Health Insurance?

[muted]

What are people paying a month or year here? i have no frame of reference any more.

Me: In my 40s / male
Blue Cross Blue Shield individual, not part of ACA, don't qualify for it anyways
Deductible: 5000
4 office visits 4 'free'
In-network coinsurance 30%
Rx Generic Copay/Coinsurance $10.00
Rx Brand Copay/Coinsurance 50%
270 month / 3240 a year

Sadly, I *think* that's a good deal or am I way off?

[GeezerSteve]

I got this in the mail today. What are they trying to tell me?

You too can have a once sorta hot now past her prime beech on the back of your bake

[Cono Este]

We're shopping for our Med Advantage plan and thinking of buying a more expensive and better plan. I got this in the mail today. What are they trying to tell me?

Attachment 213186

I sell all those plans. Med Advantage makes sense if your healthy and never go to the doctor. Then you can save yourself having to pay a monthly premium for a medicare supplement. But if your not healthy, then you will have co pays in Med Advantage and would be better off back on Straight medicare with a supplement, if your still healthy enough to get a supplement.

Paying a higher premium for an advantage PPO usually makes no sense to me. All the co pays are higher, out of network you have 20-30% coinsurance so you probably won't even use that feature. I sell 1 PPO for every 50 hmo's.

I try not to be biased, but I tell my clients to be careful with medicare advantage because your giving an insurance company more control over your healthcare and you can be stuck in one of you are not healthy enough to answer health questions for a supplement, if you decide to go back to straight medicare.

For 300 bucks a month, including your part b premium, a supplement that covers everything, no network, and a part d premium, straight medicare is pretty darn sweet.

Also realize insurance companies make more off you in med adv. and agents make up to twice as much vs selling you a supplement.


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[wooley12]

Thanks. Good info for all to digest. We have been 100% reimbursed for any premiums by a union retirement plan but at the point where "being healthy" is a state of mind and relative. Paid $2k for my share of a $25k Roto-Rooter procedure on the plan we have now. Need cheap drugs. Next step is to see how far the union can go in covering the premiums.

[Cono Este]

Thanks. Good info for all to digest. We have been 100% reimbursed for any premiums by a union retirement plan but at the point where "being healthy" is a state of mind and relative. Paid $2k for my share of a $25k Roto-Rooter procedure on the plan we have now. Need cheap drugs. Next step is to see how far the union can go in covering the premiums.

You are lucky.

On a group retirement plan you have a one time election period to drop it and join any medicare plan, or buy and medicare supplement guaranteed issue.

Most people only have a one time election period to buy a supplement guaranteed issue when there part begins.


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[iceclimb]

Ice, didn't you have an aortic aneurysm? Given that history..., go for the gold plan.

[iceman]

Little plumbing problem. I got better.

[wooley12]

[Bunion 2020]

What are people paying a month or year here? i have no frame of reference any more.

Me: In my 40s / male
Blue Cross Blue Shield individual, not part of ACA, don't qualify for it anyways
Deductible: 5000
4 office visits 4 'free'
In-network coinsurance 30%
Rx Generic Copay/Coinsurance $10.00
Rx Brand Copay/Coinsurance 50%
270 month / 3240 a year

Sadly, I *think* that's a good deal or am I way off?

Is that though work and is the 270 a month your share?

[ncskier]

Is that though work and is the 270 a month your share?

That is cheap if its not employer subsidies kicking in the difference.

[muted]

Is that though work and is the 270 a month your share?

No, self employed. I pay 100% of my insurance. Good to hear it's probably cheap, but what are others paying for reference?

[ncskier]

No, self employed. I pay 100% of my insurance. Good to hear it's probably cheap, but what are others paying for reference?

So my boss kicks in $500 and I pay about $100 a month for the pleasure of having an 80/20 HSA with $3500 max out of pocket. No wife or dependents.
Wife has her and kids, she works for the largest not for profit hospital system in NC. She kicks in $400 a month with employer kicking in about $500. For this she has a $6750 max out of pocket and we seem to hit it each year. Embarrassing really.
We are all healthy but a single visit to ER wipes out our HSA saving rather quickly.

[Bunion 2020]

No, self employed. I pay 100% of my insurance. Good to hear it's probably cheap, but what are others paying for reference?

Interesting, I am on the ACA, just turned 60, decent health, small city, self employed. I am paying 224.00 for 2017 for a BC/BS plan. 6.5K deductible & 6.5K max out of pocket. I don't get the 4 free visits or the 30%.

Sadly, no that isn't too bad a deal you have.

[Kinnikinnick]

Don't cheap out on Health insurance. Think of all the stupid bills you have and think of this as an umbrella policy. You're not getting a subsidy and you don't want to trigger capital gains on anything restructuring your portfolio, just be glad you have it and know you are probably on the winning end of the deal

Check your doctors and your drugs, then call carrier direct and get a silver plan if you have any considerable meds. The results will speak for themselves.

When you get on medicare, buy the best priced plan g in your state, look up your meds on medicare.gov and don't answer the phone for the 6 month around your 65th b-day.

In a similar situation to Iceman here.

Wife’s company sold and we went on CoBRA for December and looks like January too.

I’m CO we can jump on an exchange plan in February.

Definitely don’t qualify for subsidy - at least based on 2017 income.

Question is how do I assess what’s worth cutting down the premium cost vs. the cobra. For an Anthem plan (catastrophic) I can cover all 4 of us for $1200/mo vs $1700 for CoBRA
Have DRs were ok with and meds, But how do I assess the est net cost to me. A low med expense/medium expense/high expense scenario analysis ?

Advice how to assess?

Cono, you say not to cheap out, Where’s the devil in the details that might burn me?


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[4matic]

I thought it as forward looking income? Run the numbers:

http://planfinder.connectforhealthco.com/

[El Chupacabra]

Does the catastrophic Anthem plan count as a qualifying ACA plan?

[Conundrum]

Look at the annual max out of pocket and annual premium cost. Build in any med expenses that you can budget for and then do a serious self reflection on your risk tolerance.

Nothing happens for a few years of lower premiums and you’re ahead. Because you said Anthem, you’re in a state I’m not too familiar with but I could give you some general ideas. Shoot me a PM.

[hikesalot]

Health insurance just sucks. We are on my husband's insurance. He was doing consulting for a while, but the premiums and out of pocket max were just too high (2 kids with medical issues - we usually hit the out of pocket max) so he went back to a large corporation - just for better health insurance. We wanted to sell the house & do the RV the country thing for a couple years, but just can't figure out health insurance. Sucks. Looked into the ACA , but too high for us.

Hope you all can figure out reasonable insurance.

[hikesalot]

might I add that "better" health insurance is still super high - out of pocket like $9k/year now or something. (down from $13k/year when he was consulting - who can afford that??) I am just thankful we can manage the $9k somehow. Other families with my kids' condition aren't so lucky. I get pretty fired up about it sometimes - often think about going back to law school just to be an advocate for this type of shit. Insurance companies piss me off to no end. (they deny shit left and right - wtf why r we paying so much then?)

[4matic]

Be careful saying anything about your employer by name.

[Art Shirk]

In a similar situation to Iceman here.

Wife’s company sold and we went on CoBRA for December and looks like January too.

I’m CO we can jump on an exchange plan in February.

Definitely don’t qualify for subsidy - at least based on 2017 income.

Question is how do I assess what’s worth cutting down the premium cost vs. the cobra. For an Anthem plan (catastrophic) I can cover all 4 of us for $1200/mo vs $1700 for CoBRA
Have DRs were ok with and meds, But how do I assess the est net cost to me. A low med expense/medium expense/high expense scenario analysis ?

Advice how to assess?

Cono, you say not to cheap out, Where’s the devil in the details that might burn me?


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Weird question I know, but does your first name start with a T?

[wooley12]

1984

[basinbeater]

Don't worry about it. Donald trump is going to get everyone the best Healthcare. The best!

[huckbucket]

Don't worry about it. Donald trump is going to get everyone the best Healthcare. The best!

You forgot .... "for a fraction of the cost"

then again

that was before he found out healthcare was so complicated.

[fastfred]

this shit makes me get upset fucking health insurance

I have come to realize that it's so much easier to not work or work very little in the usa, the gov't will provide you with heath ins, food stamps, and cut rate housing, I am one step away from doing that, I don't know why I'm such a pussy for working so hard, for the time being I will help subsidize everyone else's health insurance costs since I get to pay full market rate, been buying my own insurance since I was 22 years old

$750.00 a month 2k deductible, 6,500.00 total out of pocket, if you live in the mountains of colorado you are fucked! So many transients and most of them have no health insurance. So costs are double if not tripple what someone will pay in denver just an hr or so away. Plus there is a complete monopoly on health care and insurance providers so they can price gouge you