Health Insurance

[Deechef]

I'm in tears .........

I just home last night from a great trip to Florida to visit friends and play a bit of golf. I pay the airfare and they take care of the rest - great friends! I felt so energized and ready to weather (no pun intended) the rest of the winter. Even looked forward to going to work today. Got home, opened my mail and got a notice from my insurance compnay that were raising my monthly premium from $195.00 to $312.00. I'm single and don't have health benefits with my job - love my job. I'm divorced hence the insurance problem. My X has great insurance and the biggest mistake I made in my divorce was to not cover this issue but that is water under the bridge. I only have catastophic insurance so its a lousy policy anyway.

I'm thinking of just saying f*** it and go without. I am probably one of the most frugal people on the earth but this premium would send me to the poor house.

Any ideas?

[LakeMartinGal]

I don't know how old you are, Deechef, but I sure wouldn't go without it... maybe shop around for another policy? If you are in good health, with no pre-existing conditions, you hopefully could find a better policy! Good luck! I know this is a big blow! ((((hugs))))

[blazedog]

I feel your pain as my premium is over $700 for a high deductible policy.

You certainly can't go without health insurance. If you don't have insurance you will be charged a higher rate since you don't benefit from the negotiated preferred provider rates and of course any kind of medical issue will wipe you out.

You can speak to a broker or check on rates on line -- do make sure you go with a reputable insurance company as some of the low rates have resulted in people not having coverage when then need it.

I don't know where you are located but in California going with an HMO like Kaiser Permanente is cheaper generally -- and of course you can adjust the deductibles and the co-payments with a PPO.

This is all assuming that you don't have any kind of medical issues -- even stuff that you don't consider to be chronic because private insurance exists to NOT underwrite people frankly.

Not that I wish this on you but the bright spot in what is happening to lots of people is that perhaps Congress will finally act and clean up the current mess -- over 25% of amounts paid for medical care goes to administering claims -- i.e. determining whether something should be paid -- what a waste.:rolleyes: I don't have the statistics at my fingertips but as I recall something like 50% of bankruptcies arise from medical situations and a

http://www.washingtonpost.com/wp-dyn/articles/A9447-2005Feb8.html

[Peggy]

Do you have a high deductible plan? We have a high deductible plan with Blue Shield and our deductible is $5000 a person. Our monthly rates are very reasonable and affordable. We usually just go to the MD once a year for an annual checkup (Pap and mammogram for me). This is included separate from the deductible and only costs me a $35 co-payment for everything. RX coverage is also included outside of the deductible, but none of us get prescriptions on a regular basis so I can't remember how much it is per RX.

I would shop around and if you are healthy, go for a high deductible plan.

I would never go without health insurance.

Peggy

[Grace]

I'm sorry you are feeling so upset. Is it possible to look for another job that does offer insurance? Or get a part time job in addition to what you do now that might have some insurance? (Like a grocery store or Costco or something?) Just some ideas.

I don't mean this to sound judgemental, but I know when I was single, I wouldn't take a job unless it offered health insurance. I would have taken a secretarial job (as opposed to something I love - nothing wrong with secretarial, just not what I went to school for or what I love) if I had to just to be sure I had insurance. I also know that sometimes these kicks in the butts, while painful when they happen, are actually blessings in disguise. They lead to much better things (I had a job once that I loved, but didn't pay enough for me to live on - I asked for a small raise, they said no. I was devastated!! It forced me to look or something else. But the job I got instead I loved a million times more and payed double. I would never have looked for that job if they had given me the raise I asked for).

Or perhaps you can find a better policy. Maybe someone here can direct you to a company that has good rates. I hope you get things figured out.

[TwinMom]

Our insurance went up substantially as well - almost 80%. Very frustrating to have our family premium go up that much in one year! Especially since we have $10,000 and no drug coverage. It sure takes a chunk out of our budget. Plus the insurance co. hasn't paid any of our health care costs in the past 6 years. We have paid everything out of pocket yet they raise our rates that much. But what do you do - our hands are tied for the "what if" scenario...

Oh - if only this country could come together and solve this health care crisis...wishful thinking...

[MikeC]

I second blazedog's idea about finding a broker. An insurance broker investigated several plans for me when my COBRA coverage ended. My premium is just slightly lower than yours, Deechef.

[blazedog]

And speaking of health insurance, this was in Sunday's New York Times -- Very interesting and perhaps helpful for those with high deductibles

http://www.nytimes.com/2007/02/27/health/27cons.html

[DmOrtega]

You are not alone! My dh & I pay about $600 per month for dual insurance coverage with a fairly high deductable, for our family, through work. The employers also are paying a portion. It is crazy and scarry to even think what we would have to do if we didn't have jobs. This is a national problem.

[Deechef]

Thanks for all your replies.

To clarify further.........I'm 60 yo (and a young 60). Love life and try to live it to its fullest. I have done the online search for insurance and thats how I got this policy - Aetna - reputable company. I have no health issues so could go do the search again and proably will. Yes...I could go get another job with benefits but at 60 I think about quality of life. I love my job and enjoy the whole day I am there - its not something I am willing to give up. Why should I be a check out person at Stop and Shop so I can afford health benefits and hate my whole day? I refuse!!!!!!!!!!! Maybe I will put everything I own in my daughter's name and just wing it - then Medicaid would have to pay???? Just thinking here.........

[blazedog]

Just out of curiousity, for those with high deductible plans -- what would you do if you actually needed medical care -- do you have the resources to pay for it without incurring tremendous financial strain?

I ask because people blithely advise going with high deductible health insurance (which I do have) because otherwise the premium for private insurance is completely unaffordable.

However, in the event one actually USES it, the expense can be significant -- as the deductible is just the start -- there are generally high co-payments as well which means that one can incur significant expenses above and beyond the premiums in a year -- not to mention what it would be like if one had the bad luck to get something chronic like cancer.

It's an insane and terrible system.

[DmOrtega]

...Maybe I will put everything I own in my daughter's name and just wing it - then Medicaid would have to pay???? Just thinking here.........

This is the cycle that keeps pushing us in the direction of the government overseeing our health care. I do understand.

[Canice]

I'm sorry to hear about that. I dread getting my renewal packet every December, with its rate increase. I now pay just under $300/mo for myself and it seems so high. But there's no deductible and it has very good drug benefits, so every time I consider reducing coverage I chicken out.

[blazedog]

Thanks for all your replies.

To clarify further.........I'm 60 yo (and a young 60). Love life and try to live it to its fullest. I have done the online search for insurance and thats how I got this policy - Aetna - reputable company. I have no health issues so could go do the search again and proably will. Yes...I could go get another job with benefits but at 60 I think about quality of life. I love my job and enjoy the whole day I am there - its not something I am willing to give up. Why should I be a check out person at Stop and Shop so I can afford health benefits and hate my whole day? I refuse!!!!!!!!!!! Maybe I will put everything I own in my daughter's name and just wing it - then Medicaid would have to pay???? Just thinking here.........

Frankly if you are 60 years old, your rate is phenomenally low -- you can look but I would doubt you are going to find anything better -- You might have been kicked into a higher age group or something as my premiums rose significantly after I hit 55.

In the scheme of things, realistically you are going to have to pay as it's essentially only another $7000 for the next 5 years until you hit Medicare.

Transferring assets won't work because they go back 3 or 4 years and look for inter-family transfers.

[BucknellAlum]

Thanks for all your replies.

To clarify further.........I'm 60 yo (and a young 60). Love life and try to live it to its fullest. I have done the online search for insurance and thats how I got this policy - Aetna - reputable company. I have no health issues so could go do the search again and proably will. Yes...I could go get another job with benefits but at 60 I think about quality of life. I love my job and enjoy the whole day I am there - its not something I am willing to give up. Why should I be a check out person at Stop and Shop so I can afford health benefits and hate my whole day? I refuse!!!!!!!!!!! Maybe I will put everything I own in my daughter's name and just wing it - then Medicaid would have to pay???? Just thinking here.........

Do you work fulltime? If so, are there other benefits or salary rates that compensate for no health insurance? Just curious. . .

I do certainly agreee that you should work at a job you love, and not take something that would make you miserable, just to have benefits. But perhaps there is a happy medium?

Regarding having Medicaid pay for care, and I can't comment on the logistics of that, just consider that without your own health insurance, you do not have a lot of say in what doctors you can visit. I know I have always kept a PPO as opposed to an HMO so that I can research and choose which specialists to see.

It has only taken one health issue for me to have that be the best decision I have made. You don't want to turn up with cancer or some other hard to diagnose illness and not be able to see the best diagnosticians in your area.

[wallycat]

Have you checked what AARP offers? I know they started carrying dental.

*on soapbox* I can't believe that countries that provide health-care for their citizens have better outcomes and longevity than we do. :mad: :mad:
Our rates keep going up and and up and less and less is covered. I wouldn't go without insurance but there are plenty of times I was tempted.
I'm lucky to be on DH's insurance (my ex-employer) till I end up on medicare, but the whole thing just seems wrong.

OK, off my soapbox.

Good luck to you and please do NOT do without insurance...you never know what curveball life will throw you. Who knew that at 49, I'd need a breast MRI for a possible cancer diagnosis :( .

[jmarie]

Insurance is one of the reasons h doesn't want a divorce, but would like to have this arrangement. :mad: I am the one carrying the insurance.

[erinlovesmarc]

Have you checked what AARP offers? I know they started carrying dental.

*on soapbox* I can't believe that countries that provide health-care for their citizens have better outcomes and longevity than we do. :mad: :mad:
Our rates keep going up and and up and less and less is covered. I wouldn't go without insurance but there are plenty of times I was tempted.
I'm lucky to be on DH's insurance (my ex-employer) till I end up on medicare, but the whole thing just seems wrong.

OK, off my soapbox.

Good luck to you and please do NOT do without insurance...you never know what curveball life will throw you. Who knew that at 49, I'd need a breast MRI for a possible cancer diagnosis :( .

In Canada we do have "free" health care but it isn't really free. Let me explain...We pay higher taxes than in the USA, especially income taxes (55% and up), plus we have a goods and services tax of 15% (in Montreal - other provinces have less) which is applied to everything but unpackaged/unprocessed food! It used to be the cost of living in Canada was lower than in the USA but we are now at par with the USA! On top of all that we still have to pay a fee every week for insurance - it isn't much ($20) but still!

Because our health care is subsidized our system does not even come close to that of the USA. We have crazy waiting lists just to get an Xray - when you go to emergency you can wait 8-12 hours to see a doctor (unless it is a life-threathening situation) - emergency rooms sometimes only have one doctor working at one time :eek: ! When I was diagnosed with cancer a few years ago (totally okay now) I was on a waiting list for 4 months before I was on the operating table! Hospitals have to put patients in moveable beds in the hallways because our federal government won't give the provinces more money to build more hospitals....

So free YES but far from what it should be...

[muriel3002]

In Canada we do have "free" health care but it isn't really free. Let me explain...We pay higher taxes than in the USA, especially income taxes (55% and up), plus we have a goods and services tax of 15% (in Montreal - other provinces have less) which is applied to everything but unpackaged/unprocessed food! It used to be the cost of living in Canada was lower than in the USA but we are now at par with the USA! On top of all that we still have to pay a fee every week for insurance - it isn't much ($20) but still!

Because our health care is subsidized our system does not even come close to that of the USA. We have crazy waiting lists just to get an Xray - when you go to emergency you can wait 8-12 hours to see a doctor (unless it is a life-threathening situation) - emergency rooms sometimes only have one doctor working at one time :eek: ! When I was diagnosed with cancer a few years ago (totally okay now) I was on a waiting list for 4 months before I was on the operating table! Hospitals have to put patients in moveable beds in the hallways because our federal government won't give the provinces more money to build more hospitals....

So free YES but far from what it should be...



Thank you, thank you, thank you for stating this! I keep telling friends here that the US has to be so careful if they want the government to get involved in health care. I lived in Ontario for 23 years and the health care system declined rapidly while I lived there.

We have friends in Ontario - the wife was diagnosed with uterine cancer. It was 8 months til she saw a specialist (oncologist?) and another 6 months or more before she got her hysterectomy. I cannot imagine living with that for more than a year wondering - is it spreading???

My DD needed to see a doctor. She phoned in November for appt. They told her they were not taking appts until March, please call back then. She asked - what if this gets worse? They told her to go to an urgent care clinic. Great, she says, so I have to take a day or two off of work, wait around for 8+ hours and maybe come back the next day if I don't get seen.....

In fact, DH & I were talking about returning to Ontario, but their very poor health care system is the one thing that keeps us here in the U.S. We are fortunate to be covered by DH's insurance at work and only pay a small part of the premium.

[erinlovesmarc]

Thank you, thank you, thank you for stating this! I keep telling friends here that the US has to be so careful if they want the government to get involved in health care. I lived in Ontario for 23 years and the health care system declined rapidly while I lived there.

We have friends in Ontario - the wife was diagnosed with uterine cancer. It was 8 months til she saw a specialist (oncologist?) and another 6 months or more before she got her hysterectomy. I cannot imagine living with that for more than a year wondering - is it spreading???

My DD needed to see a doctor. She phoned in November for appt. They told her they were not taking appts until March, please call back then. She asked - what if this gets worse? They told her to go to an urgent care clinic. Great, she says, so I have to take a day or two off of work, wait around for 8+ hours and maybe come back the next day if I don't get seen.....

In fact, DH & I were talking about returning to Ontario, but their very poor health care system is the one thing that keeps us here in the U.S. We are fortunate to be covered by DH's insurance at work and only pay a small part of the premium.

It has NOT changed....actually it got worse...I lived in Ontario going to school a few years ago and that's when they found the cancer...my mom is a nurse in a hospital here in Montreal and she told me that had I been in Montreal at the time when they found out I had cancer, I would have waited close to 9 months to a year to get operated! :mad: :eek: And I thought 4 months was a long time to wait!...I feel really sorry for the people (and their families) who have to wait for treatments or surgery and they die waiting (thankfully my cancer did not progress while I was waiting!) ...it's horrible and unacceptable to have waiting lists that horrendous! The Canadian government should be embarrassed and ashamed! Seriously...

[blazedog]

I have family living in Canada and none of them would trade the Canadian system -- not even the doctors.

Here is a recent statistic relating to Canadian satisfaction

Surveys show very high patient satisfaction in Canada. 96% prefer their system to ours, and 89% rate care good or excellent (up from 71% 4 years ago).

and a complete url to the article dispelling the myths regarding long waits in Canada

http://www.pnhp.org/facts/why_the_us_needs_a_single_payer_health_system.php

[beacooker]

Here's an article from Slate about a health care plan that they say looks promising. Honestly, I'm too tired tonight to read the article closely, so I can't comment. :)

http://www.slate.com/id/2160834/nav/tap1/

[erinlovesmarc]

I have family living in Canada and none of them would trade the Canadian system -- not even the doctors.

Here is a recent statistic relating to Canadian satisfaction

Surveys show very high patient satisfaction in Canada. 96% prefer their system to ours, and 89% rate care good or excellent (up from 71% 4 years ago).

and a complete url to the article dispelling the myths regarding long waits in Canada

http://www.pnhp.org/facts/why_the_us_needs_a_single_payer_health_system.php

Where does your family live? Ontario or Quebec?

The health care system in Canada varies greatly across the country, British Columbia and Alberta having the best supposedly and Quebec one of the worst.

I strongly disagree that the long waiting lists are a myth! Do you think it's normal that someone who is diagnosed with cancer should have to wait 4 months for treatment! :eek: Cancer spreads! :eek: Even if I would have gone to another hospital or even to Ontario for treatment I would have simply been put on another list...I agree that some procedures have shorter lists than others but there are still waiting lists just the same! If I could have, back then, I would have PAID to have had the treatment the same day I found out but you can't do that...you can't mess around with cancer, it can go from harmless to terminal in no time at all - no one should have to wait that long! :eek:

[badunnin]

Where does your family live? Ontario or Quebec?

The health care system in Canada varies greatly across the country, British Columbia and Alberta having the best supposedly and Quebec one of the worst.



So, when you say that you would trade the Canadian system for the American, you really mean that you just don't want the system of Quebec or Ontario, right? You aren't speaking about the entire nation.

[erinlovesmarc]

So, when you say that you would trade the Canadian system for the American, you really mean that you just don't want the system of Quebec or Ontario, right? You aren't speaking about the entire nation.

In a perfect world there would be a system somewhere in between Canada and the USA's system where both the government and individuals would contribute equally to a health care system...how you get there and what exactly that is, I don't know but something has to change...

I haven't lived in other provinces in Canada so I can't comment on their healthcare but it can't be worse than in Quebec...

[Natasha]

Interesting thread!

I'm not going to wade into the healthcare debate, but did want to say that I wouldn't agree that in Canada the personal income tax rates are 55% and up.

See, for example, http://www.kpmg.ca/en/services/tax/documents/PersTable2007.pdf

Even with surtaxes, health premium taxes, and mandatory program spending like EI and CPP, this is not the case. A great many Canadians pay far less than 55% total. GST and provincial sales taxes (where applicable) also don't apply to everything here but unprocessed food. I'm not trying to pick on you, Erin, just trying to provide a bit more info on this if anyone is interested :).

Deechef, sorry if we are derailing your thread. I'm sorry to hear about the situation and do hope you're able to find a good rate. Good luck!!

[badunnin]

Interesting thread!

I'm not going to wade into the healthcare debate, but did want to say that I wouldn't agree that in Canada the personal income tax rates are 55% and up.

See, for example, http://www.kpmg.ca/en/services/tax/documents/PersTable2007.pdf

Even with surtaxes, health premium taxes, and mandatory program spending like EI and CPP, this is not the case. A great many Canadians pay far less than 55% total. GST and provincial sales taxes (where applicable) also don't apply to everything here but unprocessed food. I'm not trying to pick on you, Erin, just trying to provide a bit more info on this if anyone is interested :).

Interesting table - according to that, I'd pay roughly 31% in Ontario between fed and provincial taxes, which, when you take into account all my deductions here (health care and the like), is about what I'm paying in Michigan. Nat - I think we discussed this around your kitchen table at one point and decided that I don't pay all that much less living in the States, all things considered.

[mbrogier]

For being 60, your payments aren't actually that high, Dee. My mom is going to be 62 in May, and she pays $800 a month. She did have cancer 11 years ago, so her high payment is partly because of that. Even with how much she's paying, she still had to pay $3k out of pocket last year when she was hospitalized for an attack of diverticulitis that caused an infection. She' healthier than I am at almost 30. She works out at the gym almost daily and eats an almost 100% vegetarian diet.

High deductibles are fine if you can afford to pay the deductible and be sick at the same time. They sound great on paper, but if you're sick and can't work that extra money you have to pay hurts a lot more.

Mom said she was going to start taking social security this year. You can take it early, so maybe that's an option for you.

I wouldn't dream of being uninsured. I had a stroke at 26 years old. It's hard enough for Rob and I to pay for our medical bills *with* insurance. We would have had no choice but to file for bankruptcy if we had been uninsured. Health isn't a guarantee even if you do everything right and have no risk factors.

Erin, I didn't know you were a cancer survivor. If you don't mind my asking, how old are you? You don't look like you're over 25. Cancer is a lot to go through at any age, but when you're so young it just makes it harder.

[Deechef]

Guess I can take *moving to Canada* off my list of options :rolleyes:

I would never be without health insurance so I will just bite the bullet. I'm due for a raise in April and that should help - if I get one.

I can't collect SS until 63 and because I worked for my XH for 15 years without pay I don't have a lot to draw but that is another story.

My blessings are many so I really can't complain. It just hit me hard yesterday when I was on such a high. Life goes on and life is good.

[erinlovesmarc]

For being 60, your payments aren't actually that high, Dee. My mom is going to be 62 in May, and she pays $800 a month. She did have cancer 11 years ago, so her high payment is partly because of that. Even with how much she's paying, she still had to pay $3k out of pocket last year when she was hospitalized for an attack of diverticulitis that caused an infection. She' healthier than I am at almost 30. She works out at the gym almost daily and eats an almost 100% vegetarian diet.

High deductibles are fine if you can afford to pay the deductible and be sick at the same time. They sound great on paper, but if you're sick and can't work that extra money you have to pay hurts a lot more.

Mom said she was going to start taking social security this year. You can take it early, so maybe that's an option for you.

I wouldn't dream of being uninsured. I had a stroke at 26 years old. It's hard enough for Rob and I to pay for our medical bills *with* insurance. We would have had no choice but to file for bankruptcy if we had been uninsured. Health isn't a guarantee even if you do everything right and have no risk factors.

Erin, I didn't know you were a cancer survivor. If you don't mind my asking, how old are you? You don't look like you're over 25. Cancer is a lot to go through at any age, but when you're so young it just makes it harder.

I just turned 27....I was diagnosed with cancer in the uterus when I was 19 years old and it came back a few years later...so far so good, it hasn't come back...I was very lucky that they caught it very early and they say that I "might" still be able to have kids...it was the end of the world to me when it first happened but you learn to deal with it and I've accepted the fact that I might not ever have kids...DH too, we've decided if we can't have kids we'll have 3-4 dogs :)

And sorry everyone if I has a bit cranky yesterday! :o As you can see I have issues with the health care system because of what I went through when I had cancer...I didn't mean to take it out on anyone...I might have been a bit harsh and I'm sorry...wasn't like me and I feel really bad! :(

[mightyh]

I worked for the Medicaid program a few years back.... while it tries to provide health care coverage to those who are lacking, it's rules are very stringent and they have ways of looking at how you recently distributed your assets. Even if you could get around that, as a 60 year old woman with no major health issues, it is highly unlikley Medicaid would cover you--so please do not give up insurance if that would be what you would hope to count on.

The rules are too vast to go into here, but Medicaid is designed to catch certain folks and a health 60 year old female is not one of them.

[blazedog]

The rules are too vast to go into here, but Medicaid is designed to catch certain folks and a health 60 year old female is not one of them.

I agree with this as I stated in my previous post although I think what the poster really meant to say is that Medicaid is meant to provide a safety net to "catch" those in need and you are not the sort of person who would be able to quality -- - particularly since you would be required to go back several years and show how you divested assets.

On a slightly different note, today's NY Times had the results of a survey in which a majority of people in the US supported universal health coverage even if it meant a rise in their taxes -- see url for complete article.

It also reinforces why I am not a Republican - although 62% of independents support some sacrifice to ensure universal health coverage, only 46% of Republicans do. It's hard for me to imagine that kind of personal greed -- at the expense of others -- including as noted in this thread many on this Board who are hardly deadbeats

http://www.nytimes.com/2007/03/02/washington/02poll.html?_r=1&hp&oref=slogin

[LakeMartinGal]

Just out of curiousity, for those with high deductible plans -- what would you do if you actually needed medical care -- do you have the resources to pay for it without incurring tremendous financial strain?

I ask because people blithely advise going with high deductible health insurance (which I do have) because otherwise the premium for private insurance is completely unaffordable.

However, in the event one actually USES it, the expense can be significant -- as the deductible is just the start -- there are generally high co-payments as well which means that one can incur significant expenses above and beyond the premiums in a year -- not to mention what it would be like if one had the bad luck to get something chronic like cancer.

It's an insane and terrible system.Every state is a little different...

We each have personal policies, with a $2500 deductible each, and 80% paid after the deductible is reached. We have an additional $1500 out-of-pocket, before they pay 100%.

The prescriptions are a separate $750 deductible each, and 80% paid upon reaching deductible. DH reaches this deductible in the first month, because one of his meds is $1300/month! And he has several prescriptions, as do I, though none of mine are that expensive!

We have reached our deductible (or one of us has) every year since we've had the policies. I had breast cancer with radiation one year, and met my deductible by March! Another year, I had a couple of out-patient surgeries, and met it, but later in the year. DH gets a shot at a doctor's office every week.

We set the deductible so that it wouldn't break us if we had to pay it! We pay ~$500/month each for these policies. Ours is a HIPPA policy, in the state of Alabama, and is a traditional policy. The HMO policies are more expensive per month, but you don't pay as much for visits/prescriptions/etc.

[blazedog]

Every state is a little different...

We each have personal policies, with a $2500 deductible each, and 80% paid after the deductible is reached. We have an additional $1500 out-of-pocket, before they pay 100%.

The prescriptions are a separate $750 deductible each, and 80% paid upon reaching deductible. DH reaches this deductible in the first month, because one of his meds is $1300/month! And he has several prescriptions, as do I, though none of mine are that expensive!

We have reached our deductible (or one of us has) every year since we've had the policies. I had breast cancer with radiation one year, and met my deductible by March! Another year, I had a couple of out-patient surgeries, and met it, but later in the year. DH gets a shot at a doctor's office every week.

We set the deductible so that it wouldn't break us if we had to pay it! We pay ~$500/month each for these policies. Ours is a HIPPA policy, in the state of Alabama, and is a traditional policy. The HMO policies are more expensive per month, but you don't pay as much for visits/prescriptions/etc.

By HIPPA I assume you mean the insurance that a carrier is obligated to provide assuming one has been insured previously? That's what I have also.

Since it's Los Angeles, my costs are higher as the insurance company is of course sets the premiums based on the cost of medical care.

My premium is higher ($720) and co-payment is higher (30%). My deductible is lower ($2000) but I don't cap out on co-pays until I hit $5000. My prescription is an additional deductible of $500 for brand names that are in the formulary -- A generic prescription is $10 with no deductible -- a brand name in the formulary is $35 co-payment subject to the deductible.

And of course the whole thing is a quagmire in terms of making sure everything is pre-approved, within the network etc. because the costs are significantly higher if go outside the network or in some other way miss the fine print.

Just today there was an ad in the paper for a BC policy that was simply for hospitalization and it was about $320 in my age group. And of course a policy like that would leave one with massive medical bills if one had the misfortune to be ill since most chronic illnesses involve significant costs outside the hospital -- chemotherapy leaps to mind as it is almost entirely done on an outpatient basis.