Am I the only one having to work until 65 just for healthcare?

[ShokWaveRider]

If the pre-existing condition protection is the "candy" we all want to have, then the individual mandate is the "spinach" many people don't want to have. The latter is the price for the former.

Some folks do not like Spinach, or Broccoli for that matter. As a result they suffer from Iron deficiency and have to take supplements….

Seriously though, folks were not told that about the mandate, only that it would save them money if they did not want to have any insurance at all. I cannot understand why having no HI is so acceptable. OK they say they are healthy and do not need it...…., until they fall off their motorbike and get are $500,000 hospital bill and a financially ruined. (I know of someone that this actually happened to).

 

[VanWinkle]

If the pre-existing condition protection is the "candy" we all want to have, then the individual mandate is the "spinach" many people don't want to have. The latter is the price for the former.

I would be shocked if the pre-existing condition protection goes away. It was actually guaranteed before the ACA law through federal and state protections- as long as you kept your insurance in force without interruption. Now if you want to jump in and out of Insurance, you are asking for problems.

 

[Fedup]

I would be shocked if the pre-existing condition protection goes away. It was actually guaranteed before the ACA law through federal and state protections- as long as you kept your insurance in force without interruption. Now if you want to jump in and out of Insurance, you are asking for problems.

Is this true? If you were covered by your employer, then got laid off, you have to go in individual market, are you still cover? It must be with the same health insurance company right? But not with a different provider right.

 

[pb4uski]

... BTW, I DO realize this is "the price of freedom" and have budgeted accordingly for it - but it still tweaks me off no end that I have to shovel out roughly $75 - $100K over the next 5 years till DW gets to Medicare and another $50K+ for the 5 years after that until I do. That's significant and definitely NOT "affordable".

You have a couple other choices. 1. Continue to work. 2. Skip health insurance and take your chances.

Time to put your big boy pants on.

 

[Fedup]

And so I don't have a problem with anyone working within the system I just feel that part of the system isn't working properly..ie people getting free healthcare because it does have to be paid for by somebody.

I don’t mind people getting subsidies, but what I do not like is people with large asset like over 5 Million plus complaints incessantly about health care. In fact some is at the point of being stressful. News for those people, you might die young of that stress, just spend the money, you don’t have to worry about eating broccoli and spinach.

 

[pb4uski]

Why is it folk LOVE to blame the ACA for all THEIR healthcare woes? It is the Insurance companies that are gauging the folk, and NOT providing adequate coverage. ACA just says you need to cover some BASIC items (Quite reasonable really). Insurance companies are the ones that set the prices. If we had a proper system then Insurance and Basic healthcare would not even be used in the same sentence. It should be NOT FOR PROFIT!

It is shocking to me the number of people that don't have the most elementary understanding of our health insurance system.... you couldn't be more wrong.

Under the law, insurers are limited to charging 125% of their health claim costs... the 25% providing for overhead, taxes and profit. Any premiums charged that end up exceeding 125% of claims paid must be refunded to the insureds.

The reason that health insurance premiums are so high is because health care services (docs, hospitals, prescriptions, etc) are so high... not anything the insurers are doing.

 

[VanWinkle]

It is shocking to me the number of people that don't have the most elementary understanding of our health insurance system.... you couldn't be more wrong.

Under the law, insurers are limited to charging 125% of their health claim costs... the 25% providing for overhead, taxes and profit. Any premiums charged that end up exceeding 125% of claims paid must be refunded to the insureds.

The reason that health insurance premiums are so high is because health care services (docs, hospitals, prescriptions, etc) are so high... not anything the insurers are doing.

Here is a recent article by a medical professional addressing the way to "fix" the health care system. It is very interesting and makes 4 points of contention with the current system- one being that people need to have more "skin in the game".

https://www.whitecoatinvestor.com/health-care-reform/

VW

 

[24601NoMore]

You thing setting the penalty to $0 has caused costs to stabilize?
That's funny.

Yes, and that's actually already proven to be the case.

Funny thing when you have a product people don't "have" to buy. The companies selling (in this case, the insurers) can't simply keep raising rates into infinity with an inelastic demand curve. They actually have to let the free market (there's a concept) decide what people will be willing to pay, or they just won't buy it.

 

[24601NoMore]

You have a couple other choices. 1. Continue to work. 2. Skip health insurance and take your chances.

Time to put your big boy pants on.

I think that's not realistic. Saying "put your big boy pants on" when our system has been utterly destroyed by bad politics and premiums and deductibles have skyrocketed as a result is not a reasonable position.

Had the ACA never come along, I wouldn't have to be budgeting $200K+ to get me and DW to Medicare. It would have been half - or LESS - than that.

Seems there's two camps on our board - those who are managing income to get subsidies (and hence love the ACA) and those who have higher expenses and cannot manage our income to get the subsidies. The first group basically says "too bad" to the second, which doesn't seem overly reasonable..

 

[Fedup]

You have to live with the current system, reasonably or not, it is what it is.

 

[MRG]

You have to live with the current system, reasonably or not, it is what it is.

Ding ding.

ACA certainly cost me much more money than pre-ACA days. Back then my health insurance cost would be zero cause I couldn't buy any.....

 

[pb4uski]

.... The companies selling (in this case, the insurers) can't simply keep raising rates into infinity with an inelastic demand curve. They actually have to let the free market (there's a concept) decide what people will be willing to pay, or they just won't buy it.

Actually, they couldn't keep raising rates to infinity because premiums are limited to 125% of medical claim costs. It is a free market because each insurer can decide what to price its product for as long as it doesn't exceed 125% of claim costs... some may be happy with less and their premiums will be lower.

 

[Fedup]

Ding ding.

ACA certainly cost me much more money than pre-ACA days. Back then my health insurance cost would be zero cause I couldn't buy any.....

It can still be zero for some, I understand the mandate was removed.

 

[DeborahB]

The ACA didn’t exist when I retired in 2010. I had to do 18 months of COBRA and then I was in the state high risk pool for 16 months. In a lot of ways I did work, toward the end, for the health insurance. Also for the money. But I think I could have retired earlier. High risk pool was $941/mo at the time: bankruptcy insurance.

 

[razztazz]

Yes, and that's actually already proven to be the case.

Funny thing when you have a product people don't "have" to buy. The companies selling (in this case, the insurers) can't simply keep raising rates into infinity with an inelastic demand curve. They actually have to let the free market (there's a concept) decide what people will be willing to pay, or they just won't buy it.

So, they were lying all along about how much "it costs" but took the money anyway simply because they could? The the icing isn't so thick anymore so they make the product more affordable.

 

[MRG]

It can still be zero for some, I understand the mandate was removed.

+1 for them.

I have a c-spine that could cost hundreds of thousands to make whole, if I survive. Of course there's a great chance of being paralyzed surgery or a fall. I'll keep paying whatever, to prevent medical bankruptcy.

A few years ago I had an emergency room visit that was 25k( CTs, ultrasound. and an IV). Trust me, no one would bear that pain I got to experience. They gave me Dilaudid for pain management.

I was still in my deductible stage but the insurance companies discount saved like 23k. I'm not sure about anyone else but it seems foolish to go without.

 

[ivinsfan]

I don’t mind people getting subsidies, but what I do not like is people with large asset like over 5 Million plus complaints incessantly about health care. In fact some is at the point of being stressful. News for those people, you might die young of that stress, just spend the money, you don’t have to worry about eating broccoli and spinach.

So Fed my comment you referred to was, if you are over Medicaid income you should pay at least something toward your healthcare ...below Medicaid income.. free I have no problem with that and over Medicaid level some amount even if it seems like a token amount but ZERO is just too generous IMO..

 

[ShokWaveRider]

The good thing about Medicare is at least you know what your costs are. Based on your choice of supplement plan of course. With advantage I am sure it is just a crap shoot. Prior to that it is whatever it is...

 

[Fedup]

The ACA didn’t exist when I retired in 2010. I had to do 18 months of COBRA and then I was in the state high risk pool for 16 months. In a lot of ways I did work, toward the end, for the health insurance. Also for the money. But I think I could have retired earlier. High risk pool was $941/mo at the time: bankruptcy insurance.

That’s what my sister would have to pay before ACA for high risk pool. She decided to skip it. Crazy idea for a person with a lot of health issues, actually she had just high blood pressure then.

 

[Fedup]

+1 for them.

I have a c-spine that could cost hundreds of thousands to make whole, if I survive. Of course there's a great chance of being paralyzed surgery or a fall. I'll keep paying whatever, to prevent medical bankruptcy.

A few years ago I had an emergency room visit that was 25k( CTs, ultrasound. and an IV). Trust me, no one would bear that pain I got to experience. They gave me Dilaudid for pain management.

I was still in my deductible stage but the insurance companies discount saved like 23k. I'm not sure about anyone else but it seems foolish to go without.

No, I don’t recommend for you. But I’m saying before the mandate some people like my sister went without when she got laid off.

 

[Fedup]

So Fed my comment you referred to was, if you are over Medicaid income you should pay at least something toward your healthcare ...below Medicaid income.. free I have no problem with that and over Medicaid level some amount even if it seems like a token amount but ZERO is just too generous IMO..

I don’t know how much people pay but even with retiree health insurance, my family pay over $6000 a year for the premium. There is no free lunch for us. However, we are grateful, we won’t be complaining.

 

[ivinsfan]

I don’t know how much people pay but even with retiree health insurance, my family pay over $6000 a year for the premium. There is no free lunch for us. However, we are grateful, we won’t be complaining.

That's an example of why everyone should pay something, even government subsides have to be paid by taxpayers. I don't want people thinking I'm heartless and do believe the Medicaid limit is a good thing, but if you are over the line you need to pay something IMO...

 

[gauss]

That's an example of why everyone should pay something, even government subsides have to be paid by taxpayers. I don't want people thinking I'm heartless and do believe the Medicaid limit is a good thing, but if you are over the line you need to pay something IMO...

Pay me now or pay me later. If you have a $0 premium policy you probably have some significant deductibles and out-of-pocket maximums that you will be responsible for.

Its kind of similar to home mortgages where you can buy down your interest rate by paying points up front.

You need to look at the full cost of the health insurance policy before saying that someone isn't paying anything for it.

 

[Dtail]

That's an example of why everyone should pay something, even government subsides have to be paid by taxpayers. I don't want people thinking I'm heartless and do believe the Medicaid limit is a good thing, but if you are over the line you need to pay something IMO...

In FLA, there is no Medicaid expansion, so how much should one pay if they can't qualify for the ACA minimum?

 

[ivinsfan]

Pay me now or pay me later. If you have a $0 premium policy you probably have some significant deductibles and out-of-pocket maximums that you will be responsible for.

Its kind of similar to home mortgages where you can buy down your interest rate by paying points up front.

You need to look at the full cost of the health insurance policy before saying that someone isn't paying anything for it.

Not necessarily, if you have a silver no cost plan and it hits zero you will get a lot of cost sharing.