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Old 10-15-2016, 08:29 AM   #41
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Nope! You also gain access to the discounted "in-network" provider rates via the insurer--
My thoughts (and experience) exactly. Recently, a family member, who hadn't had any serious (or even minor) medical problem in over 25 years, had a sudden two week hospital stay. The total bills added up to over 200k. The insurance paid about 1/3 of that, which was their negotiated rates, and the family paid 3k which was their max annual coinsurance rate. To me medical insurance is a major discount card, which you pay for and hope to never need.

It made me wonder why everyone was jumping all over the makers of EpiPens recently for their "pricing models" when the medical industry as a whole has been doing this for as long as I can remember. Somebody didn't get their cut!
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Old 10-15-2016, 08:35 AM   #42
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Originally Posted by Car-Guy View Post
My thoughts (and experience) exactly. Recently, a family member, who hadn't had any serious (or even minor) medical problem in over 25 years, had a sudden two week hospital stay. The total bills added up to over 200k. The insurance paid about 1/3 of that, which was their negotiated rates, and the family paid 3k which was their max annual coinsurance rate. To me medical insurance is a major discount card, which you pay for and hope to never need.
I think the govt is having a hard time getting that message out to the young people who need to hear it. They think they are healthy so it doesn't matter.

Yet... A badly twisted and broken ankle that requires:
- X-rays
- MRI
- Surgery with hardware
- Surgery to take out the hardware later

Can easily cost 20k to 30k (face value).

It is way too easy to blow through 10k in costs, and pretty darn easy to bump that to 30k. The negotiated rates are really important in this case to bring it down to something more reasonable, even with a very high deductible.
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Old 10-15-2016, 08:55 AM   #43
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Would anyone roll the dice and not get health insurance under these circumstances?
I will probably be in your same situation in the future with rental income and/or consulting income exceeding the ACA numbers.

I would not semi-ER or ER without medical insurance as it'll be too easy to delay some things which may increase risk to myself or family. I would bite the bullet and factor that as required expense in my barebone budget.
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Old 10-15-2016, 09:14 AM   #44
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Originally Posted by Car-Guy View Post
My thoughts (and experience) exactly. Recently, a family member, who hadn't had any serious (or even minor) medical problem in over 25 years, had a sudden two week hospital stay. The total bills added up to over 200k. The insurance paid about 1/3 of that, which was their negotiated rates, and the family paid 3k which was their max annual coinsurance rate. To me medical insurance is a major discount card, which you pay for and hope to never need.

It made me wonder why everyone was jumping all over the makers of EpiPens recently for their "pricing models" when the medical industry as a whole has been doing this for as long as I can remember. Somebody didn't get their cut!
BBM

I agree drug companies have been doing this for years. I think the reason for the EpiPen outrage is because most patients that need them are children. When a product is used for children many people are outraged due to emotion. The sad thing is older sick people have been dealing with reduced drug coverage and outrageous costs for years but the outrage is ignored in the media.
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Old 10-15-2016, 09:22 AM   #45
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Even if you were in your 20s, going without is a very bad idea.
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Old 10-15-2016, 11:56 AM   #46
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+1 I insist that DD and DS carry health insurance... it is really financial protection for me as well as for them. No parent wants to get a call that their child just had a minor health event and is $50k in debt (or worse) because they failed to carry health insurance.
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Old 10-15-2016, 12:42 PM   #47
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+1 I insist that DD and DS carry health insurance... it is really financial protection for me as well as for them. No parent wants to get a call that their child just had a minor health event and is $50k in debt (or worse) because they failed to carry health insurance.
And if they refuse for "whatever reason"?
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Old 10-15-2016, 12:54 PM   #48
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No. No no no no no.

I was in a bike crash several years ago, and the bill for my treatment and rehab amounted to over $250K. I had insurance at the time and I only paid about $8K out of pocket.

If I had to go without health insurance, I'd stay home wrapped in bubble wrap.
+1
A guy who started Megacorp in '84 with me went without insurance for 90 days. During that time he laid a bike down at high speed. Yeah stupid move but hey I don't need insurance.
Days/weeks in the burn unit and a lengthy rehab was something like $35k back then. Today?
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Old 10-15-2016, 01:18 PM   #49
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Bankruptcy is just the ticket for young un-insured folks without assets who incur a huge medical bill. Add in credit card debt and presto, debt goes away, and spend the next 10 years rebuilding financial stability, the hard way.

Medical bills are supposedly the #1 reason for personal BK , not just among the young. My late uncle and his wife ended up in BK over long term care. They were very financially set, but had no long term care insurance. ( never imagined the cost of nursing home care, or how long he would end up living in same )
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Old 10-15-2016, 01:35 PM   #50
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No health insurance? NO WAY!
I was 52 and perfectly healthy until I wasn't. Diagnosed with cancer.
35 Radiation treatments @ $6,000 each
Other tests and many MRI's CT scans about $60,000
Followups to this day. Over $300,000.
Without insurance I would have been destitute, with insurance it cost me about $500.
There was no warning, routine yearly physical. Oh you have cancer. From healthy to not in less than an hour, go figure.
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Old 10-15-2016, 01:52 PM   #51
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Playing financial Russian Roulette. Is this the year the cancer cells awaken or you fall off the ladder cleaning out the gutters or you get hit by a bus or, or...
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Old 10-15-2016, 02:17 PM   #52
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Update: I just received an email from our state insurance commissioner with rates for 2017. It looks like the rate increase we will be paying is 128% for a HDHP, more than double. We'll pay $1,555 per month from $682 this year. If I understand the subsidy calculations correctly, we will try to qualify for the subsidy. If not, it's back to work we go.


You might want to take look at how much subsidy you would get... if you are just below the MAGI, it might not be as much as you think...
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Old 10-15-2016, 02:19 PM   #53
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And if they refuse for "whatever reason"?
Then I would probably pay for it... but don't tell them that.
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Old 10-15-2016, 02:20 PM   #54
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My thoughts (and experience) exactly. Recently, a family member, who hadn't had any serious (or even minor) medical problem in over 25 years, had a sudden two week hospital stay. The total bills added up to over 200k. The insurance paid about 1/3 of that, which was their negotiated rates, and the family paid 3k which was their max annual coinsurance rate. To me medical insurance is a major discount card, which you pay for and hope to never need.

It made me wonder why everyone was jumping all over the makers of EpiPens recently for their "pricing models" when the medical industry as a whole has been doing this for as long as I can remember. Somebody didn't get their cut!

The new law and plans are designed to show the EpiPen issue... IOW, if you have insurance and it only cost $25 you really do not care what the retail price is... but, if you have to shell out $600... then pricing quickly becomes an issue...

My plan pays nothing for medication until I hit max deduction which is I think $6600.... so I would be complaining with that cost...
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Old 10-15-2016, 02:57 PM   #55
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Update: I just received an email from our state insurance commissioner with rates for 2017. It looks like the rate increase we will be paying is 128% for a HDHP, more than double. We'll pay $1,555 per month from $682 this year. If I understand the subsidy calculations correctly, we will try to qualify for the subsidy. If not, it's back to work we go.
Wow we stayed with a BCBS PPO grandfathered plan $1065 a month for both of us for 2016. I am on Medicare now Ms G is in the last age group before Medicare with $5000 deductible $554 a month.
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Old 10-15-2016, 05:00 PM   #56
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Option #1: 100% chance of financial ruin by paying exorbitant health insurance premiums

Option #2: 1% chance of financial ruin by experiencing a major medical event without health insurance

What is the more attractive option?

(OK, Iím being a tad facetious. )
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Old 10-15-2016, 06:09 PM   #57
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You missed #3, 100% chance of an affordable premium by keeping your income low enough to get generous subsidies. And which may be more important in these days of insane 50%+ rate increases.
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Would you risk no insurance and ACA Penalty?
Old 10-15-2016, 06:22 PM   #58
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Would you risk no insurance and ACA Penalty?

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No way. The financial risk is far too great. Not having health insurance was one of the few things that kept me up at night. Costly premiums irritate me but I sleep so much better.
+100000

I never want to be in a situation where I need medical care and can't afford it. Oh my goodness, I can't even imagine anything else with a higher priority than that.

OK, maybe saving a loved one's life; maybe World Peace (thinking of Sandra Bullock in the movie "Miss Congeniality"). Health insurance is a must, for me.
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Old 10-15-2016, 09:04 PM   #59
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Nope. I'm amazingly healthy but all it takes is a bozo who runs into me when I'm out on my bike and I'd be in deep doo-doo without insurance. (Yeah, Bozo MIGHT have liability insurance but the minimum limits most people carry is around $25K per person/$50K per accident so that might get me through the first day in the hospital.) And I have plenty of assets that creditors could get their claws into. I'm fortunate- when I ER'd, DH was old enough for Medicare, so only one of us needs private coverage.
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Old 10-15-2016, 09:11 PM   #60
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Option #1: 100% chance of financial ruin by paying exorbitant health insurance premiums

Option #2: 1% chance of financial ruin by experiencing a major medical event without health insurance

What is the more attractive option?

(OK, Iím being a tad facetious. )
The OP has so much income there is no way to get a subsidy. Most likely has the income to cover the expense easier than those with a subsidy So facetious option 1 likely is really false. Buck up an pay it... or take the risk. If the OP can take advantage of a catastrophic plan ... then maybe the best of both worlds
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