By: Revanche

Remember, remember, the fifth of November

November 11, 2014

Actually, I don’t mean Guy Fawkes Day at all.ย  That just reminds me that it’s November which, for us, means the days of open enrollment!

I used to do a comprehensive analysis with pen and paper: comparing all possible copays and deductibles, estimating the cost of possible treatments and coverages, etc, etc, etc. We always ended up signing back up with the HMO.

This year?ย  Hell with it.

I know what our HMO covers for medical services and it’s fine. I’ve never had trouble getting a referral to a specialist when I need one and they have a pretty awesome (read: they have one at all) department that specifically deals with chronic pain. Don’t use them much but they’re there to provide support.

I could have wished to go with a provider who would let me have my regular OB deliver LB but it’s way the hell too late to worry about that and besides, I’d really want that because I LIKE my OB. She wouldn’t be available if we went with a PPO.

Our prescriptions are made as easy as I could ask for generally, except if I forget to order a medication refill far enough in advance for mail order delivery, then I just have to wait a few more days. Prescriptions are basically $10 or less without fighting over getting this brand or that generic. I don’t have to deal with approvals and the hassle of hit or miss,ย  inept retail pharmacies, we get pharmacy folks who are dog people so they understand the plague of the paw-licking dog, and remind us that people are kind of ridiculously stocking up on wound cleanser in their fear of Ebola. (What the hell is a wound cleanser going to do for you if you get Ebola?)

Our dental coverage is the more expensive one but it’s good for our needs as far as treatments being covered. They are really stupid at billing, sending us bills that say we owe 100% but I ignore those and three weeks later, I invariably get a zeroed out bill.

We have basic vision coverage for literally less than $5 a month and this is sufficient to keep PiC in glasses or contacts every other year.ย  I have been lucky enough only to need my eyes checked for medication side effects (none) and have thus far avoided glasses.

So we’ll keep the same coverage options. With the projected increases in medical and prescription premiums for 2015, and then a new one to cover, we’ll be paying an additional $857 annually for the privilege. Yay.

Edit: It could actually cost us $1457 extra depending on one thing out of my control right now. ARGH.

Have you made your elections for the upcoming year? Are you looking at some serious increases?

15 Responses to “Remember, remember, the fifth of November”

  1. Ours is Nov 15 and I will be exploring new insurance or a new plan. Mine went WAY up this year. ๐Ÿ™
    Tonya@Budget and the Beach recently posted…Health & Wealth Challenge-Week OneMy Profile

  2. My insurance open enrollment ends December 7th, and I just don’t want to do it. But I need to because Tim hates the doctors on the plan, and I’m not thrilled with them either. Plus I’d like to get something that has dental insurance because I want to get at least something deducted when we do Tim’s teeth. I’m hoping that we could do one jaw at the end of next year and the upper jaw and the start of the next. But we’ll see.

    Point being, I have to wade through a lot of choices and… blech.
    Abigail Perry recently posted…Why Iโ€™ll never feel safe financiallyMy Profile

  3. SP says:

    We had increases last year. I had no idea how good my coverage was until I switched jobs! T’s isn’t bad, but it is mediocre. I think we pay over $150 a month for a basic HMO. I hate making this decision every year. It really should not be so difficult.
    SP recently posted…The library isnโ€™t freeMy Profile

    • Revanche says:

      Yeah we’ll be paying at least that much for the basic HMO, if not more, this coming year. Though the basic has been sufficient for our needs, it’s still really expensive!

  4. Patti says:

    I’ve had two do four open enrollments this year: Un-enroll from min, enroll in hubby’s for our family, check out Medicare enrollment for my dad (will try to add a Prescription Drug plan) and am waiting for open enrollment for my mom with the ACA. All different animals w/different needs. As far as switching between mine and husband’s the cost won’t be significant difference but we’re going from 90% coverage (mine) to 85% coverage (his). Also impact will be felt less because he makes more money than I do, so the % taken out of his pay will be less than mine. So much work to do tho.

    • Revanche says:

      Holy cow. I was dreading having to deal with my dad’s ACA but thankfully a 3rd party was able to help with that. I don’t think my brain can take much more than that.

  5. Linda says:

    I used to be the same way about open enrollment, but what made it easier for me to decide which plan to pick was finding an awesome doctor…who doesn’t bill insurance. That pretty much determined that I needed to go with a PPO, and I’ve stuck with it ever since. Even though I’m moving and will have to get a different doc, I didn’t want to take the chance that I’d end up with another doc like the one that told me I needed SSRIs and Weight Watchers instead of treating me for hypothyroidism (despite the blood work showing otherwise).

    As I told my doc when I saw her in September for my final check up, I’m worried I won’t find a doc as awesome as her after I move. Considering that I’ll be in the Bay area, though, I’m hoping my chances of finding a good doc who doesn’t think an SSRI is the magic answer to all of life’s ills is fairly high. ๐Ÿ™‚

    Frankly, I don’t care how much I pay for insurance as long as I get competent care and have the choice of whatever doc I want to see without a lot of hassle. That pretty much guarantees that I need to stick with our PPO for now. I also pay for dental and expanded vision coverage so I can get new eyeglasses every year. I think next year I’ll be getting prescription sunglasses since California is so relentlessly sunny in the area I’ll be living. ๐Ÿ™‚
    Linda recently posted…The waterworks editionMy Profile

    • Revanche says:

      I’m starting to feel the same: I want the least amount of trouble for the best amount of care that I actually need. So far we’re at an ok equilibrium so I’m happy to just hold steady even if we’re paying a ton more (which I don’t love…)

  6. Clare says:

    I just finished the process of getting Drew added to my insurance for 2015 now that we’re married. He works for a startup with minimal coverage and mine is just better. I crunched all the numbers too– puts us back about $50 per month for him to share my coverage. For great health care, worth it!
    Clare recently posted…Why You Drink and How to Stop: A ReviewMy Profile

  7. […] We’re looking down the barrel of nearly $1500 in increased medical insurance costs for 2015. […]

  8. Stephanie says:

    They’ve slowly been making the PPO less and less appealing, by increasing the premiums DRAMATICALLY and also pushing up the deductible significantly. And the out of pocket maximum is also insanely high. It’s obvious that they’re trying to push us towards the high deductible plans that come with the HSAs. I actually picked the HDP last year, and while I think it was cheaper in the long run, it definitely dissuaded me from going to the doctors. Since next year the out of pocket max for the PPO is actually 2x that of the HDPs, and the deductible is almost as high (though not high enough to qualify as a high deductible plan) and the premium is crazy high (3-4x of HDP), the benefit of having copays for visits doesn’t seem worth it, especially since most auxiliary things (lab tests, xrays, etc) are only covered after deductible), we are probably going to stick with one of the HDPs and hope for the best.
    Stephanie recently posted…Our Honeymoon to Ireland: IntroMy Profile

    • Revanche says:

      And the PPO was already expensive to begin with! At least our PPO offerings were 30-50% more than the HMO. Sounds like the HDP is the lesser of two evils in your case :/

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