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Are Benefits Packages Worth It?


Oggie

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Need a little advise. As a retiree I pay for a benefits package. I finally stopped after 10 years to do the math. The total cost to buy the coverage and the 20% cost I pay for each submission adds up to a lot more than i get back from the Insurer. When I was employed the employer paid the premiums but now that I'm retired I pay them. I'm coming to the conclusion that I should self-ensure. If I take the monthly premium and put it in my own account I'd be money up virtually every year. Some years would be much better than others but I have yet to come very close to the yearly cost I pay.

 

Anyone else self-insuring??

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If Jennifer hadn't of had an OPSEU benefit plan though her employer I would have been bankrupt a few years ago, with $3000 anti-infection needles every 3 weeks, all the other high $ drugs and her final $5000 / month "hail mary" pill prescription that ran for almost 7 months.

 

Like most things in life it's a crap shoot. I'm still paying about $320 a month for our company drug / ltd/ etc medical coverage through my own plastics plant and like you my prescriptions and $150 every two years for eye glasses certainly doesn't come out in the wash, but what IF your medical situation changes? Can you afford that gamble if you need a hail mary play or will it put your family in a tail spin? One of those better the devil you know than the devil you don't!?

Edited by irishfield
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I regard my benefit package as one of the single biggest benefits of my employment. Between prescriptions for wife and kids, dental and eyewear etc, it would add up. But god forbid our situation changed and I had something come up as was mentioned above , and it would eventually bankrupt me. I have a friend who's wife recently became very ill and had retired with no post retirement benefits. He is very glad for his benefits as the meds she needs are outrageously expensive. I'd keep paying and consider it money well spent personally. You never know what the future will bring.

Edited by porkpie
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Need a little advise. As a retiree I pay for a benefits package. I finally stopped after 10 years to do the math. The total cost to buy the coverage and the 20% cost I pay for each submission adds up to a lot more than i get back from the Insurer. When I was employed the employer paid the premiums but now that I'm retired I pay them. I'm coming to the conclusion that I should self-ensure. If I take the monthly premium and put it in my own account I'd be money up virtually every year. Some years would be much better than others but I have yet to come very close to the yearly cost I pay.

 

Anyone else self-insuring??

You will most likely come out ahead by just paying your own expenses.

 

The benefits company takes your money from their customers, incurs overhead costs, pays out the cost of benefits, and still has some money left over for profit. Clearly, they take more money in than they pay out. If they didn't, they wouldn't be in business.

 

While they they will collect more than they pay out on a total basis; it may not work that way for each individual. A few individuals will claim more than they pay; and some will pay more than they claim. On average, members premiums will exceed the benefits they receive.

 

The only advantage would be if you have some health issues and need to make a lot of claims in a short period of time. In that case the benefits may pay off. In some cases it may ward off financial hardship.

 

Just make sure your plan covers the big expenses if you need them. I looked into continuing my plan after I left IBM but the annual caps on dental and prescriptions completely defeated the entire purpose of having a benefits plan.

 

If it covers the big expenses (e.g. $27,000 injections, dental surgery, etc.) it may be worth it for peace of mind.

Edited by JohnBacon
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Before I retired, very early with our 25 and out plan, I had a script for arthritis and went to the Dentist every 6 months. Last November I met with my family doc and the staff Pharmacist that tries and keep up with my 2 page list of scripts I get now because I wanted to know what I can stop taking without risking death. I had coverage since starting at the plant at 18 years old. At 61 I as well as few members here were told tomorrow you have zero coverage. Just like that. Insulin is a no brainer, everything else except the meds to control a tumour on my Thyroid was on the table, plus the post bladder cancer meds so I don't piss myself in public, that's a no brainer. With all my meds I was and still am looking at around $700.00 a month on average not including dental. As Doc Andy put it no matter what you believe I don't give you meds you don't need so I can go to Jamaica paid by the drug companies. As far as dental I'll clean my own teeth from now on.

 

If you are a healthy now, bless you, what about tomorrow?

 

I can't get another insurer to touch me for 700 bucks a month coverage, maybe $1200.00 monthly with this new health scenario until I'm 65, and it is limited.

 

edit: I took Denver and won so I can cover next months meds, so I'm good.

 

I think you know my opinion unless someone can guarantee you won't need any meds now or in the future.

 

Like our great orator Yogi Berra said about insurance, " If ya got it ya don't need it, if ya don't got it ya need it".

Edited by Old Ironmaker
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So glad my wife is still covered after retiring from work. Tween the 2 of us, we look at $500 a month for meds. Repeated surgeries, cancer treatments, therapies,hospitalizations, etc... every year for the past 8 years. We could not afford most of it without the extended health package.

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likw wayne stated above,if you ever need serious healthcare or meds you would be in trouble or worse bankrupt,i have awesome benefits and while I work iam covered for everything including dental,medical perscriptions physio,and lots more but when I retire I have to pay my own at a cost of about $300.00 a month to have the same covereage I have now,and without a doubt I will for sure,you only need 1 serious issue with your health or spouse and your house and life savings could be gone in a second.......

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Congratulations on your good health Oggie. Scares me to imagine losing my retirement health benefits that I earned working 30 some years. I'm guessing $500 probably more a month would be my wife's and I break even point since I retired, for dental , drugs , vision care. Last month we got a CPAP machine , $1200 and no cost to us between the Government Assistive Devices Program and our benefits insurance. I wouldn't take a chance on losing our home just to stay alive.

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I totally agree with Old Ironmaker, I was at Stelco and now we have zip for benefits.

Widows and retired workers are deeply hurt by this but the Government turns a blind eye.

It is criminal what USS Steel is doing , but don't get me started on this topic, gggrrrrr.

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You will most likely come out ahead by just paying your own expenses.

 

The benefits company takes your money from their customers, incurs overhead costs, pays out the cost of benefits, and still has some money left over for profit. Clearly, they take more money in than they pay out. If they didn't, they wouldn't be in business.

 

While they they will collect more than they pay out on a total basis; it may not work that way for each individual. A few individuals will claim more than they pay; and some will pay more than they claim. On average, members premiums will exceed the benefits they receive.

 

The only advantage would be if you have some health issues and need to make a lot of claims in a short period of time. In that case the benefits may pay off. In some cases it may ward off financial hardship.

 

Just make sure your plan covers the big expenses if you need them. I looked into continuing my plan after I left IBM but the annual caps on dental and prescriptions completely defeated the entire purpose of having a benefits plan.

 

If it covers the big expenses (e.g. $27,000 injections, dental surgery, etc.) it may be worth it for peace of mind.

 

 

That's the problem. The cap on drugs is $1500/year and the dental cap is $750 plus I pay the 20% on top of my premiums. The amount within the cap wouldn't make or break me. A large drug cost would be difficult but this plan wouldn't help me out much.

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I totally agree with Old Ironmaker, I was at Stelco and now we have zip for benefits.

Widows and retired workers are deeply hurt by this but the Government turns a blind eye.

It is criminal what USS Steel is doing , but don't get me started on this topic, gggrrrrr.

Don't get me going too. I want to do something that I shouldn't when I think about what's going on. 20 some odd years of 21 turns and Tuesday, Thursday off. Man. Did we work together I wonder? When I left I was basically General Foreman of E Blast Furnace operations on Special Duties which means we don't need you anymore.

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That's the problem. The cap on drugs is $1500/year and the dental cap is $750 plus I pay the 20% on top of my premiums. The amount within the cap wouldn't make or break me. A large drug cost would be difficult but this plan wouldn't help me out much.

 

I agree, this plan is no help at all in case of a majour illness with high drug costs that could financially ruin you. I'd much rather have a plan where I paid a deductable and insurance anything over. This is akin to auto insurance that would only pay 5G if you new vehicle was a write off or 10G if your house burned to the ground. There is some relief at 65, which I just hit, the government takes on a lot of your drug costs.

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Before you drop it make sure you can qualify for a new plan that is less expensive. A preexisting health issue can make it difficult to get insured.

 

art

 

 

Couldn't agree more, great sage advise.

I would agree if it was a more useful plan. But with a $1,500 & $750 annual limits on drugs dental and $3,700+ in annual fees; it doesn't sound like this plan is going to much help anyway. Unless the plan include life and disability and/or critical illness payouts, it will be pretty hard to come out ahead.

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Another this to consider is Ontario's Trilium plan.

The government will provide assistance with prescription drugs over and above a deductable. The deductable will be based on your family income. In the case of my wife, we had to pay the first $1,250 per quarter; any prescription drugs over that amount will be covered by the government.

It didn't help us much because our costs were about equal to our deductable; but it may take the sting out a major illness for some families.

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I would agree if it was a more useful plan. But with a $1,500 & $750 annual limits on drugs dental and $3,700+ in annual fees; it doesn't sound like this plan is going to much help anyway. Unless the plan include life and disability and/or critical illness payouts, it will be pretty hard to come out ahead.

Great points John. I'm going to call today and see if I'm missing something here. I did call about reinstating the coverage and there's no problem. I think they can afford to reinstate my coverage because the coverage they provide is so limited they'll still make money on you even with a preexisting condition. The caps are so low it's a win-win for them.

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Another this to consider is Ontario's Trilium plan.

 

The government will provide assistance with prescription drugs over and above a deductable. The deductable will be based on your family income. In the case of my wife, we had to pay the first $1,250 per quarter; any prescription drugs over that amount will be covered by the government.

 

It didn't help us much because our costs were about equal to our deductable; but it may take the sting out a major illness for some families.

Excellent info John, if things get worse until I'm 65 I will need it.

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Damn for $230 a month of my pay my whole family is is covered.

 

And I recoup that monthly with prescriptions (almost)

 

Dental and eyecare are big too for a younger guy with kids.

 

Id never drop my coverage unless it was absolutely needed.

 

Mi moms did now I cover her costs. Its kinda stupid but ya know, she didnt know better.

 

Now she has rheumatoid arthritis and the meds arent exactly cheap.

 

Once she changes her address etc and I can add her to my plan Ill save a ton.

 

Im not sure how it works but I pay up front then I submit and get doller per doller back

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