Open enrollment increases for 2026

#51
#51
BigOrangeMojo said:
I am planning on participating in St Jude races this December


And by participating, I mean drop WTF off and go find a doughnut shop while she runs...
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How do you prep for that? Start visiting donut shops once a week and work up, or just bite the bullet and make 4 or 5 runs each week, adding the number of donuts per trip?
 
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#53
#53
Burhead said:
My company is switching from Meritan health/Aetna to Highmark

Plan on I'm on now:
2025 Aetna PPO - $268.74 ($722.22 for family)
2026 Highmark PPO - $295.61 ($924.44 family)
2026 Highmark PPO HPN (In-network only, certain zip codes) - $266.05 ($839.50 family)

2025 CDHPs (Aenta)
3500 - $75 ($488.58 family)
2000 - $175.03 ($627.11 family)

Highmark CDHPs (Both plans deductibles increased by $250 & OOPM by $500)
3750 - $72.62 ($548.05 family) ($3750 deductible/$7500 OOPM, 30% co-insurance after deductible)
2250 - $169.46 ($682.16 family)
2250 HPN - $152.51 ($621.44 family) ($2250 deductible/$4500 OOPM/20% co-insurance after deductible)

Dental and vision premiums are staying the same $6.60 ($18.86 family) for vision. $20.48 ($73.19 for family) or $32.14 ($117.36 family) for dental depending on the plan selection.

I won't know until Nov 3rd if I'm eligible for the in-network only plans.

PPO
Preventive - 100% (Same)
Deductible - $1,000 (Staying same)
Coinsurance - 25% after deductible (same)
Out of Pocket Max - $3,500 (Same)
Telemed through Cirrus - $0 copay (New, was $40 on Aenta)
Doc Visit - $40 copay (same)
Specialist - $50 copay (same)
Emergency Room - $400 copay waived if admitted (Same)
Urgent care - $50 (same)

Prescription through Express Scripts (same)
Generic - $10 (retail) - $25 (mail)
Preferred - $50 (retail) - $125 (mail)
Non-preferred - $75 (retail) - $200 (mail)
Specialty - $150

Some operations (bariatric, hip/knee surgery, spinal, or CAR T-cell therapy) must be performed now through Carrum Health with Highmark and its covered 100% no deductible. All other operations are optional through Carrum Health but Highmark won't cover 100% of the cost, it goes to cost sharing after I meet the deductible.

They also stopped the company contribution to HSAs this year.

All this is for single person. Honestly I don't know what I'm going to do. I'm actually thinking about just dropping it altogether only way I'd keep it is if I can get the in-network only PPO plan. I'm 33 and never go to the doctor and I'm not any prescriptions so I'm giving away free money. I'm worth more with the life insurance honestly haha plus insurance is a scam anyways.
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Is be there a max out of pocket?
 
#56
#56
BeardedVol said:
Good thing Republicans are using all those Doge cuts to pay down the deficit on your behalf.

When they cut the ACA subsidies at the end of the year, I'm sure those will also go to paying down the debt as well.
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Dems don’t have any room to even mention the debt either after their s*** show of four years under Biden and eight under Obama. Just knock it off. So, sure…Let’s do absolutely zero about cost cutting or the debt because I’m literally this guy that wants to see the calamity when economic Armageddon comes and people realize the .gov is 1) completely incompetent and 2) isn’t effing Santa Claus.

IMG_5716.gif
 
#58
#58
Vol737 said:
Dems don’t have any room to even mention the debt either after their s*** show of four years under Biden and eight under Obama. Just knock it off. So, sure…Let’s do absolutely zero about cost cutting or the debt because I’m literally this guy that wants to see the calamity when economic Armageddon comes and people realize the .gov is 1) completely incompetent and 2) isn’t effing Santa Claus.

View attachment 783271
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That's a lot of words to type out when you could have just said "I don't really care about the national debt if Republicans are in power".
 
#59
#59
K-town Vol Fan said:
What sucks even more is even after paying all these insane premiums if something does happen and you end up needing surgery or a few nights stay in the hospital you are going to owe thousands upon thousands of dollars. It's totally a scam. Idk why Americans just go along with this system and scoff at universal.
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Name one government ran program that you have confidence in them not screwing up , overcharging and over regulating . Then add another 20% in new taxes to cover their cost just to start with . A National health care system like the one in the UK will be the example here but worse . Their will be the free one that are short on drs and nurses , with long wait times , then there will be private ones .
 
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#60
#60
0nelilreb said:
Name one government ran program that you have confidence in them not screwing up , overcharging and over regulating . Then add another 20% in new taxes to cover their cost just to start with . A National health care system like the one in the UK will be the example here but worse . Their will be the free one that are short on drs and nurses , with long wait times , then there will be private ones .
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Instead of all these pharmaceutical commercials we’ll see assisted suicide ones.
 
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#61
#61
C-south said:
Instead of all these pharmaceutical commercials we’ll see assisted suicide ones.
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When there are discussions about nationalizing our health care model, there is rarely discussion of rationing of services. It is my understanding that other countries do that outright or accomplish the same with wait times for procedures. I do not know how America could nationalize without needing to ration like other countries do. I don't think Americans are in favor of rationing.
 
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#62
#62
McDad said:
When there are discussions about nationalizing our health care model, there is rarely discussion of rationing of services. It is my understanding that other countries do that outright or accomplish the same with wait times for procedures. I do not know how America could nationalize without needing to ration like other countries do. I don't think Americans are in favor of rationing.
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We're rationing services right now. It's just happening at the individual level so you don't have to concern yourself with it yet.
1000005631.png
www.kff.org

Americans’ Challenges with Health Care Costs | KFF

This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.
www.kff.org www.kff.org
 
#63
#63
BeardedVol said:
We're rationing services right now. It's just happening at the individual level so you don't have to concern yourself with it yet.
View attachment 783361
www.kff.org

Americans’ Challenges with Health Care Costs | KFF

This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.
www.kff.org www.kff.org
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So instead of the state making the decision at least the individual had the choice.
 
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#64
#64
McDad said:
When there are discussions about nationalizing our health care model, there is rarely discussion of rationing of services. It is my understanding that other countries do that outright or accomplish the same with wait times for procedures. I do not know how America could nationalize without needing to ration like other countries do. I don't think Americans are in favor of rationing.
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I still remember our Aussie friends being amazed at how quick their kid was seen in the ER on one of their trips here.
 
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#65
#65
BeardedVol said:
We're rationing services right now. It's just happening at the individual level so you don't have to concern yourself with it yet.
View attachment 783361
www.kff.org

Americans’ Challenges with Health Care Costs | KFF

This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.
www.kff.org www.kff.org
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I may be wrong in how Americans think about things but I don't think we like having a fixed choice or prohibitions on services (classical definition of rationing). I don't think we approach things that are offered but unaffordable with the same attitude.
 
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#66
#66
hog88 said:
So instead of the state making the decision at least the individual had the choice.
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Lol, sure, if you considers "I can't afford healthcare so I didn't purchase it" to be a "choice".

treating it as such does serve the purpose of allowing you to continue to turn a blind eye to the broken system, so there's at least that.
 
#68
#68
BeardedVol said:
Lol, sure, if you considers "I can't afford healthcare so I didn't purchase it" to be a "choice".

treating it as such does serve the purpose of allowing you to continue to turn a blind eye to the broken system, so there's at least that.
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1st you would need to define exactly what "needed healthcare" was deferred. For example, was it cancer treatments or a mole removal.
 
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#69
#69
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#72
#72
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#73
#73
K-town Vol Fan said:
What sucks even more is even after paying all these insane premiums if something does happen and you end up needing surgery or a few nights stay in the hospital you are going to owe thousands upon thousands of dollars. It's totally a scam. Idk why Americans just go along with this system and scoff at universal.
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Because under universal those costs don't change without addressing the REAL issue(s). Those costs won't go down under Universal Health Care, they will likely just go up with added bureaucracy.

Separating people from costs and choices never makes anything more affordable.

There are too many takers and not enough providers for Universal Healthcare to work here IMO. We are already taxed entirely too much. You would crush a significant portion of the lower middle class and force them into the "taker" status.
 
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#74
#74
BeardedVol said:
That's a lot of words to type out when you could have just said "I don't really care about the national debt if Republicans are in power".
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Oh, STOP! You can’t read. My point was that your post I was quoting basically says the same thing you’re trying to assign me. I’m on record all over this board berating both sides for doing so, but nice try. Didn’t hear a peep out of you when Biden was piling on the debt.
 
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#75
#75
Vol737 said:
Oh, STOP! You can’t read. My point was that your post I was quoting basically says the same thing you’re trying to assign me. I’m on record all over this board berating both sides for doing so, but nice try. Didn’t hear a peep out of you when Biden was piling on the debt.
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And you won't hear me railing about it under Trump either. Neither party is going to stop deficit spending.

The difference is that I don't pretend otherwise in order to use fear of increasing the deficit as as excuse for supporting moronic policies.
 
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