Health Insurance

[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? 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!)

[Scott P]

Here's Trump's latest tweet on healthcare:



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:



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):



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:



$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:



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):



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.