Health Insurance

[Iceaxe]

I need to look into finding more affordable health insurance as my family is currently paying over $2000 a month and I've just been told it's going up 10% in June.

Anyhoo.... anyone have a good agent or any other recommendations? I'm open to just about anything as this is getting ridiculous.

I can set this up as either company or family.

[Sandstone Addiction]

I've heard some good things about this one and others like it, but not sure how they feel about "non-believers"

http://www.chministries.org/

Sean Hannity is always talking about a DR. that is doing something similar, but I can't recall the guys name.

I think this might be it:

http://www.bizjournals.com/wichita/news/2017/03/08/atlasmd-founder-featured-on-fox-news-program.html

[moab mark]

Same boat 2200 per month. My wife and I research that heavily last fall and really did not come up with a good scenario to lower it. Raising the deductible substantially helps but not that much if we moved away from IHC we go to a higher rate coming back because we are grandfathered somewhat from the start of the Obamacare disaster. The Christian Ministry thing I know people that are using it and it seems to work but we weren't comfortable doing it. I'm open for suggestions but all I know is your bend over and take it.

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[hank moon]

“You know what, Americans have choices. And they’ve got to make a choice. And so maybe, rather than getting that new iPhone that they just love and they want to spend hundreds of dollars on, maybe they should invest in their own healthcare.”

- J. Chaffetz

[dakotabelliston]

Haven't you guys heard that healthcare.gov is the greatest !!!

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[Brian in SLC]

Dont' worry, its just going to get better and better...

https://www.washingtonpost.com/video/politics/trump-this-will-be-great-health-care/2017/04/20/db9e5438-2608-11e7-928e-3624539060e8_video.html

http://www.cnn.com/2017/04/21/politics/donald-trump-healthcare/

http://www.cnn.com/2017/04/27/politics/donald-trump-health-care-100-days/

[moab mark]

Could it get any worse? Ok it could, I was paying 800 per month in 09. Now 2200 with double the deductible I had in 09. I could buy a lot of cell phones for 2k a month.

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[moab mark]

Chaffetz is right, might not be politically correct but he's right.

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[moab mark]

Obama care had to much forced fluff. Let people sign up for what they want. Solving the pre existing problem is the real Achilles heel.

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[devo_stevo]

“You know what, Americans have choices. And they’ve got to make a choice. And so maybe, rather than getting that new iPhone that they just love and they want to spend hundreds of dollars on, maybe they should invest in their own healthcare.”

- J. ChaffetzWhile I agree with this statement in spirit, the fact that I can buy 3 iPhones for the cost of one months premium on my insurance kind of blows this out of the water in all reality. Imagine paying for 36 iPhones in a year. That's a lot of coin. An that doesn't include the deductibles or the cost to actually use the insurance.

Obamacare is doing exactly what it was designed to do. It's ruining the health insurance industry to the point where the people are going to start demanding a single payer system. It's about the only way out of this mess at this point. If you repeal Obamacare, things are not going to go back to the way they were. They can't. The only ideas that Washington is giving us are as bad or worse in many ways than what we've got now. I don't know where you go from here, but it's not pretty.

[Scott P]

Trump's latest Tweet:

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[Iceaxe]

I'm not sure if Trump could do worse then what we have now even if he trid.

[devo_stevo]

I'm not sure if Trump could do worse then what we have now even if he trid. I'd like very much to believe you on this, but I'll admit, I'm skeptical. Wait and see, I guess.

[hank moon]

I'd like very much to believe you on this, but I'll admit, I'm skeptical. Wait and see, I guess.

Single payer is the only rational future. If anyone has the ability to accelerate its arrival, it's a non-pol like Trump. Still, I'm not holding my breath.

[devo_stevo]

Single payer is the only rational future. If anyone has the ability to accelerate its arrival, it's a non-pol like Trump. Still, I'm not holding my breath. i'm afraid you are correct on this. The politicians have ruined health insurance. Now it's time to work on the actual health care industry so they can take that over too.

[hank moon]

i'm afraid you are correct on this. The politicians have ruined health insurance. Now it's time to work on the actual health care industry so they can take that over too.

In a so-called free society, the ultimate responsibility is with the people. Pols are bound to fail. Must we fail with them?

http://www.npr.org/templates/story/story.php?storyId=114045132
https://en.wikipedia.org/wiki/Health_insurance_in_the_United_States

[Iceaxe]

A great article explaining why insurance and pre existing conditions simply do not work. Explained simply with no politics. Please read!

https://thewriterinblack.com/2017/05/05/health-insurance-and-pre-existing-conditions/

[phatch]

You might be better off buying catastrophic coverage and then self-insuring for the rest. Bank your current costs as your own insurance.

[Iceaxe]

I've been looking into that. If going that route you can also open a health savings account, which is similar to an IRA and allows your money to grow tax free.

[Scott P]

I've been looking into that. If going that route you can also open a health savings account, which is similar to an IRA and allows your money to grow tax free.

Hopefully the rules do get changed for HSA's. The current rules are that if you don't use all the money in the current year, you lose it. It is good that the limits were expanded recently, but this is only useful if you know you have a major medical expense coming.

[Iceaxe]

Hopefully the rules do get changed for HSA's. The current rules are that if you don't use all the money in the current year, you lose it.

You are wrong about this and have it confused with a flex spending account. The money you place in a Health Savings Account is yours and you never lose it. But the HSA does come with a lot of rules, similar but different to an IRA.

[Scott P]

You are wrong about this and have it confused with a flex spending account. The money you place in a Health Savings Account is yours and you never lose it. But the HSA does come with a lot of rules, similar but different to an IRA.

You are right. I was confusing it with our flex account. Flex accounts can be a pain since if you don't use it, you lose it and if you do need it, the caps are too low. As long as the money is used for medical expenses, personally I think the law should be changed so it rolls over from year to year. The maximums should be changed as well. Our max is $2600, which doesn't go very far for something like a heart surgery or cancer treatments.

Personally I think that flex accounts should be canned in favor of HSA's.

[devo_stevo]

I thought catastrophic plans were a thing of the past with Obamacare. Can you still get one of those?

[Iceaxe]

You can get something like catastrophic, they are called HealthSave plans and require you to maintain a health save account.

[devo_stevo]

I'm going to have to look into that. I've been wishing for the old catastrophic plans to come back.

[phatch]

Under the ACA, you can have catastrophic only if you're under 30 without a penalty. If you're over 30, you'll have to pay the individual mandate penalty but can still buy a catastrophic policy and self insure.

Under Trumpcare, if it passes the senate as written now, the individual mandate goes away and Catastrophic is a penalty free option for all ages.

Where Iceaxe has kids, I don't understand how the current penalties apply in that situation. The total penalties might make self insurance less reasonable. Also where his family participate in somewhat more risky pursuits, spending some time with an sports focused actuary to better understand his risks could also be worthwhile in the calculation.

My gut instinct (which lacks detailed knowledge and information) would be to stay the course this year and see how and when Trumpcare passes in the details and when it will take effect. There's too much change coming to make a long term decision such as self insurance this year.

[devo_stevo]

Under the ACA, you can have catastrophic only if you're under 30 without a penalty. If you're over 30, you'll have to pay the individual mandate penalty but can still buy a catastrophic policy and self insure.

Under Trumpcare, if it passes the senate as written now, the individual mandate goes away and Catastrophic is a penalty free option for all ages.

Where Iceaxe has kids, I don't understand how the current penalties apply in that situation. The total penalties might make self insurance less reasonable. Also where his family participate in somewhat more risky pursuits, spending some time with an sports focused actuary to better understand his risks could also be worthwhile in the calculation.

My gut instinct (which lacks detailed knowledge and information) would be to stay the course this year and see how and when Trumpcare passes in the details and when it will take effect. There's too much change coming to make a long term decision such as self insurance this year.I already am self insured. I'm self employed since June 2015 and health insurance would cost me anywhere from $850 per month with a $15,000 deductible to $2,100 per month with a $5,000 deductible. It's tough for me to justify that right now. I've been paying the tax penalty for the last two years because it is roughly equal to one months insurance premiums.

I also have kids, by the way. Five of them. I've found that I can pay cash for medical services for far less than I can pay for insurance. All I need and want is something like a catastrophic plan for a couple hundred bucks a month just to prevent bankruptcy in case of something major. I'll pay for the rest.

So I guess I'm a fan of Trumpcare for my situation if what you say is true. I think that's a step in the right direction. At least for me and my situation.

[Iceaxe]

My gut instinct (which lacks detailed knowledge and information) would be to stay the course this year and see how and when Trumpcare passes in the details and when it will take effect. There's too much change coming to make a long term decision such as self insurance this year.

I think this is the course of action we'll take this year. It appears no matter what I do it will be a whole new ball game again next year. There is no way Obamacare can succeed in it's current format, and who knows where Trumpcare will end up.

[twotimer]

What a friggin' mess, huh? I'm leaning 100% on the VA right now. The problem with that is if I get jacked up away from a VA hospital and have to get patched up, I'm on the hook for it. It would be cash. I can't imagine how many veterans are like me. Even though I had a high deductible with the plan that Obamacare destroyed, I'd still like to be covered for major emergency room care, anywhere I am. You can burn (well, they will, actually) thru eight grand real quick if you're busted up good.

I'm hoping for the more reasonably priced cata plans to come back. Right now the insurance companies aren't getting a plum nickle from me.

Single payer? Hell, who knows what 3 years from now will look like with this stuff goin' on. Trump is right when he opposes paying for a big, high tech military policing the world while these countries that we protect have lavish health plans and virtually no military. Check out Germany's right now...it's pathetic. You can die waiting for treatment in England and France seems to be willing to take it up the rear in taxes to pay for it. Were is the money gonna come from to pay for it here? The insurance companies aren't going anywhere...they're deeply embedded in the government, on both sides of the aisle.

Personally, I think that those people that smoke, drink and do drugs to the point that they're rotting themselves should be allowed to suffer the consequences. Instead we'll have to pay for new knees, hips and any number of expensive medical procedures to keep them going. I think the end of the human race may be the complete failure of applying compassion. Spend ourselves to death trying to help out.

Yeah, well...Trump is the man for the next 4 years and I sincerely hope whatever is done will get the costs down, one way or another. I'm optimistic and I think it might take a couple of years to whip things into shape. I actually want to buy insurance.

Hmmm...I wonder if I'll be exempt paying for single payer if I'm a veteran? :naughty: It's all a waiting game. Big bucks, big politics, big power all making moves.

Be careful, boys and girls!

[Scott P]

You can burn (well, they will, actually) thru eight grand real quick if you're busted up good.

For a major procedure, 8K won't get you much. I calculated my wife's heart surgery out to costing about $4167 per minute. That means 8K would pay for 1 minute 55 seconds of treatment!


Personally, I think that those people that smoke, drink and do drugs to the point that they're rotting themselves should be allowed to suffer the consequences.

I'd have to agree. I have an extended family member who basically fried her brain doing drugs. It's more that the medical costs; she is on permanent disability because of it.


I think the end of the human race may be the complete failure of applying compassion. Spend ourselves to death trying to help out.

There are people who deserve compassion. For example, I think children deserve compassion because they don't have a choice in their parent's circumstances.

[twotimer]

There are people who deserve compassion. For example, I think children deserve compassion because they don't have a choice in their parent's circumstances.I agree with you, and of course we need to take care of not just these poor kids, but the moms with the deadbeat dads, the indigent, the truly disabled and poor elderly. We can't have these people dying in the streets. Other conservatives, like me, complain about those that assume that we want every man for themselves, and that's just not true.

I'm just gripping that those who pollute themselves get to drink deeply from the trough.

[Rob L]

Medical bills can rack up exceedingly quickly (as of course US residents & citizens will know). Three weeks ago I had a small medical emergency in Moab requiring helicopter medivac and three days in Grand Junction hospital.

The helicopter was $32,000 and the medical care was $20,000 (fortunately my travel insurance will pay this).

Rob

(ironic that I required a helicopter; Scott P will understand!)

87069

[Scott P]

Here's Trump's latest tweet on healthcare:

87154

I found the part about "let's add more dollars to healthcare" interesting. I wonder what his plan is?

[hank moon]

Here's Trump's latest tweet on healthcare:

87154

I found the part about "let's add more dollars to healthcare" interesting. I wonder what his plan is?

Wow. Given his recent comments about OZ healthcare, maybe he's going all in with Single Payer (the sensible solution to current insanity®). But I doubt it. More likely just the limitations of Tweeter.

The missing words:

"CEOs' pockets"

[Scott P]

Medical bills can rack up exceedingly quickly (as of course US residents & citizens will know).

Yes, they do.

As for me, I got my first job at age 11 (loading carpet cleaning equipment into trucks early in the morning and before school started, have never been unemployed more than a few days since age 16, left home to work at the scout camp at age 16, joined the military on my 17th birthday, came back shortly before getting engaged at age 18, married shortly after, bought my first house at age 19, worked graveyards full time while going to college in the daytime, while my wife worked two jobs to help pay for school, moved to Colorado with a job that required working up to 117 hours a week (my record), and trying to get ahead and pay off all debts as quickly as possible.

I religiously track my spending, investments, and debt and even graph them to pick out trends.

I don't think it can be said that I have been irresponsible with money, but periodically we expect to take a punch from medical expenses.

Here is my debt graph for the last five years (I always update it once a month-on the 11th):

87155

This isn't a complaint as it's better than the alternative and we can absorb the costs. I have never defaulted on any kind of debt or even bounced a check or been late on bills. My credit score is in the 800's.

Still, it does show the effect that medical expenses have on finances.

We make a good wage and have worked hard to make good decisions, and have been able to do fine, but what if medical expenses happen when someone is just starting out or can't work temporarily due to medical expenses that weren't any fault of his or her own?

It's kind of scary that one medical problem can bankrupt someone and ruin their life for several years.

[Iceaxe]

Obama care created an entitlement, and once given it's impossible to resend an entitlement..... so the only logical outcome from where we are today is single point pay. It might take 20 years for us to get there, but it's the only possible outcome from where we are today.

[Scott P]

Just got a bill for fixing four teeth/jaw.

Our share of total medical expenses this past year (mostly heart surgery and teeth/jaw fix), with supposedly good insurance = $42,989.24.

I make a pretty good wage, but that's almost a full year of take-home pay.

[devo_stevo]

Ouch. That hurts. Does that include the premiums that you paid?

[Scott P]

Ouch. That hurts. Does that include the premiums that you paid?

No. The premiums I paid are as follows:

87175

$396.24 per pay period for Medical + $27.77 per pay period for Dental + $4.74 per pay period for Vision = $401.75 per pay period X 26 pay periods in the year = $10,455.50 annually (plus my employer contributed another $13,269.82 towards premiums).

Coverage:

87176

Breakdown of medical expenses since July 1 2017:

Heart tests and heart surgery for Kimberly = $6250 max out of pocket for 2016 and 2017 = $12,500.

Miscellaneous medical expenses for rest of family = $2619.81
__________________________________________________ ________________________

Dental Plan Coverage (I did get a supplemental policy as well, so if you include that cost, it was actually higher):

87177

Dental implants = $4500 X 4 = $18,000.00
Bone grafts, extractions, maxillofacial/oral surgery = $8926.13
Miscellaneous dental expenses for rest of family = $943.30

Grand total since July 1 2016:

Premiums = $10,455.50
Medical = $15,119.81
Dental = $27,869.43

Grand total since July 1 2016 = $53,444.74.

It varies, but I take home about $48,000 per year, so if you include premiums, the medical expenses are more than my take home pay for the year.

The good news is now that we have the two biggest medical expenses out of the way, it should be better in upcoming years.

[Iceaxe]

That is not very good insurance, at least according to your premiums. I have "pretty good" insurance and my premiums are more than double yours and do not include dental or vision. Pretty good insurance has a stop lose (A limit on what you have to pay) in the $5k to $10k range.

I've learned a fair amount about insurance the past few years and something you could have done if you knew the heart surgery was coming is to purchase a "platinum" plan for the year and your stop lose would have kicked in at about $5000.

This is one of the big problems with Obama care that people are exploring, and that is preexisting conditions, which the law now requires insurance companies to cover. Think of it this way, what if you did not buy car insurance, but when you got in an accident you could run down and buy a great policy that covered everything, including any dings or scratches from the time the car was new. That is Obama care in a nutshell.

[Rob L]

Scott,

There seems to be a lot of "dental" care in your policy, And a lot of "eye care" in your policy.

Is this normal?

Shirley an insurance policy is for "unexpected" medical conditions, rather than for:
"The teeth of my kids need braces for the usual reasons in their teenage years" and
"As I get old, my eyesight deteriorates therefore I will need glasses".

I ask this in all honesty, because I don't quite understand why US folks pays so much for so-called "health insurance" whereas so much of it could be called "vanity insurance" in the case of eyes and teeth.

I'm willing and open to be educated, and no offence is intended to Scott or other readers.

Rob

[Scott P]

Pretty good insurance has a stop lose (A limit on what you have to pay) in the $5k to $10k range.

Our max out of pocket is $6250 per individual/$12,500 family, which doesn't seem that much different from the above, unless I am missing something.


I've learned a fair amount about insurance the past few years and something you could have done if you knew the heart surgery was coming is to purchase a "platinum" plan for the year and your stop lose would have kicked in at about $5000.

We found out on December 6 2016 that she needed the heart surgery, and it was performed on January 11.2017. Unfortunately that meant we had two out of pocket maxes to pay close together.

We knew the surgery was coming eventually, but last we heard before this that it would probably be in the 10-20 more years range.

Anyway, most of the rest was considered Dental and I did get a supplemental policy, but as far as I know there is no out of max pocket in Dental insurance.

If you do know of any, I'd really like to know because I haven't had all of the work done yet.



There seems to be a lot of "dental" care in your policy, And a lot of "eye care" in your policy.

Is this normal?

Shirley an insurance policy is for "unexpected" medical conditions, rather than for:
"The teeth of my kids need braces for the usual reasons in their teenage years" and
"As I get old, my eyesight deteriorates therefore I will need glasses".

I ask this in all honesty, because I don't quite understand why US folks pays so much for so-called "health insurance" whereas so much of it could be called "vanity insurance" in the case of eyes and teeth.

No, it is not normal.

When I was a kid, maybe 7-8 years old, at the park I was hit by someone riding a snow-tube down the hill. It shattered my jaw, but I didn't go to the doctor for it. The jaw eventually healed up, but it left a lot of cracks and spaces that grow bacteria.

A few decades later I had to get root canals on many teeth because they "died". The jawbones started to die to and pieces were periodically removed.

Fast forward to last January. I was flossing my teeth when one of the teeth actually came out along with part of the jawbone. The bone was orange and very stinky.

Unfortunately, in the US at least, oral surgeries are covered under Dental Insurance, rather than medical insurance. The jaw surgeries and teeth fixing and replacing are what costs the $27,869.43 (some of which hasn't been done yet).

I bought a supplemental policy, but as far as I know, there are no out of pocket maximums for dental insurance. Of course if anyone does know of such a policy, I'd like to hear about it!

[Iceaxe]

Our max out of pocket is $6250 per individual/$12,500 family, which doesn't seem that much different from the above, unless I am missing something.

Our policies are nothing alike. I'm guessing your's is what the government now calls a "silver" plan with a dental and vision add-on. My current policy is what the government calls a platinum plan with no vision or dental (those are add-ons to any policy).

Yearly Premium for family of 4
You - $10,302
Me - $36,373 (Edit: this should be $25,788)


Our max out of pocket
You - $6250 per individual
Me - $2,000


Our max out of pocket
You - $12,500 family
Me - $4,000


Deductible
You - $1500 per person
Me - $500


Deductible
You - $3000 family
Me - $1000


You - Dental and Vision
Me - None

[Scott P]

Our policies are nothing alike. I'm guessing your's is what the government now calls a "silver" plan with a dental and vision add-on. My current policy is what the government calls a platinum plan with no vision or dental (those are add-ons to any policy).

Yearly Premium for family of 4
You - $10,302
Me - $36,373


Our max out of pocket
You - $6250 per individual
Me - $2,000


Our max out of pocket
You - $12,500 family
Me - $4,000


Deductible
You - $1500 per person
Me - $500


Deductible
You - $3000 family
Me - $1000


You - Dental and Vision
Me - None

If I had your plan, it seems that this would be the total costs for the same services?:ne_nau:

Premium = $25,788 (edited in light of above)
Dental = $27,869.43
Max out of pocket = $4000 X 2 (assuming December 31/January 1st start end date for max) = $8000
Total = $61,657.43

[Rob L]

Forgive me please, both Scott and Iceaxe. I must be misunderstanding the term "premium" here. To me, an insurance "premium" is the amount you pay to protect yourself, financially, against a future unexpected risk.

You don't pay $72K for health insurance. surely ??? Or even $36K ?

[Iceaxe]

You understand premium correctly. And now you know why the entire U.S. is upset with our health care system. I pay over $25k per year for health insurance. I have to pay my $4k deductable on top of that, I pay dental and vision out of pocket.

You will also now understand why Trump was elected partly on his promise to repeal and replace Obama care (our current health care system).

But the only way I see to actually fix the system is to remove the private insurance companies from the equation (go to single point pay). The problem with that is the Insurance companies are making mega dollars and funnelling money to lawmakers not to remove them from the equation.

[Iceaxe]

Yearly Premium for family of 4
You - $10,302
Me - $36,373

The above should have read:

Yearly Premium for family of 4
You - $10,302
Me - $25,788

[Rob L]

Wow.

:dropmouth:

[Iceaxe]

Wow.

:dropmouth:

And my insurance premium went up 8.97% this year and has done something similar every year since Obama care was put into place. This system can't sustain itself. It's only a matter of time before it implodes. I see the actual damage being done as I'm an employer and I pay for all my employees insurance, Those who don't actually pay the premiums (those with employer provided health care) still haven't caught on to what is actually happening. You can tell your employees what's happening, but until it actually comes out of their pocket they really don't understand.

[devo_stevo]

It is indeed a serious crap show. I agree with Iceaxe. Most people don't realize what Obamacare has done to health care in this country. It's like taxes. Nobody really worries about it because it just comes out of their paycheck and they never see it go away. If everyone was forced to sit down once a quarter and write a check to the IRS for taxes, or sit down and write a check for their entire health insurance premium, there would be a second civil war in this country. Either that or law makers would actually do something to fix the mess we're in. But because it is all provided or done by someone else, nothing changes and it only gets worse every year.

[twotimer]

I sincerely feel sorry for you guys. Sorry for myself, too. But I sure am glad that I never married or had any kids. I've had a lot of girlfriends but rarely one that makes any real money. Not tryin' to take a dig at you guys or anything like that, but obviously when you're the man of the house, you've got to come up with some serious bucks.

I dumped my health insurance when Obamacare blew it up. I've got the VA and it's fine and it costs nothing. I was perfectly happy with having private insurance especially because it covered me anywhere I am, whereas if they don't wheel me into a VA emergency room I'm on the hook for at least the patch up.

I'll buy insurance again when things (hopefully) iron out. I figure a year, maybe two.

Single payer, eh? I don't think that'll work well with the entrenched system. All those doctors, specialists and such are going to work under a government edict? I can't see that happening in the good ole' USA, boys and girls.

Yeah, well...we've got nothing to do but hang out and watch whatever happen.

[Iceaxe]

Thanks Obama

Molina out of federal health exchange in Utah, leaving 70K without carrier
http://www.ksl.com/index.php?sid=45268583&nid=960

[rockgremlin]

Hmmm...an insurance carrier falling on hard financial times? It's like music to my ears.

Was their deductible too high? :roflol:

[Iceaxe]

Hmmm...an insurance carrier falling on hard financial times? It's like music to my ears.

Was their deductible too high? :roflol:***insert eyeroll here***

You're not reading that right. Molina is pulling out of Obama Care because it's a loser for them. This is nothing but a smart business decision for a company. Smart companies only keep the money making sections and dump the losers. Molina will continue to bank coin, and their profits should increase by cutting out their participation in the insurance exchange. Just like all the other insurance companies that are bailing out.

The real loser is the public as this will do nothing but toss gas on the dumpster fire that is Obama Care. It will contribute to skyrocketing premiums an ridiculously high deductibles.

[Iceaxe]

Imagine still holding the belief that the governmnnt should have control of your healthcare when they just finished deeming who is “essential.”