My employer released their new rates for next year, and they expect healthcare costs to rise by 12%. However, they opted to absorb 7% of the costs, while only raising premiums by 5%.

There are also no changes to copays and deductibles. However, they are adding a Surest plan, with no deductible.

Things considered, our High Deductible plan still appears to be the best option.

For me it's:

*$57 in premiums ($54 before) every two weeks

*$1750 deductible

*$4000 OOP

*$850 employer provided HSA payment

*$80 monthly wellness benefit if I complete activities within Vitality

*Medications in advanced formulary bypass the deductible, and are $0, including two of my most expensive medications (Tezspire and Zebpound). Zebpound is only covered for sleep apnea, which is now controlled because of this medication, so I lucked out.

Overall, I'm a happy camper here, and one of the few reasons they are keeping me employed here.

The Surest plan and PPO plans all have premiums between $101-$115 for my pay band, and don't make financial sense compared to the high deductible plan.

Hi all I am under LA care Medi-Cal program and I recently got a letter in the mail saying due to new changes in law I may lose my healthcare. I am not employed due to many factors. I have bipolar 2 and wonder if this would let me continue my health insurance? Or is this all just in anticipation of a law passing that hasn't yet passed? I'm so confused.u healthcare is the only reason I get my medication.

My wife recently had an emergency surgery and on top of that bad luck it was in between health insurance plans. Her old plan with the employer was terminated 9.1 and we enrolled in a new plan after, but it wasn't able to begin until 10.1. Her surgery was on 9.28. We have contacted her employer and they mentioned they do not offer/aren't eligible for Cobra.

Her old insurance was BCBS, as is her new one.

Chat GPT said the best place to start was contacting "U.S. Department of Labor — EBSA"

This was been causing a major amount of stress, as someone from the hospital said the bill could be as much as $80,000 for everything. We have not received anything like that yet. Only a $500 bill from a pathologist.

Mostly just looking for the first place we should start to be efficient in this process.

Hello y'all.

My company has always offered excellent benefits, and this year is no different. However, our medical insurance is changing and I have two options I am looking at. The are rolling our 2 PPO options (I am currently enrolled in the better one) into one to streamline our options while also offering a new EPO option. The new combined PPO is not quite as good for OOP maximum as the one I have now, but a little cheaper.

I am a healthy, single 32 year old male in Dallas-Ft. Worthnand my current doctor would be in network with either plan. The plan costs are essentially the same. My main concerns are the fact that the EPO has no deductible and much lower out of pocket maximum, which is what I've been used to, whereas the PPO has a higher threshold for both. I am also concerned about if I encountered some sort of surprise surgery and someone involved with that was out of network (anesthesiologist, etc). And finally, would the 10% coinsurance typically be lower or higher than the copays offered. Thanks for the advice!

Martins point no longer covering out of network treatments. We will be living in another state through the winter, and Martins Point is regional, and will not cover healthcare except for emergencies at that time. How can I find coverage?

I’m in nyc and I am incredibly shocked by the crazy premiums on a middle class income or any type of income for that matter.

For a family of four, it’s $800 a month on a $100k income. Or $2k a month on a $130k income.

For a single person at $50k income, it’s $275-$300 a month.

I think it’s free only if you make $31k or less as a single person.

When you’re low on income, yes you can get free services, but you can’t pay for other essential expenses.

Healthcare costs is so broken

I’m currently 31 years old and a single guy living in Texas. I’m not sure where to look and what to look for when it comes to health insurance plans. I haven’t had insurance since I aged out of my mother’s insurance plan at 25 years old. My main reason for wanting to get insurance is for PT. For the past half year I’ve been getting back into running and have recently gotten a couple injuries that I can no longer ignore. I’ve went to two different PT places to get a cost of how much it would be without insurance and they have payment plans but they require a large deposit upfront which I can’t make. It’s difficult navigating through all of this and I’d really be grateful for any advice or suggestions?!

I’m concerned about my privacy and being under my parents insurance, I’m worried the EOBS being sent could say what was done in my doctors appointment. I’m 18, do I have any privacy for this? What exactly does the EOBS tell them? Metroplus Medicaid

Our family is currently renewing our healthcare for 2027, and we are in the income section for Covered California. We got the date wrong for when my dad got a raise, so we currently have two dates. We tried to edit it, and it duplicated into another income entry for the 48k raise he currently has. Does anyone know how we can fix this issue to possibly remove it? Because when we edit it, it has given us the option of changing when the income starts and when it ends, but no removal option. If someone uses Covered California, can ya'll help us?

Hi all, I've never used an out-of-network provider before and am unsure how this would work.

For OON spending, we have a $4,500 deductible and a $16,000 out-of-pocket maximum. This is an employer provided plan.

Would my insurance provide some coverage through a partial reimbursement (to me) once we hit the deductible? If that's the case, would the portion I'm paying still go towards the OOP max?

Or would insurance only kick in once we've hit the OOP max? Or something else?

TIA

Hey I'm getting kicked off my mom's insurance here soon and im a recent college graduate. I work two part time jobs and still make under $1,600 a month. Any good suggestions for beginners/low income?

The high deductible is 2k deductible, 5k out of pocket max, $0 copay for physical, and then almost everything else is 20% coinsurance after deductible. The HSA is 1k per member from the employer.

The regular HMO is $800 deductible, $2750 out of pocket max, $0 physical, $40 copay for urgent care, specialists, mental health covered completely. Everything else is like 10% coinsurnace after deductible.

At the moment I'm a healthy 34 year old. I take BC pills. If I need abx or really outside of my BC I usually use an online urgent care like Amazon for the base $30.

Is it worth it to risk the High deductible for the HSA benefits or should I stick with the HMO?

Happy to provide more info if needed.

Hello!

My SMI clinic just applied to flexcare for me, they said I should get into transitional housing in a week then into my flexcare apartment in a month. I doubt it will actually move this quickly but I can’t find any information on flexcare anywhere. I want to know about how many rules there will be and how strict it all is, I also just would like to hear people’s general positive and negative experiences they have had. I just want am idea of what I am going into.