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Old 07-12-2019, 06:14 PM   #61
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And btw when I had ACL surgery a few years ago I had the same surgeon that operates on the knees of the sports teams for the local major ACC university. So ACA does not (necessarily) imply Medicaid level medical care. Heck, I'm not sure Medcaid even implies that anymore from what I hear, but I have no experience with that.
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Old 07-12-2019, 06:45 PM   #62
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I am 59, retired at 53, and was paying a small fortune in Calif where I lived from 2014 to 2016. Too much income to qualify for ACA so I got the cheapest high deductible plan I could find. Still paid $750 a month for essentially diaster only insurance. First 6k was my responsibility. It went up 10-20% over that time too.

Solution: Left the USA. I moved to Vietnam and now have a worldwide plan with low deductible, good benefits like dental and eye care for $2000 a year. The coverage excludes the USA. Price would double if I included it. Medical care had been great so far - fractured ankle while hiking and a voluntary surgery. Both experiences went without a hitch and cost peanuts.

We are really getting screwed on medical costs in the USA!
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Old 07-12-2019, 06:46 PM   #63
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My question to those on ACA - are you happy with the choice of physicians/specialists?

When I looked at plans in our state that was the issue I saw. None of the doctors we have seen over the past decade accepted any of the plans.
Very happy. But that probably depends on the state and perhaps the county as well.

When we lived in MA, our plan covered both of our PCPs and all of our specialists.

Since we have moved to ME, our new plan required us to get new PCPs (no problem). But I was glad to see that I could retain my oncologist. I'm very pleased about that.
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Old 07-12-2019, 06:58 PM   #64
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And btw when I had ACL surgery a few years ago I had the same surgeon that operates on the knees of the sports teams for the local major ACC university. So ACA does not (necessarily) imply Medicaid level medical care. Heck, I'm not sure Medcaid even implies that anymore from what I hear, but I have no experience with that.

My guess is that the insurer has a set rate that they will pay for a specific service, doubt they care if it's a well known surgeon or some unknown, just as long as the surgeon is willing to accept the insurers negotiated rate.
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Old 07-12-2019, 07:23 PM   #65
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Iím 59. Iíve been retired for 9 years. I pay ~$1000 a month through my wifeís plan at Suntrust. Itís a high deductible plan that pays nothing for the first $1500 and 80% after that with a annual payout of $3000 as long as you stay in network. Otherwise itís $6000.
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Old 07-13-2019, 12:20 AM   #66
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I pay $672/month with a $275 deductible through my employer-provided retiree insurance (BCBS PPO). Iíve been paying that for 4 years (retired at 55), and in one more year (at age 60), said employer (school district) will pay the premium for five years until Iím 65 and eligible for Medicare. DH is 7 years my senior, worked for same employer, retired 2 years ago at 64... so his premiums were paid by the district for 1 year, until MC eligibility. Combined OOP expenses (after premiums) have been about $1500- 2500/year.
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Old 07-13-2019, 12:59 AM   #67
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There a popular Clint Eastwood film where he says something like "Do you feel lucky? ...well do ya?"

Meaning carry no insurance, essentially pocketing the insurance premium costs and rolling those dollars forward as part of your own self-insurance plan. Yes it is foolish, but given the high premiums and high deductibles before the first dollar of insurance coverage is paid out it is most tempting. Especially if you travel a lot making the coverage less valuable and the yearly reset arrives after fewer days pass while in your coverage area.

As a side comment, now I understand those news stories of people signing up for ACA and stop paying the premiums before the year ends...why bother if Christmas is near and the high deductible is likely out of reach for the calendar year.
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Old 07-13-2019, 05:06 AM   #68
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There a popular Clint Eastwood film where he says something like "Do you feel lucky? ...well do ya?"

Meaning carry no insurance, essentially pocketing the insurance premium costs and rolling those dollars forward as part of your own self-insurance plan. Yes it is foolish
Yes, it most certainly is.

Calling that a "self-insurance plan" is quite a stretch.
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Old 07-13-2019, 05:48 AM   #69
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Until I got on Medicare 2 years ago we were paying full freight of about ~$2.5K a month with a $3K deductible for BCBS.

Now it's the same plan but only for DW who pays $1200 a month; she has another 3 years before Medicare but that will be mitigated--and then some--by her SS which will start one year from this month.

What was interesting was that we originally were paying via her COBRA thinking we were getting a deal. Once COBRA expired we ended up paying about $20 a month more; her former company was apparently doing nothing as far as getting a deal.
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Old 07-13-2019, 06:10 AM   #70
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Having been self-employed for my career, shopping healthcare annually has unfortunately become part of my job description. Having raised 4 kids (last one just graduated and hope to have fully employed/insured soon!), I am expecting my healthcare analysis to get a little simpler. To me, its about making a business decision and evaluating the risks/rewards. Barring the major catastrophes (i.e cancer), I feel like I have enough experience where I can guesstimate my annual out of pocket costs for my different healthcare buckets (i.e. dental, prescription drugs, checkups) and then also plan for the annual unknown expense (i.e. tooth implant, knee surgery, physical therapy). DW and I are both 55 and in good overall health with are biggest issues being related to old sports injuries. I hit a wall almost 2 years ago when my ACA plan as it not only became ridiculously expensive (no subsidy due to income level), but had none of our desired doctors. I did my research and decided to try a health share ministry plan. So far, I couldn't be happier with the plan and have saved over $18K/yr in premiums alone! Additionally, I can go to any doctor/health facility I choose without needing a referral! I have had 2 "claims" so far (knee injections for an old ACL injury and a broken foot) that totaled approximately $12K - $15K in costs and I paid essentially zero out of pocket after reimbursements. I am fortunate that I have significant resources to cover out of pockets which weighs into my risk/reward analysis, but I also can look back and say I am over $18K ahead after 1 year on the plan.

As the rules and options continue to change, I will continue this strategy of doing an annual assessment as before in hopes this bridges the gap until 65. From what I have read, if the SHTF and I came down with a ridiculously expensive condition and my health share plan just didn't provide the expected coverage (no reason to believe that yet), I could bail and go back on ACA, even at the higher premiums as that might be the better business decision at that time.

No one size fits all, but that's my plan (and has been my plan for 31 years) and until I find a better mousetrap, will run accordingly.
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Old 07-13-2019, 06:20 AM   #71
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Understanding cost is important.

My question to those on ACA - are you happy with the choice of physicians/specialists?

When I looked at plans in our state that was the issue I saw. None of the doctors we have seen over the past decade accepted any of the plans.
We went on our first ACA plan this year. A bronze Hi/HSA plan with Florida Blue. Premiums for 2 about $420 pm, w/6500 each deductible. Yes, we had to change our docs, but had a wide range of choices. We chose a new PCP as part of a group associated with a university.

Dh met w/new PCP early in the year. She was more proactive than his old PCP and immediately zero'd in on a test that the old PCP had been going "eh, probably fine." Had him to some specialists. Turned it wasn't fine, but it was easily resolved. Had we continued going "eh" then in another year or two it would have been a much bigger issue.

Sometimes getting a new doc isn't a bad thing.
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Old 07-13-2019, 06:30 AM   #72
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What was interesting was that we originally were paying via her COBRA thinking we were getting a deal. Once COBRA expired we ended up paying about $20 a month more; her former company was apparently doing nothing as far as getting a deal.
Why did you think COBRA would be more than a $20 deal?

I've paid less on ACA plans than I did when I was an employee. COBRA (since you pay both sides plus an administrative fee) was more than twice that amount.
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Old 07-13-2019, 07:00 AM   #73
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I'm not much of a data point, but here's my plan. My mega-corp employer is self-insured, with claims handled by Aetna. They allow retirees to stay on the same plans available to active employees for their cost. The HDHP/HSA I'm on now as an active employee will be available to me for $8K per year as a single. I am planning on using that, as I won't qualify for ACA subsidies. The plan is 100% coverage with no network requirement, drugs, dental, vision with $2K annual deductible and a good zero expense HSA available.

I haven't done extensive research yet, but the little bit I have done leads me to believe it's a better than open-market deal for a plan that fits my needs.
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Old 07-13-2019, 07:09 AM   #74
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Please share. Anyone between retirement and age 65 your paid out of pocket HC experiences. I am not interested in the provided HC stories. Good for you. I am interested in learning who is doing what and how much it costs annually to cover you and you spouse. Sorry is this is redundant but I have searched back a ways and have not found this discussion. Thanks for any and all information shared.
I'm single, male, age 51. I use Golden Rule HSA Saver. Grandfathered under [mod edit ACA ]. $417 per month minus ~$100 tax rebate on the HSA part. Premiums tax deductible through my LLC so final cost is about $190 per month. Deductible is $5K. PPO. Nationwide coverage and no networks - skinny or otherwise. Unlimited lifetime max coverage. Includes prescriptions, too.

Out of pocket 2015 was 781.15, 2016 was 854.07, 2018 was 888.58, 2019 so far is 695.01. I have type 2 diabetes so it's gone up a little.

These OOP numbers include dental expenses which are not covered under medical insurance but the spreadsheet I use for budgeting doesn't separate medical vs dental and I'm too lazy to do it now. Probably subtract about $150 per year for the dental stuff.

I also use Christian Health Ministries Silver plan. It costs $101 per month. $1K unshared per incident. Incident max sharing is $525,000. Ministry plans pay bills exceeding the unshared amount but count discounts toward that amount so basically I owe nothing for any incident above $1,000. CHM is also federal tax deductible and in Missouri at the state level, too. So that's another $30-ish/month off.

Dental insurance is $22.98 per month, $1500 max benefit per year, 50 - 80% discounts on covered procedures. The name of the plan is AlwaysCare. It's a company in Louisiana. Don't remember the company name.
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Old 07-13-2019, 07:47 AM   #75
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There a popular Clint Eastwood film where he says something like "Do you feel lucky? ...well do ya?"

Meaning carry no insurance, essentially pocketing the insurance premium costs and rolling those dollars forward as part of your own self-insurance plan. Yes it is foolish, but given the high premiums and high deductibles before the first dollar of insurance coverage is paid out it is most tempting. Especially if you travel a lot making the coverage less valuable and the yearly reset arrives after fewer days pass while in your coverage area.

As a side comment, now I understand those news stories of people signing up for ACA and stop paying the premiums before the year ends...why bother if Christmas is near and the high deductible is likely out of reach for the calendar year.
What you could do is save like crazy into 401k/HSA/Roth, etc. Use CHM Gold plan at $162 per month to "share" most health expenses with your savings as a backup. Now you've self-insured the bits and pieces that the ministry plan won't share without paying out the a**. Ministry plans have no networks so no surprise bills.

Also, for any expense that is not share-able, CHM has the Prayer Page where members voluntarily chip in to pay your remaining bills. Every month, the 400,000 members collectively contribute millions of dollars to pay the remaining bills of other members. The amount wobbles over time but typically a contribution of $11 per month pays off any expenses that aren't shareable under the main CHM plans.
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Old 07-13-2019, 09:02 AM   #76
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What you could do is save like crazy into 401k/HSA/Roth, etc. Use CHM Gold plan at $162 per month to "share" most health expenses with your savings as a backup. Now you've self-insured the bits and pieces that the ministry plan won't share without paying out the a**. Ministry plans have no networks so no surprise bills.

Also, for any expense that is not share-able, CHM has the Prayer Page where members voluntarily chip in to pay your remaining bills. Every month, the 400,000 members collectively contribute millions of dollars to pay the remaining bills of other members. The amount wobbles over time but typically a contribution of $11 per month pays off any expenses that aren't shareable under the main CHM plans.
So basically a religious based Go Fund Me with your retirement savings as your backup. This is what you want for your healthcare? House of cards. You buy insurance for what you canít or do not want to pay for. You donít put the rest of your financial future on the line because of a medical issue.
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Old 07-13-2019, 10:07 AM   #77
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Retired ~6 yrs ago at 57, have UHC insurance thru previous employer at $827/month with a $2000 deductible.

My sweetie is still working and carries her own insurance thru her employer.

My insurance ain't cheap but it's still cheaper than getting it thru the ACA.

Medicare next May!!
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Old 07-13-2019, 10:43 AM   #78
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I did my research and decided to try a health share ministry plan. So far, I couldn't be happier with the plan and have saved over $18K/yr in premiums alone! Additionally, I can go to any doctor/health facility I choose without needing a referral! I have had 2 "claims" so far (knee injections for an old ACL injury and a broken foot) that totaled approximately $12K - $15K in costs and I paid essentially zero out of pocket after reimbursements. I am fortunate that I have significant resources to cover out of pockets which weighs into my risk/reward analysis, but I also can look back and say I am over $18K ahead after 1 year on the plan.
I am looking at them now...would you mind sharing (no pun intended ) which one you went with?
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Old 07-13-2019, 10:55 AM   #79
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I hit a wall almost 2 years ago when my ACA plan as it not only became ridiculously expensive (no subsidy due to income level), but had none of our desired doctors. I did my research and decided to try a health share ministry plan. So far, I couldn't be happier with the plan and have saved over $18K/yr in premiums alone!

I've been on ACA since day one but have researched the ministries a little. I hadn't heard many (if any) negative comments until recently. It seems that Liberty HealthShare may be in a bit of a financial pinch from what I've read, last year they increased premiums by 50%, doubled the deductible, and many more complaints about very slow or no reimbursements.
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Old 07-13-2019, 10:58 AM   #80
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Wish we could use the ACA for coverage.

Based on our location, income, and family size we could pay as little as $100/month, $2600 max out of pocket for a silver-level plan (using the KFF calculator)

But we get health insurance through spouse's plan...~$900/month employee share, $13,500 max out of pocket...for a HDHP.
Are you saying you would rather have taxpayers cover your insurance cost versus your wife's employer?

There sure are a lot of rich people on this site who see nothing wrong with the rest of us supporting your medical costs (beyond Medicare which we all have been paying into for decades).

Marc
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