Health Insurance how much is to much

[elcolombiano]

I am retired and buy my health insurance from the exchange (affordable care act). I earn to much to get any subsidy from the government. The cheapest plan for my wife and I for 2017 under covered California per year after you add the annual deductible is $21,100/year. This year I was not even in the country almost half the year. Next year I plan to travel even more. Would I just be better off being self insured? Every year the money I would save not carying insurance I could place in a bank account to pay for future unforeseen medical bills. All the years I was working other than an occasional visit to the doctor for a cold I never used my health insurance. In the event of an emergency I can pay for medical care out of my pocket until I am ambulatory and then go to Colombia that has very good health care and medical costs are a fraction of what they are in the US. Actually any country in the world has medical costs a fraction of what they are in the US. I have special cycling insurance that pays $10K if I am injured riding my bike. I also have high coverage under my car insurance for uninsured/underinsured motorist. In the event I need a non emergency procedure I can wait until the the following January when I can enroll in health care if I do not want to pay for it in the US or leave the country. Even if an emergency occurs and I spend $60K in medical bills in the US after 3 years I will still be ahead. My wife and I have no health issues that require medical attention. I will be 58 next month. What do you guys think? Lets say I crash and break a limb or a clavicle that requires surgery. If I pay out of my pocket what is the probability its going to cost me more than $60K in emergency medical care?

[Polyglot]

Why are you adding the deductible if you do not have any history of ever making use of the insurance. Simply look at the cost of the straight monthly fee. Try speaking to a broker. I buy my insurance through a broker and I pay half of what I was able to find online.

As an aside, the father of one of my daughter's friends is a physician with a successful 10 person practice. They planned to switch over from everybody with their own insurance to one overall policy to cover everybody. Once they chose the plan that they were going to start up, it turned out that he would personally be left uncovered for 3 weeks. Since he had never made anything but a minor claim on his insurance in the past, he didn't worry. As luch would have it, he had a stroke during that period and needed immediate care, to the tune of over $400K. Even after bargaining with the hospital and doctors, he is now the CO-owner of a successful 11 person practice

[ripvanrando]

I paid $10,800 per year with $25 office co-pays and no deductible for health insurance before Obamacare. I paid nearly $26,000 in the first year of this healthcare fiasco. I now buy the cheapest plan and it runs me $19,000 with $50 visit co-pays or more and $11,8000 deductible IIRC. I did not get to keep my Doctor or my plan.

I would self insure in a heart beat if my wife would go along with it.

[ripvanrando]

Why are you adding the deductible if you do not have any history of ever making use of the insurance. Simply look at the cost of the straight monthly fee. Try speaking to a broker. I buy my insurance through a broker and I pay half of what I was able to find online.



It is against the law to buy health insurance anywhere in the USA but thru Obamacare using healthcare.gov.

Nobody sells health insurance online in the USA. Impossible.

[soulspinner]

guess Ive been lucky...five figures for good health insurance?

[eddief]

single payer may not be the answer for everyone, but would be good enough for most. maybe in our liftetime.

people are talking:

http://www.latimes.com/nation/la-na-obamacare-california-model-20161007-snap-story.htm

http://nypost.com/2016/10/07/bill-clintons-obamacare-rant-was-scripted-and-approved-by-obama/

[thwart]

What do you guys think? Lets say I crash and break a limb or a clavicle that requires surgery. If I pay out of my pocket what is the probability its going to cost me more than $60K in emergency medical care?
First of all, odds are in your favor that you won't get nailed.

But... last year when I had my bad bike crash/hospital stay/neck fusion surgery, the costs were ~ $150K.

And I'd agree with the above, that most folks don't figure their annual insurance costs per year by the MOOP (maximum out-of-pocket cost). Last year, we MOOP'd (duh) and it cost us about $21K altogether. A 'typical' year would've cost us about $10K for premiums/co-pays.

And for those who think the ACA sucks... well, I hope you (or your children) don't ever have a pre-existing health condition. Because getting health insurance (outside of a group/employer plan) back in the day was near impossible, and if you could find it, unbelievably expensive.

Does the ACA need work? I'd say so. But it beats what preceded it hands down.

[Schmed]

As an aside, the father of one of my daughter's friends is a physician with a successful 10 person practice. .......

Even after bargaining with the hospital and doctors, he is now the CO-owner of a successful 11 person practice

Ouch. It took me a minute to realize what you are saying here.

[staggerwing]

The good of the ACA was getting more people than ever covered, but did nothing to address ever spirally costs.

Around here, the larger medical groups must be flush with cash as they are building new facilities at breakneck speeds and paying their top execs big bonuses. The institution I work at just opened a $120 million proton therapy center and finished a $180 million, 15 story clinical research center.

[FlashUNC]

Sooner or later you'll need health insurance. Everyone does.

And $60k can get eaten up real quick in the US health system.

[R3awak3n]

I bought my health insurance through the health insurance company itself. You do have to show proof of insurance when its time to pay taxes so the gov knows you have it and wont make you pay a penalty.




It is against the law to buy health insurance anywhere in the USA but thru Obamacare using healthcare.gov.

Nobody sells health insurance online in the USA. Impossible.

[El Chaba]

It's too bad that nobody saw this coming and spoke up prior to the passage of the ACA...;);)

[Fatty]

First of all, odds are in your favor that you won't get nailed.

But... last year when I had my bad bike crash/hospital stay/neck fusion surgery, the costs were ~ $150K.

And I'd agree with the above, that most folks don't figure their annual insurance costs per year by the MOOP (maximum out-of-pocket cost). Last year, we MOOP'd (duh) and it cost us about $21K altogether. A 'typical' year would've cost us about $10K for premiums/co-pays.

And for those who think the ACA sucks... well, I hope you (or your children) don't ever have a pre-existing health condition. Because getting health insurance (outside of a group/employer plan) back in the day was near impossible, and if you could find it, unbelievably expensive.

Does the ACA need work? I'd say so. But it beats what preceded it hands down.

Beats what preceded it ? Not for me. Not by a long shot.

My premiums went from nearly free to a very good chunk of change.

The deductibles went from zero to stupid high.

Fewer choices and many miscellaneous restrictions.

So yeah, I think Obama care sucks.

[rnhood]

Actually, a contingent of Congress did see it coming but they got railroaded before they could even finish reading it.

[ripvanrando]

guess Ive been lucky...five figures for good health insurance?

5 figures for lousy healthcare coverage

Socialism works until people like me run out of money

[malcolm]

Why are you adding the deductible if you do not have any history of ever making use of the insurance. Simply look at the cost of the straight monthly fee. Try speaking to a broker. I buy my insurance through a broker and I pay half of what I was able to find online.

As an aside, the father of one of my daughter's friends is a physician with a successful 10 person practice. They planned to switch over from everybody with their own insurance to one overall policy to cover everybody. Once they chose the plan that they were going to start up, it turned out that he would personally be left uncovered for 3 weeks. Since he had never made anything but a minor claim on his insurance in the past, he didn't worry. As luch would have it, he had a stroke during that period and needed immediate care, to the tune of over $400K. Even after bargaining with the hospital and doctors, he is now the CO-owner of a successful 11 person practice

Read the above carefully because it contains the problem with paying out of pocket for otherwise healthy people.

It's catastrophic things that you need insurance for. The unforeseen stroke, MI, cancer or accident. Costs can become 6 digits very quickly. Some people can come up with those kind of funds but not many.
As you age the likelihood of a catastrophic illness is higher I suspect.
If you have the funds some sort of catastrophic plan with a really high deductible may be good choice if you can find one.

[DHallerman]

single payer may not be the answer for everyone, but would be good enough for most. maybe in our lifetime.



Does the ACA need work? I'd say so. But it beats what preceded it hands down.

I like both of these fellows.

And I like and totally agree with both of them here.

Which came first? Liking the guys or then liking their perspectives?

Dave, who says those questions are among the perpetual conundrums of human relationships

[John H.]

I am 52 and my wife is 56. We pay about 18k per year for pretty decent coverage (we are both self employed).
It seems like a lot- but a single episode can make it worthwhile.
2 years ago my wife had an emergency appendectomy-
This year I electively had hardware (from an old fracture) removed.

[sitzmark]

Not a simple fix. Extremely complex actually.
The medical industrial complex (MIC) has long been a driver of the economy. Pension funds, personal retirement investments, Wall Street, all tied to the success of the MIC, which has long been a major segment of the economy.

Rising HC costs have been baked into the equation for 30+ years. Most didn't see them because they have been employer paid. Even 10 years or so ago employers were beginning to squeal like little piggies at the 15%/year growth in premiums they were paying to cover employees. A huge shift happened toward HMO's to control cost, which subsequently transitioned again as people found out what controlled access to healthcare by "accountants" is like.

This is an issue that no one would address for 20+ years and thankfully something finally got traction. Needs some serious tweaking, but HC for all but the most affluent has been on a collision course with disaster for a long time.

... or everyone just realizes they are responsible for their own health. And physicians (specialists) who have benefitted GREATLY from access to ever growing insurance/investment money flowing into technologies that allow $500,000+ incomes for specialities vs $150,000 incomes for primary care physicians will find a return to general practice and/or less specialty will be necessary as (if) money drains out of the system. Malpractice insurance companies that charge some specialists $300k-$500k/yr for insurance will change .... everything related will spiral down in a similar manner. Not as simple as we would all like it to be.

[CunegoFan]

The good of the ACA was getting more people than ever covered, but did nothing to address ever spirally costs.

In other words, it forced everyone to become a customer while allowing prices to be hiked to the moon. The CEO of every company in the country is wondering who he has to bribe--uh, I mean pay a $250k speaking fee to--to get a law like that for his business sector.

Just wait for the thing to collapse. With the figures you guys are throwing around ($20K+) and the annual price hikes, it is in the end stages now. At the current rate it will hit the wall within five years, which at 15% growth would have the figures being discussed here at $40K - 50K a year.

[PQJ]

In other words, it forced everyone to become a customer while allowing prices to be hiked to the moon. The CEO of every company in the country is wondering who he has to bribe--uh, I mean pay a $250k speaking fee to--to get a law like that for his business sector.

Just wait for the thing to collapse. With the figures you guys are throwing around ($20K+) and the annual price hikes, it is in the end stages now. At the current rate it will hit the wall within five years, which at 15% growth would have the figures being discussed here at $40K - 50K a year.

Yes, one of the big problems with the PPACA (colloquially referred to as Obamacare, and not Clintoncare) is its fealty to the private sector.
Hopefully before it collapses we will get both halves of our government working towards a solution. A solution is out there but it has to be desired.

[echappist]

5 figures for lousy healthcare coverage

Socialism works until people like me run out of money

I'd infer you are saying that your money ended up benefiting those who signed up on the exchanges, which is a complete mis-labeling of the situation. The middlemen in this are for-profit entities (although some are nominally non-profits that still seek to turn a profit) for whom maximizing shareholder returns is the preeminent goal. Since corporations are people, i guess one can call the for profit insurance companies the true welfare beneficiaries of the "socialism" at work here.

Insurance, per se, is a risk-hedging operation that does not necessarily need to be for-profit. All the publicly-traded large insurance companies can kvetch about hemorrhaging money for the ACA business and how much operating losses they've taken, yet somehow they still a) managed to have a positive net income since the exchanges went in effect, which b) increased equity over this period of time.

They certainly don't need to raise the premiums and the deductibles and still remain in the black (net income in the range of 2B/yr despite the exchange-related losses), but hey, they can get away with doing it under the aegis of "maximizing shareholder returns."

[BobO]

Socialism works until people like me run out of money

This isn't socialism, it's crony capitalism at it's worst. People near the bottom get crappy coverage for free, people at the top get richer, people in the middle get screwed.

My costs, as in total out of pocket including premiums, copays, deductibles, etc., have literally tripled in the past four years. Yes, heathcare costs were racing towards a cliff, Obamacare moved the cliff closer. On top of the increased costs, the actual coverage sucks. For example, I have a dislocated bone in my hand. It will take surgery to repair. There are exactly zero orthopedic surgeons in my network, none. There were when I signed up, and the website still shows them as providers, but they've dropped out. I can go out of network, but half of those doctors don't want my cash. Some do, but it will cost many thousands as the negotiated rates no longer apply. Cash prices are two to three times higher. This is for someone who has insurance, a platinum level policy at that.

I feel for those people in Pinal County Arizona who, in 2017, may not have any plans available.

[ripvanrando]

This isn't socialism, it's crony capitalism at it's worst. People near the bottom get crappy coverage for free, people at the top get richer, people in the middle get screwed.

My costs, as in total out of pocket including premiums, copays, deductibles, etc., have literally tripled in the past four years. .

Why should anyone get anything for free? ($78K AGI gets a subsidy....not exactly the bottom)

I'm paying twice the price for less coverage so somebody else gets similarly crappy coverage for free or reduced.

Nobody ever said that the Socialists at the top didn't get their cut.

[BobO]

I was actually referring to the millions dumped into Medicaid.

But ya, and as I said, Obamacare policies are largely terrible.

[ripvanrando]

I was actually referring to the millions dumped into Medicaid.

But ya, and as I said, Obamacare policies are largely terrible.

Apologize....rode too far without food today....brain fart on my part

[malcolm]

In other words, it forced everyone to become a customer while allowing prices to be hiked to the moon. The CEO of every company in the country is wondering who he has to bribe--uh, I mean pay a $250k speaking fee to--to get a law like that for his business sector.

Just wait for the thing to collapse. With the figures you guys are throwing around ($20K+) and the annual price hikes, it is in the end stages now. At the current rate it will hit the wall within five years, which at 15% growth would have the figures being discussed here at $40K - 50K a year.

It's interesting now a while past the onset of ACA and many insurance companies are saying it's bankrupting them.

Someone mentioned paying cash for medical care is more expensive. That shouldn't be true. Medical care is billed as medicare plus a percent/multiplier that varies depending on the setting. When dealing with a cash pay situation you try and bill the average that insurance pays in that situation.
As an example in my clinics our average co-pay is 30 and bill is 110-120, so we would for a standard visit bill a self pay or cash patient somewhere between 110 and 120 maybe more maybe less depending on testing etc.. The insured patient would give us 30 and the insurance company would send us a check for 80-90.
Now occasionally it's not caught in the billing cycle and the self pay patient will get the full bill 200 or so but we always scale it back to the average.
I know of no situation where docs routinely collect more from self pays. It's confusing and complicated because of the system not created by the providers in which you have this bill that is much larger than what you know you will collect but that the system that was created.

[BobO]

That was me and it was based on rough estimates from out of network providers. It may well be that they wouldn't charge me that much, but the quotes were deep in pucker territory.

The issue here isn't so much the cash price as the fact that my resources have been depleted by escalating premiums for a policy that won't cover me for a legitimate injury. If I stopped paying my premiums I could afford to self-pay our normal healthcare plus a couple minor incidents. But that's a risk.

Bottom line, for my family in particular, this is a train wreck.

[malcolm]

That was me and it was based on rough estimates from out of network providers. It may well be that they wouldn't charge me that much, but the quotes were deep in pucker territory.

The issue here isn't so much the cash price as the fact that my resources have been depleted by escalating premiums for a policy that won't cover me for a legitimate injury. If I stopped paying my premiums I could afford to self-pay our normal healthcare plus a couple minor incidents. But that's a risk.

Bottom line, for my family in particular, this is a train wreck.

It's the difference between what you bill and what you collect. If you get a big bill that seems inordinate don't just send in the money call to investigate. If you think you are being charged more than an insured patient ask what would be collect for that DRG or visit. Things are more negotiable than you may think especially with hospitals.

It's not just you it's a train wreck for lots of folks. Change is difficult and there are unforeseen consequences but you have to start somewhere.

[ripvanrando]

Paying cash is more expensive. When our plan does not cover a procedure say like a mamogram or emergency laser repair to a torn retina or an MRI because they thought my wife had a stroke, the bill will be ten times higher than Medicare or what the insurance company pays. Think like $1300 for a mamo that gets billed more favorably to the insurers and the providers are not allowed to negotiate and in fact I know a dentist who got in trouble for doing so (with the government). This is an utter pricing conspiracy....Sherman Act...where are you?

[Polyglot]

It is against the law to buy health insurance anywhere in the USA but thru Obamacare using healthcare.gov.

Nobody sells health insurance online in the USA. Impossible.

Perhaps the word broker is incorrect. Perhaps it should be called an advisor. The advisor evaluated the plans that are available and I pay to the insurance company. I do not know how the advisor is retributed for his work, but he is more than happy to do it for me and at least 10 of my friends, We are all self-employed and the healthcare.gov website was hugely defficient in explaining how one is supposed to declare one's estimated income. I spent hours talking to the healthcare.gov people both before and after speaking with the advisor. For the first 12 months of existence of Obamacare, the healthcare.gov people were never able to properly explain what line from my tax return was supposed to be used to declare my expected income. The advisor was the only one to give proper advice. Only recently have the healtcare.gov people been able to specify which box from the tax return was supposed to be used. I would expect that a retiree who is not covered by medicare would likewise benefit from speaking to such an advisor.

[BobO]

It's the difference between what you bill and what you collect. If you get a big bill that seems inordinate don't just send in the money call to investigate. If you think you are being charged more than an insured patient ask what would be collect for that DRG or visit. Things are more negotiable than you may think especially with hospitals..

Thanks for that information.

It's not just you it's a train wreck for lots of folks. Change is difficult and there are unforeseen consequences but you have to start somewhere.

I agree that something had to be done. This isn't going to turn out to be that something. The costs are still escalating and now this is escalating the escalation. We are, in most tangible measures, worse off than we were before.

The real problem is costs outpacing wage increases in a big way. What are the real world whys?

[93legendti]

Thanks for that information.



I agree that something had to be done. This isn't going to turn out to be that something. The costs are still escalating and now this is escalating the escalation. We are, in most tangible measures, worse off than we were before.

The real problem is costs outpacing wage increases in a big way. What are the real world whys?

Yup. You have to be hard, hard core to the left and not self employed to make the brazen claim that "Obamacare works". My premiums doubled since my Blue Cross plan was cancelled for non compliance.

I never got my $2500 reduction.
So that's three failures:
No reduction. Plan cancelled. Premiums doubled.


Michigan has had a ban on rejecting coverage for pre existing conditions for quite some time, otherwise I wouldn't have coverage for years.

Billy C is right, it's the "craziest system".

[elcolombiano]

That was me and it was based on rough estimates from out of network providers. It may well be that they wouldn't charge me that much, but the quotes were deep in pucker territory.

The issue here isn't so much the cash price as the fact that my resources have been depleted by escalating premiums for a policy that won't cover me for a legitimate injury. If I stopped paying my premiums I could afford to self-pay our normal healthcare plus a couple minor incidents. But that's a risk.

Bottom line, for my family in particular, this is a train wreck.

You hit the nail on the head. "escalating premiums for a policy that won't cover me for a legitimate injury". My insurance that costs $21K per year covers me for medical care only at a clinic in a very bad neighborhood, 10 miles from my house with a foreign 3rd world educated physician if I am lucky. Most people do not even get an MD but a PA, which is someone with only 2 years of schooling in medicine and no experience. I am willing to bet that if I had something serious the insurance company would stall around forcing me to pay out of pocket. My insurance even though it is expensive may be almost worthless.

[El Chaba]

Incidentally, if you have an insurance policy with a high deductible and you don't have enough cash on hand to cover the deductible, you are essentially uninsured. This situation describes millions of people who have been forced to purchase the only policies that they can afford off the exchanges....

[bshell]

Contrary to Ripvanrando's claim(?) I bought insurance online and without the governmental financial aid of the Affordable Care Act.

I am self employed/insured with no employees...just a guy doing some work with no safety net if I get hurt, etc. My premium went from $975/month to $450/month the first year. It has crept back up to $675/month in 2016.

My deductible/copays are the same and I didn't have to give up any doctors.

I think the health care industry is a total fraud and needs to go social but 'Obamacare' helped me a lot financially at first. Less so as the years go on but I blame the providers and the insurance agencies. Not Barack.

I had an appendectomy 3 years ago. Not an accident, not the result of a crappy lifestyle or diet, etc. Just crap luck as far as I know. They operated and vacuumed out the infectious material at midday. They kept me overnight to keep some eyes on me until noon.

The bill for everything in that @24 hour period was $86,000.00. I thanked the surgeon and IIRC his cut was about $3,000.00

That's a seriously flawed system and it existed long before this administration.

[elcolombiano]

Contrary to Ripvanrando's claim(?) I bought insurance online and without the governmental financial aid of the Affordable Care Act.

I am self employed/insured with no employees...just a guy doing some work with no safety net if I get hurt, etc. My premium went from $975/month to $450/month the first year. It has crept back up to $675/month in 2016.

My deductible/copays are the same and I didn't have to give up any doctors.

I think the health care industry is a total fraud and needs to go social but 'Obamacare' helped me a lot financially at first. Less so as the years go on but I blame the providers and the insurance agencies. Not Barack.

I had an appendectomy 3 years ago. Not an accident, not the result of a crappy lifestyle or diet, etc. Just crap luck as far as I know. They operated and vacuumed out the infectious material at midday. They kept me overnight to keep some eyes on me until noon.

The bill for everything in that @24 hour period was $86,000.00. I thanked the surgeon and IIRC his cut was about $3,000.00

That's a seriously flawed system and it existed long before this administration.

$86K for an appendectomy/hospital stay. That is crazy.

[sitzmark]

Incidentally, if you have an insurance policy with a high deductible and you don't have enough cash on hand to cover the deductible, you are essentially uninsured. This situation describes millions of people who have been forced to purchase the only policies that they can afford off the exchanges....

Actually it just means you are insured and have a high deductible. You choose the risk you want to take. ("You" being a catch all term for any of us) The previous all too prevalent alternative (prior to reform) was for the "uninsured and/or under funded" to use the EMTALA laws as an insurance policy - i.e. never paying in and being fully covered in the event of major medical emergency because the law says everyone with a MDE (medically diagnosed emergency) cannot be turned away regardless of ability to pay.

Repealing EMTALA, allowing medical providers to push people out the door who cannot demonstrate an ability to pay in advance of service, would have been the simple solution and would eliminate the need for ACA or any other healthcare acrobatics. Problem solved.

No stomach for that as a society? Hello "crazy system".

[ripvanrando]

None of the three carriers in my state would write me a policy directly and all three told me it was illegal for them to do so.

This might be because our Governor did not participate in Obamacare and my state along with 27 others are what is called a federally facilitated marketplace. (see link)

My first year took over 50 hours to complete the application on healthscare.gov because the system would crash every few minutes.

In the first year, the government inadvertently cancelled my insurance and it took nearly six months of constant followup to get reinstated.

In the second year, we switched from the one carrier to the only other carrier available to us on healthcare.gov. The original carrier continued automatic payment withdrawals from my checking account. This fiasco took a year to resolve.

This year was especially precious. We had to go to the cheap $19,000 plan because I could not afford the half decent plan at 26 big ones. We switched plans on healthcare.gov. I was smart enough to take screen shots with confirmation numbers soup to nuts of the entire transaction. We got cancelled. It took 4 months of constant calls to the insurance company and to the healthcare exchange government representative. It turns out to have been another software coding problem. We found out we had no healthcare coverage when they initially refused treatment at the ER.

Obamacare sucks so bad that I am still pulling the lever for Trump

https://en.wikipedia.org/wiki/Federally_Facilitated_Marketplace

Contrary to Ripvanrando's claim(?) I bought insurance online and without the governmental financial aid of the Affordable Care Act.

I am self employed/insured with no employees...just a guy doing some work with no safety net if I get hurt, etc. My premium went from $975/month to $450/month the first year. It has crept back up to $675/month in 2016.

My deductible/copays are the same and I didn't have to give up any doctors.

I think the health care industry is a total fraud and needs to go social but 'Obamacare' helped me a lot financially at first. Less so as the years go on but I blame the providers and the insurance agencies. Not Barack.

I had an appendectomy 3 years ago. Not an accident, not the result of a crappy lifestyle or diet, etc. Just crap luck as far as I know. They operated and vacuumed out the infectious material at midday. They kept me overnight to keep some eyes on me until noon.

The bill for everything in that @24 hour period was $86,000.00. I thanked the surgeon and IIRC his cut was about $3,000.00

That's a seriously flawed system and it existed long before this administration.

[ripvanrando]

My favorite part of my new Obamacare healthcare policy?

I can't use my health insurance in any other state.

Obamacare sucks.

[oldpotatoe]

Contrary to Ripvanrando's claim(?) I bought insurance online and without the governmental financial aid of the Affordable Care Act.

I am self employed/insured with no employees...just a guy doing some work with no safety net if I get hurt, etc. My premium went from $975/month to $450/month the first year. It has crept back up to $675/month in 2016.

My deductible/copays are the same and I didn't have to give up any doctors.

I think the health care industry is a total fraud and needs to go social but 'Obamacare' helped me a lot financially at first. Less so as the years go on but I blame the providers and the insurance agencies. Not Barack.

I had an appendectomy 3 years ago. Not an accident, not the result of a crappy lifestyle or diet, etc. Just crap luck as far as I know. They operated and vacuumed out the infectious material at midday. They kept me overnight to keep some eyes on me until noon.

The bill for everything in that @24 hour period was $86,000.00. I thanked the surgeon and IIRC his cut was about $3,000.00

That's a seriously flawed system and it existed long before this administration.

I had a PE(pulmonary embolism)..trip to ER, blood test, EKG, CT, ultrasound on my right leg(found 2 DVT clots)...in the hospital for 3 days..Lovonox, Heparin..monitoring..about $40,000...yup, it's nutz..medicare tho-paid $zero.

[ripvanrando]

I am self employed/insured with no employees...just a guy doing some work with no safety net if I get hurt, etc. My premium went from $975/month to $450/month the first year. It has crept back up to $675/month in 2016.



You get a tax subsidy.


You're welcome.

[ripvanrando]

We have had a pre-existing law in my state for decades.

I never had to meet deductibles in the past and my old plan was around half what I pay now.

How much is too much?

More than a grand a month.

Why? Because I used to pay under $900 on a plan that I liked and indeed, the Liar in Chief Obama promised I could keep it and his words were, "If you like your health care plan, you can keep it"

[oldpotatoe]

We have had a pre-existing law in my state for decades.

I never had to meet deductibles in the past and my old plan was around half what I pay now.

How much is too much?

More than a grand a month.

Why? Because I used to pay under $900 on a plan that I liked and indeed, the Liar in Chief Obama promised I could keep it and his words were, "If you like your health care plan, you can keep it"

wow, took 3 pages..adios thread...

[ripvanrando]

wow, took 3 pages..adios thread...

Bye.

I guess you get a flavor of how disruptive this insurance scam has been. It is horrible. He lied. Period.

[buddybikes]

Yes this whole thing sucks due to Industry involvement (drug mfr, insurance companies, etc) and it is quite solvable.

1. Med schools are horrendously expensive, good brains go into other things rather than core primary care so they can pay off their 400K loans. So, if like in the military, student agrees to work in clinic for x years, then they are funding for school. Setup real clinics where needed - can help beyond a cut but not a trama center.

2. Allow Medicaire/Medicaid to negotiate with drug makers

3. Encourage, offer for free and push things like contraceptive implants, IUD's etc

4. Mandate coverage for out of state. Our daughter, with ulcerative colitis, worked for americorps in Oregon, only coverage she had was emergency room. Fed's own program didn't provide Obamacare level of support

5. Reign in the outragious "cash" billing, often 10x what is negotiated by insurance companies.

Fortunately I am in MA that has it's own coverage and mandates (Like full coverage for diabetes, like insulin pumps) that makes things easier.

that is basic stuff,

[GScot]

I'm late to the thread but here with my own story. I buy my own insurance as a contractor/small business owner. Live in Missouri and two of the three providers including ours are pulling out next year. So far the healthcare sight shows information not available for alternatives in 2017.

Not at all upset about losing my silver United Healthcare plan. When I broke my ulna and radius last year in spite of $5500 per person deductible they managed to stick me with about $20k. That accident after the surgery center gave me drug resistant bacteria ended up costing over six figures so they did at least pay the biggest share. What's crazy is the surgeon who did a hell of job on an injury other doctors had passed on only billed around $3500 on five combined surgeries.

[bshell]

Maybe you missed it, Rip. As I stated in the beginning of my response--I don't qualify for any subsidy under the ACA and I bought directly from Health Net. You're welcome.

My guess is the initial lower prices were the response of the insurance companies trying to be competitive in light of a large group of new subscribers. Since there were basically no teeth (for anyone) in this whole 'mandatory' coverage charade they had no obligation to the customer as far as prices...hence my $2,700 increase in two years.

It hasn't been my dream scenario but here in California we had a number of nation wide carriers to choose from. Bummer about your governor and state decisions. I'm confident Donald Trump will sort it out soon.

[oldpotatoe]

Maybe you missed it, Rip. As I stated in the beginning of my response--I don't qualify for any subsidy under the ACA and I bought directly from Health Net. You're welcome.

My guess is the initial lower prices were the response of the insurance companies trying to be competitive in light of a large group of new subscribers. Since there were basically no teeth (for anyone) in this whole 'mandatory' coverage charade they had no obligation to the customer as far as prices...hence my $2,700 increase in two years.

It hasn't been my dream scenario but here in California we had a number of nation wide carriers to choose from. Bummer about your governor and state decisions. I'm confident Donald Trump will sort it out soon.

You forgot one of these:mad:;):o:confused::):eek:

[echappist]

Yes this whole thing sucks due to Industry involvement (drug mfr, insurance companies, etc) and it is quite solvable.

1. Med schools are horrendously expensive, good brains go into other things rather than core primary care so they can pay off their 400K loans. So, if like in the military, student agrees to work in clinic for x years, then they are funding for school. Setup real clinics where needed - can help beyond a cut but not a trama center.

2. Allow Medicaire/Medicaid to negotiate with drug makers

3. Encourage, offer for free and push things like contraceptive implants, IUD's etc

4. Mandate coverage for out of state. Our daughter, with ulcerative colitis, worked for americorps in Oregon, only coverage she had was emergency room. Fed's own program didn't provide Obamacare level of support

5. Reign in the outragious "cash" billing, often 10x what is negotiated by insurance companies.

Fortunately I am in MA that has it's own coverage and mandates (Like full coverage for diabetes, like insulin pumps) that makes things easier.

that is basic stuff,

almost forgot about that one

[jlwdm]

Medicare is so behind the times on technology. Even with auto pay Medicare will not send an email bill - they send a hard copy every month. What a waste of time, trees and money.


Jeff

[rnhood]

Lord only knows, our government needs no introduction to inefficiency.

[dgauthier]

I am retired and buy my health insurance from the exchange (affordable care act). (...) The cheapest plan for my wife and I for 2017 under covered California per year after you add the annual deductible is $21,100/year. (...) I will be 58 next month. (...)

Congrats on retiring in your 50's. I'm 56, live in Los Angeles, and my wife and I are self employed. We pay $990 a month for a HealthNet silver plan for three: ourselves and our daughter. Without our daughter it would be around $700 and change.

When the Covered California website opened I used it to shop for plans but was unsuccessful signing up, so I just called HealthNet directly. I appear to have gotten a different, and slightly better plan from the one offered on Covered California. I think you need to shop around outside of the plans offered by Covered California.

[93legendti]

“Ultimately… the reality is the Affordable Care Act is no longer affordable for an increasing number of people,” the DFL governor, who signed the state law ushering in the Affordable Care Act in Minnesota, said Wednesday. “We’re going to need both state and federal governments to step in and do what they need to do to remedy these problems.

Last month, state officials announced that health insurance companies on the individual market will increase their premiums between 50 and 67 percent. The massive increases are among the largest in the nation and come amid shrinking provider networks on health insurance plans. Additionally, many counties outside of the Twin Cities metro area will have more limited choices of health insurers.

“It’s a very serious problem,” Dayton said Wednesday...

Still, Dayton’s commerce commissioner said the rate increases indicate an emergency.

“These are middle-class Minnesotans,” Commerce Commissioner Mike Rothman said in announcing the rates last month. “They are getting squeezed — crushed — by these health insurance costs.”

https://www.twincities.com/2016/10/12/mark-dayton-affordable-care-act-no-longer-affordable-obamacare/

[Zoodles]

Jeez, after reading this am I glad to live in the socialist Mecca north of your border. I'd hate to have to fit healthcare costs in with other living expenses or limit my sports activities because I was worried about coverage.

I've never had to pull out more than my gov't issue health card and while the service is a bit meh sometimes I won't be fleeing for the US anytime soon to avoid any waits.

[elcolombiano]

Congrats on retiring in your 50's. I'm 56, live in Los Angeles, and my wife and I are self employed. We pay $990 a month for a HealthNet silver plan for three: ourselves and our daughter. Without our daughter it would be around $700 and change.

When the Covered California website opened I used it to shop for plans but was unsuccessful signing up, so I just called HealthNet directly. I appear to have gotten a different, and slightly better plan from the one offered on Covered California. I think you need to shop around outside of the plans offered by Covered California.

Thanks for the info. I will start shopping around for insurance outside the Covered California to see if I can do better. My wife gave me permission to go the self insured route. I called my local Doctor and he said he will see me if I pay out of my pocket for less than the copay on my insurance. I live 2 hours from Mexico and apparently there is very good health care in Mexico. Even an Uber ride to Tijuana if I am to sick to drive will cost me a fraction of an ambulance ride to the local Hospital.

[Mikej]

Jeez, after reading this am I glad to live in the socialist Mecca north of your border. I'd hate to have to fit healthcare costs in with other living expenses or limit my sports activities because I was worried about coverage.

I've never had to pull out more than my gov't issue health card and while the service is a bit meh sometimes I won't be fleeing for the US anytime soon to avoid any waits.

Yeah I don't get it, Canada HAS free healthcare, yet everybody want to come to the US.

[mcteague]

Yeah I don't get it, Canada HAS free healthcare, yet everybody want to come to the US.

They pay for it in taxes. Where do you get this "everybody want to come to the US" nonsense? Lately I have been wanting to leave.:( If only Canada had a warmer climate!

Tim

[Mikej]

they pay for it in taxes. Where do you get this "everybody want to come to the us" nonsense? Lately i have been wanting to leave.:( if only canada had a warmer climate!

Tim

b.c. ?

[Fatty]

They pay for it in taxes. Where do you get this "everybody want to come to the US" nonsense? Lately I have been wanting to leave.:( If only Canada had a warmer climate!

Tim

Ever look at Vancouver Island? I sure have contemplated moving there.