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Thread: Health Insurance

  1. #41
    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

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  3. #42
    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!


    Utah is a very special and unique place. There is no where else like it on earth. Please take care of it and keep the remaining wild areas in pristine condition. The world will be a better place if you do.

  4. #43
    Quote Originally Posted by Scott P View Post
    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

  5. #44
    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?

    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

    Utah is a very special and unique place. There is no where else like it on earth. Please take care of it and keep the remaining wild areas in pristine condition. The world will be a better place if you do.

  6. #45
    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 ?

  7. #46
    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.

  8. #47
    Quote Originally Posted by Iceaxe View Post
    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

  9. #48

  10. #49
    Quote Originally Posted by Rob L View Post
    Wow.

    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.

  11. #50
    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.

  12. #51
    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.
    Suddenly my feet are feet of mud
    It all goes slo-mo
    I don't know why I am crying
    Am I suspended in Gaffa?

  13. #52
    Thanks Obama

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

  14. #53
    Hmmm...an insurance carrier falling on hard financial times? It's like music to my ears.

    Was their deductible too high?
    It's only "science" if it supports the narrative.

  15. #54
    Quote Originally Posted by rockgremlin View Post
    Hmmm...an insurance carrier falling on hard financial times? It's like music to my ears.

    Was their deductible too high?
    ***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.

  16. #55
    Imagine still holding the belief that the governmnnt should have control of your healthcare when they just finished deeming who is “essential.”

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