Health Insurance Y/N

[Serf Life]

You got it, or not? Just learned you need to have health insurance to open and contribute to an HSA. No health insurance because it’s not affordable and want to save money instead for out of pocket, it counts against you if applying for any aid. Own a house to have secure housing, they assume you can/will sell it to pay for your med bills.

$6k/yr in premium payments and need to spend $4.5k to reach deductible to get 30% coinsurance for anything significant assuming in network, that’s with gov assistance! Most copays that cover pcp visits or physical therapy etc don’t count toward deductible. Made an appointment in Sept to see primary care provider to get a referral for a specialist, visit for PCP is end of March.

What is the fiscally smart thing for a working class person to do in this fucked system??

 

[VenasNursery]

You got it, or not? Just learned you need to have health insurance to open and contribute to an HSA. No health insurance because it’s not affordable and want to save money instead for out of pocket, it counts against you if applying for any aid. Own a house to have secure housing, they assume you can/will sell it to pay for your med bills.

$6k/yr in premium payments and need to spend $4.5k to reach deductible to get 30% coinsurance for anything significant assuming in network, that’s with gov assistance! Most copays that cover pcp visits or physical therapy etc don’t count toward deductible. Made an appointment in Sept to see primary care provider to get a referral for a specialist, visit for PCP is end of March.

What is the fiscally smart thing for a working class person to do in this fucked system??

I pay 18k a year which is $1500 a month
10k family deductible
5k per person personal deductible
Blue care network is what we have.

My family is me my wife and daughter the system if no good we just was shopping around and only thing comparable was a no name company that I had to change primary dr for $50 cheaper a month!
Not worth it.

Good luck

 

[ATH]

We use health care sharing program - Samaritan Ministries. It's not for everyone, but has worked. More than anything it's a safety net if something catastrophic happens. Frankly auto insurance and workers comp (if you pay that on yourself) would cover most likely such events.

My wife does the paperwork and doesn't like it because of that. But I point out we are saving over $1000 per month over insurance premiums, and the filing bills is certainly not $1000 worth of labor.

One thing I like, is we get to make decisions - is and the doctor. Not an insurance company. And that swings both ways. When we tell them we are self pay they aren't recommending things just because insurance will pay for it.

The thing I've learned is that it's not (or, maybe not JUST) the insurance companies that have made the system mess. It's rare that any provider can tell you how much a service will cost beforehand.

 

[Treetopflyer]

I pay 18k a year which is $1500 a month
10k family deductible
5k per person personal deductible
Blue care network is what we have.

My family is me my wife and daughter the system if no good we just was shopping around and only thing comparable was a no name company that I had to change primary dr for $50 cheaper a month!
Not worth it.

Good luck

Very similar for me
Little different
All rip offs

 

[Treemuel]

You got it, or not? Just learned you need to have health insurance to open and contribute to an HSA. No health insurance because it’s not affordable and want to save money instead for out of pocket, it counts against you if applying for any aid. Own a house to have secure housing, they assume you can/will sell it to pay for your med bills.

$6k/yr in premium payments and need to spend $4.5k to reach deductible to get 30% coinsurance for anything significant assuming in network, that’s with gov assistance! Most copays that cover pcp visits or physical therapy etc don’t count toward deductible. Made an appointment in Sept to see primary care provider to get a referral for a specialist, visit for PCP is end of March.

What is the fiscally smart thing for a working class person to do in this fucked system??

Yeah, our system is totally screwed. My wife and I just renewed our plan on the marketplace at nearly $800/mo with a $7500 deductible! It's pretty much worthless, but figure in a worst case scenario (cancer, major accident, etc.) our maximum out-of-pocket will be $30k instead of losing all our assets and filing for bankruptcy. The system seems to screw over those of us in the middle income bracket the worst, where we don't qualify for much of a subsidy but the cost is still a significant portion of our income.

 

[RyanCafferky]

Well let’s all drive to our nearest health insurance corporate office and start a large protest. Here is the chant “hey hey, ho ho, time to get rid of another CEO.”

We have insurance. My wife and I are totally healthy and barely ever go to the doctor so it feels like throwing money in a hole. Our accountant told us that we can have the business pay for our premiums which takes the sting off a little bit. Healthcare in this country is a racket. Just look at our costs compared to other countries. We have a lower life expectancy but we spend more per person than any other country.

 

[Boomslang]

What is the fiscally smart thing for a working class person to do in this fucked system??

Well, there was this guy in NYC......

 

[ATH]

Another thing to consider before shooting more CEOs:
People wanna complain on both ends - premiums are too high and insurance company won't cover EVERYTHING I want them to cover. You cannot have it both ways. I'm not saying that's anyone here, but are people who are costing hundreds of thousands if not millions per year. How much of that is "necessary" or even actually beneficial?

Very familiar with one case... person has heart issues. Was doing really well (as well as in the last 10 years). Wanted to get a procedure to go off of blood thinner...$110k was initial estimate. Supposed to be out patient. That turned into 2 weeks into the hospital...so another, what maybe $70K. And they are worse now.

 

[ATH]

...The system seems to screw over those of us in the middle income bracket the worst, where we don't qualify for much of a subsidy ....

I'm gonna disagree with that. To me, "middle class" should mean pretty self sufficient. Not depending on subsidies. So complaining subsidies aren't enough just sounds out of whack. I'd suggest those being screwed over the worst are those paying for well more than they are buying. Sure, "they" are rich. But there's a lot of (upper) "middle class" in there too - $200k per year or so range - that are paying full price + subsidizing their neighbors who make $90k per year.

Another thing to remember... NOBODY wanted the affordable care act as it was passed. It was supposed to go to committee and get worked over and improved. But when Kennedy died, and it was clear there wouldn't be enough seats in the Senate to pass an improved bill, this was shoved down our throats... before anybody had opportunity to read it.

 

[data farm 26]

In America today it is better to be poor or very rich. Middle will struggle eternally.

 

[Boomslang]

Another thing to consider before shooting more CEOs:
People wanna complain on both ends - premiums are too high and insurance company won't cover EVERYTHING I want them to cover. You cannot have it both ways. I'm not saying that's anyone here, but are people who are costing hundreds of thousands if not millions per year. How much of that is "necessary" or even actually beneficial?

Obviously I'm not super familiar with all the intricacies of the American healthcare system, but wouldn't something as simple as if a doctor deems it medically necessary that it's covered. Period.

 

[ATH]

Obviously I'm not super familiar with all the intricacies of the American healthcare system, but wouldn't something as simple as if a doctor deems it medically necessary that it's covered. Period.

It would seem that simple, but it's not.

For example:

Define "necessary".

Is it really necessary...or does the doc (who is making the determination and doing the procedure) need to make a boat payment, so he deems it necessary? (Let's not pretend that doesn't happen.)

How much cost is associated with that "necessary" procedure? Often times that's the rub. It's "necessary" but doc isn't willing to do it for less than $xyz and insurance says they'll only pay $abc. Something has to give.

 

[surveyor]

I have never had health care (except I am now on Medicare)
I have heard that 3/4 of those who are bankrupt from medical expenses have health care.

 

[data farm 26]

Me neither, or workers comp. I put my trust in the gods and the great magnet to see me through or not. I risk it all every day. In my family tradition you go to the doctor to get dead.

 

[evo]

Obviously I'm not super familiar with all the intricacies of the American healthcare system, but wouldn't something as simple as if a doctor deems it medically necessary that it's covered. Period.

I wish..
I have a good friend that came down with a cancer.
Apparently there is a new treatment that will give her a 70% chance of survival.
Health insurance denied the treatment, saying she had to take the oldschool chemo which has about a 30% success rate for survival at 5 years.

A mutual friend is a retired investigative journalist, tracked down the CEO’s personal cell and had a little chat interrupting his dinner on a Saturday night.

Monday morning all the needed appointments were lined up.

The really f-ed part was she needed appointments for x, y, z before the doctors could figure out a treatment plan. The Doc’s gave her about 3-4 months of life without any intervention. Yet the initial appointment were spaced out over a 6 month period, and this is to develop a treatment plan!

 

[Matias]

Isn't there some penalty on your taxes (in the US) if you don't have insurance? I was about to find out how much insurance would cost me, but as I am back to being under employed, it is still totally free to me and my family, but we can only go to a suuuuper limited network of providers. I never bought insurance until I started paying taxes and paid a nice chunk that first year for not having any.

 

[data farm 26]

Afaik there was a penalty but it was removed in the first Trump presidency. I paid the penalty a time or two under Obama.

 

[surveyor]

Most providers will give a discount for service provided if you pay out of pocket, so they don't have to deal with insurance paperwork.

 

[Boomslang]

It would seem that simple, but it's not.

For example:

Define "necessary".

"Absolutely needed". As in, without this necessary procedure the patient's quality of life will be negatively impacted or they'll die.

Is it really necessary...or does the doc (who is making the determination and doing the procedure) need to make a boat payment, so he deems it necessary? (Let's not pretend that doesn't happen.)

And that's the real rub with privatized healthcare and capitalism. You start having individuals use people as investments. We have it up here with the real estate market.

In my opinion, the basic needs of humanity (water, food, shelter, medicine) should be made as high quality and affordable as possible. Everything else can be left to the bourgeoisie to play with.

How much cost is associated with that "necessary" procedure? Often times that's the rub. It's "necessary" but doc isn't willing to do it for less than $xyz and insurance says they'll only pay $abc. Something has to give.

Develop something similar to a mechanic's book time. It takes X time and Y materials/personnel to complete Z procedure. Doc gets paid based on those standards.

 

[Mike H]

Yes, pay for health insurance or workman's comp insurance. It doesn't feel worth the cost until you need the service. My hospitalization would have cost over $110,000 last year. I wasn't in the shape to be shopping from the menu of procedures and the system spared no expense because I was insured. About $10,000 out of pocket on a payment plan for the next few years but the alternate outcome might have been bankruptcy.