Surviving Fear and Obamacare

FrugalFannie

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I thought I would start a thread on this topic because ever since the ACA went into effect we have seen our "employer sponsored" health care plan rates easily quadruple. We also don't "qualify" for a subsidized plan (not that we want one) and the "free market" individual plans are also astronomical in cost.

So since the ACA we have not had health insurance. Mostly we are healthy individuals. I see a chiropractor regularly and pay out of pocket. I actually used to pay about $3 more than the insurance companies would reimburse and he never had to pay anyone to process anything for me. Then we "qualified" for a discount went my son had to go a couple of times and he dropped the rate $5 (to $30 per visit). Since all the plans we had seen since the ACA went into effect limited visits to 12 per year (with a $20-$25 copay for those 12) we easily "made out" by paying out of pocket. I actually calculated at one point that I could see the doc 6 days per week and still wouldn't cost me as much as our premiums did.

People tell us we have just been lucky that nothing has happened and eventually we will need insurance. Well, that's what they do. They poach on your fear. Everyone knows SOMEONE who has had a devastating illness in their family and IF IT WASN'T FOR INSURANCE they would be in ruin today!

But it's not like we haven't had things happen. Our son has been in 2 car accidents. And 1 of those we didn't have car insurance either. Were we lucky with those? yep. the second accident he did get hurt a bit and our auto insurance took care of doctors visits for that.

He has been sick. You know colds, ear infections, etc. And most recently some "as yet undiagnosed rash." Well, let's say that we have learned not to run to the doctor every time his throat is sore or he has a temperature. We actually did visit an ER a few years back for a temp of 103 but the doc assured us that since he was acting fine mentally there was no need to worry (and in fact his temp dropped as we were there after staying up at 103 for 18 hours).

So at least now I don't freak out when his temp gets really high which it did just about 10 days ago. He had a series of what we thought were bites. Let's say that the place we were staying temporarily in Dallas was not in the best of condition so we speculated that it could be bed bugs, mites, fleas, etc. After doing what the inter webs told us to do in these cases (several times) there seemed to be no resolving the issue. During this time we had also just moved into our rental house and the problem persisted even though he was using bedding not associated with the old place (we had left a bunch of stuff there because of this issue in hopes it would help us get rid of any bugs). So we called Terminix. They came out and assured us there were no bugs of any kind and the guy actually looked at the "bites" and said they looked like nothing he had ever seen. So we decided to go to the doctor with no insurance, in a town we had only been in for 4 days. So I "googled." I came across a place that doesn't take insurance and every patient sees a doctor. Ok. Figured this will be expensive. So I called to see about an appointment - no appointment necessary, first come, first served and open until 7PM week nights. Nice. Then I asked "how much for a visit, generally?" $45-$75. Sweet! (but yes, I was afraid of tests and prescription costs)

So we go to the doc. She's confused. They have been seeing an atypical chicken pox recently in vaccinated people or those who have already had the pox. This is actually a vaccine my son did have before we decided to stop vaccinating. So she thought it could be that but he also had a headache (which he failed to tell me) a runny nose (which I knew) and a sore throat (typical when he gets a runny nose) and a temp of 103 degrees (which I should have checked as he was very cold in the house and had been wearing a jacket earlier that day). And these symptoms are not typical for the pox. But she felt there may be more than 1 thing going on, ordered a CBC ($20) and gave us 2 prescriptions. She also gave us a "discount card." It's really a website thing where you go to check out who has the lowest prices on your prescriptions if you have to pay cash. the website is www.goodrx.com. We did have to stop at 2 pharmacies to fill both but I ended up paying just over $50 for both prescriptions instead of nearly $300 if I hadn't used the site (and they have an app). So well worth the trouble in my mind. Total cost to visit her was $65. $45 for a pediatric visit (my son is under 18). $75 for an adult visit. Payment at time of services.

2 days later his throat was worse. I called back. They saw him no charge because it was a symptom he had come in with the first time! When was the last time you got a free doctor visit? 2 more prescriptions as things were not getting better. $28 that time and we only went to the pharmacy next door. The pharmacy had been closed the first time as they close at 6pm every night so we couldn't get his first prescriptions filled there.

So you may be asking "why don't you have health insurance?" Well, I will admit that part of it is that I don't like being told what to do. But really, it's because insurance is SO DAMN EXPENSIVE!

My husband just got a great job. Best he has ever had and pays much better than any he has ever had and still the premiums for health insurance are astronomical. He actually works for a technical staffing company and therefore has to pay the full premium (I think as I looked at the cost). It would cost us more than $14,000 per year!!! Something like $278 per week! Who the hell can afford that??? And let's not forget the deductibles and out of pocket costs which are $6000 and $6000 per year and then they pay 80% after that. So we are not insuring. The premiums alone easily exceeds 8% of his/our income. What does that matter? Well, that means we will not have to pay the penalty for not having it. Each year since the ACA went into effect we have qualified in one way or another to not be subject to the penalty. The 8% test is by far the easiest one to figure out but there are other exemptions as well.

So put your fear away that you or a loved one will end up in a catastrophic medical situation and make the best decision for your family. And find doctors who will cut their fees or charge you only what they would be reimbursed by the insurers. And use that website www.goodrx.com I told you about.
 
The problem with your strategy is that a bad accident or illness will sink you.

The best way to protect your family is to work for a company that has really good health insurance.

I was self employed for 13 years, and my monthly premiums went from less than $300 per month, to over $2000 per month.

I went back to work in higher education, and they provide a really good health package.

Don't just shop for the job, shop for the entire benefits package.
 
The problem with your strategy is that a bad accident or illness will sink you.

The best way to protect your family is to work for a company that has really good health insurance.

I was self employed for 13 years, and my monthly premiums went from less than $300 per month, to over $2000 per month.

I went back to work in higher education, and they provide a really good health package.

Don't just shop for the job, shop for the entire benefits package.

Under Obamacare, he should be paying a penalty for having no insurance, right? And you can sign up if you get really sick, thanks to no pre existing conditions. But I think he'd have to wait for the signup period, not sure.
 
It's a family deductible.

And sure, having a job with good benefits would be ideal but that's not what he has.




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The problem with your strategy is that a bad accident or illness will sink you.

There's that fear popping up. Why assume that we will have a bad accident or illness? And yes, I have seen much of that in my family and my eyes are wide open.
 
Under Obamacare, he should be paying a penalty for having no insurance, right? And you can sign up if you get really sick, thanks to no pre existing conditions. But I think he'd have to wait for the signup period, not sure.

There are many exemptions to the penalty.

See this set of instructions http://www.irs.gov/pub/irs-pdf/i8965.pdf

Also, I would recommend people read the IRS website in regards to it. But no, we have never paid a penalty and we have been uninsured since May 2013. No penalty for 2013 and none for 2014.
 
I'm ****ed....Here's my situation

After ACA went into affect my employer got rid of the regular no-deductible HMO that we always had for approx $120 a month. They replaced it with a high deductible plan for the same $120 a month, $2000 annual deductible and $5K annual out of pocket max. YOU pay 30% of every bill after your deductible is met up to the annual OOP max. This is for me, alone on individual plan.

My wife is self employed and so she has to buy her own plan on the open market. For her alone it was $350 a month for $500 annual deductible plan. We had a baby in May. With the baby added to her plan it's $550 a month.

I can't afford to go to the doctor if I get sick even though the democrats see me as "rich" or at least rich enough to not qualify for any subsidies while paying for everyone else's free shit.

If things get much worse (they are and will) I don't know what the **** we'll do. My company is HQ'd in Minnesota and I just read the Blue Cross Blue Sickle MN is asking for approval for a 52% rate hike next year.

Quitting and just going on welfare is looking more and more attractive. Why the **** should I keep working so hard, so many hours to buy other people what I can't even afford for myself? Ugh.
 
I'm ****ed....Here's my situation

After ACA went into affect my employer got rid of the regular no-deductible HMO that we always had for approx $120 a month. They replaced it with a high deductible plan for the same $120 a month, $2000 annual deductible and $5K annual out of pocket max. YOU pay 30% of every bill after your deductible is met up to the annual OOP max. This is for me, alone on individual plan.

My wife is self employed and so she has to buy her own plan on the open market. For her alone it was $350 a month for $500 annual deductible plan. We had a baby in May. With the baby added to her plan it's $550 a month.

I can't afford to go to the doctor if I get sick even though the democrats see me as "rich" or at least rich enough to not qualify for any subsidies while paying for everyone else's free shit.

If things get much worse (they are and will) I don't know what the **** we'll do. My company is HQ'd in Minnesota and I just read the Blue Cross Blue Sickle MN is asking for approval for a 52% rate hike next year.

Quitting and just going on welfare is looking more and more attractive. Why the **** should I keep working so hard, so many hours to buy other people what I can't even afford for myself? Ugh.

You can't add your wife and baby to your plan? Having a baby is a qualifying event which allow you to change your plan within a window of the event happening. I usually see this as being 30 days. You should check. Also, you should check to see if you can be added into her plan. That way you guys have 1 set of family deductibles as they usually cap out at 2 -2.5x an individual deductible. So if an individual deductible is $3000 per person, a family plan is usually capped at $3000 per person and $6000 per family. With 2 separate plans you could end up with $9000 OOP.
 
PP, Your strategy will work for a while but sooner or later you could regret the massive risk you're taking. One car accident, even a highly curable cancer or other expensive sickness could completely bankrupt you over night. It's not fear-mongering, it's reality.

Cheap docs treating the sniffles is one thing. Good luck finding a radiation oncologist (hope you never need one) or a surgeon to screw a bone back together (again, hope you don't need one) who will treat you for $70 bucks.

You're "smart" decision today could be one of the most reckless you've ever made in the future.

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You can't add your wife and baby to your plan? Having a baby is a qualifying event which allow you to change your plan within a window of the event happening. I usually see this as being 30 days. You should check. Also, you should check to see if you can be added into her plan. That way you guys have 1 set of family deductibles as they usually cap out at 2 -2.5x an individual deductible. So if an individual deductible is $3000 per person, a family plan is usually capped at $3000 per person and $6000 per family. With 2 separate plans you could end up with $9000 OOP.
I can but the premium TRIPLES (not doubles like you'd think), the deductible goes from 2k to like 4500 and the OOP goes to like 7K. Add the baby and it's like 800 a month with even higher deductibles and OOP.

I can be added to her plan but it would be very expensive. I have to wait until their open enrollment to even find out the cost. She bought her unsubsidized plan through the MA Health Connector at full cost so now everything has to go through them. It took over 2 full month to get them to add the baby to her plan. She called 5 times a week for 8 weeks. They kept having a "technical issue" that wouldn't let her application go through....they make you apply for a subsidized plan even though you know you don't qualify. Only after your application is predictably denied can you get the full price options. I had to call and scream at a lady. Week after week..technical issue. I called the governer's office and it was magically fixed 3 days later.
 
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PP, Your strategy will work for a while but sooner or later you could regret the massive risk you're taking. One car accident, even a highly curable cancer or other expensive sickness could completely bankrupt you over night. It's not fear-mongering, it's reality.

Cheap docs treating the sniffles is one thing. Good luck finding a radiation oncologist (hope you never need one) or a surgeon to screw a bone back together (again, hope you don't need one) who will treat you for $70 bucks.

You're "smart" decision today could be one of the most reckless you've ever made in the future.

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I can but the premium TRIPLES (not doubles like you'd think), the deductible goes from 2k to like 4500 and the OOP goes to like 7K. Add the baby and it's like 800 a month with even higher deductibles and OOP.


It's really not a "decision." It's that we cannot afford more than $1000 per month for insurance. Plain and simple. If his contract position turns into an employee position health insurance will be about $350 per month. Much more affordable. But until that happens, we can't afford it.

Your insurance rates are insane! Are you saying that your insurance would go to $1500/month? It looks like separate plans may very well be the best way for you to go. Nuts.
 
My premiums keep going up and up. I was paying right at $800/mo for the wife and I at my last job. (Had to take the "family" plan because they didn't have a single +1 plan. I hate subsidizing people with kids, but that's a whole different story.) It's more like $700/mo at my current place, but the employer covers more of the insurance, so the reality is that it's even more expensive now. We got a break this year with "only" a 4% premium increase, but I don't expect to get lucky next year.
 
Consider an HSA plan, lower premiums, high deductibles, but you keep what you don't use, and your contributions are tax deductible. Probably favors high incomes though. In America it pays to be rich, or a deadbeat, but most of us are in between.
 
Consider an HSA plan, lower premiums, high deductibles, but you keep what you don't use, and your contributions are tax deductible. Probably favors high incomes though. In America it pays to be rich, or a deadbeat, but most of us are in between.

HSA plans are for those with high deductible plans. not sure what was available through his employer actually qualifies us for the HSA. Plus, that means we would nee to participate in the insurance plan at $14K per year and then put money into an HSA?
 
Consider an HSA plan, lower premiums, high deductibles, but you keep what you don't use, and your contributions are tax deductible. Probably favors high incomes though. In America it pays to be rich, or a deadbeat, but most of us are in between.
I had to go with an HSA plan this year. The regular plan with the $1000 or so deductible had its price increased so much, it was clear they were trying to push everyone to the HSA. The HSA costs the same out of each paycheck as before, but the deductible is 7 or 8 thousand (forget which). It kinda sucks but not much I can do until they make this plan too much to afford, in which case I will also join the ranks of the uninsured.

Medical tourism may help some for high cost conditions. I accidentally drank the water in the Philippines earlier this year and had to spend 2 days in the hospital. The whole ordeal turned out to only cost $100...


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I was diagnosed with cancer at 25. Even though it was (is) a highly treatable form with a very long term survival rate, I've had to have three surgeries and still do yearly screening to make sure what metastatic disease that is left is in check and nothing new crops up. So unless I'm destitute, I don't think NOT having insurance is going to be an option for me. My wife works for a company with very, very good benefits - my main concern is how badly we're going to get screwed when the "Cadillac" tax goes into effect, assuming she's still with the same company.
 
There's that fear popping up. Why assume that we will have a bad accident or illness? And yes, I have seen much of that in my family and my eyes are wide open.

Because sooner or later you will.

Add in a factor of 10X if you have kids.

If you own property, then the huge bills that were not covered by insurance will be covered by liens on your house and/or your wages.
 
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It's really not a "decision." It's that we cannot afford more than $1000 per month for insurance. Plain and simple. If his contract position turns into an employee position health insurance will be about $350 per month. Much more affordable. But until that happens, we can't afford it.

Your insurance rates are insane! Are you saying that your insurance would go to $1500/month? It looks like separate plans may very well be the best way for you to go. Nuts.

If I sing on to her plan we're probably looking at 1K a month or so wiht very small deductibles. IF she and the baby went on my plan we'd probably be looking at up to $800 a month but the deductibles and OOP would be like $8K and $12K respectively.

Regardless the monthly is way too expensive either way. I can't really afford either option but I'm still in "we can find a way" territory.
 
Well, we've been "touched" by Obama care, as well. I won't go into detail because it's useless and you all understand the way things go.

I just keep on wondering how did the American people let this pass ? We have been betrayed and sold out, we are now paying 100's of $$ each month more, which are not spent for our own benefit.

Well, I know the answer, the elected class basically sold us, completely. I can't really see anyone other citizen as more than a clown if he votes for anyone that does not post repealing Obama care as one of his top 5 items.

Obviously, making less money in order to pay less and get on the .gov dolly is not a solution, when you do that - you agree to participate and be a test mouse lab for all the medication they'll shove down your throat (and your kids'), I don't really need to look it up, I'm pretty sure once you're on the .gov plans - you have to adhere to some items that "science approved", otherwise - you will be kicked off the plan.
And, the above "demands" will only increase with time.

so - no way that's going to come through as long as I can help it.
 
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Obamacare is a tax, plain and simple.

The people who can pay this tax subsidize those who can can't pay.

The government has shifted the responsibility to the taxpayers.

How do you think all of the needy people will get insurance?

Why there is no rioting in the streets is beyond me.
 
Obamacare is a tax, plain and simple.

The people who can pay this tax subsidize those who can can't pay.

The government has shifted the responsibility to the taxpayers.

How do you think all of the needy people will get insurance?

Why there is no rioting in the streets is beyond me.

It's not just "needy" who can't afford these insurance premiums. I would definitely NOT consider us "needy." But the health insurance options we have available to us are unaffordable.


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Obamacare is a tax, plain and simple.

The people who can pay this tax subsidize those who can can't pay.

The government has shifted the responsibility to the taxpayers.

How do you think all of the needy people will get insurance?

Why there is no rioting in the streets is beyond me.

Someone has to work to provinde for those who won't.
 
Obamacare is a tax, plain and simple.

The people who can pay this tax subsidize those who can can't pay.

The government has shifted the responsibility to the taxpayers.

How do you think all of the needy people will get insurance?

Why there is no rioting in the streets is beyond me.

It's also about rewarding insurance companies - they were big supporters of Obamacare, I wonder why.
 
It's not just "needy" who can't afford these insurance premiums. I would definitely NOT consider us "needy." But the health insurance options we have available to us are unaffordable.


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But, if you like your plan, you can keep it!

It's also about rewarding insurance companies - they were big supporters of Obamacare, I wonder why.

Because it forced consumers to buy their product, it vastly expanded the market for their product, it removed what could have been competition for them to sell their product, and it allowed them to re-write their product at a higher cost with fewer services, with a convenient excuse that it was the ACA that did it.

My repeal and replace would allow the insurers to sell their product over state lines. It is the second highest cost for my company after payroll, and it is actually more than the 3rd, 4th and 5th largest expenses COMBINED.
 
ACA is intended to fail. The Roberts rewrites are only stalling the inevitable until the dems are out of office so they can blame the opposition. The next step is for the statists to claim the only solution is UK style government run healthcare.
 
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