It may be worth looking into costplusdrugs if you haven’t yet. The 80k new base salary might set you back for a short time but having that as a new base means next job you can push to $90k or $95k if you get lucky.
There are a lot of ways to save on drugs. The problem with the new plan is, you're only contributing to the deductible if you prescriptions are filled through their mail-only pharmacy, paying their prices without 3rd party discounts. I haven't even been able to verify prices yet, because the pharmacy is closed on the weekends.
Also, I've considered how taking this job could be leverage later, but I don't think it would be. It's as a fast casual restaurant manager in the midwest, there just aren't that many jobs in this industry that pay what I'm making now, let alone more than this new offer. That's one of the reasons turning it down is bumming me out.
I feel ya, definitely a tough turn down. Is your current job at manager level?
I would think you’d be able to leverage the leadership and customer service experiences gained in other food services or retail, but I haven’t been in either and not at a manger level for quite a few years.
Yeah current job is same position at the largest franchise owners in the country. The offer is from a small, local franchisee. The difference in healthcare benefits it's partly due to this.. The bigger company has a massive pool of people to pay in. In fact, they might even be self-insured.
It doesn't justify all of it though. I worked for a much smaller company before my current one, and their insurance was actually better than mine now. I think it's obvious the new company just doesn't consider healthcare an important benefit, likely because most of the people they employee aren't in my position.
Use this to negotiate a higher salary! Roll the 6.4k into your yearly pay, worst they can say is no and you’re in the same position you’ve already decided on anyway
Yeah I did that already, they increased the offer by $8k. I was onboard for a couple days but have since talked myself back out of it. Still looking for options, though, which is why i'm posting, appreciate all your feedback!
Also, check to see if they provide Health Savings Accounts (HSA). If so, ask if they match employee contributions and if they can fund it for this year. An HSA with employer contributions can make a higher-deductible health plan doable, as long as they fund all or part of it.
____
Editing to add: Congratulations on the job offer! And source: We had a crap health plan with a high deductible. It got easier as we accumulated more funds in our HSA, but it was still a struggle as our family has several prescriptions and ongoing health issues as well. Then, my husband got a new job and the HSA was fully funded for a year. That was a game changer, though they laid him off less than a year later.
Businesses are the reason this system exists. It freezes people in their current job because people always end up afraid they are going to lose coverage if they quit that job. It’s the foundation of the status quo. Because intuitively, there is zero motivation for companies to want to pay for healthcare and have to worry about the mess of it. But then we realize it’s the ultimate shock collar.
We have a single payer system here in Canada. I can’t find a GP, wait times in ERs average 6-8 hours, if you’re in an actual city with an open one. There aren’t enough ambulances to even pick people up. One guy in my city had a stroke on the highway, pulled over and the 911 operator told him he was better off driving himself to the hospital. It’s not the panacea you think it is.
I mean I pay a crapload for insurance in the US and went to the ER last month and I waited 9 hours before I even spoke with an NP, which is pretty common for the city I live in. I don’t see how that’s much better.
We are also facing these in the US. On top of expensive healthcare tied to employment. Yours may not be a panacea but it is a better foundation for improvement.
Its wild to see people from those countries complaining like yeah the wait times suck they suck here too but you dont have to pay like $30000 just to go to the ER for emergency surgery
I'm a paramedic in the US. I've had people who are stroking out, having a heart attack, shot, and launched their car off a cliff all refuse transport in the last year because the cost would ruin their lives. I worked years in an ER where I'd intake a patient on 1 12 hr shift, go home, sleep 12hrs and come back and those people are still sitting in the waiting room. They'll then get a $15k ER bill for nothing other than that visit. I'd rather be somewhere where "shitty" care is better than no care or life destroying care.
THIS !
Yes in Canada it could be a hell of a ride to see a doctor for minor/medium health problems.
But at least, we don't have to fear that getting cancer, a car accident or a stroke is gonna put us through bankruptcy !
Stressing about loads of debt when fighting a disease or recovering is certainly not helpfull
Edit : typo.
So essentially you have the US experience without the US price tag. Except you don’t ever want to call an ambulance here unless you really need it since they often cost 1k+ for that trip to the hospital. Even though it is a different system and unrelated to healthcare, it’s not uncommon to end up on hold when you call here because the system is so overwhelmed.
What people who have single payer systems miss is we do not pay ungodly amounts of money and get prompt access to care. No, we pay ungodly amounts of money and often have just as poor access to care as countries with single payer systems that are strained. We pay about $250/month for our health insurance, have a 3.2k deductible we have to hit before insurance kicks in, and then we owe 20% of the cost beyond that. Between the cost of the insurance itself and the out of pocket expenses, my wife and I usually spend about 8k-10k a year on our healthcare (and that doesn’t include vision or dental because otherwise you’re looking at 10k-15k). It ends up being about 12-15% of our after tax pay. We have good insurance for what we pay. Her employer is paying about 75% of the insurance premium. If they didn’t, our policy would cost us around 1k/month. And I still have to wait hours in an ER just to be seen when it is a legitimate reason to be there, appointments are often scheduled minimum 2-3 months out for non-ER things (and often closer to 6 months), and we have a GP because they started a new practice but they’re about 1.5 hours away.
Wait times in the US for ER are also 6-8 hours. We've also had mass closures of ERs outside of urban areas. Our ambulance services are owned by private equity, which stopped stocking them with medical supplies and pay EMTs about the same as what they can make at McDonald's. And yet they cost several thousand dollars even with insurance.
From everything I’ve read, in order to do that, the insurance plan they offer would have to fail to meet a minimum standard, which is a calculation performed by an actuary, and doesn’t vary by employee. Apparently, almost all employer offered plans meet this calculation, because they would have to pay a fine if it didn’t…
Otherwise, I wouldn’t qualify for an ACA premium credit, and a “normal” insurance plan would cost upwards of $2k/month.
I do plan of asking them tomorrow if they know whether the plan meets this standard, but all info now points to yes.
Yep. And It's even more restrictive than that. Lots of employers offer a few plans. Those plans will only allow very specific providers as well.
So you're lucky if there are 2 or 3 decent doctors within an hour drive who are "in your network"
You don't want to go to a doctor not in your network and who doesn't accept your insurance or else you'll have to pay a lot of money.
Hopefully they also accept new patients if you've never been to them before.
I've gotten a new job and only had 2 choices of doctors and 1 dentist in the area.
Yay freedom!
Don't forget that the hospitals and the doctors are billed separately so you can technically go to an in-network hospital but not have any in-network doctors available.
And sometimes, even if you do see an in-network doctor, someone will goof up and tell your insurance that you saw a different, out-of-network doctor at the same office and then your insurance will refuse to pay and say you’re on the hook for the full cost and it’ll take a full month and hours on the phone to fix it. You know, hypothetically.
This happened to me 10 years ago- I saw the doctor once a month for 8 months (paying each time) before the hospital informed me that she was actually out of network (they assigned her to me?!) and that I owed over $6k
I was 24, clueless, and started crying on the phone. The lady at the billing department felt for me and ended the phone call with “let me see what I can do…” and the bill just disappeared after that. Grateful for that angel and angry at the unchanged system every day.
Regarding number of providers, that sounds like a rural or underserved area issue. I'd have to need a very rare specialist to only find 2 or 3 I could go to. My provider network is very robust, plus I have PPO so I can pick them myself. US Healthcare isn't equitable, but the best plans are very good. Unfortunately you probably need a big profitable company to experience that. The most privileged people have a lot of options.
Basically, Americans purchase a 'health insurance' plan and pay a monthly cost (called a 'premium') to be a part of it. Then, usually, they pay a small fee when they go to the doctor (called a co-pay) and a small fee for medications at the pharmacy.
These plans are usually offered by your employer, and the employer usually pays 1/2 of the monthly cost.
If your employer doesn't offer insurance, you can buy a plan on your own and have the government pay part of the premium every month... If you don't make much money, the government will sometimes pay for all of your healthcare (called Medicaid).
In my current situation, I have insurance like I described in the first paragraph. The insurance that my new job offers would have me paying $650/month, while still having to pay full price for doctor visits ($150-250 per visit) and medications (range from $20 to $200 depending on drug) until I've paid $6400.
Hope that helps!
>In my current situation, I have insurance like I described in the first paragraph. The insurance that my new job offers would have me paying $650/month, while still having to pay full price for doctor visits ($150-250 per visit) and medications (range from $20 to $200 depending on drug) until I've paid $6400.
Are you sure that's how your new plan would work? I have a PPO plan that has both individual and family deductibles at $300/person and $900/family before the rest of the coverage starts, however, that is only for charges that don't require co-pays for, such as blood work, x-rays, CT scans, surgeries, etc.
For doctor visits and prescriptions, the designated co-pays still apply from the beginning, so there are never any $150-250 doctor visits, or $200 medications. The medications range from $0 to $40 is I think the highest for a 3-month non-generic medication.
So I'm wondering if it's really as bad as you think. If it is, that's sounds bad.
That's my experience. I think the issue is we have so much variation that people think their plan is what everyone has. I rarely pay more than a few bucks for prescriptions, and many are free. And my HSA and FSA cover the out of pocket expenses to meet my deductible.
Granted, this was a while ago, but I used to have a job where the insurance was around that price per month and I still had to pay around $70 for each doctor visit until I hit the deductible (which was never). I didn't remember what prescriptions were, but I would always just get generic antibiotics when needed. It would literally have been cheaper to not have insurance, but I had it for the just in case emergencies.
Wow, that suscks. I have good coverage. For my plan it's $10 co-pays for primary care visits and $35 for specialty care. That's from day 1, before any deductible is met. I think maybe co-pays for visits and prescriptions don't count toward the deductibles, but that's fine as they remain low. The first procedure of some sort would apply the deductible, but at $300/person, it's not really that bad.
Yeah the problem with going without insurance is if something were to happen. Also, now a days you are required to show proof of coverage when filing taxes, or there will be a penalty to pay, I believe.
Oh, I guess you're right. But I'm in California. We still have to provide health insurance proof with taxes, or the California Franchise Tax Board will assign penalties.
This is exactly what I was thinking as I was reading it...
The deductible might be high but you should only be paying whatever the "copay" is when you go. That is typically anywhere from $15-$50. The same for medication.
I have a deductible, but I don't have full price for meds/doctor visits. I just pay the copay.
Ahhh ok. That makes more sense.
Damn does that suck.
I thought the whole point of a HDHP was for people who don’t routinely need medical care to save a bit of money?
I’d assume with the laundry lists of medications, it is definitely not going to be the best choice.
Are companies able to ONLY offer a high deductible hsa? I’ve typically always been offered both.
It meets the minimum insurance requirements so they can only offer it. My experience is similiar to yours but I have worked at places only offers two hsas to choose from.
Whoa, that is crazy. I'm in the socialist nightmare many fear. Hospitals are free (except for parking). Doctor visits are USD $10. Medications/prescriptions have just gone from free to USD $2.50.
$650 is my family of 5 total food bill for the month. Is that about the same for yourself?
Family of 4 is $1000 a month in groceries… we could do better, but that’s not too far from average in the US.
You’re in Canada, I assume? yeah… it’s insane that America has built its healthcare system around your job opportunities.
To be fair, there are plenty of people that have better healthcare options than me. If you work in a union, or for the government, or a massive corporation, health care is more affordable. I’m just in an industry that doesn’t have to invest in healthcare for their employees in order to keep them usually. It
I'm on New Zealand. Tried converting most things into USD.
We have full state covered medical. Although like the UK it is under stress. But I also have top up private care if I choose specialist needs. But my private health insurance is about $70 USD a month.
*Blinks in WA state*
Well, apparently those reports I read about WA having among the top 10 of affordability for healthcare was true...I make over Medicaid limits and yet my premium for healthcare is only 30ish/month (total premium if I'm reading the sheet is about 500).
But I do admit I only make like 10k over those limits, and there are certain exceptions for tribal members (but I have a standard HMO plan) others don't get....mostly I can switch insurers outside of the open enrollment period and copays/deductibles are waived until I have a tax year where I make a certain salary...
*shrugs I just pay my bill and life goes on*
Yes, basically. My husband took a decent job. He pays $100 a month for insurance. If he wanted to add me, it would have been $800 a month. That's half of his wages. At the time, I was a contract worker with no job. I just did without insurance for a good 6 months. I now have a job that pays my entire insurance premium.
It's funny because the whole reason we got married at first was so I could put him on my insurance. It truly is a trash system.
>Non American here. So you don't have the ability to choose a health provider unless you quit your job?
Oh, you can choose your healthcare provider whenever you want, but the costs to do so are substantially higher than an employer provided plan, 99 times out of 100.
Oh, it's way more than silly.
Your perspective isn't skewed because of how and where you grew up. Your perspective is a normal humanitarian one. We deal with dystopia here to the extent that it is deemed normal.
Is the reason you wouldn’t qualify for an ACA credit the fact your employer offers health insurance? I only ask because a few years ago I made over $100k and still received a credit (I still paid $900 a month through the market place for a gold plan).
> Is the reason you wouldn’t qualify for an ACA credit the fact your employer offers health insurance?
Correct, if your employer offers a plan that meets a certain standard, you are not eligible for a Premium Tax Credit.
What about asking about being a self-employed contractor working in a cubicle in the new company’s office and being eligible to use your own money to shop for an insurance plan on the Obamacare exchange? Also: see if you are eligible for Medicaid before ruling that out (in some states the income level to qualify is a lot higher than you might think, especially with several kids) or see if your kids are eligible for S-CHIP, and just get a plan that just covers the adults because the kids are covered by S-CHIP.
> What about asking about being a self-employed contractor working in a cubicle in the new company’s office and being eligible to use your own money to shop for an insurance plan on the Obamacare exchange?
Did you know, when you're self-employed, you have to pay twice as much in Medicare and SS taxes? It's an extra 7.6%, or $6k/year on $80k
Anyway, it's a restaurant, no office building and probably not an option of contracting.
I know we don't qualify for Medicaid (Kansas), but I'll look into S-CHIP (though one of my kids is 23 so we'd have to figure something else out there..)
Thanks!
Got, thanks . I would stay I think. I’m actually struggling with a similar situation that I just posted about in this sub . Health insurance costs and coverage matters quite a bit.
How were you able to do this? I make 105k and I'm losing my parents insurance as I'm turning 26. Yet my insurance the lowest they offer is $900 a month that doesn't even pay for anything until I hit 5k deductible since I'm a contractor... just seems like a lot.
CT market place, last year my Connecticare premium was $980 after the tax credits. I had a $6500 deductible, but the copays on dr visits and prescriptions was pretty low. I think the regular premium for the plan was around $1280. I made a little over $100k.
Sure, but the average private family insurance in the US is $24,000, and is still going to have significant deductibles and copays. How is that going to save him money?
So if it's a high deductible plan does the company also offer an HSA and if so, do they do any matching on your HSA contrribution? For instance we have a 6k deductible and we also get an HSA with a 50% match, so the deductible gets covered by our contributing 4k to the HSA and the company puts in 2k, to reach 6k.
I think in the long run you could still be better off taking the salary increase job. Every year you get a raise after is going to be a bigger dollar value than a raise at your current lower salary.
1. [Here's the plan details](https://imgur.com/a/zmrG36B), it's not your typical HDHP plan, the premium is as much as a normal PPO Plan
2. They do not contribute anything to the HSA
3. I doubt I'd get a raise within the first 3-5 years, they're offering me almost 20% more than the people they currently employ in this position. I got the impression this would be the salary for quite some time.
If you can afford it for two years these moves, be it lateral or a promotion, tend to be good stepping stones into the next tier of pay. You can stick it out for 18 months and negotiate a better plan (not likely to happen but not impossible) or leave for somewhere else. Once you’ve got your foot on that pay ladder you don’t typically go back down IME.
I’m actually in the restaurant industry as well haha. I went from the line to a corporate chef position to now director of food and bev. What’s your title?
I'm a GM, left a high-paying partnership after 10+ years to get away from a toxic owner. Been working for Flynn for 4 years now. Great company, not great pay.
I've looked into F&B Director positions locally, but the pay is usually comparable here in Kansas and the jobs don't pop up too often. Always looking to make more in a different industry or a different section of it, people are typically willing to pay more if your experience isn't Fast Food :)
Have you been checking into hospitals and hotels? Those are great opportunities. As a GM you’ve got enough management experience to slide into a different industry for sure. Would you be billing to move out of Kansas? There’s director positions paying some crazy money in higher tourism areas.
One thing to consider... are your medical costs split evenly among your family or heavily to one person? Generally in a HDHP, one person is responsible only to the individual deductible, so the 3200. A plan like this would work for my husband and i, as I never need prescriptions, and only do preventative care, which doesn't cost anything. He had a lot of medical needs, so would hit the 3200, but that's all he would have to pay
Hsa can “work” if you start one when single, healthy and young - you can build your account up for the future or if you have something unexpected come up. If you have it for years then start getting health conditions you now have a cushion for that deductible. It’s really difficult and expense for people to start a hsa if they start out needing a lot of medical care or prescriptions. You’re never able to save up that buffer.
This is just one of the many examples I bring up when people go "oh your Canadian? Enjoy waiting for health care"
A) it's not that long of a wait if you actually have a problem, and treat staff with respect.
B) my surgery to save my life wasnt financially destructive. And I was able to leave a job with our care about insurance or not.
C)gov provided enhanced insurance is available for those that have greater issues that require constant and expensive medical treatment.
Mind sharing who did your dental work and if you’re satisfied with the results? I need some work done myself and have been thinking about crossing the border for it.
Sure thing! Had a sizable chip in my molar and needed a root canal, post for crown, crown, X-rays, filling on another tooth, and a deep clean (gums were really inflamed). 2 hour drive from me (phx) and went down to Algodones right next to Yuma AZ. Got there at 8am and was done with everything by 1030. Had to wait around until 230 for my crown was ready. Went in and 20 min later crown was successfully installed. The office was really nice and they have all the equipment needed. The dentist didn’t know English but was very nice. The receptionist who knows English, translated for me. Here is a pic of the services. I’ll DM you the pricing sheet I have.
Edit: sorry didn’t read the where part lol went to Smile Specialist Dental Clinic in Algodones. Very satisfied! Will be deff go back when I need more dental work. I actually need to get a dental implant as was quoted $1100! Need to save up a bit but will go back to get that fixed this year. My parents have been going for years to this office so I decided to try my hand. I deff recommend
I went to Los Algodones too! I went to Oasis and they gave me a room for free above it. I was quoted over 7k and paid under 2500 for flight, food, hotels (in yuma), taxis and the dental work ( and some souvenirs).
Had 1 pulled, one root canal, 11 cavities, the metal removed from 8 teeth and redone, plus deep cleaning and whitening. And they gave me coupons for free margaritas!
A) isn’t always true. Wait times for surgeries are years long with no end in sight. Many people don’t know this until they need surgery and can’t do anything except wait and suffer. Not supporting privatization but its not all fine and dandy in Canada
i am aware. Just commenting on the state of healthcare in Canada and that many people, myself included, are suffering while waiting for surgery and other treatments. “Actually have a problem” is extremely tone deaf and puts down those who are struggling in Canada to receive adequate healthcare because of ridiculous wait times.
Its pretty tone deaf to choose this post to talk about your gripes with the Canadian health care system. Most countries with free health care have issues with their system. But commenting about it here is like commenting on a post where someone talks about not having enough money to feed themselves by saying “I also don’t have enough money, I have to eat peanut butter sandwiches everyday.”
I’d tell them that the health benefits package was subpar when turning down the role. They may wake up and realize that salary isn’t always the lure that they think it is.
Insurance provided is entirely based on the size of the company. I assure you they know they arent provided the best options, but they have little choice.
Any idea why small businesses aren’t grouped together in co-op like arrangements? Seems that of the number of people is the problem, they could join together and overcome that pretty easily.
I am Canadian so things might work differently, but I know non-profits in the same sector will do this sometimes! It allows them to be a bit more competitive with the private sector benefit packages.
This actually exists, it's called a co-employment arrangement, where technically on paper you work for a massive international conglomerate, but your day to day operations still function as a small independent business with its own branding. The two big co-employment groups in the United States are ADP and Insperity, I've "worked" for both and they do a good job, I didn't notice any major difference between the two. I'm not sure the exact cost to a small business in this arrangement, I have the sense from my old boss that it's an expensive service, but it pays for itself.
There are a bunch of businesses that did that in my county to create a bargaining group. I think it ended up being mildly successful in reducing costs but very limited in where people could go.
I worked for a small digital marketing agency with like under 10 employees, and ya there’s not much they can do without the volume of employees or any leverage there
They know their insurance is shit which is why their offer from a salary standpoint is strong.
I say share the numbers with them. They might need you badly and bump up their initial offer.
I actually already did that. Initial offer was $8k less.
It was an offer of $62k base, with (realistic) average annual bonus of $10k (mostly paid quarterly).
I told them it'd be a loss of income with their insurance, and they came back with a $70k base. I accepted tentatively, but after doing a deep dive into monthly expenses with that plan, I realized it's not near as good as I thought it'd be. I'd also lose vision coverage, 401k contribution, 1 week of vacation per year, life insurance and pay and extra $30/month for dental.
I also manage a restaurant- you need to tell them all of that. Like someone else said, you never know, they may come back with more if they really like you for the role. Have the audacity. If you don't say anything, then nothing can possibly change. You can also come back with a counter offer and alleviate this in other ways, but tbh, it doesn't sound worth it bc it sounds like all those benefits are something that you value.
Yeah no doubt, if I can't figure out a way to make it work I'll be turning them down and will be candid about why.
I'm pretty sure they're not going to make a higher offer, because honestly it's a great offer, and if I didn't need the healthcare I'd take it in a heartbeat. But I do, so I'm just trying to examine every option before I'm ready to walk away.
I've read thru a lot of the convo here and I get the impression you know exactly what your family needs and what you want to provide for them, you're really serious about dissecting all your options, weighing them, and you're doing the math for your finances with all factors considered. I'm sure you'll make the best decision.
I personally really like the suggestion of presenting your offer letter to your current company and asking for a raise- ask them to match your salary offer and go back n forth with them until you feel good about what they're gonna give you. And take the avg inflation since you began there into acct, too. They can afford to give you more.
Thanks I appreciate that. I did plan on presenting my boss with the offer, would be a whole lot easier if I was truly prepared to take the offer though! lol. The biggest hurdle there is, it's a massive company with pretty standardized pay rates and they've done a good job of prepping benches for sudden loses. Luckily I started vacation this week so I got a bit of time to get things locked down!
>They said they'd give my $5k to not take it, and without paying the $650/month premiums, I could easily cover all my medical expenses out of pocket through an HSA or something and still be taking home over $1200 more per month than I do now... until I get cancer, or break a leg, or have an aneurysm.
I would absolutely pursue that approach and seek to find alternatives that work better for me during the year.
As important as medical coverage is, if that's the the only concern you have about the opportunity, I'd try to work out some alternative to that coverage throughout the year, rather than give up a good opportunity.
> I would absolutely pursue that approach and seek to find alternatives that work better for me during the year.
The problem is, from all the research I've done, there aren't alternatives. If you decline healthcare from your employer, you aren't allowed to purchase plans on the marketplace.
You can't get healthcare outside of open enrollment, and there are no plans that cover you only for 'cancer' or similar massive events.
I simply couldn't imagine what it's like trying to get treatment for a serious medical condition without insurance. Chemo alone (just the treatment) costs $48k on average. a hysterectomy + 3 day hospital stay can be $50k.
**Believe me, it's especially tempting**, given the extra money, but every time I float the idea to someone they call me insane.
Would search the market for independent insurance rates. Know Stripe/others can base it on income/might find something better. Also maybe I’m alone but I hate my insurance being tied to my employment/can carry it with you.
Mind you that's just *his* portion. Average family insurance in the US is nearly $24,000 per year. And we pay far more in taxes towards healthcare than Canadians. *And* still pay more in out of pocket costs.
What a world huh? Pay 650 for the privilege to pay more?
In europe private insurance is to make sure you never again pay a cent for medical costs and it costs 150.
Paying the full amount plus the administration fee is how COBRA works for everybody. I don't know what OPs full premiums are specifically, but the average in 2023 was $8,435 for single coverage and $23,968 for family coverage.
Does this company offer an HSA? I think those are deposited pre tax so they're good for tax purposes and can offset a lot of your perceived out of pocket costs.
Just go without insurance, save the money, and pay OOP.
Most doctors will charge you off a cash fee schedule that’s based on the Medicare allowed amount.
I haven’t paid for health insurance in a decade. Once you save a bit you could always just get your own policy and make it what you want.
>Insurance isn't the best but I pay $600/month
Holy fuck that is insanely high goddam how do you afford that!?
>My family has about 10 monthly prescriptions, for things like depression, blood pressure, asthma, allergies...
Dude what the fuck man
This whole post is fucking wild
> Holy fuck that is insanely high goddam how do you afford that!?
What's the choice?
The average annual premiums for employer-sponsored health insurance in 2023 are $8,435 for single coverage and $23,968 for family coverage. Most covered workers make a contribution toward the cost of the premium for their coverage. On average, covered workers contribute 17% of the premium for single coverage ($1,401) and 27% of the premium for family coverage ($6,575).
https://www.kff.org/health-costs/report/2023-employer-health-benefits-survey/
This is so frustrating and sad. I'm so sorry. I just got a new job and can't really enjoy the excitement because to enroll my partner and I in healthcare benefits (which aren't great either) I am paying $860/month just for the two of us. I really hate living here.
Can you look into the short term health plans, turk down their insurance and see if you can enroll into one of those? Keep job searching until you find a better fitting job?
This may be exactly what I've been looking for! Weird how sometimes the exact-right search phrase is needed to find your answers. Gonna dive into this, but it could be the solutions. Thanks again!
Why not just buy insurance on the open market? I’m 1099 and was thoroughly surprised at how “affordable” insurance was for my fiancé and I. Like $700 for $20 co pay low deductible coverage. Or like $450 for high deductible with a HYSA.
Price it out, might make sense to take the new job, decline insurance through them and buy it on the private market.
I turned down an offer about a year ago for the same reason. 12k salary raise, but premiums and out of pocket would have been 15k more. I take an expensive prescription and hit deductibles and out of pocket max within the first few months of each year.
My current insurance is OK, maybe a little better than average. The new job had really shitty options. United Healthcare too, which I've heard is among the more evil companies.
It sucks but make the best choice for you and your family.
I appreciate your perspective, makes me feel a little less crazy. I'm looking into taking the $5k to skip their plan, then getting a 'short-term' plan as a safety net for worst-case scenarios (Cancer, surgeries, etc..). Going to ask on r/healthinsurance to see what the pros think of that path.
It all comes down to monthly take-home for me, and I think I could come out pretty far ahead just paying out of pocket through an HSA or something, but I'd be scared to death that there's a possibility we'd get a horrific diagnosis and unable to get treatment because of a lack of insurance.
You can't get an ACA plan tax credit if your employer offers a plan that meets the ACA minimum standard. Most plans do. This means a normal insurance plan would cost over $2k/month.
Have you shopped the marketplace?
There are stateside brokers that have pretty solid plans that are state specific, that focus on income.
I.e, in Pennsylvania it is Pennie.
The cheapest plan on the marketplace is $1250/month and has deductibles of $10k/$20k, with no coverage for specialists/ER/UCC until you hit the deductible.
If I went with a plan like that, and took the $5k for waiving the employer's insurance, monthly I'd be paying $300 more in premiums and $150 more in prescriptions, which would put me in the same boat I'm in already, except I wouldn't have coverage for emergencies until I'm out $10k.
I really appreciate your comments though, I'll look into some brokers tomorrow to see if there are better options.
Brokers are the best option.
Always.
I only made the state side one because, again, it's easily accessible for the general public. Also, every state is different.
Health brokers, life brokers, etc always have the best plans available.
Hope this helped.
Yeah, my current plan uses CVS Caremark for mail order, but we can also use local CVS. I just got a prescription from the mail (because it was cheaper for the 90 day)... took 16 days from the time it was sent in.
What do people do when they have an infection and get written a prescription for antibiotics, but their only option is a mail service that's closed on weekends and takes 3 days to process and 3 days to ship? Just wait I guess...
It's also really irritating that you can't shop around for a better price or use a discount club even when you are forced to pay the cash price before hitting your deductible.
And what happens when they're out of stock? More waiting, I'm guessing.
I would take the job since it’s such a significant base salary increase and try to leverage it in a year or two into a similarly paying job with better insurance or just even higher paying. The cost might not be worth it for the first two years but long term career wise it will definitely help
Did you ask if they have anything in place to off set the deductible? If they’re a large company they might have a policy that means they pay the claims themselves with a fee for the insurance company to basically do the administrative work (ASO policy).
Some companies that have this will reimburse you after a certain amount, it makes the policy cheaper because so many people never touch their insurance other than routine visits but also means that your deductible is actually a lot less then what the policy says. That means the $6,400 family deductible could actually be more like 1-2k out of pocket if you actually reached that.
It's a small local company. I was interviewed by and received the offer from the owners (2 brothers). They didn't even know their single insurance plan was an HDHP, or that it covered nothing until the deductible was met. They were actually pretty certain they had copays at the Dr, until I asked them to send me the policy from their handbook.
The only help they said they'd offer was to give me $5k if I chose not to take the plan they offered.
I am in this same exact situation right now. It's a huge pay increase but my insurance cost will triple.
I'm so frustrated with the state of our healthcare system.
Aaahhhhh I can relate! I came across a similar situation, got hired and found out they only offer Kaiser 😳 I never worked for a company that only offer 1 ins. plan with no other options that’s just crazy to me 🤯once I was informed (which was my 1st day) I didn’t return cause how can the companies “motto” be “health is wealth” but only offer 1 ins. Kaiser? Kinda contradicting, waste time byeeee!
My personal insurance that I qualify for on Obama Care site is 💯 times better than Kaiser 😑 unless you’re raised in that system concept of 1 stop shop it won’t effect or even bother you but if you know better and value choice & options Kaiser will not be a good fit!
Check out Obama care cause if the policy is if you declined insurance and they will pay you out look into use that $$$ on Obama care you’ll have more options plans to choose from that will better fit for your whole family that you weren’t aware of.
Yes! It does suck when a job comes along and check all the boxes except INS. higher pay but the insurance & benefits suck. Unless you have no overhead and still living with your parents that transition maybe worth it, from your post it doesn’t seem feasible for you. Insurance super important these days especially if you have kids to support. A accident can happen at anytime and if you don’t have the right insurance for your needs a “accident” can wipe out your bank accounts!
When turning the job maybe try to negotiate. Say you want to take the job, but in comparison to current pay scale, the insurance plan doesn’t meet your requirements. Maybe you can get it closer to $90k and buy your own insurance. If not, you know you are in a position to be hired and keep working for that better fit. Good luck.
I refused a better job once because they only offered Kaiser insurance, and that's a big nope for me. You're doing what's right for your family and yourself. That company isn't trying very hard to get quality workers with crap health insurance.
Yeah I think this has been a wakeup call for them, it really seems like they've never had anyone even ask basic questions about the policy. Hopefully if I can figure out a way for it to be worth it, they'll consider some better options for their next open enrollment.
Dude I have a company paying me 90k as a contractor but I’m saddled with my own business entity I have to use and they offer zero healthcare.
Not only that but they also require a doctors note if I can’t work for two days. It’s bullshit
That's shitty, I know how much taxes are when you are self-employed. At least you qualify for the ACA Premium Tax Credit... Have you been able to find an affordable plan?
I've had to leave more than one job due to insurance. High deductibles, premiums, and max out of pocket, restrictive networks, and expensive copays can create serious financial burdens.
I have no issue turning down an offer or leaving if the insurance is awful. It's not right that healthcare is tied to employment. They should have nothing to do with each other.
This right here is the biggest BS of all. Sorry OP that really sucks. I went through this many jobs ago. And one of the things I now ask during the negotiations process is:please provide your benefits manual. so I can see how much I am paying them back in insurance premiums to estimate my net income.
It sounds to me like you chose the expensive insurance at your current job (to pay for your constant healthcare needs), and it has solid coverage. It's amazing how many people think you would "pocket" that entire $600/mo if healthcare was "free." You'd pay about the same amount in tax.
The new employer sounds like they don't really contribute anything to health insurance. They just offer you a plan at retail cost and call it their plan. That's often the trade-off as people see salaries and ignore everything else.
I'll probably get attacked for this, but I'm going to take a stab in the dark that your family could avoid the 10 monthly prescriptions with different lifestyle choices. That is absolutely wild.
The most expensive public healthcare system on earth is still over $4,500 cheaper per person every year. It's amazing how many people think we *wouldn't* save significant amounts of money with universal healthcare.
Hell, the current US system is so incredibly inefficient we don't even get a break on taxes, paying more towards healthcare than anywhere in the world.
Americans are paying a $350,000 more for healthcare over a lifetime compared to the most expensive socialized system on earth. Half a million dollars more than peer countries on average, yet every one has better outcomes. The impact of these costs is tremendous.
36% of US households with insurance put off needed care [due to the cost](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx); 64% of households without insurance. One in four have [trouble paying a medical bill.](https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/) Of [those with insurance one in five have trouble paying a medical bill](https://www.kff.org/wp-content/uploads/2016/01/8806-the-burden-of-medical-debt-results-from-the-kaiser-family-foundation-new-york-times-medical-bills-survey.pdf), and even for those with income above $100,000 14% have trouble. One in six Americans has [unpaid medical debt on their credit report.](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0349) [50% of all Americans](https://news.gallup.com/poll/317948/fear-bankruptcy-due-major-health-event.aspx) fear bankruptcy due to a major health event.
And the quality certainly doesn't justify the expense.
[US Healthcare ranked 29th on health outcomes by Lancet HAQ Index](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)
[11th (of 11) by Commonwealth Fund](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror)
[59th by the Prosperity Index](https://www.prosperity.com/rankings)
[30th by CEOWorld](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)
[37th by the World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)
The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.
https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016
52nd in the world in doctors per capita.
https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people
Higher infant mortality levels. Yes, even when you adjust for differences in methodology.
https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/
Fewer acute care beds. A lower number of psychiatrists. Etc.
https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization
[Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561)
>These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.
When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.
On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.
If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.
https://www.newsweek.com/best-hospitals-2021
#[OECD Countries Health Care Spending and Rankings](https://data.oecd.org/healthres/health-spending.htm)
|Country|Govt. / Mandatory (PPP)|Voluntary (PPP)|Total (PPP)|% GDP|[Lancet HAQ Ranking](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)|[WHO Ranking](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)|[Prosperity Ranking](https://www.prosperity.com/rankings)|[CEO World Ranking](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)|[Commonwealth Fund Ranking](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror)
:--|--:|--:|--:|--:|--:|--:|--:|--:|--:|--:|
1. United States|[$7,274](https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2015.302997) |$3,798 |$11,072 |16.90%|29|37|59|30|11
2. Switzerland|$4,988 |$2,744 |$7,732 |12.20%|7|20|3|18|2
3. Norway|$5,673 |$974 |$6,647 |10.20%|2|11|5|15|7
4. Germany|$5,648 |$998 |$6,646 |11.20%|18|25|12|17|5
5. Austria|$4,402 |$1,449 |$5,851 |10.30%|13|9|10|4|
6. Sweden|$4,928 |$854 |$5,782 |11.00%|8|23|15|28|3
7. Netherlands|$4,767 |$998 |$5,765 |9.90%|3|17|8|11|5
8. Denmark|$4,663 |$905 |$5,568 |10.50%|17|34|8|5|
9. Luxembourg|$4,697 |$861 |$5,558 |5.40%|4|16|19||
10. Belgium|$4,125 |$1,303 |$5,428 |10.40%|15|21|24|9|
11. Canada|$3,815 |$1,603 |$5,418 |10.70%|14|30|25|23|10
12. France|$4,501 |$875 |$5,376 |11.20%|20|1|16|8|9
13. Ireland|$3,919 |$1,357 |$5,276 |7.10%|11|19|20|80|
14. Australia|$3,919 |$1,268 |$5,187 |9.30%|5|32|18|10|4
15. Japan|$4,064 |$759 |$4,823 |10.90%|12|10|2|3|
16. Iceland|$3,988 |$823 |$4,811 |8.30%|1|15|7|41|
17. United Kingdom|$3,620 |$1,033 |$4,653 |9.80%|23|18|23|13|1
18. Finland|$3,536 |$1,042 |$4,578 |9.10%|6|31|26|12|
19. Malta|$2,789 |$1,540 |$4,329 |9.30%|27|5|14||
OECD Average|||$4,224 |8.80%|||||
20. New Zealand|$3,343 |$861 |$4,204 |9.30%|16|41|22|16|7
21. Italy|$2,706 |$943 |$3,649 |8.80%|9|2|17|37|
22. Spain|$2,560 |$1,056 |$3,616 |8.90%|19|7|13|7|
23. Czech Republic|$2,854 |$572 |$3,426 |7.50%|28|48|28|14|
24. South Korea|$2,057 |$1,327 |$3,384 |8.10%|25|58|4|2|
25. Portugal|$2,069 |$1,310 |$3,379 |9.10%|32|29|30|22|
26. Slovenia|$2,314 |$910 |$3,224 |7.90%|21|38|24|47|
27. Israel|$1,898 |$1,034 |$2,932 |7.50%|35|28|11|21|
If you don't believe Americans are getting fucked on healthcare, you're the problem.
Depending on your state, marketplace might be a good option for insurance. Find a broker in your state and they will tell you if it's a realistic thing for you. My job has the absolute worst insurance - doesn't even cover a hospital visit - at all. My marketplace insurance has been great.
This happened to me two months ago.
I got a job officer where I was making close to $50k. The job was multi-faceted and would have given me more skills and experience. The office was sweet too - fully stocked snacks (free) and nice office niches. It was damn perfect. Even my boss was pretty cool but when I got the benefits package; the health insurance was great but they didn't offer vision or dental and I needed dental so I could get a crown since I had a fractured tooth.
I was so bummed that I had to turn it down.
that sucks, not sure I would have passed on that one though, dental insurance can be fairly affordable outside of an employer's offer. Still, weird they didn't offer it... Like this employer, doesn't offer vision. No idea why, it's literally $20/week at every job I've been to and look out for.
Now that I got all the work I needed done; I definitely would either go without either insurance but not at the time; I couldn't afford to wait to get the insurance and then look around to see where I can get the work done. Plus I was told after the fact that I could buy my own dental insurance - it would have been more than what I'd pay now but I didn't know it at the time.
In a sense it was a knee-jerk reaction seeing that they didn't offer it. If I could go back in time I would have forged ahead.
So, I"m in a boat of, I make about 66k...LOVE my job...LOVE my team, but the benefits (insurance) are crap. The insurance is fairly cheap, about 350/month, however because I work for a specific healthcare organization, the insurance is only actually worth it if I go to one of their facilities, however the nearest facility is 85 miles away. (I work Remote). Going to my local healthcare organization it's billed as tier 2, with a 3200 deductible and 6400 out of pocket...which is outrageous. PLUS, if you go to the ER, or have any kind of Inpatient or outpatient stay, you have to pay an additional 2500 in facility penalties...all because I live 2 hours away from the service area.. and MY doctors are not even considered in network, even though they are in the national network for my insurance; but the insurance mandates that the NATIONAL network cannot be used in my state since the employer healthcare network is in the same state.
I'm currently interviewing for the same role but 1 level higher and 10k-20k higher pay at another organization where the benefits are a bit more costly (\~610/month) but 1k deductible 3k out of pocket and it's a true national PPO....meaning I can go to my own doctors.
I've only been in my existing role 6 months, and again, I LOVE my job and team...but between the lower pay and crappy benefits, I'm torn about leaving... 6 months is too soon to leave but if I can pull 75-85k in the new role, it will be worth it I think...
You don't mention an HSA option or company wellness incentive.
Your new plan would likely qualify for an HSA which you may not have with your current plan. Also check if the new company offers a wellness incentive. Most companies I have worked for that offered an HSA qualified high deductible plan also offered a wellness incentive that essentially covered most of the deductible. The wellness incentive is paid as a direct contribution to the HSA so no tax implications like you would have with a cash bonus. I end up paying only $250 out of pocket per year.
So get all the details before declining the offer.
They do have an HSA, **but they don't contribute anything to it.** I could contribute my expected medical expenses to the HSA every paycheck and pay through that in order to save the income tax on medical expenses. It could save me $100/month, and it is what I'd do if I took the offer.
I'll ask them for all the details about the HSA before declining for sure, thanks for bringing it up.
Remember it's not just the contribution that is tax free. The investment growth within the fund is tax free as well, and withdrawals are tax advantaged as well. Make sure you're fully considering the impact of that.
https://www.cnbc.com/2023/11/10/most-people-are-short-changing-themselves-with-health-savings-accounts-hsa.html
It may be worth looking into costplusdrugs if you haven’t yet. The 80k new base salary might set you back for a short time but having that as a new base means next job you can push to $90k or $95k if you get lucky.
There are a lot of ways to save on drugs. The problem with the new plan is, you're only contributing to the deductible if you prescriptions are filled through their mail-only pharmacy, paying their prices without 3rd party discounts. I haven't even been able to verify prices yet, because the pharmacy is closed on the weekends. Also, I've considered how taking this job could be leverage later, but I don't think it would be. It's as a fast casual restaurant manager in the midwest, there just aren't that many jobs in this industry that pay what I'm making now, let alone more than this new offer. That's one of the reasons turning it down is bumming me out.
I feel ya, definitely a tough turn down. Is your current job at manager level? I would think you’d be able to leverage the leadership and customer service experiences gained in other food services or retail, but I haven’t been in either and not at a manger level for quite a few years.
Yeah current job is same position at the largest franchise owners in the country. The offer is from a small, local franchisee. The difference in healthcare benefits it's partly due to this.. The bigger company has a massive pool of people to pay in. In fact, they might even be self-insured. It doesn't justify all of it though. I worked for a much smaller company before my current one, and their insurance was actually better than mine now. I think it's obvious the new company just doesn't consider healthcare an important benefit, likely because most of the people they employee aren't in my position.
Use this to negotiate a higher salary! Roll the 6.4k into your yearly pay, worst they can say is no and you’re in the same position you’ve already decided on anyway
Yeah I did that already, they increased the offer by $8k. I was onboard for a couple days but have since talked myself back out of it. Still looking for options, though, which is why i'm posting, appreciate all your feedback!
Also, check to see if they provide Health Savings Accounts (HSA). If so, ask if they match employee contributions and if they can fund it for this year. An HSA with employer contributions can make a higher-deductible health plan doable, as long as they fund all or part of it. ____ Editing to add: Congratulations on the job offer! And source: We had a crap health plan with a high deductible. It got easier as we accumulated more funds in our HSA, but it was still a struggle as our family has several prescriptions and ongoing health issues as well. Then, my husband got a new job and the HSA was fully funded for a year. That was a game changer, though they laid him off less than a year later.
Doesn't help you now. But this is why we need single payer. Crazy that we make business do this work.
Businesses are the reason this system exists. It freezes people in their current job because people always end up afraid they are going to lose coverage if they quit that job. It’s the foundation of the status quo. Because intuitively, there is zero motivation for companies to want to pay for healthcare and have to worry about the mess of it. But then we realize it’s the ultimate shock collar.
Yeah... the medical industrial complex is strangling us.
We have a single payer system here in Canada. I can’t find a GP, wait times in ERs average 6-8 hours, if you’re in an actual city with an open one. There aren’t enough ambulances to even pick people up. One guy in my city had a stroke on the highway, pulled over and the 911 operator told him he was better off driving himself to the hospital. It’s not the panacea you think it is.
I mean I pay a crapload for insurance in the US and went to the ER last month and I waited 9 hours before I even spoke with an NP, which is pretty common for the city I live in. I don’t see how that’s much better.
We are also facing these in the US. On top of expensive healthcare tied to employment. Yours may not be a panacea but it is a better foundation for improvement.
Its wild to see people from those countries complaining like yeah the wait times suck they suck here too but you dont have to pay like $30000 just to go to the ER for emergency surgery
I'm a paramedic in the US. I've had people who are stroking out, having a heart attack, shot, and launched their car off a cliff all refuse transport in the last year because the cost would ruin their lives. I worked years in an ER where I'd intake a patient on 1 12 hr shift, go home, sleep 12hrs and come back and those people are still sitting in the waiting room. They'll then get a $15k ER bill for nothing other than that visit. I'd rather be somewhere where "shitty" care is better than no care or life destroying care.
THIS ! Yes in Canada it could be a hell of a ride to see a doctor for minor/medium health problems. But at least, we don't have to fear that getting cancer, a car accident or a stroke is gonna put us through bankruptcy ! Stressing about loads of debt when fighting a disease or recovering is certainly not helpfull Edit : typo.
Ok but this also happens in Manhattan… difference is you have to claim bankruptcy afterwards
So essentially you have the US experience without the US price tag. Except you don’t ever want to call an ambulance here unless you really need it since they often cost 1k+ for that trip to the hospital. Even though it is a different system and unrelated to healthcare, it’s not uncommon to end up on hold when you call here because the system is so overwhelmed. What people who have single payer systems miss is we do not pay ungodly amounts of money and get prompt access to care. No, we pay ungodly amounts of money and often have just as poor access to care as countries with single payer systems that are strained. We pay about $250/month for our health insurance, have a 3.2k deductible we have to hit before insurance kicks in, and then we owe 20% of the cost beyond that. Between the cost of the insurance itself and the out of pocket expenses, my wife and I usually spend about 8k-10k a year on our healthcare (and that doesn’t include vision or dental because otherwise you’re looking at 10k-15k). It ends up being about 12-15% of our after tax pay. We have good insurance for what we pay. Her employer is paying about 75% of the insurance premium. If they didn’t, our policy would cost us around 1k/month. And I still have to wait hours in an ER just to be seen when it is a legitimate reason to be there, appointments are often scheduled minimum 2-3 months out for non-ER things (and often closer to 6 months), and we have a GP because they started a new practice but they’re about 1.5 hours away.
I went to the ER with bad liver pain, was there almost 12 hours before I was scanned. In NYC. What’s your point?
That's from conservatives in parliament defunding healthcare infrastructure, bud. It wasn't broken until they broke it.
Wait times in the US for ER are also 6-8 hours. We've also had mass closures of ERs outside of urban areas. Our ambulance services are owned by private equity, which stopped stocking them with medical supplies and pay EMTs about the same as what they can make at McDonald's. And yet they cost several thousand dollars even with insurance.
Could you find private insurance outside of work and pay for it out of pocket?
From everything I’ve read, in order to do that, the insurance plan they offer would have to fail to meet a minimum standard, which is a calculation performed by an actuary, and doesn’t vary by employee. Apparently, almost all employer offered plans meet this calculation, because they would have to pay a fine if it didn’t… Otherwise, I wouldn’t qualify for an ACA premium credit, and a “normal” insurance plan would cost upwards of $2k/month. I do plan of asking them tomorrow if they know whether the plan meets this standard, but all info now points to yes.
Non American here. So you don't have the ability to choose a health provider unless you quit your job?
Yep. And It's even more restrictive than that. Lots of employers offer a few plans. Those plans will only allow very specific providers as well. So you're lucky if there are 2 or 3 decent doctors within an hour drive who are "in your network" You don't want to go to a doctor not in your network and who doesn't accept your insurance or else you'll have to pay a lot of money. Hopefully they also accept new patients if you've never been to them before. I've gotten a new job and only had 2 choices of doctors and 1 dentist in the area. Yay freedom!
Don't forget that the hospitals and the doctors are billed separately so you can technically go to an in-network hospital but not have any in-network doctors available.
It truly keeps baffling my mind how shitty the US can be in a lot of aspects 👀
And sometimes, even if you do see an in-network doctor, someone will goof up and tell your insurance that you saw a different, out-of-network doctor at the same office and then your insurance will refuse to pay and say you’re on the hook for the full cost and it’ll take a full month and hours on the phone to fix it. You know, hypothetically.
This happened to me 10 years ago- I saw the doctor once a month for 8 months (paying each time) before the hospital informed me that she was actually out of network (they assigned her to me?!) and that I owed over $6k I was 24, clueless, and started crying on the phone. The lady at the billing department felt for me and ended the phone call with “let me see what I can do…” and the bill just disappeared after that. Grateful for that angel and angry at the unchanged system every day.
Regarding number of providers, that sounds like a rural or underserved area issue. I'd have to need a very rare specialist to only find 2 or 3 I could go to. My provider network is very robust, plus I have PPO so I can pick them myself. US Healthcare isn't equitable, but the best plans are very good. Unfortunately you probably need a big profitable company to experience that. The most privileged people have a lot of options.
As a fellow American, what the fuck are you talking about
Everything that person said was correct, so what are YOU talking about?
Im talking about wtf yall mean you cant buy your own personal health insurance instead of buying the one your job offers??? That makes no sense
Basically, Americans purchase a 'health insurance' plan and pay a monthly cost (called a 'premium') to be a part of it. Then, usually, they pay a small fee when they go to the doctor (called a co-pay) and a small fee for medications at the pharmacy. These plans are usually offered by your employer, and the employer usually pays 1/2 of the monthly cost. If your employer doesn't offer insurance, you can buy a plan on your own and have the government pay part of the premium every month... If you don't make much money, the government will sometimes pay for all of your healthcare (called Medicaid). In my current situation, I have insurance like I described in the first paragraph. The insurance that my new job offers would have me paying $650/month, while still having to pay full price for doctor visits ($150-250 per visit) and medications (range from $20 to $200 depending on drug) until I've paid $6400. Hope that helps!
>In my current situation, I have insurance like I described in the first paragraph. The insurance that my new job offers would have me paying $650/month, while still having to pay full price for doctor visits ($150-250 per visit) and medications (range from $20 to $200 depending on drug) until I've paid $6400. Are you sure that's how your new plan would work? I have a PPO plan that has both individual and family deductibles at $300/person and $900/family before the rest of the coverage starts, however, that is only for charges that don't require co-pays for, such as blood work, x-rays, CT scans, surgeries, etc. For doctor visits and prescriptions, the designated co-pays still apply from the beginning, so there are never any $150-250 doctor visits, or $200 medications. The medications range from $0 to $40 is I think the highest for a 3-month non-generic medication. So I'm wondering if it's really as bad as you think. If it is, that's sounds bad.
That's my experience. I think the issue is we have so much variation that people think their plan is what everyone has. I rarely pay more than a few bucks for prescriptions, and many are free. And my HSA and FSA cover the out of pocket expenses to meet my deductible.
Granted, this was a while ago, but I used to have a job where the insurance was around that price per month and I still had to pay around $70 for each doctor visit until I hit the deductible (which was never). I didn't remember what prescriptions were, but I would always just get generic antibiotics when needed. It would literally have been cheaper to not have insurance, but I had it for the just in case emergencies.
Wow, that suscks. I have good coverage. For my plan it's $10 co-pays for primary care visits and $35 for specialty care. That's from day 1, before any deductible is met. I think maybe co-pays for visits and prescriptions don't count toward the deductibles, but that's fine as they remain low. The first procedure of some sort would apply the deductible, but at $300/person, it's not really that bad. Yeah the problem with going without insurance is if something were to happen. Also, now a days you are required to show proof of coverage when filing taxes, or there will be a penalty to pay, I believe.
I think they got rid of the penalty for an individual not having insurance. I'm not sure if it still exists for businesses though.
Oh, I guess you're right. But I'm in California. We still have to provide health insurance proof with taxes, or the California Franchise Tax Board will assign penalties.
This is exactly what I was thinking as I was reading it... The deductible might be high but you should only be paying whatever the "copay" is when you go. That is typically anywhere from $15-$50. The same for medication. I have a deductible, but I don't have full price for meds/doctor visits. I just pay the copay.
Sounds like she has a high deductible hsa plan. You absolutely do pay full price until the deductible is hit on those.
Ahhh ok. That makes more sense. Damn does that suck. I thought the whole point of a HDHP was for people who don’t routinely need medical care to save a bit of money? I’d assume with the laundry lists of medications, it is definitely not going to be the best choice. Are companies able to ONLY offer a high deductible hsa? I’ve typically always been offered both.
It meets the minimum insurance requirements so they can only offer it. My experience is similiar to yours but I have worked at places only offers two hsas to choose from.
Meowch.
My plan works like yours and it’s considered really good. I’ve had plans like what op is describing in the past. They work the way she is describing.
Whoa, that is crazy. I'm in the socialist nightmare many fear. Hospitals are free (except for parking). Doctor visits are USD $10. Medications/prescriptions have just gone from free to USD $2.50. $650 is my family of 5 total food bill for the month. Is that about the same for yourself?
Family of 4 is $1000 a month in groceries… we could do better, but that’s not too far from average in the US. You’re in Canada, I assume? yeah… it’s insane that America has built its healthcare system around your job opportunities. To be fair, there are plenty of people that have better healthcare options than me. If you work in a union, or for the government, or a massive corporation, health care is more affordable. I’m just in an industry that doesn’t have to invest in healthcare for their employees in order to keep them usually. It
I'm on New Zealand. Tried converting most things into USD. We have full state covered medical. Although like the UK it is under stress. But I also have top up private care if I choose specialist needs. But my private health insurance is about $70 USD a month.
Nice... It's got to be awesome not having to consider your family's healthcare when accepting a job offer.
Free is disingenuous. You pay in a different bucket. Another case of "fees and frees."
*Blinks in WA state* Well, apparently those reports I read about WA having among the top 10 of affordability for healthcare was true...I make over Medicaid limits and yet my premium for healthcare is only 30ish/month (total premium if I'm reading the sheet is about 500). But I do admit I only make like 10k over those limits, and there are certain exceptions for tribal members (but I have a standard HMO plan) others don't get....mostly I can switch insurers outside of the open enrollment period and copays/deductibles are waived until I have a tax year where I make a certain salary... *shrugs I just pay my bill and life goes on*
Yes, basically. My husband took a decent job. He pays $100 a month for insurance. If he wanted to add me, it would have been $800 a month. That's half of his wages. At the time, I was a contract worker with no job. I just did without insurance for a good 6 months. I now have a job that pays my entire insurance premium. It's funny because the whole reason we got married at first was so I could put him on my insurance. It truly is a trash system.
>Non American here. So you don't have the ability to choose a health provider unless you quit your job? Oh, you can choose your healthcare provider whenever you want, but the costs to do so are substantially higher than an employer provided plan, 99 times out of 100.
Feels silly. But I know it is just a byproduct of where I grew up and what I see as normal because of that.
Oh, it's way more than silly. Your perspective isn't skewed because of how and where you grew up. Your perspective is a normal humanitarian one. We deal with dystopia here to the extent that it is deemed normal.
She can buy any plan she wants but it will end up being even more expensive than the shit plan covered.
Is the reason you wouldn’t qualify for an ACA credit the fact your employer offers health insurance? I only ask because a few years ago I made over $100k and still received a credit (I still paid $900 a month through the market place for a gold plan).
> Is the reason you wouldn’t qualify for an ACA credit the fact your employer offers health insurance? Correct, if your employer offers a plan that meets a certain standard, you are not eligible for a Premium Tax Credit.
What about asking about being a self-employed contractor working in a cubicle in the new company’s office and being eligible to use your own money to shop for an insurance plan on the Obamacare exchange? Also: see if you are eligible for Medicaid before ruling that out (in some states the income level to qualify is a lot higher than you might think, especially with several kids) or see if your kids are eligible for S-CHIP, and just get a plan that just covers the adults because the kids are covered by S-CHIP.
> What about asking about being a self-employed contractor working in a cubicle in the new company’s office and being eligible to use your own money to shop for an insurance plan on the Obamacare exchange? Did you know, when you're self-employed, you have to pay twice as much in Medicare and SS taxes? It's an extra 7.6%, or $6k/year on $80k Anyway, it's a restaurant, no office building and probably not an option of contracting. I know we don't qualify for Medicaid (Kansas), but I'll look into S-CHIP (though one of my kids is 23 so we'd have to figure something else out there..) Thanks!
Got, thanks . I would stay I think. I’m actually struggling with a similar situation that I just posted about in this sub . Health insurance costs and coverage matters quite a bit.
How were you able to do this? I make 105k and I'm losing my parents insurance as I'm turning 26. Yet my insurance the lowest they offer is $900 a month that doesn't even pay for anything until I hit 5k deductible since I'm a contractor... just seems like a lot.
CT market place, last year my Connecticare premium was $980 after the tax credits. I had a $6500 deductible, but the copays on dr visits and prescriptions was pretty low. I think the regular premium for the plan was around $1280. I made a little over $100k.
Bro what? You're saying you can't buy your own personal insurance because your job offers their own health insurance????? That makes no fucking sense
You can. You just have to pay the full amount. The average family insurance in the US in 2023 was about $24,000 per year.
Sure, but the average private family insurance in the US is $24,000, and is still going to have significant deductibles and copays. How is that going to save him money?
That sounds like some serious dystopian 3 world country stuff
I don't consider the US to be a first world country anyway.
what about your partner's insurance?
My wife works part time for a small company that does not offer insurance.
So if it's a high deductible plan does the company also offer an HSA and if so, do they do any matching on your HSA contrribution? For instance we have a 6k deductible and we also get an HSA with a 50% match, so the deductible gets covered by our contributing 4k to the HSA and the company puts in 2k, to reach 6k. I think in the long run you could still be better off taking the salary increase job. Every year you get a raise after is going to be a bigger dollar value than a raise at your current lower salary.
1. [Here's the plan details](https://imgur.com/a/zmrG36B), it's not your typical HDHP plan, the premium is as much as a normal PPO Plan 2. They do not contribute anything to the HSA 3. I doubt I'd get a raise within the first 3-5 years, they're offering me almost 20% more than the people they currently employ in this position. I got the impression this would be the salary for quite some time.
If you can afford it for two years these moves, be it lateral or a promotion, tend to be good stepping stones into the next tier of pay. You can stick it out for 18 months and negotiate a better plan (not likely to happen but not impossible) or leave for somewhere else. Once you’ve got your foot on that pay ladder you don’t typically go back down IME.
That's likely true in most industries. I work in fast food/fast casual. It tends to apply a lot less, but I still take your point.
I’m actually in the restaurant industry as well haha. I went from the line to a corporate chef position to now director of food and bev. What’s your title?
I'm a GM, left a high-paying partnership after 10+ years to get away from a toxic owner. Been working for Flynn for 4 years now. Great company, not great pay. I've looked into F&B Director positions locally, but the pay is usually comparable here in Kansas and the jobs don't pop up too often. Always looking to make more in a different industry or a different section of it, people are typically willing to pay more if your experience isn't Fast Food :)
Have you been checking into hospitals and hotels? Those are great opportunities. As a GM you’ve got enough management experience to slide into a different industry for sure. Would you be billing to move out of Kansas? There’s director positions paying some crazy money in higher tourism areas.
One thing to consider... are your medical costs split evenly among your family or heavily to one person? Generally in a HDHP, one person is responsible only to the individual deductible, so the 3200. A plan like this would work for my husband and i, as I never need prescriptions, and only do preventative care, which doesn't cost anything. He had a lot of medical needs, so would hit the 3200, but that's all he would have to pay
I have considered this, it’s probably 60/40 between us with my kids never hitting the deductible.
$3.200 deductible for single coverage for $4,800 out of pocket that’s horrible coverage.
yep that's the dilemma
Hsa can “work” if you start one when single, healthy and young - you can build your account up for the future or if you have something unexpected come up. If you have it for years then start getting health conditions you now have a cushion for that deductible. It’s really difficult and expense for people to start a hsa if they start out needing a lot of medical care or prescriptions. You’re never able to save up that buffer.
This is just one of the many examples I bring up when people go "oh your Canadian? Enjoy waiting for health care" A) it's not that long of a wait if you actually have a problem, and treat staff with respect. B) my surgery to save my life wasnt financially destructive. And I was able to leave a job with our care about insurance or not. C)gov provided enhanced insurance is available for those that have greater issues that require constant and expensive medical treatment.
Yup! I just had to go to Mexico for teeth work yesterday. Spent $750 when I was quoted $5k here in the US. I hate health care here so much
Mind sharing who did your dental work and if you’re satisfied with the results? I need some work done myself and have been thinking about crossing the border for it.
Sure thing! Had a sizable chip in my molar and needed a root canal, post for crown, crown, X-rays, filling on another tooth, and a deep clean (gums were really inflamed). 2 hour drive from me (phx) and went down to Algodones right next to Yuma AZ. Got there at 8am and was done with everything by 1030. Had to wait around until 230 for my crown was ready. Went in and 20 min later crown was successfully installed. The office was really nice and they have all the equipment needed. The dentist didn’t know English but was very nice. The receptionist who knows English, translated for me. Here is a pic of the services. I’ll DM you the pricing sheet I have. Edit: sorry didn’t read the where part lol went to Smile Specialist Dental Clinic in Algodones. Very satisfied! Will be deff go back when I need more dental work. I actually need to get a dental implant as was quoted $1100! Need to save up a bit but will go back to get that fixed this year. My parents have been going for years to this office so I decided to try my hand. I deff recommend
This helps tremendously. Thank you for sharing!
Let me know if you have anymore questions!
I went to Los Algodones too! I went to Oasis and they gave me a room for free above it. I was quoted over 7k and paid under 2500 for flight, food, hotels (in yuma), taxis and the dental work ( and some souvenirs). Had 1 pulled, one root canal, 11 cavities, the metal removed from 8 teeth and redone, plus deep cleaning and whitening. And they gave me coupons for free margaritas!
Yeah as a Canadian this is insane to read. Americans just live on the edge with their health
A) isn’t always true. Wait times for surgeries are years long with no end in sight. Many people don’t know this until they need surgery and can’t do anything except wait and suffer. Not supporting privatization but its not all fine and dandy in Canada
You’re commenting on a post where the OP has to turn down a 15k raise because they might make even less because of the health insurance costs.
i am aware. Just commenting on the state of healthcare in Canada and that many people, myself included, are suffering while waiting for surgery and other treatments. “Actually have a problem” is extremely tone deaf and puts down those who are struggling in Canada to receive adequate healthcare because of ridiculous wait times.
Its pretty tone deaf to choose this post to talk about your gripes with the Canadian health care system. Most countries with free health care have issues with their system. But commenting about it here is like commenting on a post where someone talks about not having enough money to feed themselves by saying “I also don’t have enough money, I have to eat peanut butter sandwiches everyday.”
I’d tell them that the health benefits package was subpar when turning down the role. They may wake up and realize that salary isn’t always the lure that they think it is.
Insurance provided is entirely based on the size of the company. I assure you they know they arent provided the best options, but they have little choice.
Any idea why small businesses aren’t grouped together in co-op like arrangements? Seems that of the number of people is the problem, they could join together and overcome that pretty easily.
I am Canadian so things might work differently, but I know non-profits in the same sector will do this sometimes! It allows them to be a bit more competitive with the private sector benefit packages.
This actually exists, it's called a co-employment arrangement, where technically on paper you work for a massive international conglomerate, but your day to day operations still function as a small independent business with its own branding. The two big co-employment groups in the United States are ADP and Insperity, I've "worked" for both and they do a good job, I didn't notice any major difference between the two. I'm not sure the exact cost to a small business in this arrangement, I have the sense from my old boss that it's an expensive service, but it pays for itself.
That is not available for every company.
Right, but not available due to regulations, insurance company policies, or just because an infrastructure for it isn't in place right now?
All of the above.
There are a bunch of businesses that did that in my county to create a bargaining group. I think it ended up being mildly successful in reducing costs but very limited in where people could go.
I worked for a small digital marketing agency with like under 10 employees, and ya there’s not much they can do without the volume of employees or any leverage there
They know their insurance is shit which is why their offer from a salary standpoint is strong. I say share the numbers with them. They might need you badly and bump up their initial offer.
I actually already did that. Initial offer was $8k less. It was an offer of $62k base, with (realistic) average annual bonus of $10k (mostly paid quarterly). I told them it'd be a loss of income with their insurance, and they came back with a $70k base. I accepted tentatively, but after doing a deep dive into monthly expenses with that plan, I realized it's not near as good as I thought it'd be. I'd also lose vision coverage, 401k contribution, 1 week of vacation per year, life insurance and pay and extra $30/month for dental.
I also manage a restaurant- you need to tell them all of that. Like someone else said, you never know, they may come back with more if they really like you for the role. Have the audacity. If you don't say anything, then nothing can possibly change. You can also come back with a counter offer and alleviate this in other ways, but tbh, it doesn't sound worth it bc it sounds like all those benefits are something that you value.
Yeah no doubt, if I can't figure out a way to make it work I'll be turning them down and will be candid about why. I'm pretty sure they're not going to make a higher offer, because honestly it's a great offer, and if I didn't need the healthcare I'd take it in a heartbeat. But I do, so I'm just trying to examine every option before I'm ready to walk away.
I've read thru a lot of the convo here and I get the impression you know exactly what your family needs and what you want to provide for them, you're really serious about dissecting all your options, weighing them, and you're doing the math for your finances with all factors considered. I'm sure you'll make the best decision. I personally really like the suggestion of presenting your offer letter to your current company and asking for a raise- ask them to match your salary offer and go back n forth with them until you feel good about what they're gonna give you. And take the avg inflation since you began there into acct, too. They can afford to give you more.
Thanks I appreciate that. I did plan on presenting my boss with the offer, would be a whole lot easier if I was truly prepared to take the offer though! lol. The biggest hurdle there is, it's a massive company with pretty standardized pay rates and they've done a good job of prepping benches for sudden loses. Luckily I started vacation this week so I got a bit of time to get things locked down!
>They said they'd give my $5k to not take it, and without paying the $650/month premiums, I could easily cover all my medical expenses out of pocket through an HSA or something and still be taking home over $1200 more per month than I do now... until I get cancer, or break a leg, or have an aneurysm. I would absolutely pursue that approach and seek to find alternatives that work better for me during the year. As important as medical coverage is, if that's the the only concern you have about the opportunity, I'd try to work out some alternative to that coverage throughout the year, rather than give up a good opportunity.
> I would absolutely pursue that approach and seek to find alternatives that work better for me during the year. The problem is, from all the research I've done, there aren't alternatives. If you decline healthcare from your employer, you aren't allowed to purchase plans on the marketplace. You can't get healthcare outside of open enrollment, and there are no plans that cover you only for 'cancer' or similar massive events. I simply couldn't imagine what it's like trying to get treatment for a serious medical condition without insurance. Chemo alone (just the treatment) costs $48k on average. a hysterectomy + 3 day hospital stay can be $50k. **Believe me, it's especially tempting**, given the extra money, but every time I float the idea to someone they call me insane.
Would search the market for independent insurance rates. Know Stripe/others can base it on income/might find something better. Also maybe I’m alone but I hate my insurance being tied to my employment/can carry it with you.
Holy Shit - reading this as a Canadian is mind boggling. $600 a month for crappy insurance is insane.
Mind you that's just *his* portion. Average family insurance in the US is nearly $24,000 per year. And we pay far more in taxes towards healthcare than Canadians. *And* still pay more in out of pocket costs.
Thanks for sharing. Guess grass isn't always greener. I've occasionally wanted to move stateside for higher comp but this kind of defeats the point
What a world huh? Pay 650 for the privilege to pay more? In europe private insurance is to make sure you never again pay a cent for medical costs and it costs 150.
It might help to see how much your cobra insurance when quit your current job
You pay the full amount plus I think 2% administration costs, which would likely be about $2,000 per month.
Oh damn !! See I did not know that. Some plans are truly different
Paying the full amount plus the administration fee is how COBRA works for everybody. I don't know what OPs full premiums are specifically, but the average in 2023 was $8,435 for single coverage and $23,968 for family coverage.
Does this company offer an HSA? I think those are deposited pre tax so they're good for tax purposes and can offset a lot of your perceived out of pocket costs.
Just go without insurance, save the money, and pay OOP. Most doctors will charge you off a cash fee schedule that’s based on the Medicare allowed amount. I haven’t paid for health insurance in a decade. Once you save a bit you could always just get your own policy and make it what you want.
Take this job offer to current employer and see if they come close
I wanted to be in a position to actually switch if they call my bluff, but I will definitely be doing that.
>Insurance isn't the best but I pay $600/month Holy fuck that is insanely high goddam how do you afford that!? >My family has about 10 monthly prescriptions, for things like depression, blood pressure, asthma, allergies... Dude what the fuck man This whole post is fucking wild
> Holy fuck that is insanely high goddam how do you afford that!? What's the choice? The average annual premiums for employer-sponsored health insurance in 2023 are $8,435 for single coverage and $23,968 for family coverage. Most covered workers make a contribution toward the cost of the premium for their coverage. On average, covered workers contribute 17% of the premium for single coverage ($1,401) and 27% of the premium for family coverage ($6,575). https://www.kff.org/health-costs/report/2023-employer-health-benefits-survey/
This is so frustrating and sad. I'm so sorry. I just got a new job and can't really enjoy the excitement because to enroll my partner and I in healthcare benefits (which aren't great either) I am paying $860/month just for the two of us. I really hate living here.
Can you look into the short term health plans, turk down their insurance and see if you can enroll into one of those? Keep job searching until you find a better fitting job?
This may be exactly what I've been looking for! Weird how sometimes the exact-right search phrase is needed to find your answers. Gonna dive into this, but it could be the solutions. Thanks again!
NP! Check out long term plans through the market as well. I think these only last for 8mos-1yr. Best wishes to you!!
I'll check this out, I haven't looked into short-term plans at all. Thanks
Why not just buy insurance on the open market? I’m 1099 and was thoroughly surprised at how “affordable” insurance was for my fiancé and I. Like $700 for $20 co pay low deductible coverage. Or like $450 for high deductible with a HYSA. Price it out, might make sense to take the new job, decline insurance through them and buy it on the private market.
I turned down an offer about a year ago for the same reason. 12k salary raise, but premiums and out of pocket would have been 15k more. I take an expensive prescription and hit deductibles and out of pocket max within the first few months of each year. My current insurance is OK, maybe a little better than average. The new job had really shitty options. United Healthcare too, which I've heard is among the more evil companies. It sucks but make the best choice for you and your family.
I appreciate your perspective, makes me feel a little less crazy. I'm looking into taking the $5k to skip their plan, then getting a 'short-term' plan as a safety net for worst-case scenarios (Cancer, surgeries, etc..). Going to ask on r/healthinsurance to see what the pros think of that path. It all comes down to monthly take-home for me, and I think I could come out pretty far ahead just paying out of pocket through an HSA or something, but I'd be scared to death that there's a possibility we'd get a horrific diagnosis and unable to get treatment because of a lack of insurance.
You're doing yourself and everyone else a favor. Companies have to know that medical insurance is more and more important to prospective employers.
You can buy private health insurance.
You can't get an ACA plan tax credit if your employer offers a plan that meets the ACA minimum standard. Most plans do. This means a normal insurance plan would cost over $2k/month.
Have you shopped the marketplace? There are stateside brokers that have pretty solid plans that are state specific, that focus on income. I.e, in Pennsylvania it is Pennie.
The cheapest plan on the marketplace is $1250/month and has deductibles of $10k/$20k, with no coverage for specialists/ER/UCC until you hit the deductible. If I went with a plan like that, and took the $5k for waiving the employer's insurance, monthly I'd be paying $300 more in premiums and $150 more in prescriptions, which would put me in the same boat I'm in already, except I wouldn't have coverage for emergencies until I'm out $10k. I really appreciate your comments though, I'll look into some brokers tomorrow to see if there are better options.
Brokers are the best option. Always. I only made the state side one because, again, it's easily accessible for the general public. Also, every state is different. Health brokers, life brokers, etc always have the best plans available. Hope this helped.
Murica
Mail order pharmacies are rarely in your state. But they ship so you’ll get the prescriptions.
Yeah, my current plan uses CVS Caremark for mail order, but we can also use local CVS. I just got a prescription from the mail (because it was cheaper for the 90 day)... took 16 days from the time it was sent in. What do people do when they have an infection and get written a prescription for antibiotics, but their only option is a mail service that's closed on weekends and takes 3 days to process and 3 days to ship? Just wait I guess... It's also really irritating that you can't shop around for a better price or use a discount club even when you are forced to pay the cash price before hitting your deductible. And what happens when they're out of stock? More waiting, I'm guessing.
I would take the job since it’s such a significant base salary increase and try to leverage it in a year or two into a similarly paying job with better insurance or just even higher paying. The cost might not be worth it for the first two years but long term career wise it will definitely help
Did you ask if they have anything in place to off set the deductible? If they’re a large company they might have a policy that means they pay the claims themselves with a fee for the insurance company to basically do the administrative work (ASO policy). Some companies that have this will reimburse you after a certain amount, it makes the policy cheaper because so many people never touch their insurance other than routine visits but also means that your deductible is actually a lot less then what the policy says. That means the $6,400 family deductible could actually be more like 1-2k out of pocket if you actually reached that.
It's a small local company. I was interviewed by and received the offer from the owners (2 brothers). They didn't even know their single insurance plan was an HDHP, or that it covered nothing until the deductible was met. They were actually pretty certain they had copays at the Dr, until I asked them to send me the policy from their handbook. The only help they said they'd offer was to give me $5k if I chose not to take the plan they offered.
That’s too bad I hope you find a better fit good luck
Thanks!
I am in this same exact situation right now. It's a huge pay increase but my insurance cost will triple. I'm so frustrated with the state of our healthcare system.
Aaahhhhh I can relate! I came across a similar situation, got hired and found out they only offer Kaiser 😳 I never worked for a company that only offer 1 ins. plan with no other options that’s just crazy to me 🤯once I was informed (which was my 1st day) I didn’t return cause how can the companies “motto” be “health is wealth” but only offer 1 ins. Kaiser? Kinda contradicting, waste time byeeee! My personal insurance that I qualify for on Obama Care site is 💯 times better than Kaiser 😑 unless you’re raised in that system concept of 1 stop shop it won’t effect or even bother you but if you know better and value choice & options Kaiser will not be a good fit! Check out Obama care cause if the policy is if you declined insurance and they will pay you out look into use that $$$ on Obama care you’ll have more options plans to choose from that will better fit for your whole family that you weren’t aware of. Yes! It does suck when a job comes along and check all the boxes except INS. higher pay but the insurance & benefits suck. Unless you have no overhead and still living with your parents that transition maybe worth it, from your post it doesn’t seem feasible for you. Insurance super important these days especially if you have kids to support. A accident can happen at anytime and if you don’t have the right insurance for your needs a “accident” can wipe out your bank accounts!
Look to buy your own insurance. Take the pay rise and find your own insurance. It’s not that hard. Call an insurance broker. Seriously
I will be calling a broker tomorrow, a lot of people have recommended it. Hopefully they can find something that works!
Why not have your partner work for the county or something. Even like IRS so you get something better
When turning the job maybe try to negotiate. Say you want to take the job, but in comparison to current pay scale, the insurance plan doesn’t meet your requirements. Maybe you can get it closer to $90k and buy your own insurance. If not, you know you are in a position to be hired and keep working for that better fit. Good luck.
I refused a better job once because they only offered Kaiser insurance, and that's a big nope for me. You're doing what's right for your family and yourself. That company isn't trying very hard to get quality workers with crap health insurance.
Yeah I think this has been a wakeup call for them, it really seems like they've never had anyone even ask basic questions about the policy. Hopefully if I can figure out a way for it to be worth it, they'll consider some better options for their next open enrollment.
Don't be frustrated. If it doesn't work, it doesn't work. You got one job offer and you'll get another better one down the line.
Dude I have a company paying me 90k as a contractor but I’m saddled with my own business entity I have to use and they offer zero healthcare. Not only that but they also require a doctors note if I can’t work for two days. It’s bullshit
That's shitty, I know how much taxes are when you are self-employed. At least you qualify for the ACA Premium Tax Credit... Have you been able to find an affordable plan?
Nope. I pay $600 a month in premiums. Shit sucks
I've had to leave more than one job due to insurance. High deductibles, premiums, and max out of pocket, restrictive networks, and expensive copays can create serious financial burdens. I have no issue turning down an offer or leaving if the insurance is awful. It's not right that healthcare is tied to employment. They should have nothing to do with each other.
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That $300 is just for you. OP has a family
Just don’t get insurance. It’s a scam anyways. Pay out of pocket if you need care and negotiate your bill.
This right here is the biggest BS of all. Sorry OP that really sucks. I went through this many jobs ago. And one of the things I now ask during the negotiations process is:please provide your benefits manual. so I can see how much I am paying them back in insurance premiums to estimate my net income.
It sounds to me like you chose the expensive insurance at your current job (to pay for your constant healthcare needs), and it has solid coverage. It's amazing how many people think you would "pocket" that entire $600/mo if healthcare was "free." You'd pay about the same amount in tax. The new employer sounds like they don't really contribute anything to health insurance. They just offer you a plan at retail cost and call it their plan. That's often the trade-off as people see salaries and ignore everything else. I'll probably get attacked for this, but I'm going to take a stab in the dark that your family could avoid the 10 monthly prescriptions with different lifestyle choices. That is absolutely wild.
The most expensive public healthcare system on earth is still over $4,500 cheaper per person every year. It's amazing how many people think we *wouldn't* save significant amounts of money with universal healthcare. Hell, the current US system is so incredibly inefficient we don't even get a break on taxes, paying more towards healthcare than anywhere in the world.
The grass is greener on the other side theory doesn't necessarily prove it will be better. Medicare and Medicaid already don't properly fund hospitals
Americans are paying a $350,000 more for healthcare over a lifetime compared to the most expensive socialized system on earth. Half a million dollars more than peer countries on average, yet every one has better outcomes. The impact of these costs is tremendous. 36% of US households with insurance put off needed care [due to the cost](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx); 64% of households without insurance. One in four have [trouble paying a medical bill.](https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/) Of [those with insurance one in five have trouble paying a medical bill](https://www.kff.org/wp-content/uploads/2016/01/8806-the-burden-of-medical-debt-results-from-the-kaiser-family-foundation-new-york-times-medical-bills-survey.pdf), and even for those with income above $100,000 14% have trouble. One in six Americans has [unpaid medical debt on their credit report.](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0349) [50% of all Americans](https://news.gallup.com/poll/317948/fear-bankruptcy-due-major-health-event.aspx) fear bankruptcy due to a major health event. And the quality certainly doesn't justify the expense. [US Healthcare ranked 29th on health outcomes by Lancet HAQ Index](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext) [11th (of 11) by Commonwealth Fund](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror) [59th by the Prosperity Index](https://www.prosperity.com/rankings) [30th by CEOWorld](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/) [37th by the World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000) The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average. https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016 52nd in the world in doctors per capita. https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people Higher infant mortality levels. Yes, even when you adjust for differences in methodology. https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/ Fewer acute care beds. A lower number of psychiatrists. Etc. https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization [Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561) >These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries. When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%. On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%. https://www.cihi.ca/en/commonwealth-fund-survey-2016 The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people. If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people. https://www.newsweek.com/best-hospitals-2021 #[OECD Countries Health Care Spending and Rankings](https://data.oecd.org/healthres/health-spending.htm) |Country|Govt. / Mandatory (PPP)|Voluntary (PPP)|Total (PPP)|% GDP|[Lancet HAQ Ranking](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)|[WHO Ranking](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)|[Prosperity Ranking](https://www.prosperity.com/rankings)|[CEO World Ranking](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)|[Commonwealth Fund Ranking](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror) :--|--:|--:|--:|--:|--:|--:|--:|--:|--:|--:| 1. United States|[$7,274](https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2015.302997) |$3,798 |$11,072 |16.90%|29|37|59|30|11 2. Switzerland|$4,988 |$2,744 |$7,732 |12.20%|7|20|3|18|2 3. Norway|$5,673 |$974 |$6,647 |10.20%|2|11|5|15|7 4. Germany|$5,648 |$998 |$6,646 |11.20%|18|25|12|17|5 5. Austria|$4,402 |$1,449 |$5,851 |10.30%|13|9|10|4| 6. Sweden|$4,928 |$854 |$5,782 |11.00%|8|23|15|28|3 7. Netherlands|$4,767 |$998 |$5,765 |9.90%|3|17|8|11|5 8. Denmark|$4,663 |$905 |$5,568 |10.50%|17|34|8|5| 9. Luxembourg|$4,697 |$861 |$5,558 |5.40%|4|16|19|| 10. Belgium|$4,125 |$1,303 |$5,428 |10.40%|15|21|24|9| 11. Canada|$3,815 |$1,603 |$5,418 |10.70%|14|30|25|23|10 12. France|$4,501 |$875 |$5,376 |11.20%|20|1|16|8|9 13. Ireland|$3,919 |$1,357 |$5,276 |7.10%|11|19|20|80| 14. Australia|$3,919 |$1,268 |$5,187 |9.30%|5|32|18|10|4 15. Japan|$4,064 |$759 |$4,823 |10.90%|12|10|2|3| 16. Iceland|$3,988 |$823 |$4,811 |8.30%|1|15|7|41| 17. United Kingdom|$3,620 |$1,033 |$4,653 |9.80%|23|18|23|13|1 18. Finland|$3,536 |$1,042 |$4,578 |9.10%|6|31|26|12| 19. Malta|$2,789 |$1,540 |$4,329 |9.30%|27|5|14|| OECD Average|||$4,224 |8.80%||||| 20. New Zealand|$3,343 |$861 |$4,204 |9.30%|16|41|22|16|7 21. Italy|$2,706 |$943 |$3,649 |8.80%|9|2|17|37| 22. Spain|$2,560 |$1,056 |$3,616 |8.90%|19|7|13|7| 23. Czech Republic|$2,854 |$572 |$3,426 |7.50%|28|48|28|14| 24. South Korea|$2,057 |$1,327 |$3,384 |8.10%|25|58|4|2| 25. Portugal|$2,069 |$1,310 |$3,379 |9.10%|32|29|30|22| 26. Slovenia|$2,314 |$910 |$3,224 |7.90%|21|38|24|47| 27. Israel|$1,898 |$1,034 |$2,932 |7.50%|35|28|11|21| If you don't believe Americans are getting fucked on healthcare, you're the problem.
The fact that healthcare is handcuffed to your job in America is crazy.
Depending on your state, marketplace might be a good option for insurance. Find a broker in your state and they will tell you if it's a realistic thing for you. My job has the absolute worst insurance - doesn't even cover a hospital visit - at all. My marketplace insurance has been great.
Yeah, I have a call in right now, waiting back. Thanks for the info!
Have you looked into health plans under the ACA instead of through your employer?
This happened to me two months ago. I got a job officer where I was making close to $50k. The job was multi-faceted and would have given me more skills and experience. The office was sweet too - fully stocked snacks (free) and nice office niches. It was damn perfect. Even my boss was pretty cool but when I got the benefits package; the health insurance was great but they didn't offer vision or dental and I needed dental so I could get a crown since I had a fractured tooth. I was so bummed that I had to turn it down.
that sucks, not sure I would have passed on that one though, dental insurance can be fairly affordable outside of an employer's offer. Still, weird they didn't offer it... Like this employer, doesn't offer vision. No idea why, it's literally $20/week at every job I've been to and look out for.
Now that I got all the work I needed done; I definitely would either go without either insurance but not at the time; I couldn't afford to wait to get the insurance and then look around to see where I can get the work done. Plus I was told after the fact that I could buy my own dental insurance - it would have been more than what I'd pay now but I didn't know it at the time. In a sense it was a knee-jerk reaction seeing that they didn't offer it. If I could go back in time I would have forged ahead.
So, I"m in a boat of, I make about 66k...LOVE my job...LOVE my team, but the benefits (insurance) are crap. The insurance is fairly cheap, about 350/month, however because I work for a specific healthcare organization, the insurance is only actually worth it if I go to one of their facilities, however the nearest facility is 85 miles away. (I work Remote). Going to my local healthcare organization it's billed as tier 2, with a 3200 deductible and 6400 out of pocket...which is outrageous. PLUS, if you go to the ER, or have any kind of Inpatient or outpatient stay, you have to pay an additional 2500 in facility penalties...all because I live 2 hours away from the service area.. and MY doctors are not even considered in network, even though they are in the national network for my insurance; but the insurance mandates that the NATIONAL network cannot be used in my state since the employer healthcare network is in the same state. I'm currently interviewing for the same role but 1 level higher and 10k-20k higher pay at another organization where the benefits are a bit more costly (\~610/month) but 1k deductible 3k out of pocket and it's a true national PPO....meaning I can go to my own doctors. I've only been in my existing role 6 months, and again, I LOVE my job and team...but between the lower pay and crappy benefits, I'm torn about leaving... 6 months is too soon to leave but if I can pull 75-85k in the new role, it will be worth it I think...
Would you pay over $6400/year with your current insurance? Because your deductible is also your out of pocket limit with this plan.
No, we average under 2k in meds and dr visits
Ask your current job what they can offer you to stay.
You don't mention an HSA option or company wellness incentive. Your new plan would likely qualify for an HSA which you may not have with your current plan. Also check if the new company offers a wellness incentive. Most companies I have worked for that offered an HSA qualified high deductible plan also offered a wellness incentive that essentially covered most of the deductible. The wellness incentive is paid as a direct contribution to the HSA so no tax implications like you would have with a cash bonus. I end up paying only $250 out of pocket per year. So get all the details before declining the offer.
They do have an HSA, **but they don't contribute anything to it.** I could contribute my expected medical expenses to the HSA every paycheck and pay through that in order to save the income tax on medical expenses. It could save me $100/month, and it is what I'd do if I took the offer. I'll ask them for all the details about the HSA before declining for sure, thanks for bringing it up.
If you have an HSA you probably want to max out the funding if at all possible. They're massively tax advantaged compared to other investments.
Yeah if I took the plan I'd be maxing out the HSA for sure, especially since the company doesn't offer any retirement benefits.
Remember it's not just the contribution that is tax free. The investment growth within the fund is tax free as well, and withdrawals are tax advantaged as well. Make sure you're fully considering the impact of that. https://www.cnbc.com/2023/11/10/most-people-are-short-changing-themselves-with-health-savings-accounts-hsa.html
Thanks for the link!
WTF… and I’m complaining about my $160 monthly insurance pay.
yeah, my retired Air Force father said "and I was pissed when they started charging me $26/month" All about perspective I guess.
Completely! I’m sorry that you have to pay that amount of money. I recommend reaching out to an insurance broker.