nakedfrog
No Lifer
- Apr 3, 2001
- 58,537
- 12,843
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But we get to choose which shitty health plan we want, and we get to choose our doctor! Kinda, sorta, maybe. And we don't have long waits for care... well, except we have that too.
But we get to choose which shitty health plan we want, and we get to choose our doctor! Kinda, sorta, maybe. And we don't have long waits for care... well, except we have that too.
Oh yeah, forgot about that. editing my post.the big missing piece to all this is monthly premium
Well, generally at least some of that is shouldered by the employer, would we be providing what we're actually paying ourselves, or the actual total premium?the big missing piece to all this is monthly premium
Just imagine if you could cut out the expenses for insurance companies and actually do health care.But we get to choose which shitty health plan we want, and we get to choose our doctor! Kinda, sorta, maybe. And we don't have long waits for care... well, except we have that too.
It was fascinating how much my prior insurance company was willing to pay in order to be able to deny me care. I had a regularly scheduled procedure, explicitly covered in my plan documentation, and their business processes were set up such that it was ALWAYS declined the first time it was submitted. They literally paid someone to watch my account for these, and that person then resubmitted them, upon which they would be approved. I mean, obviously I had to have back and forth with them to get this going, and after a few months of it I told my rep "this is, for lack of a better word, stupid. Isn't there some way better way to do this?" and was informed this is simply how the process works. But naturally not everyone is going to be willing to wade through the bullshit to get this accomplished, so they win out profit-wise there.Just imagine if you could cut out the expenses for insurance companies and actually do health care.
I heard an interview with the CEO of Novo, and he said that American system was absolutely worst in term of pricing your products, because it is neither a free market or a government body. Those who skimmed the milk was the middlemen in this very complicated insurance system.It was fascinating how much my prior insurance company was willing to pay in order to be able to deny me care. I had a regularly scheduled procedure, explicitly covered in my plan documentation, and their business processes were set up such that it was ALWAYS declined the first time it was submitted. They literally paid someone to watch my account for these, and that person then resubmitted them, upon which they would be approved. I mean, obviously I had to have back and forth with them to get this going, and after a few months of it I told my rep "this is, for lack of a better word, stupid. Isn't there some way better way to do this?" and was informed this is simply how the process works. But naturally not everyone is going to be willing to wade through the bullshit to get this accomplished, so they win out profit-wise there.
It's so fucking irritating 😣
Supposedly bureaucracy accounts for 30% of the healthcare bill, between providers, insurance, and all those middle men.Just imagine if you could cut out the expenses for insurance companies and actually do health care.
IMHO, total premium is the only legit way to compare plans.Well, generally at least some of that is shouldered by the employer, would we be providing what we're actually paying ourselves, or the actual total premium?
To add, since people were interested in premiums and how that plays in to overall costs:I cover my spouse and myself through one my employer's options. Deductible is $3k, OOP max is $8k; they also throw $500/year into an HSA for us and we also contribute to it. Our yearly healthcare expenses are low: 1-2 maintenance meds filled via the plan's online pharmacy (which thanks to some IRS rules, allows pre-deductible cost sharing) and maybe 1-2 office visits/year outside of annual physicals, which are covered pre-deductible.
The other options we had available to us:
- Move to a higher tier plan with more upfront cost-sharing: the additional premiums and loss of the HSA meant we would be spending more than we'd be getting in benefits
- Have my spouse take her insurance through her medical school instead: the premium for that was absurd; it had tons of cost sharing upfront, but in aggregate, the cost was way more than the option we ended up selecting
Total premium is just over $15.5K/year.Deductible is $3,000 for self plus one plan but there is an employer premium pass through to an HSA that knocks the effective deductible down to $1,200. Out of pocket max is $10,000. We blow through the deductible every year thanks to corrupt U.S. patent laws.
$14,385 total premium for the year (employee + children)I have a $6k family deductible and $13.8k family out of pocket limit
Saw a specialist today, was referral was made exactly 2 months ago. Quick health care is just another All American Red White & Blue republican Lie.But we get to choose which shitty health plan we want, and we get to choose our doctor! Kinda, sorta, maybe. And we don't have long waits for care... well, except we have that too.
But that will cause a serious downturn in private jet and mega yacht sales to insurance company CEOs.Just imagine if you could cut out the expenses for insurance companies and actually do health care.
i have anthem.We just got a letter from United Healthcare, the health insurance that our family has had since January 1, when they switched over from Anthem. The letter said something about annual maximum in network deductible, so I went online to find some examples of that, to understand it better. I found this example:
Deductible vs out-of-pocket-max example
Let’s say you have a health insurance plan with a deductible of $1,000 and an out-of-pocket maximum of $4,300.
So I looked down at our insurance, and I see that we have a family annual in network family deductible of $5,000. It also shows that we have a Maximum in network Out of Pocket Maximum of $6,850.
The letter also showed that as of March 31, we are about $4,000 of the way towards meeting the $5k annual deductible, and $6,850 out of pocket annual maximum.
WOW!!! These numbers are definitely higher than they were last year under Anthem, and they have really jumped up a LOT over the past 8 or 9 years. It was about 9 years ago when my wife's workplace took away the choice of
traditional health insurance, where you would just have insurance, and you would pay a copay, something like 10% each time you went in for medical treatment. They switched over to high deductible, which the first year had something like
$3,000 that we had to pay up front, maximum. It has grown every year.
Anyway, I found myself thinking how unlikely the example is, but then realized that I have absolutely no idea what typical numbers are for a family. Is the $1,000 annual deductible and $4,300 annual out of pocket max example
pretty common for a family, or is out situation more common?
All I know for sure is that we used to be able to put money into our IRA, but now that we pay the first $5K or more of health care costs out of pocket each year, we don't have much left to sock away for retirement. Not sure what folks are going to do if it keeps going this direction. Let's say, in 15 years - how will the typical family deal with having to pay the first $15,000 of heatl care costs up front out of pocket each year???
I actually do put money into an HSA each year, but I leave it in there for health care costs in retirement, rather than dip into it now. That makes it kind of like an IRA. It makes things a bit harder financially for the first half of the year or so, until we hit our maximum out of pocket each year. However, putting the money into the HSA gives us a deduction on our taxes, so it is worth it. Eventually, I should find an HSA that lets us put the $ into index funds.I have a $6k family deductible and $13.8k family out of pocket limit
If you have an HDHP you could be putting money into an HSA.
Not hard to find cheap or free HSAs that let you invest in cheap index funds. It seems that most HSAs have this option nowadays.I actually do put money into an HSA each year, but I leave it in there for health care costs in retirement, rather than dip into it now. That makes it kind of like an IRA. It makes things a bit harder financially for the first half of the year or so, until we hit our maximum out of pocket each year. However, putting the money into the HSA gives us a deduction on our taxes, so it is worth it. Eventually, I should find an HSA that lets us put the $ into index funds.