We don't need 'insurance'. When we get ill, need an operation, etc, etc we go to the doc or hospital and get fixed. Ambulance everything all gratis. The way it should be of course..........
Whew, I have health insurance for 2014 !!!!
- Thread starter Cujet
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JHZR2
Staff member
Originally Posted By: TrevorS
Originally Posted By: volk06
Originally Posted By: d00df00d
My wife and I will be making extensive use of an HSA account. It's a great tool, and so much better than an insurance plan with a lower deductable.
Can you elaborate on this? If the premium for a HDHP and a Copay plan were the same is there any benefit other than the tax benefit?
The premium for a HDHP is far lower than for a copayment plan.
If they were the same, it is unlikely you would go for the HDHP because you would have to pay a high deductible for the first few thousand of your healthcare expenses.
The only reason to go with the HDHP if the premium is the same would be to fund and build up an HSA during a period you expect low healthcare costs.
Right. HDHP is, IMO, how insurance should be. You pay out of pocket until you hit your deductible, which is a few thousand dollars. So you pay the FULL (but insurance co negotiated) bill up until the point that you hit the deductible.
To me that's reasonable, as insurance should have always been a catastrophic protection, not a payment system for when you have the flu and go to the doctor. And at the deductibles that are generally invoked, seems like $3-6k in a year for a family, any kind of real issue would hit that pretty quick.
Problem is that most folks aren't disciplined to save a minimal sum of money, like say $3k because they burn it if they have it. The HSA is a great deal to shield taxable income and reduce your gross income. Prior "advisement" was that if ugly typical have a lot of claims per year, to stick with a regular plan. Problem is that the regular plans cost SO much more. Worst case I'm out around $8k in a year, between what I pay 100% for under the HD part, and the 10% coin durance I pay on the next amount (so $50k in bills in a year). Past that, insurance pays 100%.
So worst case scenario, say I had a heart attack and quad bypass, and my wife had breast cancer (heaven forbid) in the SAME year, we would be out $8k plus the premium we paid, which is around $12k TOTAL, between my employer and me.
Seems like such a better option. 30% less than cujet is paying as worst case, and more like 60%+ savings if he doesn't have a ton of claims.
But as Steve mentioned, the insurers didn't want to open the risk pools properly, this they prevented reL competition and truly lower prices. And that is the problem at the core. Exchanges should have enabled combination of risk pools like never before to take costs down. You can be sure the insurance company is profiting off my plan, otherwise they wouldn't be selling it. Problem is that this didn't happen, for reasons unsuitable to discuss here, and it causes the principal issue, IMO.
But everyone should look into hdhps.
Originally Posted By: volk06
Originally Posted By: d00df00d
My wife and I will be making extensive use of an HSA account. It's a great tool, and so much better than an insurance plan with a lower deductable.
Can you elaborate on this? If the premium for a HDHP and a Copay plan were the same is there any benefit other than the tax benefit?
The premium for a HDHP is far lower than for a copayment plan.
If they were the same, it is unlikely you would go for the HDHP because you would have to pay a high deductible for the first few thousand of your healthcare expenses.
The only reason to go with the HDHP if the premium is the same would be to fund and build up an HSA during a period you expect low healthcare costs.
Right. HDHP is, IMO, how insurance should be. You pay out of pocket until you hit your deductible, which is a few thousand dollars. So you pay the FULL (but insurance co negotiated) bill up until the point that you hit the deductible.
To me that's reasonable, as insurance should have always been a catastrophic protection, not a payment system for when you have the flu and go to the doctor. And at the deductibles that are generally invoked, seems like $3-6k in a year for a family, any kind of real issue would hit that pretty quick.
Problem is that most folks aren't disciplined to save a minimal sum of money, like say $3k because they burn it if they have it. The HSA is a great deal to shield taxable income and reduce your gross income. Prior "advisement" was that if ugly typical have a lot of claims per year, to stick with a regular plan. Problem is that the regular plans cost SO much more. Worst case I'm out around $8k in a year, between what I pay 100% for under the HD part, and the 10% coin durance I pay on the next amount (so $50k in bills in a year). Past that, insurance pays 100%.
So worst case scenario, say I had a heart attack and quad bypass, and my wife had breast cancer (heaven forbid) in the SAME year, we would be out $8k plus the premium we paid, which is around $12k TOTAL, between my employer and me.
Seems like such a better option. 30% less than cujet is paying as worst case, and more like 60%+ savings if he doesn't have a ton of claims.
But as Steve mentioned, the insurers didn't want to open the risk pools properly, this they prevented reL competition and truly lower prices. And that is the problem at the core. Exchanges should have enabled combination of risk pools like never before to take costs down. You can be sure the insurance company is profiting off my plan, otherwise they wouldn't be selling it. Problem is that this didn't happen, for reasons unsuitable to discuss here, and it causes the principal issue, IMO.
But everyone should look into hdhps.
Agreed.
I like the HDHP + HSA combo philosophically, too. It prevents people from getting too out-of-touch with their health care costs, which facilitates personal responsibility and increases the exposure of those costs to market forces. At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
I like the HDHP + HSA combo philosophically, too. It prevents people from getting too out-of-touch with their health care costs, which facilitates personal responsibility and increases the exposure of those costs to market forces. At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
Originally Posted By: d00df00d
Not gratis. Paid for through taxes.
Semantics.
Not gratis. Paid for through taxes.
Semantics.
Originally Posted By: d00df00d
Agreed.
I like the HDHP + HSA combo philosophically, too. It prevents people from getting too out-of-touch with their health care costs, which facilitates personal responsibility and increases the exposure of those costs to market forces. At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
While this is a great option, it is unlikely that the masses will participate. It requires WAY too much personal responsibility and involvement.
We are also exploring a medical concierge agreement with a local doctor. Three of my doctor clients are going to market themselves this way next year. Several more are retiring early...
Agreed.
I like the HDHP + HSA combo philosophically, too. It prevents people from getting too out-of-touch with their health care costs, which facilitates personal responsibility and increases the exposure of those costs to market forces. At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
While this is a great option, it is unlikely that the masses will participate. It requires WAY too much personal responsibility and involvement.
We are also exploring a medical concierge agreement with a local doctor. Three of my doctor clients are going to market themselves this way next year. Several more are retiring early...
Quote:
At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
I am under impression that it provides complete protection from health care related bankruptcy. Do I have to look at my HDHP policy with a fine tooth comb? I am under impression that once I reach my deductible, I am no longer on the hook.
At the same time, it still provides a fair amount of protection from health care-related bankruptcy.
I am under impression that it provides complete protection from health care related bankruptcy. Do I have to look at my HDHP policy with a fine tooth comb? I am under impression that once I reach my deductible, I am no longer on the hook.
There will be a coinsurance max which you have to worry about after paying the deductible.
There may be other limits as well, but they are probably similar to any insurance. After you reach the deductible, its similar to having insurance.
I am putting away the maximum into the HSA. If you can begin doing that in your 20s, you could have hundreds of thousands of tax free dollars to spend on retirement healthcare, and if you need it for other reasons, you pay tax on it just like a 401k.
There may be other limits as well, but they are probably similar to any insurance. After you reach the deductible, its similar to having insurance.
I am putting away the maximum into the HSA. If you can begin doing that in your 20s, you could have hundreds of thousands of tax free dollars to spend on retirement healthcare, and if you need it for other reasons, you pay tax on it just like a 401k.
My company offers a HDHP and even offers to compensate employees (I'm not a real employee remember) some money per quarter, by placing it directly in a health saving account. Makes it easy!
However, the problem with the HDHP is that it's not just the deductible that is high. It's also that the maximum out of pocket for a family of 4 is "outa sight" high.
AND, God forbid you need to use a doctor out of network. The compensation is 70% of the customary rate. In other words, if you travel to California and pay a premium doctor to fix you up, coverage will likely be well less than 70% of the actual bill. It's entirely likely that you may end up 70% of the actual bill!
However, the problem with the HDHP is that it's not just the deductible that is high. It's also that the maximum out of pocket for a family of 4 is "outa sight" high.
AND, God forbid you need to use a doctor out of network. The compensation is 70% of the customary rate. In other words, if you travel to California and pay a premium doctor to fix you up, coverage will likely be well less than 70% of the actual bill. It's entirely likely that you may end up 70% of the actual bill!
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Originally Posted By: JHZR2
Originally Posted By: TrevorS
Originally Posted By: volk06
Originally Posted By: d00df00d
My wife and I will be making extensive use of an HSA account. It's a great tool, and so much better than an insurance plan with a lower deductable.
Can you elaborate on this? If the premium for a HDHP and a Copay plan were the same is there any benefit other than the tax benefit?
The premium for a HDHP is far lower than for a copayment plan.
If they were the same, it is unlikely you would go for the HDHP because you would have to pay a high deductible for the first few thousand of your healthcare expenses.
The only reason to go with the HDHP if the premium is the same would be to fund and build up an HSA during a period you expect low healthcare costs.
Right. HDHP is, IMO, how insurance should be. You pay out of pocket until you hit your deductible, which is a few thousand dollars. So you pay the FULL (but insurance co negotiated) bill up until the point that you hit the deductible.
To me that's reasonable, as insurance should have always been a catastrophic protection, not a payment system for when you have the flu and go to the doctor. And at the deductibles that are generally invoked, seems like $3-6k in a year for a family, any kind of real issue would hit that pretty quick.
Problem is that most folks aren't disciplined to save a minimal sum of money, like say $3k because they burn it if they have it. The HSA is a great deal to shield taxable income and reduce your gross income. Prior "advisement" was that if ugly typical have a lot of claims per year, to stick with a regular plan. Problem is that the regular plans cost SO much more. Worst case I'm out around $8k in a year, between what I pay 100% for under the HD part, and the 10% coin durance I pay on the next amount (so $50k in bills in a year). Past that, insurance pays 100%.
So worst case scenario, say I had a heart attack and quad bypass, and my wife had breast cancer (heaven forbid) in the SAME year, we would be out $8k plus the premium we paid, which is around $12k TOTAL, between my employer and me.
Seems like such a better option. 30% less than cujet is paying as worst case, and more like 60%+ savings if he doesn't have a ton of claims.
But as Steve mentioned, the insurers didn't want to open the risk pools properly, this they prevented reL competition and truly lower prices. And that is the problem at the core. Exchanges should have enabled combination of risk pools like never before to take costs down. You can be sure the insurance company is profiting off my plan, otherwise they wouldn't be selling it. Problem is that this didn't happen, for reasons unsuitable to discuss here, and it causes the principal issue, IMO.
But everyone should look into hdhps.
$3k is not a minimal amount of money for someone who is recently out of college and trying make a living. I don't blow my money and use my assets to make money (truck). 3k is still a lot of money to me!
Originally Posted By: TrevorS
Originally Posted By: volk06
Originally Posted By: d00df00d
My wife and I will be making extensive use of an HSA account. It's a great tool, and so much better than an insurance plan with a lower deductable.
Can you elaborate on this? If the premium for a HDHP and a Copay plan were the same is there any benefit other than the tax benefit?
The premium for a HDHP is far lower than for a copayment plan.
If they were the same, it is unlikely you would go for the HDHP because you would have to pay a high deductible for the first few thousand of your healthcare expenses.
The only reason to go with the HDHP if the premium is the same would be to fund and build up an HSA during a period you expect low healthcare costs.
Right. HDHP is, IMO, how insurance should be. You pay out of pocket until you hit your deductible, which is a few thousand dollars. So you pay the FULL (but insurance co negotiated) bill up until the point that you hit the deductible.
To me that's reasonable, as insurance should have always been a catastrophic protection, not a payment system for when you have the flu and go to the doctor. And at the deductibles that are generally invoked, seems like $3-6k in a year for a family, any kind of real issue would hit that pretty quick.
Problem is that most folks aren't disciplined to save a minimal sum of money, like say $3k because they burn it if they have it. The HSA is a great deal to shield taxable income and reduce your gross income. Prior "advisement" was that if ugly typical have a lot of claims per year, to stick with a regular plan. Problem is that the regular plans cost SO much more. Worst case I'm out around $8k in a year, between what I pay 100% for under the HD part, and the 10% coin durance I pay on the next amount (so $50k in bills in a year). Past that, insurance pays 100%.
So worst case scenario, say I had a heart attack and quad bypass, and my wife had breast cancer (heaven forbid) in the SAME year, we would be out $8k plus the premium we paid, which is around $12k TOTAL, between my employer and me.
Seems like such a better option. 30% less than cujet is paying as worst case, and more like 60%+ savings if he doesn't have a ton of claims.
But as Steve mentioned, the insurers didn't want to open the risk pools properly, this they prevented reL competition and truly lower prices. And that is the problem at the core. Exchanges should have enabled combination of risk pools like never before to take costs down. You can be sure the insurance company is profiting off my plan, otherwise they wouldn't be selling it. Problem is that this didn't happen, for reasons unsuitable to discuss here, and it causes the principal issue, IMO.
But everyone should look into hdhps.
$3k is not a minimal amount of money for someone who is recently out of college and trying make a living. I don't blow my money and use my assets to make money (truck). 3k is still a lot of money to me!
JHZR2
Staff member
Originally Posted By: Cujet
However, the problem with the HDHP is that it's not just the deductible that is high. It's also that the maximum out of pocket for a family of 4 is "outa sight" high.
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
The absolute most I'm out in a year is $8k - $3k deductible and then $5k coin durance. This would equal $53k in services rendered. Once I hit the out of pocket max, everything else is paid at 100%.
Including the $12k policy premium shared by my employer and I, the most money paid in is $20k.
However, the problem with the HDHP is that it's not just the deductible that is high. It's also that the maximum out of pocket for a family of 4 is "outa sight" high.
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
The absolute most I'm out in a year is $8k - $3k deductible and then $5k coin durance. This would equal $53k in services rendered. Once I hit the out of pocket max, everything else is paid at 100%.
Including the $12k policy premium shared by my employer and I, the most money paid in is $20k.
Originally Posted By: Turk
Originally Posted By: Cujet
Premium went up 22+%! And the coverage is far worse, with fewer in network doctors here in FL. (remember, it's a NY plan and I'm away from the network) Premium is just shy of $30K.
I have NOTHING NICE TO SAY ABOUT THE CURRENT REGULATIONS. In 3 years time, my premiums have nearly doubled, my max out of pocket has quadrupled and my deductible has increased 10 fold. Affordable Care Act? I don't think so!!
I won't be able to afford good insurance. This is truly horrible.
All everyone needs to know.
- HOW are Americans going to come up with this much greater expense?
- Have wages gone up this much to compensate?
People will have to CUT BACK on discretionary spending and this will equal an economy that will TANK.
It's sad, but easy math.
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
Originally Posted By: Cujet
Premium went up 22+%! And the coverage is far worse, with fewer in network doctors here in FL. (remember, it's a NY plan and I'm away from the network) Premium is just shy of $30K.
I have NOTHING NICE TO SAY ABOUT THE CURRENT REGULATIONS. In 3 years time, my premiums have nearly doubled, my max out of pocket has quadrupled and my deductible has increased 10 fold. Affordable Care Act? I don't think so!!
I won't be able to afford good insurance. This is truly horrible.
All everyone needs to know.
- HOW are Americans going to come up with this much greater expense?
- Have wages gone up this much to compensate?
People will have to CUT BACK on discretionary spending and this will equal an economy that will TANK.
It's sad, but easy math.
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
JHZR2
Staff member
Originally Posted By: ram_man
Originally Posted By: Turk
All everyone needs to know.
- HOW are Americans going to come up with this much greater expense?
- Have wages gone up this much to compensate?
People will have to CUT BACK on discretionary spending and this will equal an economy that will TANK.
It's sad, but easy math.
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
So who exactly is paying for all the maternity care, delivery charges, well baby visits, immunizations, etc for your children? Because I've seen what the health systems try to charge...
Before making too strong of claims of who "gets it" or not, make sure you're aware of who is paying your bills... If you paid 100% truly out of pocket, good for you. But if it has been subsidized or income-based billing or cost pooled any other way, then I'd say the old bit about people living in glass houses.
The problem as was pointed out pages ago is that we're all human and we all will indeed use the system, which has high costs. Even the financial elites don't self insure. Perhaps that's part of the problem, but at the end of the day, being human and existing is the problem. Because it costs more than any one of us can typically afford.
Originally Posted By: Turk
All everyone needs to know.
- HOW are Americans going to come up with this much greater expense?
- Have wages gone up this much to compensate?
People will have to CUT BACK on discretionary spending and this will equal an economy that will TANK.
It's sad, but easy math.
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
So who exactly is paying for all the maternity care, delivery charges, well baby visits, immunizations, etc for your children? Because I've seen what the health systems try to charge...
Before making too strong of claims of who "gets it" or not, make sure you're aware of who is paying your bills... If you paid 100% truly out of pocket, good for you. But if it has been subsidized or income-based billing or cost pooled any other way, then I'd say the old bit about people living in glass houses.
The problem as was pointed out pages ago is that we're all human and we all will indeed use the system, which has high costs. Even the financial elites don't self insure. Perhaps that's part of the problem, but at the end of the day, being human and existing is the problem. Because it costs more than any one of us can typically afford.
Originally Posted By: JHZR2
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
Well, I do know the folks at the company. They have not done a "poor job". In fact, the choices available to them have been "stripped away" by the ACA. What's left costs much more and covers less.
Steve is right. The ACA should have opened up markets, not closed them down with an insane level of restrictions.
Sorry, but this time, we've succeeded "in spite" of the new laws, not because of them. And, the 3 year, near 100% increase in premiums (for worse coverage) is an unprecedented increase driven directly by the ACA.
I remain hopeful that the issues here will be worked out over time. But we need brave people to write policy that Americans can actually benefit from.
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
Well, I do know the folks at the company. They have not done a "poor job". In fact, the choices available to them have been "stripped away" by the ACA. What's left costs much more and covers less.
Steve is right. The ACA should have opened up markets, not closed them down with an insane level of restrictions.
Sorry, but this time, we've succeeded "in spite" of the new laws, not because of them. And, the 3 year, near 100% increase in premiums (for worse coverage) is an unprecedented increase driven directly by the ACA.
I remain hopeful that the issues here will be worked out over time. But we need brave people to write policy that Americans can actually benefit from.
Originally Posted By: ram_man
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
You disagree with people who have much more advanced educations and do this for a living, and you think YOU'RE the one who's right?
That's bold.
funny how a bunch of oil junkies get it but our "superiors" with Harvard degrees cant figure it out! of course they cannot figure out the www. thing either
You disagree with people who have much more advanced educations and do this for a living, and you think YOU'RE the one who's right?
That's bold.
I'm 28 and my plan went from $250 a month to $241 so no change really, the deductible went up $1k as well.
My yearly out of pocket max went from $5k to $6k.
My yearly out of pocket max went from $5k to $6k.
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I got a letter from my insurance company a month ago that my company's health plan does not meet the requirements of this new law and will be cancelled in 2014. I'm waiting to see what my employer does. The construction industry around here is so bad there is a 90+ week lay-off wait to get back to work. This economy is just as bad as I remember in November 2008 only now we're told it's "recovered."
Originally Posted By: Cujet
Originally Posted By: sciphi
Cujet, did you call into the NY exchange with your particular situation, or just window-shop? Your situation may warrant a call or spending an hour making an account on the NY exchange to figure out your exact costs.
I was provided an exchange price list by my company. I did not call. I would never choose silver or bronze. To match what I need and want, I'd go Platinum. Remember, I've gone from the high end of insurance plans to a PPO. I don't want to go lower.
Take the time and run the numbers with the call center. That's what they are there for. This is NY we're talking about, you never know what they are up to unless you talk to them via phone or email. My experiences as a life-long resident have led me to get clarification on financial matters with anything to do with NY state.
Originally Posted By: sciphi
Cujet, did you call into the NY exchange with your particular situation, or just window-shop? Your situation may warrant a call or spending an hour making an account on the NY exchange to figure out your exact costs.
I was provided an exchange price list by my company. I did not call. I would never choose silver or bronze. To match what I need and want, I'd go Platinum. Remember, I've gone from the high end of insurance plans to a PPO. I don't want to go lower.
Take the time and run the numbers with the call center. That's what they are there for. This is NY we're talking about, you never know what they are up to unless you talk to them via phone or email. My experiences as a life-long resident have led me to get clarification on financial matters with anything to do with NY state.
JHZR2
Staff member
Originally Posted By: Cujet
Originally Posted By: JHZR2
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
Well, I do know the folks at the company. They have not done a "poor job". In fact, the choices available to them have been "stripped away" by the ACA. What's left costs much more and covers less.
Steve is right. The ACA should have opened up markets, not closed them down with an insane level of restrictions.
Sorry, but this time, we've succeeded "in spite" of the new laws, not because of them. And, the 3 year, near 100% increase in premiums (for worse coverage) is an unprecedented increase driven directly by the ACA.
I remain hopeful that the issues here will be worked out over time. But we need brave people to write policy that Americans can actually benefit from.
Well obviously something isn't right if the entire cost for my policy has gone up $840 between my employer and myself, while yours is changing by thousands. As I said, and agree with you/Steve, that the ACA hasn't allowed the exchanges to properly pool risk. But obviously better deals do exist.
Originally Posted By: JHZR2
The real problem is that your company is doing a poor job shopping around and negotiating, and the exchanges haven't helped folks to get that buying power. So it's business as usual.
Well, I do know the folks at the company. They have not done a "poor job". In fact, the choices available to them have been "stripped away" by the ACA. What's left costs much more and covers less.
Steve is right. The ACA should have opened up markets, not closed them down with an insane level of restrictions.
Sorry, but this time, we've succeeded "in spite" of the new laws, not because of them. And, the 3 year, near 100% increase in premiums (for worse coverage) is an unprecedented increase driven directly by the ACA.
I remain hopeful that the issues here will be worked out over time. But we need brave people to write policy that Americans can actually benefit from.
Well obviously something isn't right if the entire cost for my policy has gone up $840 between my employer and myself, while yours is changing by thousands. As I said, and agree with you/Steve, that the ACA hasn't allowed the exchanges to properly pool risk. But obviously better deals do exist.
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