if it makes more sense to you, I could have chosen the $300/month plan with a $2500 deductible, higher office visit and prescription costs but did not since I am not paying for it. When I get to the office tomorrow, I can give you more accurate numbers.
                                 

                                gng930

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                                  First of all I am closer to your parent's age than I am to 30.:p

                                  Secondly, I never said I paid that much for the insurance. My employer pays the entire amount for me. Once I become partner, then yes, I will be responsible for the cost myself and I will likely choose a different plan (not because of the cost per se but because I think their coverage stinks).

                                  See that clears things up. I was under the impression that they were DEDUCTING that amount from your paycheck each month.
                                   

                                  Winged Scapula

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                                  1. Attending Physician
                                    See that clears things up. I was under the impression that they were DEDUCTING that amount from your paycheck each month.

                                    Ahh...see my post #8 above in which I stated that my employer pays for it all; there is 0 payroll deductions for my health insurance.
                                     
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