This is absolutely crazy ......

[deleted310399]

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Allright , so I am a resident in Psychiatry at an East coast program. Like everybody , I am covered by my program as far as health insurance goes and so is my wife ( she is not working right now and is about to start residency this June when her own HI would kick in ). She recently got sick - Gastritis , it was pretty bad for a couple of hours. We called the insurance guys as we were planning to go to the ER. What she told me was kinda shocking , It was a 600 $ deductible for EVERY ER visit with a 20 percent coverage after that until 3000 $. This after I pay ( what I believe ) is a huge amount every month as mine and her's premiums. Now , this got me thinking , every-time something happens to me and my wife and I mean ANYTHING and we have to go to the ER ( at the hospital that I work at ) , it is 600 $ and more - the 20 percent that is. This sucks !!!!......do the other residents have similar deductibles?
I mean the majority of hospital visits for a healthy person would be ER visits , right - everything ranging from abdominal pain to cutting your hand while cooking, and we are basically paying for it out of pocket - after already paying money each month. I don't care what you say but THIS IS EXTORTION !!

What do you guys have to say ? Should I change plans ? try and get on my wife's plan starting June ....

 

[Stellar Clouds]

My program's plans range from a $500-700 deductible, $115 co-pay (per visit for the ER) and either 10 or 20% after I pay the deductible with an out of pocket maximum ranging from $3000-3750. Not outrageously different from yours, except your seemingly exorbitant co-pay (from what I can gather--what you are calling a deductible). For minor stuff, try an urgent care center. It's usually a lower co-pay.

If you think your plan is unreasonable, then hop on your wife's plan if it provides better benefits for less cost.

 

[koennen]

Allright , so I am a resident in Psychiatry at an East coast program. Like everybody , I am covered by my program as far as health insurance goes and so is my wife ( she is not working right now and is about to start residency this June when her own HI would kick in ). She recently got sick - Gastritis , it was pretty bad for a couple of hours. We called the insurance guys as we were planning to go to the ER. What she told me was kinda shocking , It was a 600 $ deductible for EVERY ER visit with a 20 percent coverage after that until 3000 $. This after I pay ( what I believe ) is a huge amount every month as mine and her's premiums. Now , this got me thinking , every-time something happens to me and my wife and I mean ANYTHING and we have to go to the ER ( at the hospital that I work at ) , it is 600 $ and more - the 20 percent that is. This sucks !!!!......do the other residents have similar deductibles?
I mean the majority of hospital visits for a healthy person would be ER visits , right - everything ranging from abdominal pain to cutting your hand while cooking, and we are basically paying for it out of pocket - after already paying money each month. I don't care what you say but THIS IS EXTORTION !!

What do you guys have to say ? Should I change plans ? try and get on my wife's plan starting June ....

Get used to it. Once the train wreck called Obamacare fully kicks in you will think back to this as the good old days.

 

[dpmd]

I have seen sometimes where the insurance company has a high copay for the ER visit but it is waived in certain circumstances (such as if you end up admitted after, or have some other sign that it was for a true emergency). Since going to the ER is a lot more expensive than urgent care or your PCP it makes sense that they would want to create an incentive to reduce ER visits. Since it sounds like she didn't end up going to the ER (and presumably nothing awful happened) if this is their policy it would have worked.

 

[Gasworks]

get used to this.. my groups "cadillac" insurance left me with almost $6k in out of pocket expenses after my wife had a baby. This is the same insurance carrier that forced the group into a new contract that cost us nearly $750,000 in decreased revenue last year and guess what my insurance premiums will soon be subject to a 40% obamacare tax.

Luckily I earn enough to be able to cover these added costs without too much pain but I cant imagine how a family with a $100k combined income can survive with this level of increased overhead.

 

[IlDestriero]

get used to this.. my groups "cadillac" insurance left me with almost $6k in out of pocket expenses after my wife had a baby. This is the same insurance carrier that forced the group into a new contract that cost us nearly $750,000 in decreased revenue last year and guess what my insurance premiums will soon be subject to a 40% obamacare tax.

Luckily I earn enough to be able to cover these added costs without too much pain but I cant imagine how a family with a $100k combined income can survive with this level of increased overhead.

That doesn't really sound like Cadillac insurance at all.
With a real premium plan, you would have been out of pocket a few hundred and your max annual out of pocket would be far lower. Or maybe I have a Rolls Royce plan.😉

 

[dpmd]

As a resident we were pretty low on the pay scale, but for about 200 a month for two people our insurance let me get a lot of care for not much money (no copays for meds obtained from our campus pharmacy, or for any care received in our facility-including lab/imaging/PT/hospitalization. Got a specialty med twice that costs several thousand dollars-free the first time and $30 the second, and I got an outpatient surgery for only $100 including DME). They are actually coming out with a version of the plan making our facility the only network facility and our docs the only network providers (plus some private practice primary care types since we don't have enough) that will cost about $60 a month for two people. Not sure how the will deal with the stuff we don't really do here or what kind of wait times there will be for stuff since we are already pretty busy and the majority of employees go elsewhere for care right now (since we are the county hospital and the clinics/facility aren't that nice looking-I only did stuff here because I know people here that let me cut the line for stuff).
It is way better than what I will end up paying once I leave here for private practice.

 

[rokshana]

wow...do your hospitals not cover your deductibles if you go to your own hospital?

 

[45408]

That doesn't really sound like Cadillac insurance at all.
With a real premium plan, you would have been out of pocket a few hundred and your max annual out of pocket would be far lower. Or maybe I have a Rolls Royce plan.😉

When my wife had a baby last year, it cost me $75 total. I don't even pay my premiums either.

 

[Psychiatrized]

That is insane. I have great health insurance at Tufts. At my hospital almost everything is 100% covered. PCP visits are $10, ER $50 but no co-insurance or deductibles. MRI I had was $0. I had a baby and paid a single $10 copay. Regular ob and preventive visits are $0 at Tufts, $10 elsewhere. Medication copays are between $5-20. I think that if we having expensive imaging at other hospitals it costs up to a couple hundred bucks so I just get my care here.