Individual health insurance?

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Originally Posted by Danno

That's not really how it works. No doubt insurance has gone up, and no doubt that the ACA was favorable to insurance companies, but your anecdote is comparing a single healthy adult with a family of 4.

You know, back when I was 25 and single I was paying a lot less for insurance. Now, 25 years later with a family and the ACA and I'm paying through the nose. Fuck Obamacare!

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Yeah. I totally see what you're saying, but a $300 bump for a healthy baby? Something wrong with that picture. Really pisses me off when we cost the insurance companies NOTHING being that we never get to use the benefits. Even paid for her birth 100% out of pocket since we used a midwife. We of course have it in case something catastrophic happens like we get nailed with cancer or get in a bad accident.

One thing's for sure, medical insurance is NOTHING like property or auto insurance. Do you make a claim to get your oil changed, do routine maintenance, or repair a crack in your windshield? Nope. You typically save it for major things like body repair after an accident. And when you do use it, or prove you're an unsafe driver, your rates can go up. Whereas in the medical world, you can live a healthy lifestyle, be in perfect shape, never have a claim, yet you can pay through the nose while Joe Fatso who smokes, eats like crap, and lives on the couch can qualify for cheaper rates. It ain't right I tell ya.

Hmmm, FWIW I will still be a home owner in NJ for the foreseeable future and can set that as my primary residence.

Still, this shit is confusing. I can't seem to actually find info online about what cobra through my current insurance would actually cover.....

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Originally Posted by AustinFromSA

Yeah. I totally see what you're saying, but a $300 bump for a healthy baby? Something wrong with that picture. Really pisses me off when we cost the insurance companies NOTHING being that we never get to use the benefits. Even paid for her birth 100% out of pocket since we used a midwife. We of course have it in case something catastrophic happens like we get nailed with cancer or get in a bad accident.

One thing's for sure, medical insurance is NOTHING like property or auto insurance. Do you make a claim to get your oil changed, do routine maintenance, or repair a crack in your windshield? Nope. You typically save it for major things like body repair after an accident. And when you do use it, or prove you're an unsafe driver, your rates can go up. Whereas in the medical world, you can live a healthy lifestyle, be in perfect shape, never have a claim, yet you can pay through the nose while Joe Fatso who smokes, eats like crap, and lives on the couch can qualify for cheaper rates. It ain't right I tell ya.

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I agree that the system is fucked, no doubt. And the fact is, these days most policies feel like what we used to call "major medical", where the policy is worthless unless you have a potentially bankrupting medical issue. I mean, what good does a policy with a $1500 deductible do for me in a regular year?

But you also can't do it like car insurance, because the person with cancer could never afford insurance in that situation. Single payer is really the only option, it's the only one that makes sense at the end of the day if you want to live in a decent society.

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Originally Posted by Whiteroom_Guardian

Still, this shit is confusing. I can't seem to actually find info online about what cobra through my current insurance would actually cover.....

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COBRA is for the continuation of employer sponsored HI after you leave that employment. Your HR person should be able to tell you the cost for COBRA coverage. If you don't have employer-sponsored HI, I don't think COBRA applies.

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Originally Posted by AustinFromSA

And for you guys talking single payer, think about it this way. Personally, I'd love to see some form of socialized health care, but until we treat medicine the way that much of Europe does, then we simply can't afford it. The US and most Europeans approach medical care SO differently. The way we treat births is a GREAT example. Look it up.

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Except for bullshit like Part D, Medicare/Medicaid are much better at controlling costs at the provider level than private insurance. Listen to the link I posted previously. Insurance companies have no incentive to control provider costs because they can just pass costs along to their customers. Single-payer is like the Churchill quote about democracy: It's the worst form of health insurance, except for all the others.

And, yes, it would help a lot if 1) more people gave one half of a shit about what they ate and got even nominal amounts of exercise and 2) we didn't waste gobs of money on pointless care at the end of life. But, that won't solve the problem: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638261/

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Originally Posted by Whiteroom_Guardian

Hmmm, FWIW I will still be a home owner in NJ for the foreseeable future and can set that as my primary residence.

Still, this shit is confusing. I can't seem to actually find info online about what cobra through my current insurance would actually cover.....

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Cobra coverage is just an extension of the exact plan you have now. Look up your current plan details, that's the coverage. For cobra premium cost contact the person in charge of your benefits or HR. Cobra premiums aren't usually published

Yeah, I do have employer sponsored HI, so COBRA would make sense, but I have a feeling it won't really cover shit. Again, I could be wrong, but considering it's NJ and everything is so corrupt and ass backwards here they probably only will cover me out of state if I pay a $40,000 copay for a couple stitches. I went down this rabbit hole when I was living in CO and insured in NJ. Just paid off some of those bills and that was like 10 years ago.

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Originally Posted by Whiteroom_Guardian

Yeah, I do have employer sponsored HI, so COBRA would make sense, but I have a feeling it won't really cover shit. Again, I could be wrong, but considering it's NJ and everything is so corrupt and ass backwards here they probably only will cover me out of state if I pay a $40,000 copay for a couple stitches. I went down this rabbit hole when I was living in CO and insured in NJ. Just paid off some of those bills and that was like 10 years ago.

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The irony being that if you need stitches and just tell them you're not using insurance and want to pay cash, the bill can be much, much cheaper. Was in CO and busted my lip wide open on my ski edges. They used some anesthetic, had to fold my lips back inside themselves, and took a few stitches. They gave me the bill and I about fainted, then I told them I just wanted to pay cash. Lady was like "oh, well in that case," and handed me a different bill and it was just a couple hundred if that. Lesson learned. Don't tell them you have insurance. Haha.

Would it not be fantastic if this was all a non-issue?

Apparently not.

COBRA can be a pretty bad deal for a lot of people because the employer plans are often very expensive.

When I was off work I got my own personal policy with BSBC. It wasn't great and had high deductible, around $7k out of pocket max. I was like you, healthy and spending all my time mountain biking, so my main concern was injury due to crash, not illness. So my broker hooked me up with an accident benefit plan that would cover the deductible and any other out of pocket expenses if I got injured in a crash, to a $10k limit. It would cover some things my policy wouldn't, like the excess portion of medical bills for out of network providers, co-pays, etc. If anything happens to you, you are guaranteed to have to pay some or all of that deductible so something that can cover a good chunk or all of it is worth having. I think the premium was $36/mo, and it was easy to sign up for.

Best advice is to get a good insurance broker. They can get quotes and offer you advice on what will work given your situation.

all you nerds spinning on healthcare intelligence

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Originally Posted by AustinFromSA

One thing's for sure, medical insurance is NOTHING like property or auto insurance. Do you make a claim to get your oil changed, do routine maintenance, or repair a crack in your windshield? Nope. You typically save it for major things like body repair after an accident.

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It shouldn't work like auto or property insurance. People's fucking lives are at stake, FFS.

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Originally Posted by AustinFromSA

And when you do use it, or prove you're an unsafe driver, your rates can go up. Whereas in the medical world, you can live a healthy lifestyle, be in perfect shape, never have a claim, yet you can pay through the nose while Joe Fatso who smokes, eats like crap, and lives on the couch can qualify for cheaper rates. It ain't right I tell ya.

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It works that way so that people like my niece (born with a giant tumor on the back of her neck, delivered early then NICU for over a month, major surgery at 2 to remove tumor, stage 4 melanoma diagnosis at 3, followed by a year of cancer treatment with cutting-edge experimental drugs and monitoring, more shit I'm not mentioning, probably >$1M in lifetime medical costs and she's 4.5), Type 1 diabetics, people who develop cancer through no fault of their own, people with other congenital/genetic diseases, people paralyzed in accidents, etc. aren't completely fucked. Joe Fatso is a problem, but many, many people who fall into the 5% of people who account 50% of HC spending got there through no fault of their own.

yeah but profit

if doctors weren't worshiped by the elites we could have nice things

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Originally Posted by AustinFromSA

Yeah. I totally see what you're saying, but a $300 bump for a healthy baby? Something wrong with that picture. Really pisses me off when we cost the insurance companies NOTHING being that we never get to use the benefits. Even paid for her birth 100% out of pocket since we used a midwife. We of course have it in case something catastrophic happens like we get nailed with cancer or get in a bad accident.

One thing's for sure, medical insurance is NOTHING like property or auto insurance. Do you make a claim to get your oil changed, do routine maintenance, or repair a crack in your windshield? Nope. You typically save it for major things like body repair after an accident. And when you do use it, or prove you're an unsafe driver, your rates can go up. Whereas in the medical world, you can live a healthy lifestyle, be in perfect shape, never have a claim, yet you can pay through the nose while Joe Fatso who smokes, eats like crap, and lives on the couch can qualify for cheaper rates. It ain't right I tell ya.

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Babies have costs, kids not so much. All the hospital charges from minute 1 of birth to discharge. The 72 shots they get, the 100 urgent care visits the mom insists on every time the baby has a runny nose. Auditory and visual testing.

But yea, after about 2yrs old they are practically maintenance free.

Car insurance rates do increase even if you have a perfect driving record. Rates are based on groups. The 30% increase in distracted driving injuries in the the past year is about to cause a nationwide bump (if it has t already).

Talked to HR aka my brother in law. He says past employees who have gone cobra paid wayyyyy too much. Not worth it. Probably find an individual plan sorta like you found evdog.

do you have a HC problem a doctor problem or an insurance problem?

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Originally Posted by fastfred

your now going to find out how fucked up the health insurance world is, get ready to get ass fucked have a dog shit policy that covers nothing, it's a big wake up call, wish everyone had to buy their own insurance, there would be a revolution at hand if people had to acutally get insurance themselves

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QFT

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Originally Posted by evdog

COBRA can be a pretty bad deal for a lot of people because the employer plans are often very expensive.

When I was off work I got my own personal policy with BSBC. It wasn't great and had high deductible, around $7k out of pocket max. I was like you, healthy and spending all my time mountain biking, so my main concern was injury due to crash, not illness. So my broker hooked me up with an accident benefit plan that would cover the deductible and any other out of pocket expenses if I got injured in a crash, to a $10k limit. It would cover some things my policy wouldn't, like the excess portion of medical bills for out of network providers, co-pays, etc. If anything happens to you, you are guaranteed to have to pay some or all of that deductible so something that can cover a good chunk or all of it is worth having. I think the premium was $36/mo, and it was easy to sign up for.

Best advice is to get a good insurance broker. They can get quotes and offer you advice on what will work given your situation.

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Interesting, I'm going to look into one of those accident plans to cover deductible. My ACL repair a couple years ago cost me 6k out of pocket before insurance kicked in.

And whoever says premiums have not risen dramatically on the private market since Obamacare....you are not living in the same world I am. Been buying my own insurance for 30 years and in the past 3-4 premiums have tripled and almost quadrupled. Never seen that before ever.

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Originally Posted by AustinFromSA

Well, pre-ACA, I was paying around $50/month as a single guy with a high deductible individual plan. Now I'm paying around a grand a month for an even higher deductible group plan covering 2 young adults and 2 little ones. All healthy and active with zero health problems. My perfectly healthy 2 month old daughter added about $300/month to the plan. WTF? You can't tell me that isn't due to current regulation. Government said health insurance is mandatory by law, so then the insurance companies licking their chops said "Oh, did we say $50/month? What we REALLY meant was $500/month." Epipen maker, Mylan, says "Oh, we were only charging $60 for an epipen and government's gonna help foot the bill? What we REALLY meant to charge was $600." This is the reality we live in.

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Couple of reasons for that. Chances are that while the new plan has a higher deductible your current plan covers a lot more stuff--that's regulation, whether you think it's good or bad is another issue. Part of it is that there is now a woman of child-bearing age on the plan. A big part is that Congress hasn't made the necessary adjustments to the subsidies the insurance companies get to keep rates low. A big part of it is that Obamacare introduced community rating--everyone pays the same whether healthy or sick, and no one is excluded for pre-existing conditons, so you're paying a big part of the premiums for those sick people. It's the same as the FICA tax you pay for SS and Medicare. You're supporting the elderly for health care and a modest pension even though you're too young to retire and healthy. The problem is that the penalties for not being insured aren't high enough to induce enough healthy people to buy insurance to pay for the sick people, so the healthy people who do buy pay a lot more.

Part of the problem with Obamacare is that a lot of people saw it as a takeaway--we're taking away your choice of what kind of insurance to buy or no insurance at all. People don't like takeaways. Now that Congress is threatening to take away health care from a lot of people, people like that even less.

Obamacare is a structurally flawed plan that could be tinkered with if Congress were willing, but it will always be plagued with problems. The big thing it does is that it has gotten people to start seeing health care as a right and that will some day open the door for single payer.

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Originally Posted by old goat

The big thing it does is that it has gotten people to start seeing health care as a right and that will some day open the door for single payer.

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awesume !

if I break my leg I go to the hospitol, give em my name they ask when I was born and they print me a bracelet and thats it

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Originally Posted by XXX-er

awesume !

if I break my leg I go to the hospitol, give em my name they ask when I was born and they print me a bracelet and thats it

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God damn socialist! You should atleast give them your house

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Originally Posted by Whiteroom_Guardian

Yeah, I do have employer sponsored HI, so COBRA would make sense, but I have a feeling it won't really cover shit. Again, I could be wrong, but considering it's NJ and everything is so corrupt and ass backwards here they probably only will cover me out of state if I pay a $40,000 copay for a couple stitches. I went down this rabbit hole when I was living in CO and insured in NJ. Just paid off some of those bills and that was like 10 years ago.

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If you were living in Colorado and your insurance was in NJ I could see them denying your claim--as long as NJ is your home, you're traveling on vacation or for business, and the care is emergency you should be covered.

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Originally Posted by XXX-er

awesume !

if I break my leg I go to the hospitol, give em my name they ask when I was born and they print me a bracelet and thats it

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I'm thinking more along the lines of Medicare, where you pay a monthly premium which increases with income and where you have copays unless you insure to cover those, again income dependent. So not entirely free--the feds would want to discourage you from breaking your leg.

Universal HC in Canada is NOT entirely free, you or your employer do pay a monthly premium "medical" (one word) as we would refer to it up here, it can't be much $ cuz I have no idea how much it is but there is no copay and no insurcance company ... all I can see them being is an extra layer of expense

As far as i know an MD just gets a # and he uses it to bill the gov , he knows what procedures are or aren't covered cuz its single payer ... so no fucking with insurance

Getting pinned rodded plated for a broken leg and getting the HW out is compeletly covered but you do have to pay for the crutches eh?