Has Anyone Unlocked The Secret of Health Insurance?

[onewhippedpuppy]

Trying to keep this not PARF. Trying.......

After becoming self employed earlier this year, I've already seen our mediocre $600/mo family plan go up over $100/mo for absolutely no reason. Which is almost double what similar plans were quoted at last year when we were considering self employment. Internet searches with other regional/national companies don't find anything any better. Per the government website we make too much to even receive a quote, despite already taking a huge income hit this year. Am I missing something, or are we just doomed? At this rate I'm leaning heavily towards a catastrophic insurance plan and putting the rest into a savings account. My wife and I are 34, non smokers, no risk factors, kids 4/7/10 also in good health.

[ShakinJoe]

Our leader Obama has made this a mess for the self employed. Ours just doubled......again.

[Racerbvd]

Originally Posted by ShakinJoe

Our leader Obama has made this a mess for the self employed. Ours just doubled......again.

Yep, I'm in the same boat, except now I'm being dropped the end of the year

[charlesbahn]

The problem with a catastrophic plan is that there is no negotiated rate with providers and hospitals. So if you (or your wife or child), say get pneumonia, and spend a week in the hospital, the bill is the full retail rate, say 20K. Your catastrophic plan pays 5K after you pay your 15K deductible/co-pay (amounts are just for example).

If you are covered by a "regular" plan, the hospital and provider charges are negotiated and capped. So in the above example, the bill is 5K and you pay your deductible and co-pay based on the 5K bill, so maybe you pay $500.

You are almost better having no insurance than catastrophic in this example, because then you can negotiate with hospital/providers and try to at least pay the "medicare" allowed charges (which might be 1/3 or so of the full retail rate). Once your catastrophic plan picks up the bill that door is closed.

I experienced this first hand. We were young and healthy; it was my 18 year old son that got the pneumonia.

I don't roll those dice any more.

[Nickshu]

No PARF from me. Just the facts... I'm self employed too. My $650/mo policy with decent coverage was cancelled after the ACA went into effect. My new policy is over $1100/mo for similar coverage. There were policies available post-ACA at the same premium but the coverage was much less and deductible was WAY higher.

I use an HSA which cushions the blow somewhat for health expenses and helps with my taxes. I tried to chose a plan where my family deductible is close to the HSA annual maximum contribution so that when I come off my HSA then my insurance picks up.


-Sent from my Galaxy s5 using Tapatalk

[john70t]

Originally Posted by charlesbahn

I experienced this first hand.

I have too.
Any minor accident, bereft of blame, could destroy a personal economy.

[porsche4life]

Matt.... It sucks but my parents were paying around $700 a month for the three of us well before Obama was in office. But it's worth it... Moms breast cancer bill is at 30k and that's just for biopsy and treatment 1, we still haven't seen the bill for 2,3, or any of the other 7 she is doing. Plus surgery after that. I know it sucks to be paying a bunch every month, but without insurance this could cost them close to a half mill all said and done. So far they have had no out of pocket since they already hit the deductible.

[GH85Carrera]

If I told you the secret I would have to kill ya.

[gordner]

Those numbers are just staggering.

[McLovin]

My secret:













Have wife get Govt job, with, of course, full benefits.

Seriously!

It's all about the Govt these days, and probably forever henceforth, you're either with 'em or against 'em.

[john70t]

Originally Posted by gordner

Those numbers are just staggering.

Yes.

For many workers striving at the level of minimum wage, any health setback equates to decades of financial obligation.
For some PARF'ers, those stupid people deserve it.

[wdfifteen]

Matt, insurers are less able to pick and choose who they cover now. Before, we had a pool of people with no insurance (mostly sick) and a pool of better-off people with cheap insurance (people healthy enough to have jobs). When nearly everyone is covered by insurance, the sick as well as the healthy, of course premiums are going to go up. The uninsured got health care before, it was just paid for by others through bankruptcy, govt programs, higher costs for the insured, etc.
Catastrophic insurance is a way to protect your assets from huge medical bills while paying more of the cost of health insurance out of your pocket. The more people who pay directly and actually see and care what health providers are charging, the more they will shop around and put pressure on providers to lower costs. Market forces are going to be more of a factor in health care pricing, so prices should come down. Until then it's going to suck.

[dmcummins]

My wife and I are in our mid 50's, we pay $1440 a month. That's with a $2500 ded. Which we never hit. Last year the deductable was $1500 and we were paying $1330.

I need to look at the higher deductable plans and make a change. Something's got to change, maybe another move out of the country.

[red-beard]

Originally Posted by onewhippedpuppy

At this rate I'm leaning heavily towards a catastrophic insurance plan and putting the rest into a savings account. My wife and I are 34, non smokers, no risk factors, kids 4/7/10 also in good health.

I sat down and calculated the costs during a minimum year, maximum year, with different types of policies. I found the Catastrophic Care plan when tied with a HSA (Heath Savings Account) is the most cost effective plan.

Remember - the better networks will cost more money. We paid more for a better network.

You need to do the above analysis for yourself. With the Affordable Care act, there were changes and my analysis may not hold. Our plan was grandfathered and is still about $200/month cheaper than the most similar plan under the ACA.

[charlesbahn]

From the trenches:

We are now starting to see patients with affordable care act policies in my small medical office. Generally these are people that used to have regular indemnity plans like Blue Cross, etc. In the past their plans covered their eye exam less a (small) deductible/co-pay.

Now these folks come in happy to have a less expensive plan (ie affordable care act version of Blue Cross for example). But it turns out that it (the exam) isn't covered at all since they have a much higher deductible and most of the patients end up paying the whole amount.

[Rick Lee]

I have a high deductible plan. Ded. is $1800 and they pay 90% after that. I put $75 per paycheck in an HSA, so I have $1800 at the end of the year. Actually I burn through about $500/yr. on drugs, co-pays, dental stuff and other stuff not covered. So the $1300 I have left means I'll have to come up with $500 out of pocket if I get into an accident on Jan. 1, 2015, plus the 10% they don't cover, which probably won't break me. I think we're gonna have an even higher ded. plan offered when open enrollment starts in a few weeks.

FWIW, when I go to the doc. or buy scrips, I do get the insurance-negotiated price, even though I'm paying from my HSA.

[wdfifteen]

Originally Posted by Rick Lee

I have a high deductible plan. Ded. is $1800 and they pay 90% after that. I put $75 per paycheck in an HSA

$1800 is not high. I have a $3500 deductible and put the maximum ($3600) in my HSA.
The way I look at it is, I pay an insurance company to cover catastrophic events and to get me lower prices.
This is a terribly inefficient system. A lot of our health care money goes to bureaucrats and MBAs who couldn't apply a band-aide who beat on doctors (excuse me, "negotiate with health care providers") to get them to charge less. It would be a lot more efficient if health care providers just charged less to begin with and all our money went to them. The people who actually provide our health care would get more and we would pay less.
By having relatively low cost insurance (due to the high deductible) I get the same benefit of the clowns in suits beating on doctors that people with low deductible and high price insurance get, plus catastrophic event insurance.

[rick-l]

I am also looking into health care since I got laid off and am not 65.

Are you saying your health care for a family of 5 was $600? For me COBRA costs about that much and it is only available for 18 months.

Rick Lee did you get that plan on your own and about what does it cost?

[Rick Lee]

Originally Posted by wdfifteen

$1800 is not high.

It's not my opinion; just the name of the plan I get to choose from at open enrollment.

I'd be fine with a much higher deductible and lower monthly premium. But I gotta take what the company offers. Since it's hard for me to use more than $500/yr. of my HSA, I think I need to stick with the HDHP. Unfortunately, Mrs. Lee's employer's open enrollment closes before mine starts, so I can't compare options. I don't remember what I pay, probably $75-90/pay period and the company probably pays about that much too.

Someone posted a good link here a while back that had all those private, high-ded. or catastrophic plans available. Some of them seemed pretty reasonable, though it was probably before the ACA kicked in.

[gordner]

I pay about 28% tax effectively all in and have never had to even think about health care. Add to that the $32 dollars per pay check (twice a month) I pay for extended care and I have %100 percent drugs, vision care and dental for myself and my spouse as well as chiropractic/massage/homeopathy etc.
It may be a high tax amount relatively, but it is nice not having to stress about something so major as health care, and nice to know that catastrophic health issues won't leave me with staggering bills if it does happen.