Individual health insurance?

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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?

So I emailed back and forth with our companies broker. COBRA is stupid expensive, and something changed just this spring where brokers can no longer quote for individuals. Carriers cut them out of the loop unless it for groups/businesses.

Cobra has always been expensive. You're just continuing on a company policy without the company's subsidy (that they get a tax break on). In the old days, the expensive cobra was the only option if you got laid off w a pre-existing condition until you got a new gig.

As currently unemployed you could get an ACA policy w a decent subsidy for not much or maybe even qualify for Medicaid.

Well I won't get any good deals because for tax year 2017 I will have made way too much money to qualify for any type of aid. First world problem.

I just talked to Horizon BCBS about an individual plan. The "Bronze" plan is only $287 per month. $3k deductible. $7150 out of pocket max.

Honestly have no idea really what that all means totally. Like if I broke my arm and needed surgery I would basically end up paying $3k right off the bat? Assuming I actually made my way to a BCBS network hospital/doctor (which is fucking super confusing to figure out using their network site)....

287 seems reasonable. 3k is probably not bad these days as a deductible. Yes, that's what you pay out of pocket until reached. If you plug in what you expect to earn(ed) in 17, the ACA tool will tell you plan costs and subsidy if any. Not sure about the Medicaid part, but youre not working now so you might even qualify even though u made money earlier this year

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Originally Posted by Whiteroom_Guardian

Well I won't get any good deals because for tax year 2017 I will have made way too much money to qualify for any type of aid. First world problem.

I just talked to Horizon BCBS about an individual plan. The "Bronze" plan is only $287 per month. $3k deductible. $7150 out of pocket max.

Honestly have no idea really what that all means totally. Like if I broke my arm and needed surgery I would basically end up paying $3k right off the bat? Assuming I actually made my way to a BCBS network hospital/doctor (which is fucking super confusing to figure out using their network site)....

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That price isn't very out of line.

I honestly was expecting like $500+ monthly.

Also:
- Deductible doesn't apply to a number of things, so you do a $20 copay or whatever, and that's it, even though the deductible hasn't been reached.
- Where you do pay out of pocket (towards a deductible that you may or may not eventually reach), you typically pay all of or a portion of the insurance company's negotiated rate (with in-network providers anyway), which can sometimes be a fraction of the listed rate that they're prepared to send out for collection if the patient was uninsured. Like those hospital bills, which famously include charges for $20 Band-Aids and so on; insurance companies don't pay any of that crap, and when an insurance company gets back to the hospital about the part of the bill you need to cover, you don't either... but if you're uninsured, the hospital will go after your salvaged assets to pay for every one of those Band-Aids, or nail your ass to the wall trying.

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Originally Posted by old goat

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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Yep. Yes. Hopefully. Great post.

Covering pre existing conditions has a cost and the cost is magnified when young healthy people simply don't buy and choose to pay the much cheaper penalty because they can't or don't want another mortgage payment. That is a big reason why the individual market is blowing up. But nobody wants to get rid of the pre existing condition mandate because we are all only an accident or illness away from being uninsurable without it.

So something has to give. As a country we aren't ready for single payer sadly. We are still in the scapegoating and simple answer to complex problem phase.

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Originally Posted by uglymoney

But nobody wants to get rid of the pre existing condition mandate because we are all only an accident or illness away from being uninsurable without it.

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For me, that's not even the main reason. Here are some others:

- Rescission: In an individual policy and you get some disease that's going to cost six figures to take care of? The insurer gets to look for ways to avoid covering you, and the most fertile ground for that is to look at your 15-page application and disclosure and see if you left something out (doesn't even have to be connected to what you want them to cover); since they have access to more accurate records than you probably did when you filled it out, it might not be too hard. Michael Moore's "Sicko" (one of his better works, where he managed to minimize his obnoxious trolling story-telling style) covered this issue in detail. Want to sue them? Great, if you live long enough to win, they'll end up saving money anyway, on account of you being so frugal with medical care while not knowing if they'd pay.

- It's not just big-ticket illnesses. My wife had a bear of a time getting insured on account of some knee surgery she had not long before (us skiers think of that as a pretty routine shit-happens-gotta-see-doctor kind of thing). Hasn't had problems in the decade or so since, but for a while there it looked like she might have been locked out of getting (individual market) health insurance.

- There's a game insurance companies used to play. Me: "Why is my insurance premium about to go way way up?" Agent: "Oh, look at that, you should apply for this other plan from the same company that's just about exactly the same, and is only modestly more expensive than you were paying before." Me: "Great, I'll fill out the 15-page application, good thing I'm still healthy!"

No I completely agree. We have to cover pre existing conditions. I had acl surgery so I know that I would be fucked without it in the individual market because they don't want to cover my knee. My point is simply that covering everybody comes at a cost and if healthy working people skip out on coverage because it costs too much or they simply don't want it for whatever reason we end up in a cost prohibitive death spriral. Everybody has to play to make it work.

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Originally Posted by bobz

Also:
- Deductible doesn't apply to a number of things, so you do a $20 copay or whatever, and that's it, even though the deductible hasn't been reached.
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Depends on the type of insurance. I have a HDHP, free annual exam but everything else I pay 100% until I hit my deductible.

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Originally Posted by mcski

287 seems reasonable. 3k is probably not bad these days as a deductible. Yes, that's what you pay out of pocket until reached. If you plug in what you expect to earn(ed) in 17, the ACA tool will tell you plan costs and subsidy if any. Not sure about the Medicaid part, but youre not working now so you might even qualify even though u made money earlier this year

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Originally Posted by tom tuttle from tacoma washington

That price isn't very out of line.

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For what level of care? $300-500/month is bullshit if you still have to fight for coverage or pay some ridiculous deductible.

Well yeah. Given our current system and the challenges so well presented above, that is a decent quote and is reality.

And probably cheaper than his Cobra without all the potential problems with that.

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Originally Posted by bobz

For me, that's not even the main reason. Here are some others:

- Rescission: In an individual policy and you get some disease that's going to cost six figures to take care of? The insurer gets to look for ways to avoid covering you, and the most fertile ground for that is to look at your 15-page application and disclosure and see if you left something out (doesn't even have to be connected to what you want them to cover); since they have access to more accurate records than you probably did when you filled it out, it might not be too hard. Michael Moore's "Sicko" (one of his better works, where he managed to minimize his obnoxious trolling story-telling style) covered this issue in detail. Want to sue them? Great, if you live long enough to win, they'll end up saving money anyway, on account of you being so frugal with medical care while not knowing if they'd pay.

- It's not just big-ticket illnesses. My wife had a bear of a time getting insured on account of some knee surgery she had not long before (us skiers think of that as a pretty routine shit-happens-gotta-see-doctor kind of thing). Hasn't had problems in the decade or so since, but for a while there it looked like she might have been locked out of getting (individual market) health insurance.

- There's a game insurance companies used to play. Me: "Why is my insurance premium about to go way way up?" Agent: "Oh, look at that, you should apply for this other plan from the same company that's just about exactly the same, and is only modestly more expensive than you were paying before." Me: "Great, I'll fill out the 15-page application, good thing I'm still healthy!"

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Is all this true under Obamacare with community rating (sick and healthy people pay the same) and no exclusion for pre-existing conditions? Sicko came out in 2007.

My understanding is that ObamaCare addressed the rescission issue; thus, Sicko mainly addresses a problem that is no longer a problem now... but which could easily return if we move back to a system that discriminates based on pre-existing conditions.

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Originally Posted by Dantheman

If you'll be away from your official place of residence and are only interested in coverage for emergency care, you should look into travel insurance. IIRC it's cheap and the medical coverage is generally pretty good. Injuries have to occur a certain distance from "home" but I think the minimum distance is usually around 100 miles.

That said, think very carefully before you voluntarily create a gap in your medical coverage. Rates really should not be that bad for a young single person.

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I think emergency care is covered if you are away from home, but follow up care might not be. There have been lots of articles written about this. It is tricky stuff.

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Originally Posted by Whiteroom_Guardian

So I emailed back and forth with our companies broker. COBRA is stupid expensive, and something changed just this spring where brokers can no longer quote for individuals. Carriers cut them out of the loop unless it for groups/businesses.

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How expensive - north of 700?
I have to get into this next week (cobra 60 day election period) so will report back. I am using it as a bridge until I can establish something when I make a landing hopefully via a remaining ACA.

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Originally Posted by NoPostholio

How expensive - north of 700?
I have to get into this next week (cobra 60 day election period) so will report back. I am using it as a bridge until I can establish something when I make a landing hopefully via a remaining ACA.

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For comparison, I'm paying north of $1k. Central Oregon is wicked expensive.because there isn't any competition.

I don't understand the problem. There was an interview with some guy in the NYT the other day. He said you just pay twelve bucks a year and you are good to go....

If you have a high income, and therefore high tax bracket, look at the bronze HSA.Put thr max in the HSA and stay healthy. If you need to pay medical bills you get upward of 40% discount because of the tax savings. Worked great for the thousands of dollars of dental work my wife had last year.

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Originally Posted by hutash

If you have a high income, and therefore high tax bracket, look at the bronze HSA.Put thr max in the HSA and stay healthy. If you need to pay medical bills you get upward of 40% discount because of the tax savings. Worked great for the thousands of dollars of dental work my wife had last year.

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Like a lot of things--401K's, mortgage and state income tax deductions, capital gains tax rate, and on and on--HSA's are great for people with money. For the average American living paycheck to paycheck and most likely not managing to save anything for retirement HSA's are useless.

All true, but the OP made a comment about making too much money for subsidies, so he may be able to take advantage of an HSA.

I agree that HSA are just another way to give tax breaks to rich people and don't do si
hit for most people. Imagine that, one of the big parts of the GOP health plan favors the rich. I'm shocked, shocked I tell you.

Eh, I'm far from rich, and I make good use of an HSA. My employer offers a PPO or an HDHP that's much cheaper, so I went the HDHP route and put the premium savings (and some extra) into the HSA every month.

I realize that you have to have some money to use one, but it's a huge stretch to say you need to be rich. You do, however, need to have the discipline to put money in there.

I about lost my cool when I saw this commercial not too long ago showing these people dancing cause they're stoked about their super awesome health care plans. I wish I could get those sorts of rates! Instead, I'm literally days away from losing my coverage because I can't afford my crappy plan any more.
https://www.youtube.com/watch?v=odfd5qf9oiQ

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Originally Posted by Danno

Eh, I'm far from rich, and I make good use of an HSA. My employer offers a PPO or an HDHP that's much cheaper, so I went the HDHP route and put the premium savings (and some extra) into the HSA every month.

I realize that you have to have some money to use one, but it's a huge stretch to say you need to be rich. You do, however, need to have the discipline to put money in there.

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I didn't say rich. I said people with money. Plenty of people who aren't rich take advantage of the mortgage interest deduction, the property and state income tax deductions and have 401K's and capital gains--but the richer you are the more valuable those deductions are. Re HSA's --a large percentage of Americans who are too "rich" for subsidized health insurance still don't have spare cash to put into an HSA. The other problem with HSA's is that the program assumes you will have time to accumulate a substantial amount before you get sick. Saving for retirement works because you know about when you will retire and can plan your retirement contributions accordingly. No one knows when they'll get sick.

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Originally Posted by hutash

I agree that HSA are just another way to give tax breaks to rich people and don't do si
hit for most people. Imagine that, one of the big parts of the GOP health plan favors the rich. I'm shocked, shocked I tell you.

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Originally Posted by Danno

Eh, I'm far from rich, and I make good use of an HSA. My employer offers a PPO or an HDHP that's much cheaper, so I went the HDHP route and put the premium savings (and some extra) into the HSA every month.

I realize that you have to have some money to use one, but it's a huge stretch to say you need to be rich.

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You don't have to be a 1 %er to benefit from a HSA, but it (and the accompanying required HDHP) are not things that working class or poor people will use. If you're barely making it paycheck-to-paycheck, you don't have an additional $6750 per year to allocate to a HSA.

It's like the mortgage interest deduction. Only those with large amounts of mortgage interest to deduct can actually benefit (much) from it. You have to have enough interest payments to deduct to exceed the standard deduction and make it worthwhile to itemize (well, that, along with the presumably high property tax that goes along with the expensive house + large mortgage).

All that said, if you have access to a HSA, it is a fantastic tax break and should be maxed out. Contributions are completely tax free (no payroll or income tax), can invest within it, earnings are tax-free if used for qualified reimbursement. After age 65, use it like an IRA (subject to income tax) or use it for medical expenses. If you can afford it, max out your HSA, and do not withdraw from it for medical reimbursements -- pay those costs separately. Let those HSA contributions sit and let your contributions grow. If you ever need it for a medical emergency, you've got that $ to withdraw then.

Don't confuse it with a "use it or lose it" FSA.

Old Goat beat me to it....

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Originally Posted by old goat

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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Sums it up pretty well.

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Originally Posted by old goat

I didn't say rich. I said people with money.

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You didn't say rich, but hutash did.

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Originally Posted by El Chupacabra

You don't have to be a 1 %er to benefit from a HSA, but it (and the accompanying required HDHP) are not things that working class or poor people will use. If you're barely making it paycheck-to-paycheck, you don't have an additional $6750 per year to allocate to a HSA.

It's like the mortgage interest deduction. Only those with large amounts of mortgage interest to deduct can actually benefit (much) from it. You have to have enough interest payments to deduct to exceed the standard deduction and make it worthwhile to itemize (well, that, along with the presumably high property tax that goes along with the expensive house + large mortgage).

All that said, if you have access to a HSA, it is a fantastic tax break and should be maxed out. Contributions are completely tax free (no payroll or income tax), can invest within it, earnings are tax-free if used for qualified reimbursement. After age 65, use it like an IRA (subject to income tax) or use it for medical expenses. If you can afford it, max out your HSA, and do not withdraw from it for medical reimbursements -- pay those costs separately. Let those HSA contributions sit and let your contributions grow. If you ever need it for a medical emergency, you've got that $ to withdraw then.

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As noted, my employer had a PPO option that I used to use, and the HDHP is a lot cheaper, so it was a no-brainer to take the money I save from not paying for the PPO and put it in to the HSA. Granted, it takes some financial wherewithal/knowledge, but it's not complicated.

One thing: money in an HSA is not inherently free from payroll taxes, that is only the case if your employer offers the ability to deposit directly into your HSA. Mine doesn't, so I pay the payroll taxes and don't get the income tax break until I do my tax returns. And I am not sure I agree that you should pay for medical expenses out of pocket and not with the HSA; that is its whole benefit to me, that our health care expenses are essentially tax free.

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Originally Posted by Danno

One thing: money in an HSA is not inherently free from payroll taxes, that is only the case if your employer offers the ability to deposit directly into your HSA. Mine doesn't, so I pay the payroll taxes and don't get the income tax break until I do my tax returns.

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Good point. I overlooked that. Some employers even contribute to their employee's HSA -- mine doesn't, but I can do direct-from-paycheck deductions.

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Originally Posted by Danno

And I am not sure I agree that you should pay for medical expenses out of pocket and not with the HSA; that is its whole benefit to me, that our health care expenses are essentially tax free.

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If you can afford to do it that way (pay med expenses out of pocket, let the HSA grow), it's using the HSA loophole as a sort of IRA. It's another $6750 (per couple) you can sock away, on top of whatever other 401k/ IRA/ etc plans you have. It's not like you lose the money -- if you ever want to cash it out, you can get reimbursed for your medical expenses at any point in the future, so save your receipts.