So I got a new job and am trying to pick insurance. The insurance company is United Healthcare. I did a quick google search and the reviews are less than stellar, pretty craptastic actually. So, I'm asking the hive a few questions, hoping you'll have some wisdom.
Do you have private insurance, and if so, who is it through and are you happy?
Am I crazy for wanting to skip insurance totally and self-fund? (I have a wife and three kids)
Does anybody really know the laws and regulations after Obama-care?

The reason I'm considering skipping insurance is I never meet the family (or individual) deductibles, so at that point I'm self-funding my health care anyway.

1-Yes. All health insurance companies still suck. We are with Coventry. They are affiliated with a local hospital. They aren't too bad, but the bureaucracy will sucks the life out of you if you have a problem.

2-Yes. The Supreme Leader will now hit you with multiple thousands in fines if you don't support the insurance industry. You have no choice but to participate or face the consequences. You must also still pretty much pay for everything unless you are a congresscritter.

3-No. They passed it so we could find out what was in it. No one has actually read it yet. This is a joke. But the answer is still no.

Not sure what I broke up there. Not sure how to fix it.

As I am employed by a pseudo health insurance company, I feel pseudo qualified to answer.

I work for a TPA for those in the know.

When checking out insurance companies reviews may not be the best answer. Any insurer really just has to play by the rule book which is the plan.

You said you got a new job, so get your hands on a copy of the plan. That is going to be the only tell of how the plan is going to be. Look at copays, deductibles, out of pocket maxes, etc. Those are the benefits.

As for Obamacare....

Go to Healthcare.gov and walk through some of the plans. How do they stack up against the plan your employer sponsors.

You, as a consumer, are required to have health insurance of some sort. That is Obamacare too. Individual Mandate is the keyword there for more info.

I will tell you this, self funding only works if you are guaranteed healthy. First illness and you could end up with nothing. Literally.

let me know if you have more specific questions.

I am not a broker by the way, so this is all my opinion unless you corroborate it elsewhere.

I had insurance through United for many years, no complains. I now have Blue Cross Blue Shield.

It really depends on the plan they offer. I used to get it through my wife and her employer offered different plans at different prices.

Slippery wrote: I had insurance through United for many years, no complains. I now have Blue Cross Blue Shield.

+1

Or as Toyman would say

+1.

1. I am assuming that by "private insurance" you mean getting a health insurance policy from a source other than your employer's group health plan. If that's what you mean, no. For the companies I've worked for, I have found it very difficult to beat the employer's subsidy on the health plan. Keep in mind that if you are offered group health insurance, you are ineligible for income-based subsidies for health insurance plans purchased under the Affordable Care Act.

That said, my most recent group health plan was through Cigna. I had no complaints - never an issue over covered services, always was able to see who I needed, when I needed.

1. Yes. Anything more than a visit to a general practitioner for the flu has the potential to leave you bankrupt. The nights in the hospital really add up.

2. Probably not. However, I prefer pie to flounder so I'm going to leave it at that.

So, it looks like I have two options:
1) Take my employers insurance plan and deal with it 2) Move to Mexico and become a Mexican Citizen, then cross back over here and stay as an illegal alien since they are exempt from the penalty for no insurance and will still be treated in a hospital!!! AND TAX DOLLARS WILL PAY FOR IT

Nicksta and Slippery: Did you have to use your United coverage for anything other than a routine doc's visit? I'm only asking because the reviews I read were pretty terrible. I know though, that these reviews could have been written by someone that didn't understand the plan or coverage and such.

I used it for the birth of two of my kids plus all the associated visits. I also used it when I ended up at the ER due to what ended up being a kidney stone. Never a problem and I only had to pay whatever the copay was.

I also happened to get a second kidney stone while in Germany. This time I knew what it was but the pain was so bad that I went to the hospital there. I paid out of pocket and when I arrived back in the US called them and they reimbursed me everything. That, I was not expecting and was pretty happy with.

Other than that a few regular visits here and there to the dr., mostly my kids.

We later changed to Blue Cross as they had a better plan for us. My wife's work offers both and different tiers of each.

We've got a United plan via my employer. So far they seem to be pretty decent with fairly minimal fuss, but we haven't had anything big (yet). They griped about some eye medication I occasionally have to take but every insurance hates paying for that one because there is no generic alternative and it's fairly expensive.

One thing that I noticed when phoning around for a family doctor was that everybody asked if this was an ACA plan from an exchange (which they would not accept) or a regular employer plan (which they would). A lot of the ACA plans have extremely limited networks, at least out here, so I'd check with your doctor(s) first before taking out one of those plans.

Had it when our son was born. The wife had a lot of problems and they had to stop premature labor three times before the due date. She also had several other health issues and we never had any issues with them that I can remember. She says that they were one of the better companies we've had over the years.

I worked for UHG for many years. No one likes any health insurance. Take your pick of who you want to hate. It's all down to the plan, not the carrier. If you have specific question, I may be able to answer them with regards to your potential plan.

DrBoost wrote: Nicksta and Slippery: Did you have to use your United coverage for anything other than a routine doc's visit? I'm only asking because the reviews I read were pretty terrible. I know though, that these reviews could have been written by someone that didn't understand the plan or coverage and such.

The thing is... in terms of what they pay for vs deny isn't really up to them most of the time.

I can guarantee you that 99% of the terrible reviews are from customers that have no clue, or people complaining about how customer service was rude. Doubtful it has anything to do with the quality of benefits administration.

I have The Empire Plan through United Healthcare. They have been fantastic. It is the most expensive plan my company offers but with my wife's history I felt it would a good investment. She is a diabetic,was born with a number of serious issues and had a stroke two years ago. They have covered almost everything with little trouble. There are some things the don't cover and in some instances they suggested work arounds. Keep in mind if you do have a probl and have been denied something being friendly goes a long way. People have little incentive to go out of their way for someone that starts out angry.

Now that I have had more experience with doctors and insurance than anyone should I have learned to discount Internet reviews. The people who generally write them have never read their plans and just assume their cut rate plan should cover everything.

My company began all new health plans for 2014--I thought that this would be an easy year and was tempted to go light on my family's insurance coverage. Now that we've had a pregnancy, two ER visits, three surgeries, and a course of physical therapy (and it's only July!) I'm so, so glad that I didn't cheap out or (heaven forbid) self-fund.

DrBoost wrote: Nicksta and Slippery: Did you have to use your United coverage for anything other than a routine doc's visit? I'm only asking because the reviews I read were pretty terrible. I know though, that these reviews could have been written by someone that didn't understand the plan or coverage and such.

the company where I worked had United Health Care for the last 6 or 7 yrs before I retired …

it wasn't as "great" as the company prior to UHC, but it was fine … the biggest differences were those imposed by MY company .. the cost to me, the deductible, the out of pocket max. etc …

there never was any problem with my health care providers getting re-embursed

I never got any dunning letters from health care providers because of late re-embursement

as for coverage above and beyond "normal" care…

I had heart surgery (catheterization with 2 stints) and including pre-op treatment and post-op treatment + the surgery itself…. my total bill was $20

hope this helps, and do like mentioned above and read the plan very carefully, compare to anything you can get on your own

I'm in somewhat of the same boat. My company is moving to pa and I am not going, so its time for a new job. We had fully paid insurance that decent, so now I'm spoiled.

I've been on three interviews so far, and two of the three have dropped healthcare totally because of expense, and the third is 100% paid by you. Oddly they are a hospifal.

So....I've been insurance shopping...and damn is this stuff expensive. If I buy my own I am probably looking at $800 plus a month with very high deductibles. I don't qualify for any government free giveaways either. I'm going to have to keep job searching I suppose even though all three have offers.

Interestingly I did learn that the hospital wrote off $66 million last year in care to illegals. Maybe I'm heading to mexico and sneaking back too!

DrBoost wrote: The reason I'm considering skipping insurance is I never meet the family (or individual) deductibles, so at that point I'm self-funding my health care anyway.

That's what I did this year when I went with the even higher deductible plan.

$7000 out of pocket with a diagnosis of sleep apnea and acid reflux later......

re. Dr. Boost … just because you never met the family/individual deductibles, doesn't mean you're self-funding … what is happening is that you are "enjoying" the ins. co. negotiated prices for what procedures you've had … which, even if you're having to pay out of pocket, it's no where near what it would have cost if you'd been "on your own"

wbjones wrote: re. Dr. Boost … just because you never met the family/individual deductibles, doesn't mean you're self-funding … what is happening is that you are "enjoying" the ins. co. negotiated prices for what procedures you've had … which, even if you're having to pay out of pocket, it's no where near what it would have cost if you'd been "on your own"

I'm not sure I agree.

I have always paid on my own- over 30 years. Every single time we ever had need for medical care the provider or hospital was willing to negotiate and drop the prices significantly (at times by several thousand dollars) for a cash buyer.

Generally, the savings was in the vicinity of 40-50%.

YMMV

ok … I was basing my post on a friends predicament …

he was a self employed auto mechanic (had worked for a indy parts house for the original hip replacement)

when that hip went bad and needed to be replaced, he was without ins.

hospital quoted him something in excess of $50k … of course he didn't have that kind of money

he tried to negotiate for the ins price of ~ $25k … while that would have hurt financially, he could have found a way

they basically said tough E36 M3 .. they offered a payment schedule … guess he could have agreed then just stopped paying … but since he owned his home, the collection agency probably would have come after his assets

so he was resigned to becoming more and more crippled as time went by

then his Mom died (he was the only surviving relative) and she left fairly large estate

went ahead and got the surgery (at full price) …hospital still wouldn't work with him

Let me see if I can ask a reasonably balanced question about the whole "You could go bankrupt" thinking.

Though I have always self paid, I'd rather have insurance. Simply have not been able to.

I understand the possibility of a catastrophic scenario. But "you could loose everything" is simply not part of a balanced discussion, in my opinion. It's a little like selling life insurance by saying, "You could die". Uh, yeah...duh.

But that is NOT a reasonable way to measure the cost.

So, here's my dilema. The MINIMUM actual out of pocket cost to me for my family is about $12,000 per year, if we never file a claim. That is a VERY big percentage of my income. If we have a claim, there would also be a deductible of another $12K. So, I could be out $24K before I ever got a single dollar of benefit.

So, let's assume insurance is a good idea. My family is healthy, so we will be paying about $12K per year. And let's assume we have a serious medical issue in 5 years.

We will pay $12K per year for 4 years, and $24K in the 5th year (assuming no price increases- bad assumption.) We will have paid $72,000 before we ever get any significant benefit.

That sounds like a pretty good path to bankruptcy too.

That means, until we have a medical condition that exceeds $72,000, we are better off (financially) self paying.

We have savings. We could weather a $10K medical expense without too much trouble. $10K per year for 3 years would hurt badly, but we would survive. A $50K medical expense would be terrible, but it would not cause bankruptcy. A $100K medical expense would leave us indebted to the hospital for an extended period (decades?).

What am I missing here? Help me see this is a sensible way that is not extremist.

Again, I'd like insurance. Just can't make it make sense.

In reply to wbjones:

Your friend is not very good at negotiating.

The keywords are "cash, in advance".

Hospitals will jump through hoops to see green stuff. Most of what they do is all about cash flow and financing other people's problems, or wading through mountains of bureaucracy and waiting for months before they get paid. There is a cost to this- it is included in their normal operating prices, and insurance companies pay it.

The 5 times my wife gave birth we paid in advance. Price was discounted every time between 50% and 70%.

Edit: This ONLY works in a direct conversation directly with the business manager. Not a clerk, or a doctor.

Ugggghhhhhh here we go again.

I think what we're missing now is that you get a penalty for NOT having insurance. For each family member. Would you rather pay to have insurance? Or would you rather pay to not have insurance.

We've been round and round on the cash option with the providers thing, and long story short, if they're doing that, they're breaching various contracts.