The Individual Mandate is gone for year 2019

[Baz]

I've gotten a couple emails about the enrollment period for health care through health care dot gov and just realized there is no more mandate. I never liked the "gun to your head" approach anyway so good riddance!

The only times I needed any health care for the past 10 years was 2 different times over a 3 year span when I used a walk-in clinic to get Z-pacs for my acute bronchitis.

I'm eligible for Medicare next June so am coasting for the next 6 months.

For plan years through 2018, if you can afford health insurance but choose not to buy it, you may pay a fee called the individual Shared Responsibility Payment. (The fee is sometimes called the "penalty," "fine," or "individual mandate.")

Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the Shared Responsibility Payment no longer applies.

https://www.healthcare.gov/fees/fee-for-not-being-covered/

[RSBob]

Yup, no more individual mandate and my premiums went up 100%. Woo Hoo! Loving paying $1000/mo for catastrophic insurance with a $5000 deductible.

Happy that Baz is doing so well. Stay healthy and no accidents allowed for 6 months.

[Baz]

Originally Posted by RSBob

Yup, no more individual mandate and my premiums went up 100%. Woo Hoo! Loving paying $1000/mo for catastrophic insurance with a $5000 deductible.

Happy that Baz is doing so well. Stay healthy and no accidents allowed for 6 months.

Sorry Bob.

I consider myself very fortunate and realize that could change in a New York minute.

Hopefully one day we will adopt a more affordable & efficient system than what we have right now.

[RSBob]

No worries Baz. At least I am fortunate to be able to afford my premiums and don’t have to skimp on other things, but it still hurts when I shell out for basically nothing. I do feel bad for those just getting by.

In one year I get the ultimate single payer insurance for all, Medicare. I will save so much money courtesy of those people forced to pay into the system through their Federal payroll deduction not to mention the 10s of thousands I paid in for the last 42 years. Nothing like getting a raise when retired even if most of it is my own money.

[Bugsinrugs]

I’ve been on Medicare for two years now. Good thing too. Just blew my left rotator cuff and will then get a knee replacement soon after my shoulder is fixed. With Medicare and my supplemental insurance it’s around $240 a month.

[RSBob]

Sorry about the cuff, but dam, that cost is unreal. Good on ya!

[Superman]

This looks like a healthy discussion that I don't want to PARF-up, but the fact is we have socialized medicine already, today. The way we all pay for it is through taxes and medical insurance premiums. The medical service providers and especially the medical insurance providers.....decide how we pay for that. RSBob is not the only one paying for this. We all are.

[Tobra]

If you don't want to "parf it up," just don't.

Those providing the service don't have much to do with how expensive healthcare insurance is, but you already know that.

[SCadaddle]

Originally Posted by Superman

This looks like a healthy discussion that I don't want to PARF-up, but the fact is we have socialized medicine already, today. The way we all pay for it is through taxes and medical insurance premiums. The medical service providers and especially the medical insurance providers.....decide how we pay for that. RSBob is not the only one paying for this. We all are.

I recently signed up with a "concierge" medical outfit called newcare MD as the result of a "cat fight". Well, it wasn't much of a fight, as when I leaned over my sleeping tom cat he suddenly awoke and instantly "quicker than a cat can lick his butt" went into fight mode and popped me in the corner of my mouth and split my lower lip in two with a right paw.

This outfit saw me the same afternoon. Paid them the $25 fee to sign up as a client, then the $69 per month fee to cover whatever I need to have done. I can cancel anytime, otherwise they just charge the monthly fee to my card. Unlimited visits included in that fee.

So here is how it worked: $25 to sign up, $69 for the month. I hate needles, I suggested to the Doc that we try to tape my lip back together once he cleaned it out really well. He prescribed me a 4 day round of antibiotics---that he had on hand---at a cost of $2 (yes, TWO dollars) and also handed me a bottle of 100 naproxen tabs for another $8 (yes, EIGHT bucks). I left out of the office with a steri-strip taped lip and an appointment for 10:00 the next morning (something told me he knew the tape wasn't going to work...)

Needless to say, the steri-strip didn't work. So at the appointment the next morning I sat back in the chair, closed my eyes and the Doc numbed me up with 2 shots in the lower lip. DAMN that hurt! Once good and numb, he stitched me back together. He usually spends about 30 minutes with his clients, so for the next 15 minutes we shot the breeze. I'm out the door for the amazing amount of $10 (yes, TEN dead presidents). Gives me a scrip for 15 Norcos that he has a pre-arranged deal with the pharmacy and so my co-pay is $14 for those. Set me up for an appointment in a week.

A week later I go back to see the Doc and he looks and pokes and prods at my lip and declares me fixed. The next 25 minutes we discuss old cars. Out the door for $0 (yes, nada zip). The lady friend that is in the medical field wants me to go get some blood work done by them in the near future.....that's gonna set me back a whole $4. Uh huh. Four Dollars.

The best part about this whole business model is there is NO insurance involved, no medical history paperwork to deal with, and the price is right for someone without any kind of insurance. I asked the Doc how his business model is going to work out, and he told me "it's all in the numbers"----they've got 3 Docs on staff and each one plans on having between 500-1000 clients with a monthly subscription to their practice. Check it out, it's a growing medical business model around the U.S. right now called "DPC" or "Direct Primary Care". You might be surprised to find an outfit in your area.

https://newcaremd.com/

EDIT: As for the cat, he later wound up fighting with another cat and getting an abscess that I had to take him to the Vet to resolve. That trip to the Vet cost me $185. Freaking cat costs me more for healthcare than myself!

[wdfifteen]

I see my primary care doc maybe 3 times a year in a bad year. I think the charge is $85 per. OTO I’ve been billed thousands by a surgeon, hospital, and a few specialists. DPC might work out for someone who sees the primary doc a lot, but it seems expensive for folks like me.

[wdfifteen]

Originally Posted by Bugsinrugs

I’ve been on Medicare for two years now. Good thing too. Just blew my left rotator cuff and will then get a knee replacement soon after my shoulder is fixed. With Medicare and my supplemental insurance it’s around $240 a month.

Sorry about your shoulder and knee. I’ve been on Medicare for 3 years, the cost has gone up and down because my income is so variable. The worst year was $400+ per month, the best was about $165 for parts A-D. After a lifetime of complaining about paying for all those old geezer’s hospital bills (ours is the first generation to spend their entire working lives paying into Medicare) I’m now thinking it wasn’t such a bad deal.

[onewhippedpuppy]

I pay about $600 per month for a family for an HSA that is basically catastrophic coverage, and that’s through a very large employer policy. Can’t remember the last time I went to the doctor. I’m not a big fan of this “progress”.

[Sooner or later]

Originally Posted by onewhippedpuppy

I pay about $600 per month for a family for an HSA that is basically catastrophic coverage, and that’s through a very large employer policy. Can’t remember the last time I went to the doctor. I’m not a big fan of this “progress”.

What should we expect.

The system has layer upon layer upon layer or bureaucracy that is non value added.
Hospitals know to the q tip the average cost of a procedure . Yet we don't expect up front pricng. There is absolutely zero need for any type cost control since the customer doesn't know the cost until after he receives and uses rhe product.

We value life to the extreme. We would spend damn near anything to extend a life by a short amount.

[Jims5543]

Originally Posted by onewhippedpuppy

I pay about $600 per month for a family for an HSA that is basically catastrophic coverage, and that’s through a very large employer policy. Can’t remember the last time I went to the doctor. I’m not a big fan of this “progress”.

I am about to shop for a HSA, I am going to use my fine money to fund it, since I am not paying a stupid fine this year.

It blew my mind that I would have to pay over 5K in order not to spend 18K a year on something useless.

I have been exchanging PM's with another member here as he is also self employed, he did not paint a pretty picture as to what I am in for.

We are both very healthy, I never get sick and never go to doctor. I am afraid we ruined health insurance for good, it will never be affordable again.

I miss the days of my $400 a month family premiums for BCBS with $1K a year deductible and almost 100% coverage that included prescription and optical in the premium.

[onewhippedpuppy]

My in laws own a lumberyard, they are paying over $1000 per month for what is basically a catastrophic plan. So no, self employment and health insurance isn’t pretty. Maybe figure out a way to hide all of your income so you get it for free?

[CurtEgerer]

Originally Posted by onewhippedpuppy

My in laws own a lumberyard, they are paying over $1000 per month for what is basically a catastrophic plan. So no, self employment and health insurance isn’t pretty. Maybe figure out a way to hide all of your income so you get it for free?

I've got a buddy who pretty much did that. He's got a million $$ + house, cars, and LOTS of money invested and retired in his 50s. He and his wife have been on Medicaid for 2-3 years now. They have ZERO out-of-pocket for healthcare, kept their doctors and have full dental. In fact, they're actually not hiding anything, just playing the government's convoluted game to the max.

[freeform911]

Timely...
My wife and i are early 40s, 1 15 yr old and pay more then $700/month. Thats with her employer picking up the other half.

We never go to the doctors, but here recently my wife got an infected ingrow hair. We just started receiving the bills from a pretty minor thing. HOLY @#$$...hospital charged insurance almost 10000$ thats just for the hospital. The doctor charged around 3500..

Now we have around 4000 to pay out of pocket, what the hell do we carry insurance for, to be over charged?..i think a big problem is the middle man(insurance)..

Bunch of @#$% to me!!
Sorry for the rant but gotta be a better way, what it is i don't know..

[wdfifteen]

Originally Posted by Sooner or later

What should we expect.

The system has layer upon layer upon layer or bureaucracy that is non value added.
Hospitals know to the q tip the average cost of a procedure . Yet we don't expect up front pricng. There is absolutely zero need for any type cost control since the customer doesn't know the cost until after he receives and uses rhe product.

+1
Add to that the fact that if we opt NOT to use the product due to cost we may die, limp, or suffer in pain - or worse, watch a loved one die, limp, or suffer in pain and it is not a buyer's market. There is no free market solution to paying for health care.

Originally Posted by Sooner or later

We value life to the extreme. We would spend damn near anything to extend a life by a short amount.

Right again. We spend almost half of our health care dollars on the last year to year and a half of life. Here is a great article on the subject. There IS a solution, as demonstrated by LaCrosse Wisconsin. Sara Palin set the solution back a decade with her "death panels" demagoguery.

https://www.forbes.com/sites/offwhitepapers/2014/09/23/how-to-die-in-america-welcome-to-la-crosse/#31587ff7e8c6

[jhynesrockmtn]

I got a couple of boxes of my birth fathers records, pics, etc. from his family. I was adopted and he died when I was an infant (different story). The medical bills from his birth in like 1944 were in there. If I recall correctly, the cost per day for the hospital stay was $7 at Seattle General. Throw in a few other things including the doctors fee for the delivery and I think the whole bill for a birth and 5 days in the hospital was like $250. What would that be in today's $.

I got married almost 3 years ago. My wife has to buy her coverage separately as I'm not allowed to add her to my plan at work for some ACA frickin reason even if I pay 100% of the premium which would be like $500/month for a really good plan. Her cost for her coverage has gone from $400/month in 4 years to well over $700 next year and the coverage is much worse. She's 3 years away from medicare.

I am a type 1 - awe forget it, this just gets more depressing.....

[Jims5543]

Originally Posted by jhynesrockmtn

I got a couple of boxes of my birth fathers records, pics, etc. from his family. I was adopted and he died when I was an infant (different story). The medical bills from his birth in like 1944 were in there. If I recall correctly, the cost per day for the hospital stay was $7 at Seattle General. Throw in a few other things including the doctors fee for the delivery and I think the whole bill for a birth and 5 days in the hospital was like $250. What would that be in today's $.

I got married almost 3 years ago. My wife has to buy her coverage separately as I'm not allowed to add her to my plan at work for some ACA frickin reason even if I pay 100% of the premium which would be like $500/month for a really good plan. Her cost for her coverage has gone from $400/month in 4 years to well over $700 next year and the coverage is much worse. She's 3 years away from medicare.

I am a type 1 - awe forget it, this just gets more depressing.....

According to this calculator $250 1944 dollars is equal to $3600 today.

https://www.in2013dollars.com/1944-dollars-in-2018?amount=250