this is NOT a post on the national health care issue...
about that, I will only say that I believe everyone...
should have access to quality, affordable, competent & concerned health care...
no one should have to be in fear of becoming sick or hurt...
or watch a loved one struggle with pain...
because they have NO health insurance...
or can't afford to go to the doctor...
as to who should set it up or run it...
that's beyond my wisdom...
having said that...
my health insurance monthly "co-pay"...
has risen to $175 per month...
which has contributed to the rapid evaporation of my savings...
[the total monthly cost is around $675, I pay $175 of that...]
when I started teaching in 1984...
school districts not only paid ALL the premiums for medical, dental & vision...
for ALL district employees & their dependents...
they also paid all of it for retirees until age 65...
[they will cover "their share" of my medical until I'm 65...]
the last year I taught[2005]...
I took the cheapest option for health insurance...
[I don't consider K an option...]
and had to pay $15 per month, taken from my check...
and only 3 years later, my share had risen to $175...
while I also pay $55 per month...
for about 2/3 the dental plan that used to be included...
and now, I have NO vision coverage at all...
[an eye exam & new glasses cost me almost $500 last summer...]
my chiropractor has never been covered...[$40 per visit...]
so on Saturday, when I found the fat envelope from "risk management"...
[school district speak for "insurance & benefits"...]in the mail...
I opened it with great interest...
as my FFers buddies had just been talking about the "changes"...
it seems that school districts all over are jumping on the CalPers bandwagon...
CalPers is the state workers retirement/insurance organization...
my Mom had their long-term care coverage, considered the best...
and now, CalPers has opened their network to districts...
at a significant reduction in costs to the district AND the employees...
they offer Blue Shield HMOs, Blue Cross Anthem PPOs & K...
6 plans in all... 3 HMOs... 3 PPOs...
but here's the GOOD NEWS...4 plans,[2 BS HMOs & 2 BC PPOs]
ARE NO ADDITIONAL COST TO ME [for individual coverage...] !!!
the HMO plans and the PPO plans both...
have small co-pays & check-ups are free...
but... the PPOs include a maximum $500 annual deductible...
AND include paying a percentage[20%] of the cost of many services...
that HMOs don't charge for like physical therapy, surgery, etc...
I believe that when the deductible is reached...there is no further charge...
since there there is a maximum lifetime benefit...
of $2,000,000 per member...
but I'll learn more about that at the meeting...
the BIG difference between the two is...
HMOs only allow certain doctors to be your PCP...
with PPOs, there is a much bigger network of doctors available...
to to choose from, you generally don't need a referral to see a specialist...
and you can see doctors who are not in the network...
but you have to pay a higher percentage...
HOWEVER... my current PCP[doctor] is only available...
as are many other choices in care providers from S-G...
if I choose the Blue Cross Anthem Select, a PPO...
and since that is one of the plans that would require no buy-up from me...
it's looking better and better...
my current Blue shield plan is NOT available from CalPers...
with it, I paid only 2 $10 co-pays for the whole finger thing...
BUT... am paying $175 per month in a buy-up...
if I'd been under the new plan when I had the accident/surgery...
it might have cost me as much as $2000...
as it would, had my insurance NOT changed to Blue Shield from HN...
just after the accident, allowing me to have the best surgeon...
and physical therapy...at NO cost to me...
because of the advantages of Blue Shield...
so I'm sitting here, amazed at how God has threaded this maze...
open-enrollment is next week...
the "informational meeting" is Thursday night...
the new plan will start in November...
I've paid my monthly fee through March, so I'll get a $700 refund...
right when I need to renew my car insurance ...
and pay my annual dental insurance premium ...
and my property taxes... so it will help a lot...
the potential jobs are exciting...
but this saving of $175 per month is definite...
and it couldn't have come at a better time...
God is good... ALL the time...
2 comments:
Thank heavens someone is getting a break in the insurance game! I will be spending more next year for the same coverage (high deductible plan, to save mnoney) and my pension isn't going as far. We just got a bunch of notices from the retirement system - health insurance and dental are going up, and cost of living increases on the pension are frozen for the next four years. I haven't had eye coverage for several years so have had to buy three sets of glasses in the last six years out of pocket (darned cataracts) and had to spring for the prescription sunglasses for driving because I was told I should always wear them outdoors. With my husband's and my chronic problems, health care costs are becoming an issue.
I truly think we should be able to work out a national plan so that everyone gets at least the basic coverage. Having said that, I am scared of what could happen if the reforms enacted allow employers to pay into a pool and drop their current insurance offerings. My coverage right now is good for health care consumers such as us. Under another plan, who knows?
I guess the thing that bugs me the most is that this mess is called health care reform when it's actually health insurance reform. No one is addressing the real reasons people can't afford health care - exorbitant doctor charges. My dermatology specialist charges $100 for a 5 minute office visit. My husband's ophthalmologist charges nearly $200 for the same time. And there are the $30,000 back surgeries like my friend had, and $2500 for the privilege of sitting in the emergency waiting room like we did last month - we only spent maybe 10 minutes with the doctor after a 5 hour wait, so that charge was what I consider "seat cost", not care cost (and it didn't cover any of the tests or the actual doctor's time - oh, no, that was billed separately)! I could rant on and on but I'm sure you understand.
ANYWAY (deep breath) - glad to hear you're getting a break.
...I agree with many of your thoughts... I'm especially afraid of a system like what I've tried to avoid by distancing myself from K, even though they have always been the cheapest... though now, their HMO on CalPers costs $40.00 per month...
it's always something, isn't it ?
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