Datasets:
domain
stringclasses 11
values | post_id
stringlengths 5
7
| history
stringlengths 60
8.9k
| title
stringlengths 7
304
| c_root_id_A
stringlengths 32
32
| c_root_id_B
stringlengths 32
32
| created_at_utc_A
float64 1.26B
1.68B
| created_at_utc_B
float64 1.26B
1.68B
| score_A
int64 2
1.75k
| score_B
int64 3
5.43k
| human_ref_A
stringlengths 6
2.05k
| human_ref_B
stringlengths 7
2.05k
| labels
int64 0
0
| overlap_ratio
float64 0.01
1
| seconds_difference
float64 0
15.2M
| score_ratio
float64 1
1.72k
| len_ratio
float64 1
1
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
personalfinance | z2y6v5 | Hi all,
I’ve recently gotten into a new job on a yearly salary of £21k a year, with this new job it’s more a commute daily so it would be nicer to have a slightly newer car that can suit my daily needs better, however I’m finding it difficult to find the limit of what I can afford and what boxes I want to tick.
With the car I currently have I estimate I could sell and have around £4000 to put down as a deposit for another one on (HP) however this is the grey area for me-
Understanding what the limit is for what is affordable, and what makes the best decision on the financially responsible side,
Also for any car guys here who have recommendations, noting more than a 1.4L and a lower insurance group as I’m only in my early 20’s.
If anyone has any advice or questions feel free to ask as anything will help. | What car can I afford on my salary? | e57c033830f841b7947fff36fd540ec4 | bd8cad68f9b845519b134709792c5f14 | 1,669,241,093 | 1,669,243,555 | 4 | 19 | I recommend that you stick with your car if it isn’t giving you trouble. Cars are money pits; gas, insurance, maintenance, and depreciation will eat at your net worth.
What do you currently drive, what don’t you like about it, and what needs are you looking to address with a new car?
If you’re making £21k per year, I take it that your monthly income is about £1,350 after taxes. Even a modest car payment of £300/month will eat up a quarter of your take-home.
| If you have to ask, you need to keep your existing car. At £21k a year, you cannot afford a new car.
| 0 | 0.152174 | 2,462 | 4.75 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 821d56ec63d04d6d81930654c82f341f | b9a47762da9643d8bffbe6af6bfc47fb | 1,449,594,575 | 1,449,597,791 | 30 | 89 | So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.09396 | 3,216 | 2.966667 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 2547388708934be88529f84826636414 | 1,449,599,960 | 1,449,604,803 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 4,843 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | c81363b940d14650978e395990e13deb | 1,449,599,960 | 1,449,607,544 | 4 | 30 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.105634 | 7,584 | 7.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 905d4af35efa4deda8d36aba6e59c946 | 1,449,599,960 | 1,449,609,309 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 9,349 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | a610b394b25549f28b2527e28831a65d | 1,449,599,960 | 1,449,612,087 | 4 | 30 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.105634 | 12,127 | 7.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | e2fadf7257264f8e861bc72aa4eda46c | 1,449,599,960 | 1,449,612,667 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 12,707 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 1ebb753cdcb64ffca7eb94aa87a13caa | 1,449,599,960 | 1,449,614,917 | 4 | 30 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.105634 | 14,957 | 7.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | d38d43156c39400baf3a5c77d90705b0 | 1,449,599,960 | 1,449,620,379 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 20,419 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 4872b2ab592b4dce9fe9eba930c2e3cc | 1,449,599,960 | 1,449,623,052 | 4 | 30 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.105634 | 23,092 | 7.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 38d4f3dae6204bc5a9665fdd2145c715 | 1,449,599,960 | 1,449,628,942 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 28,982 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 925468a5843047aaa06c3ded464d795b | 1,449,599,960 | 1,449,634,140 | 4 | 6 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Orthodontist and former General Dentist here:
Dental insurance is a waste of money UNLESS your employer is paying for a good portion of it for you, OR you actually have dental work that needs to be done.
If you need to buy it yourself, save your money. If it's offered by the company do your financial due diligence on how much it actually will cost. Also, look into company health flex spending.
If all you are receiving is preventative care, you're likely to spend about $200-$400 a year (Exam and cleaning 2x a year, and various xrays 1x a year). If your premium for the dental plan is $600/year for $1000 of "benefit" it's a waste of money. Don't forget that there are copays and deductibles for different procedures and different tiers of insurance.
When you have family plans and such is where it gets to be closer to worthwhile.
TL;DR: dental insurance depends on what you intend on using it for.
| 0 | 0.142857 | 34,180 | 1.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 1a210bb66fd54b0489880b7a96e8d8c6 | 1,449,599,960 | 1,449,649,503 | 4 | 23 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| I was under the impression that all plans are now required to have a 1-page summary sheet available that shows most of the important information. I'd start by looking for those online.
| 0 | 0.012821 | 49,543 | 5.75 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 11e024a68a0549e2bd8862c7cb2956f3 | 1,449,599,960 | 1,449,657,429 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 57,469 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 8d3e030ab295444ab7d43f2310d9f87a | 1,449,599,960 | 1,449,669,633 | 4 | 6 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Orthodontist and former General Dentist here:
Dental insurance is a waste of money UNLESS your employer is paying for a good portion of it for you, OR you actually have dental work that needs to be done.
If you need to buy it yourself, save your money. If it's offered by the company do your financial due diligence on how much it actually will cost. Also, look into company health flex spending.
If all you are receiving is preventative care, you're likely to spend about $200-$400 a year (Exam and cleaning 2x a year, and various xrays 1x a year). If your premium for the dental plan is $600/year for $1000 of "benefit" it's a waste of money. Don't forget that there are copays and deductibles for different procedures and different tiers of insurance.
When you have family plans and such is where it gets to be closer to worthwhile.
TL;DR: dental insurance depends on what you intend on using it for.
| 0 | 0.142857 | 69,673 | 1.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 5cfa505ea8b340f58801cd0837356150 | 1,449,599,960 | 1,449,670,935 | 4 | 22 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| I'm an MD and I don't understand either side (insurance/medicare wise) of this cluster fuck we call healthcare. Whatever happened to just paying for a service? Now we employ armies of coders etc in order to extract a partial payment from the insurance who say we are owed more than we'd bill straight out. By a wide margin.
| 0 | 0.095238 | 70,975 | 5.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 86503a01ca904fdcb150b82707fa1929 | 1,449,599,960 | 1,449,673,406 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 73,446 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 5775ed3ac0ac4e1b96c653da6ec1514d | 1,449,599,960 | 1,449,685,978 | 4 | 30 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.105634 | 86,018 | 7.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 728fcd7b3eeb457a9fdb5dd922d7265d | 1,449,599,960 | 1,449,700,551 | 4 | 14 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| All i know is we pay 750 a month for health, vision, and dental. Thats for my wife, myself, and our one kid. Also it goes up every year, which is just stupid. Its just another bill the working class have to pay for.
Also I really enjoyed your rant, and let this be known you are not alone when it comes to this shit. They make it difficult for a reason, and all insurance companies basically do this shit. Shopping for car insurance and living in Wayne County (MI) is fucking terrible. Oh my insurance went up 100$ more a month because ive never got a ticket or accident. This also happens yearly. Its just a giant fucking money sink. Just consider this shit the workingmans tax.
| 0 | 0.072727 | 100,591 | 3.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | f30872096e8249b381e0eb56bf26ae03 | 1,449,599,960 | 1,449,702,799 | 4 | 6 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Orthodontist and former General Dentist here:
Dental insurance is a waste of money UNLESS your employer is paying for a good portion of it for you, OR you actually have dental work that needs to be done.
If you need to buy it yourself, save your money. If it's offered by the company do your financial due diligence on how much it actually will cost. Also, look into company health flex spending.
If all you are receiving is preventative care, you're likely to spend about $200-$400 a year (Exam and cleaning 2x a year, and various xrays 1x a year). If your premium for the dental plan is $600/year for $1000 of "benefit" it's a waste of money. Don't forget that there are copays and deductibles for different procedures and different tiers of insurance.
When you have family plans and such is where it gets to be closer to worthwhile.
TL;DR: dental insurance depends on what you intend on using it for.
| 0 | 0.142857 | 102,839 | 1.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 1aa6fb40e7fd464491a6945588309564 | 1,449,599,960 | 1,449,778,154 | 4 | 8 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Who are the vision providers who cover any part of lasik?
My wife works in healthcare and has access to just about any provider we want.
I shopped around every single one and was laughed off the phone when I asked if or how much of Lasik they would cover.
| 0 | 0.038961 | 178,194 | 2 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | e64b4827c8c3450bbd6c97b8d1320b12 | 1,449,599,960 | 1,449,940,763 | 4 | 5 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| I have no help to offer but I just do the following:
Pick *some* insurance, it seems pretty clear having none is bad and illegal. As far as I can tell there is *no* way to tell what will or won't be covered, before or after you've gotten it. They are so poorly worded and there are so many fine prints and gotchas that they can basically do whatever they want whenever they want.
So I just avoid visiting doctors as much as possible, and make a point of asking them the cost of everything on the rare occasions it seems absolutely necessary. They never know the cost, but if they know you are concerned they may charge less. Then hope for the best and as the bills come in over the next few months pay them.
Does this sounds terrible? It is, but I can't figure out any other options so I've stopped trying to understand the system that clearly does not work or make any sense. I'm also a grown-ass man myself, and by most accounts very intelligent, but there is no way I could ever figure this stuff out, and I strongly suspect the people who think they have this stuff figured out are deceiving themselves.
tl;dr Sorry, but bend over and expect to be fucked, its the only option US Healthcare offers. (Sorry also ranting)
| 0 | 0.089552 | 340,803 | 1.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 6e5ba01fe09f4b309586ec740fc18610 | 58dcb406a703459c9fd91012b567f39c | 1,449,599,960 | 1,450,130,143 | 4 | 89 | I'm sure there will be plenty of criticism here about this response, but here's what I've done:
Does the HSA your employer offer roll over? If so, I sign up for this, and set the contribution amount to be the same as if I was paying for the other insurance (the traditional plan) minus the cost of the HSA. Say the traditional insurance is $200 per pay period, and the HSA is $50. I set my contribution at $150 per pay period, so my out of pocket costs are the same. Then, after a few months, I have enough money in the account to cover my typical medical expenses (cough/cold, etc.) and screenings are free.
I look at it like this: I don't go to the doctor often, nor does my spouse. If we did, an HSA would probably not work. However, our out of pocket expenses are the same, and instead of giving the money to an insurance company in the form of premiums, we're paying into an account that will eventually turn into either retirement savings or get spent on medical expenses.
This is highly dependent on your situation.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.056 | 530,183 | 22.25 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | 34f7e95b9bbc45678e7f0e89aa9a0250 | 1,449,605,214 | 1,449,606,462 | 2 | 89 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.037975 | 1,248 | 44.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | c81363b940d14650978e395990e13deb | 1,449,605,214 | 1,449,607,544 | 2 | 30 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.028846 | 2,330 | 15 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | 905d4af35efa4deda8d36aba6e59c946 | 1,449,605,214 | 1,449,609,309 | 2 | 89 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.037975 | 4,095 | 44.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | a610b394b25549f28b2527e28831a65d | 1,449,605,214 | 1,449,612,087 | 2 | 30 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.028846 | 6,873 | 15 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | e2fadf7257264f8e861bc72aa4eda46c | 1,449,605,214 | 1,449,612,667 | 2 | 89 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.037975 | 7,453 | 44.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | 1ebb753cdcb64ffca7eb94aa87a13caa | 1,449,605,214 | 1,449,614,917 | 2 | 30 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.028846 | 9,703 | 15 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | d38d43156c39400baf3a5c77d90705b0 | 1,449,605,214 | 1,449,620,379 | 2 | 89 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.037975 | 15,165 | 44.5 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | 4872b2ab592b4dce9fe9eba930c2e3cc | 1,449,605,214 | 1,449,623,052 | 2 | 30 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| So a few things.
One costs are going up likely because a lot of the ACA required stuff has encouraged more people to actually seek out care and use their insurance. One of the secrets of insurance was that if no one uses it because they are afraid of having to pay out of pocket, then the insurance company wins. But when things like preventive care are mandated to be covered (typically for free), people use them.
So now you have members that used to have basically 0 health expense now with 3-500 expense. That has to be paid by someone, and with the way insurance works, the costs get spread across all the members. We don't treat (at least not anymore) health insurance like cars. Otherwise it would cost 10 bucks a year for a 19 year old and 60,000 a year for a 60 year old.
Now as far as understanding it, do you have specific questions?
For the most part if you understand the terms, copay, deductible, out of pocket max, and coinsurance. You should be able to figure it out.
Then after that its usually a matter of looking at the exclusions and special cases. Maybe plan A has a $500 maternity option whereas plan B just routes all maternity care thru the standard deductible and coinsurance rules.
I've been working in healthcare for about 10 years, with a fair bit of experience with insurance from the provider side, so I can try to help you understand things if you have a specific question.
| 0 | 0.028846 | 17,838 | 15 | 1 |
personalfinance | 3vy6a0 | I'll try not to rant for too long here..
Federal employee, married, two young children. I'm not MENSA material, but I'm no dolt either.
Current health insurance is going up by over $500 this year. As far as I can tell, for no increase in coverage. We were not unhappy, but also not pleased with our insurance the last two years, but a catastrophic accident and the birth of two kids planted me firmly in the "we're not changing anything in the middle of this" mindset. So now, here it is, open season, and my family is shopping around.
We know a few things
* First, our current FSA option sucks; it's so cumbersome that it's not worth my time. It's literally money thrown away because I can't get reimbursed through their online program for anything without it going through two different rejections and having to write a statement for each item. A single $2 bottle of Hydrogen Peroxide, submit the receipt, picture of the label, address of the store purchased at .. rejected. More back and forth, submitting screenshots of bank statements with purchases notated, finally accepted. Sweet, only took me 2+ hours to get my $2 back - NOT worth the time, especially not when extrapolated to a hundred or so purchases. Co-pays, large bills, even those are a headache to get back. Watched hundreds of dollars just disappear last year unused from the FSA.. So, we'd like to shift to a high deductible HSA-eligible plan; I'd really like to just have a card in my wallet we only swipe for medical related expenses - that's something we can manage easily.
* Next, I'd like to look into invisalign/ braces to fix some issues I wish my parents had when I was younger.
* After that, my wife would like to look at Lasik. If not that, then her best options for good vision coverage.
* Most importantly, we don't want to have to worry about walking into the "wrong" doctor's office if one of our kids has an emergency.
Just got back from my employer's "health fair" (30+ reps packed into 600ish sq. ft.) and could not be more disappointed. I pulled my benefits statements before going over so I'd know what I'm currently covered for and paying in co-pays etc. thinking "this will make it easy, I'll just go down the list and see who offers what!" Wrong. There's an exception to everything.
So here I am, a gigantic pile of brochures in front of me that you need a background in analysis to decipher, trudging through OPM's plan comparison tool. And I'm mad. Mad that none of these pamphlets are formatted the same. Mad that they use different measures and terms for the same services. Mad that they're nigh impossible to "side by side." Mad that no one can explain why my premium is going up so much for no new benefits. Mad that even trying to understand the difference between "basic option" and "standard option" is eye-bleedingly tedious. Mad that the reps can't answer questions about levels of coverage compared to their competitors, but can bring up no less than five times that they "cover 52 therapeutic massage visits per calendar year!" It almost feels deliberate - the difficulty here in trying to decide what's best for my family's health.
The best response and info I've been able to get are from co-workers enrolled in other plans ... "what did you pay for this, where did you go for that" etc. etc.\
I'm frustrated. This is a major deal for me. I have worked hard to be in a position to provide for my family (we're single income and I'm also the benefits provider) but can't understand it all. I'm frustrated that I feel ignorant and un-educated on something so important. Rant off. Thanks for listening, PF - if you have any tips, I'm happy to listen. | I'm a grown-ass man, and I cannot understand the options available to me for Health/Dental/Vision Insurance.. This is infuriating. | 4c029dddd88c413f95c55c6ed926dac1 | 38d4f3dae6204bc5a9665fdd2145c715 | 1,449,605,214 | 1,449,628,942 | 2 | 89 | Use the OPM comparison tool, this isn't hard and the feds have a MUCH better process than everywhere I've worked in private industry.
| Oh and to address the items you mentioned.
Lasik and Orthodontics (for adults) are almost always considered cosmetic and almost never covered. Like 0 dollars. You can use FSA dollars for these items though. In the off chance there was some coverage it would be in your vision and dental policies respectively.
Emergency care and out of network. Just depends on the plan. Most DON"T charge an out of network penalty for the emergency room care. Now after the "Emergency" is over, and they admit you and you start getting different care. That might be different.
Also there is a difference between a hospital ER, an Urgent Care clinic, and convenient care clinic and a standalone ER facility. They likely all have different rules.
Keep in mind also that doctors AND facilities can be in or out of network. So "St. Josephs Hospital" might be in your network, but the anesthesiologist Dr. Vikek Patel (who is an independent provider) might not be.
Some insurance plans will give you just reduced coverage for out of network and others will give you 0. You just have to read the fine print.
Its a giant pain in the ass.
| 0 | 0.037975 | 23,728 | 44.5 | 1 |
End of preview. Expand
in Dataset Viewer.
Dataset Card for "compred"
Dataset Details
Dataset Description
Conventional algorithms for training language models (LMs) with human feedback rely on preferences that are assumed to account for an average user, disregarding subjectivity and finer-grained variations. Recent studies have raised concerns about aggregating such diverse, often contradictory human feedback to train a single universal reward model, questioning which values or voices the models align with. Finetuning models to maximize such reward results in generic models that produce outputs not preferred by many user groups, as they tend to average out styles and norms. To study this issue, we collect and release ComPRed, a question-answering dataset with community-level preferences from Reddit. This dataset facilitates studying diversity in preferences without incurring privacy concerns associated with individual feedback.
- Curated by: Allen Institute for AI, The Ohio State University, Carnegie Mellon University
- Paper: ArXiv
- Repository: https://github.com/allenai/compred
- Language(s) (NLP): English
- License: https://opendatacommons.org/licenses/by/odc_by_1.0_public_text.txt
- Point of Contact: [Sachin Kumar & Chan Young Park](mailto:[email protected], [email protected])
Uses
ComPreD contains five subsets divided based on factors driving diverging user preferences (we followed a similar process as SHP to create this dataset).
| Subset(s) | Factor |
|---|---|
| politics | Ideologies |
| gender_and_sexuality | Demographics |
| finance, history | Community Norms |
| science | Level of expertise / Community Norms |
Loading
from datasets import load_dataset
# load finance train set
finance_train_pref = load_dataset("allenai/compred", "finance", split="train_pref")
# load finance test prompts
finance_test_prompts = load_dataset("allenai/compred", "finance_test_prompts", split="test_prompts")
Dataset Structure
Coming soon
Data Creation
Please refer to our paper for details on our dataset collection.
Licensing Information
ComPreD is made available under the ODC-BY requiring the user to follow the licenses of the subsequent parts.
Citation
@article{kumar-park2024,
title={{Personalized LMs: Aligning Language Models with Diverse Human Preferences}},
author={Sachin Kumar, Chan Young Park, Yulia Tsvetkov, Noah A. Smith, Hannaneh Hajishirzi},
journal={},
year={2024}
}
- Downloads last month
- 162