Armed Polite Society
Main Forums => The Roundtable => Topic started by: Ben on October 16, 2023, 04:12:19 PM
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That time of the year again. My insurance actually only went up $50 to $790/mo for the crappiest HSA bronze plan available. The deductible went up to $8000 though.
I hate to be a leach on the taxpayers, but I kinda can't wait until 2025 when I can get the Medicare B or whatever it is that's the supplement. Saving $400 or so a month buys a lot of ammo.
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My HSA bronze plan was $928 per month in January but I went on Medicare in February. I have a supplement and drug plan but looking at advantage plans for next year.
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Open enrollment at work starts Thursday.
I’ll probably stick with the low premium/high deductible option. Unless we’ll spend more than around $9500 as a family (after any discounts but before insurance payments) it’s cheaper than the medium premium medium deductible option. The high premium low deductible option is just stupid. I don’t know why anyone would ever pick it. There is no scenario where it saves you money vs the other options, plus you lose the HSA eligibility.
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My last year on Obamacare I was paying over $900/month for a crappy high deductible bronze plan which was the "best" available for me - I could have saved maybe $50 a month if I went to an even worse HMO plan with a tiny network of physicians, none of whom were located nearby. I'm now closing in fast on my 2nd year of Medicare and have a Medicare Advantage plan that includes a very large (PPO) network of physicians and provides better coverage than my old bronze plan, for a very small fraction of the cost. And once I turned 65, my previous employer's pension plan began kicking in an extra couple of grand per year in a health savings account I can use for premium reimbursement. I only glanced at the plans for this year so far, and right now I'm 90% sure I'll just keep the one I have - the changes for next year seem minor. But it's important enough that in the next couple of weeks, I WILL look at it more closely.
Right now I'm not too badly off, but Obamacare - and the long litany of lies it was built on - is the #1 reason I won't ever cast a vote for a Democrat. (Sometimes I have to hold my nose and suppress my gag reflex when I look at the GOP candidate, but at least I know he didn't vote for Obamacare.)
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Plan F Supplement for us. Pays for everything over the 80% Medicare covers, 0 deductible. Plan F isn't available any more, unless you had it b4 the cutoff, and so far the monthly premium is under what my old company puts in the HSA. RX coverage is $35.00 bucks a month and all of our meds are tier 1 or 2: No deductible and 0 or 3.00 for a 90 day supply. I do have an inhaler for COPD that's tier 3 and pricey, but fortunately GoodRx provides it pretty cheap at 40.00 a month VS around 350.00 retail; 1st a 500 ded and then 18% of the retail with Rx coverage.
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The VA covers me (I pay a co-pay on my meds), the wife is on "Free Care" (she pays for her meds) at the local Ochsner LSU Health (Louisiana State University) hospital, plus we both have Medicare (NOT Medicaid) and Humana Insurance through Medicare and have various co-pays.
Yes, our poor financial management and planning, along with some serious health issues pushed us to bankruptcy twice so we are the drags on the system. We do NOT have ANY income beyond my <$200/mo VA disability and our combined Social Security checks.
No "side hustles", no cash jobs, nothing. We simply are too beat up to do it. Most of you have no idea how much of a struggle it is for us to cook, clean, take the trash out or even shower as it takes SO much out of us. "Obama Care" is a *expletive deleted*ing joke and insult to the American people!
Sometimes being "dirt poor" "is better", financially, than having a good job, being ill/disabled, and being crushed under medical/insurance costs and that is just sad!
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That is messed up, I have a $1000 max out of pocket and $250 deductible health insurance plan, and it only costs my employer (state government) $753 a month and I pay $56 a month.
You would think if a state government can negotiate that, why can't the feds do the same?
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That is messed up, I have a $1000 max out of pocket and $250 deductible health insurance plan, and it only costs my employer (state government) $753 a month and I pay $56 a month.
You would think if a state government can negotiate that, why can't the feds do the same?
If you're referring to my OP, in fairness, I screwed myself in some ways by separating at 53 with the early out option. Had I waited until 60, I would have kept my cadillac plan and I don't know how much I'd be chipping in now, but I know it would be a small amount.
On the other hand, I've remained healthy and have the money to pay for it, and still believe that the additional seven years of freedom has been worth the outrageous cost for the crappy plan.
Though people in general shouldn't be stuck paying that much for non-employer insurance, and whether we blame the gov or the health care/insurance sectors, it's a travesty that needs to be corrected, though I don't know how. I have always said that if you're in a situation like mine, where you're healthy, only go to the doctor for the annual checkup, and have your insurance for being hit by a bus or the cancer, you should be paying closer to $80/mo than $800/mo.
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If you're referring to my OP, in fairness, I screwed myself in some ways by separating at 53 with the early out option. Had I waited until 60, I would have kept my cadillac plan and I don't know how much I'd be chipping in now, but I know it would be a small amount.
On the other hand, I've remained healthy and have the money to pay for it, and still believe that the additional seven years of freedom has been worth the outrageous cost for the crappy plan.
Though people in general shouldn't be stuck paying that much for non-employer insurance, and whether we blame the gov or the health care/insurance sectors, it's a travesty that needs to be corrected, though I don't know how. I have always said that if you're in a situation like mine, where you're healthy, only go to the doctor for the annual checkup, and have your insurance for being hit by a bus or the cancer, you should be paying closer to $80/mo than $800/mo.
Before the oh so affordable care act you could get a high deductible (as in the old definition of it, nowadays $3k is a low deductible!) insurance plan for around $120 a month completely out of pocket
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Right now I'm not too badly off, but Obamacare - and the long litany of lies it was built on - is the #1 reason I won't ever cast a vote for a Democrat. (Sometimes I have to hold my nose and suppress my gag reflex when I look at the GOP candidate, but at least I know he didn't vote for Obamacare.)
I asked my former congresswoman that voted for it why they called it “the Affordable Care Act” since it was NOT affordable and they obviously DON’T care.
She walked away without answering me.
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Look at the huge, fancy medical centers and their large satelites that duplicate various expensive diagnostic equipment and skilled employees. Inflated insurance costs are affected by medical charges to support that sprawl of those pricey edifices.
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I am one of the fortunate ones who actually has insurance that is affordable. I pay for Medicare Part B and the .gov throws in Tricare for Life which picks up anything the Medicare doesn't. Although many people my age and older who did a full 20 years in the military were often told about that free healthcare for life it never materialized. So I pay the Medicare Part B premium knowing that TFL will pick up the rest. This last year or two my wife and I have cost them a pretty penny but there was not a peep about deductibles or anything else.
bob
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If you're referring to my OP, in fairness, I screwed myself in some ways by separating at 53 with the early out option. Had I waited until 60, I would have kept my cadillac plan and I don't know how much I'd be chipping in now, but I know it would be a small amount.
On the other hand, I've remained healthy and have the money to pay for it, and still believe that the additional seven years of freedom has been worth the outrageous cost for the crappy plan.
Though people in general shouldn't be stuck paying that much for non-employer insurance, and whether we blame the gov or the health care/insurance sectors, it's a travesty that needs to be corrected, though I don't know how. I have always said that if you're in a situation like mine, where you're healthy, only go to the doctor for the annual checkup, and have your insurance for being hit by a bus or the cancer, you should be paying closer to $80/mo than $800/mo.
I wasn't saying anything bad about you retiring early.
I was just saying that if a state government can offer a better health plan for employees (preexisting conditions included) then what the feds offer, why can't the feds negotiate the same deal for their insurance plans?
Unfortunately, health, auto, home, causality, etc. insurance plans don't only look at the individual to set a custom rate, they look at all the risks of the pool and price accordingly, so they make money.
The August 2020 and Dec 2021 Derecho, plus the 2018 flooding in Iowa has really jacked our property insurance costs because of all the payouts. I'm paying over $1k per year more now than what I did in 2018 for my residential insurance.
One that pisses me off (in Iowa at least) is that the negotiated insurance payout of MRI of a joint is typically less than the cost of 3 physical therapy sessions. My insurance makes you complete about a dozen PT sessions before the Dr can order an MRI. Both times I've done the PT session (in weeks of constant pain), then get an MRI, then to surgery to repair. MRI after the initial office visit would of shown the tear in my rotator cuff and the torn meniscus of my knee.
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I wasn't saying anything bad about you retiring early.
I was just saying that if a state government can offer a better health plan for employees (preexisting conditions included) then what the feds offer, why can't the feds negotiate the same deal for their insurance plans?
No, I got that. The feds do (or did when I was in) have good health plans, including in retirement. You just have to both put the years in AND meet the age requirements. I got out too young to take advantage of the retirement health plan.
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No, I got that. The feds do (or did when I was in) have good health plans, including in retirement. You just have to both put the years in AND meet the age requirements. I got out too young to take advantage of the retirement health plan.
But why can't those plans also be negotiated for the plans available in open enrolment to John/Jane/They Q Public?
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But why can't those plans also be negotiated for the plans available in open enrolment to John/Jane/They Q Public?
Oh, gotchya. Yeah, I was saying the same thing when Obamafail started - that they should have just made the fed health plans available to everyone. There were plenty of options at the time - from high deductible to cadillac, and all of them were 50-75% cheaper and better than private and exchange plans a year after obamacare started.
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Oh, gotchya. Yeah, I was saying the same thing when Obamafail started - that they should have just made the fed health plans available to everyone. There were plenty of options at the time - from high deductible to cadillac, and all of them were 50-75% cheaper and better than private and exchange plans a year after obamacare started.
Someone or someones are skimming the hell out of it all.
I also think that basic health care institutions and insurance need to be non-profit, management salaries and bonuses are regulated and published with names. Basic health care and things like utilities shouldn't be investor owned. Quality and affordable healthcare is essential to a strong populace.
Cosmetic surgery and stuff like that can do whatever.
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But why can't those plans also be negotiated for the plans available in open enrolment to John/Jane/They Q Public?
Oh, gotchya. Yeah, I was saying the same thing when Obamafail started - that they should have just made the fed health plans available to everyone.
Fed/state plans could certainly have been opened up to anyone, but I'm not sure you are fully considering what happens to those plans when the risk pool is suddenly full of ultra-high-risk individuals. Unless the government were to subsidize it directly with tax dollars the price would have skyrocketed on those plans just like the plans they forced the plebes to buy.
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I also think that basic health care institutions and insurance need to be non-profit, management salaries and bonuses are regulated and published with names. Basic health care and things like utilities shouldn't be investor owned.
No.
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but I'm not sure you are fully considering what happens to those plans when the risk pool is suddenly full of ultra-high-risk individuals.
Valid point.
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Fed/state plans could certainly have been opened up to anyone, but I'm not sure you are fully considering what happens to those plans when the risk pool is suddenly full of ultra-high-risk individuals. Unless the government were to subsidize it directly with tax dollars the price would have skyrocketed on those plans just like the plans they forced the plebes to buy.
Ultra high risk people are already working there. I have stage 2 heart failure from congenital heart disease and had colon cancer all before 50.
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Ultra high risk people are already working there. I have stage 2 heart failure from congenital heart disease and had colon cancer all before 50.
You understand the basics of how insurance risk pools work, right? If so, how would your premium be impacted if instead of covering a few very expensive people who happened to work for your state government and a lot of low risk people to offset those costs, your plan suddenly had to protect everyone with regular, expensive medical bills who wanted affordable coverage?
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No.
Why not? Place like St Jude's and Shiner's hospitals are non-profit. They seem to be doing quality work.
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You understand the basics of how insurance risk pools work, right? If so, how would your premium be impacted if instead of covering a few very expensive people who happened to work for your state government and a lot of low risk people to offset those costs, your plan suddenly had to protect everyone with regular, expensive medical bills who wanted affordable coverage?
Yes, I know how low risk insurance pools work.
I would imagine the overall health of people that can afford health insurance are probably very similar to the overall health of the people that are on employer provided insurance.
Also, if the high-risk people would get regular preventative health care service, would that decrease their overall health costs. Couple checkups per year vs emergency room procedures.
I'm a bit jaded on how health care and health insurance is run, also doesn't help that my partner is a MD. She is extremely jaded by the US healthcare and insurance industries. All the crap she has experiences in the OR, many of the emergency surgeries and procedures that could have detected or avoided with affordable routine health care.
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Yes, I know how low risk insurance pools work.
I would imagine the overall health of people that can afford health insurance are probably very similar to the overall health of the people that are on employer provided insurance.
Also, if the high-risk people would get regular preventative health care service, would that decrease their overall health costs. Couple checkups per year vs emergency room procedures.
I'm a bit jaded on how health care and health insurance is run, also doesn't help that my partner is a MD. She is extremely jaded by the US healthcare and insurance industries. All the crap she has experiences in the OR, many of the emergency surgeries and procedures that could have detected or avoided with affordable routine health care.
Did she support Obamacare?
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Did she support Obamacare?
Parts of it, definitely not 100%.
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I would imagine the overall health of people that can afford health insurance are probably very similar to the overall health of the people that are on employer provided insurance.
Nope. If the state runs what is essentially an insurance provider of last resort they won't get a random selection of people needing health insurance. Anyone who expects to have low annual healthcare costs who can get coverage through their work will do that, because for those people having their employer cover the vast majority of your premium is typically way better than having a plan with lower deductibles. However, for those who expect their out of pocket to be very high - say those facing HIV treatment, ongoing cancer treatment, long-term care for a premature baby with serious birth defects, or in need of a transplant, etc. - such a person would be significantly incentivized to switch to the government offered plan. For your plan, the most an individual with no coverage by the government would have to pay is about $10,700 a year, right? If I have hemophilia and I can spend $10,700 to cover ten or twenty times that ... guess what I am going to cheerfully do? Free money, baby.
What you end up with in such a case is a plan that may well have a number of healthy people covered by it, but has a disproportionate number of people with extremely high medical costs. That does not end well for your plan, but since I'm not on it I have no issue if you'd like to try it out.
Also, if the high-risk people would get regular preventative health care service, would that decrease their overall health costs. Couple checkups per year vs emergency room procedures.
Yeah, I'm sure that factors into it some, but I don't think the math works out into a slam dunk the way you expect it to.
I'm a bit jaded on how health care and health insurance is run
Me too, brother. But government isn't the perfect fix that some people seem to think it is.
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Nope. If the state runs what is essentially an insurance provider of last resort they won't get a random selection of people needing health insurance. Anyone who expects to have low annual healthcare costs who can get coverage through their work will do that, because for those people having their employer cover the vast majority of your premium is typically way better than having a plan with lower deductibles. However, for those who expect their out of pocket to be very high - say those facing HIV treatment, ongoing cancer treatment, long-term care for a premature baby with serious birth defects, or in need of a transplant, etc. - such a person would be significantly incentivized to switch to the government offered plan. For your plan, the most an individual with no coverage by the government would have to pay is about $10,700 a year, right? If I have hemophilia and I can spend $10,700 to cover ten or twenty times that ... guess what I am going to cheerfully do? Free money, baby.
What I have seen and maybe it is just what I have experienced is that when individuals are having health situations like you have described, they aren't working anymore (many times because they can't) and are already on medicaid/medicare.
For some clarification, I am talking about people that can still work, or in Ben's situation where they were able to retire early but not eligible for Medicare. The really health compromised people are going to be on the government dole under the current system.
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What I have seen and maybe it is just what I have experienced is that when individuals are having health situations like you have described, they aren't working anymore (many times because they can't) and are already on medicaid/medicare.
For some clarification, I am talking about people that can still work, or in Ben's situation where they were able to retire early but not eligible for Medicare. The really health compromised people are going to be on the government dole under the current system.
Wherever you think the line needs to be drawn, the people who are going to jump ship to the state plan are going to be the ones for whom it makes financial sense to pay $10,700 a year out of pocket because they are currently paying more than that on their employer plan. Even if you think you can set aside the most extreme cases, you're still going to be collecting mostly the expensive people, not a random sample.
My health plan sucks and pays for almost nothing except for basic annual visits. My out of pocket maximum is $10,000 for my family, which is also my deductible and everything goes toward that deductible. But my employer also covers a significant portion of my premium and my family uses very little in the way of healthcare. Barring significant health issues I'm better served staying on my employer's plan despite your plan being way, way, way better.
So again, the state or feds acting as insurance of last resort means that they'll collect a disproportionate number of high cost subscribers. The only way that won't negatively impact your plan in either cost or reduced benefits is if the taxpayer has to subsidize it.
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My employer just started open enrollment for the upcoming year.
I need to check in and see what's changed.