How aggressive should you get with paying off debt?

[Singuy]

One way to save on health insurance if you are relatively healthy is to get the cheapest one you can find. Yes, these will have stupid high deductibles, but you are in it for the maximum out of pocket number. This number is usually 10k.

Since you don't have a chronic condition that requires regular MD visits and rx drugs, you pretty much just need coverage for those instances like falling off a ladder or getting into a severe car accidents. Since these hospital bills will usually exceed the 10k max out of pocket expenditure, you actually get a good portion of your healthcare bill covered.

[disneysteve]

One way to save on health insurance if you are relatively healthy is to get the cheapest one you can find. Yes, these will have stupid high deductibles, but you are in it for the maximum out of pocket number. This number is usually 10k.

That works as long as you are prepared to pay the out of pocket costs. Add that amount into your EF and you're basically self-insuring for those costs.

The problem I see far more often is people who pick the cheapest plan they can find to save on the premium but then can't afford the bills that they get hit with when getting medical care. You can't have it both ways. Either pay for the good insurance or buy the cheap insurance and set aside a pile of cash to pay the bills.

[Singuy]

That works as long as you are prepared to pay the out of pocket costs. Add that amount into your EF and you're basically self-insuring for those costs.

The problem I see far more often is people who pick the cheapest plan they can find to save on the premium but then can't afford the bills that they get hit with when getting medical care. You can't have it both ways. Either pay for the good insurance or buy the cheap insurance and set aside a pile of cash to pay the bills.

Usually healthcare repayment plans are extremely generous. You literally can just pay 5 dollars/month if you want to..and eventually the hospital will just write it off. Also you can just appeal it if you can't afford it..some social worker will step in and help reduce the total cost. It's pretty amazing how little you actually need to pay for healthcare if you are poor. As long as the hospital received a good portion of the money from the insurance company..what's left is highly negotiable.

[disneysteve]

It's pretty amazing how little you actually need to pay for healthcare if you are poor.

Actually, even if you aren't poor.

The last time my wife had surgery, I called with a question about the outstanding balance that was our portion and without me even asking, they knocked 30% off the bill. I was pleased with that as I was all set to pay the full amount.

[Singuy]

Actually, even if you aren't poor.

The last time my wife had surgery, I called with a question about the outstanding balance that was our portion and without me even asking, they knocked 30% off the bill. I was pleased with that as I was all set to pay the full amount.

Yup, same with my surgery. My dad literally went to the MD with 700 cash and said that's all he has for the 1500 procedure. MD gladly accepted it.

[disneysteve]

Yup, same with my surgery. My dad literally went to the MD with 700 cash and said that's all he has for the 1500 procedure. MD gladly accepted it.

It's been my experience that they will often accept well below the billed amount for payment in full. They certainly don't want $5/month. They'd rather take a discounted amount as a lump sum.

[GoodSteward]

I understand where you are coming from. The difference here is price. Health insurance is ridiculously high in premiums, just like whole life is compared to term. How is it income protection if I'm bleeding money regardless? If I have it, and use it I'm paying the high premiums plus out of pocket. Most people don't have that kind of cash flow month to month. If I have it, but can't afford to use it what good is that. The average family making 50k a year can't handle health insurance, and afford to use it too. Not without debt to pay the difference or be strapped to eat.

I also have a bias here based on family history. My grandfather was a diabetic. He later had heart trouble and needed open heart surgery. They were not related issues, thus why he was approved for the surgery. After having it done and insurance paid, they came back and claimed preexisting and the hospital and doctors had to pay it back. The hospital and doctors then billed my grandmother for the entire operation. 150,000$. A lot of good insurance did. She was paying on that until she died, plus the ongoing insurance premium and any other medical. She still owed around 50,000$ when she passed away.

My friend had an accident and was only receiving 800$ a month from workmans comp. He filed for this magical everybody should have health insurance obama care, and the best he got was 800 a month. That just isn't logical. Health insurance is too high to make sense for most americans, thus why so many go without it. Not to mention they make the rules, and don't pay if they don't want to.

When we had a baby last year, the hospital gave us 3 days to pay the full amount to get a 300$ discount on what we owed after insurance. They hadn't even filed it yet, but knew what it would be. It was 969$ vs 1260$ (I think). Three days is all. How many people have 1000$ laying around to pay that? They didn't give us a week or two to figure it out, just 3 days. I had a card I used to pay it, and then paid the card off a month later. I appreciated the offer, but the way they did that I think it was more of a way to say "we offered a discount" without really expecting someone to be able to do it.

I do not like health insurance, and I am not fond of the medical field in general as far as the financial side goes. I know insurance companies are a major cause for the medical prices in this country. I know the doctors are just doing their job(Thank you DisneySteve!), and the insurance companies stick to them too. However, I do NOT agree with hospitals being allowed to charge the full amount to non-insurance patients. I know you can negotiate cash if you can pay up front, but again, how many can actually do that. My grandmother should have never been expected to pay the full 150,000$ if everybody was only getting 1/3 of that from the insurance company. Even cutting it in half would have been better.

[GoodSteward]

Didn't mean to sidetrack this thread but on a debt repayment question to DisneySteve. We are having another baby in December. Same hospital and doctor, so I know the price to expect. How negotiable is the side that we pay to the doctors after insurance? Is there a general percentage they typically accept for payment in full? I thought about offering less to the hospital this year to see if they will take it.

[disneysteve]

How is it income protection if I'm bleeding money regardless?

I don't understand how you're "bleeding money" either way. If you pay your deductible and then the insurance picks up 80%, isn't that better than you paying 100%?

My grandfather was a diabetic. He later had heart trouble and needed open heart surgery. They were not related issues, thus why he was approved for the surgery. After having it done and insurance paid, they came back and claimed preexisting and the hospital and doctors had to pay it back. The hospital and doctors then billed my grandmother for the entire operation. 150,000$.

Certainly crap like that shouldn't happen, which is why they eliminated the pre-existing condition clauses from insurance plans.

Health insurance is too high to make sense for most americans, thus why so many go without it.

The last figure I saw, which is from 2014, is that about 90% of Americans have health insurance. Only 10% were uninsured and 80% of those were folks living in poverty. The vast majority of Americans do have coverage.

[GoodSteward]

I don't understand how you're "bleeding money" either way. If you pay your deductible and then the insurance picks up 80%, isn't that better than you paying 100%?

It's the idea that you are paying premiums the whole time on top of all the deductibles and co-pays. You are paying premiums continually, thus my reference to bleeding money. It doesn't end, but only goes up yearly and adds to it when you actually have to use it since you still have to pay out of pocket. It is obviously designed to help insurance companies more than individuals. Thus the absurd revenue they net every year, and then say our premiums have to go up. This is the same logic that the gas companies used several years ago. One of the representatives had to answer why they made so much profit when gas was so high. Their reply was that they raised the prices to slow down travel and save on oil usage in America, only people kept traveling and using gas. It wasn't their fault. Right...right.

The last figure I saw, which is from 2014, is that about 90% of Americans have health insurance. Only 10% were uninsured and 80% of those were folks living in poverty. The vast majority of Americans do have coverage.

I haven't checked any official numbers. I'm going off the people I work with and live around. I'm sure the numbers are higher now that we get fined for not having it. I mean, maybe I am skewed on this but I know a lot of people who still can't afford it. My dads insurance went up 150$ a month, and my mom was tapped out (she says...). even still she doesn't work 40 hours, and 150 a month more was a lot of money. It was already costing 300$ a month on my dads plan. That isn't chump change, especially when you have maybe 400-500 cash flow a month after bills. I don't mean to keep bashing this and I do have health insurance, however I don't feel it is worth it. My grandmother was a slave to that debt the rest of her life. If I ever find myself in a spot like that, I'll just file bankruptcy after I pay in enough to equal what they would have gotten from insurance. Have you talked to many elderly who barely make it on SS? Even their insurance is high, and it is suplimented.

[GoodSteward]

I found this on a site after doing a search.

"The number of uninsured Americans declined by 8.8 million in 2014, the first year the major insurance reforms of the Affordable Care Act (ACA) took effect, according to new federal survey of 98,000 adults released by the U.S. Census Bureau today. "

98,000 people? Which financial class did that come from? If you keep reading they are referencing the federal survey. How many people actually fill that out? I think I did for the first time this year...I think.

[LivingAlmostLarge]

The problem is the the uninsured are those who use a lot of the medical needs. Probably because of lack of preventative care.

[Outdoorsygal]

They say the majority of healthcare expenses are lifestyle related. Meaning people's choices are what caused their enormous medical bills in the first place.

There needs to be a financial incentive to stay healthy. Nutrition classes. Proper Exercise. And education to not keep giving birth if you cannot afford the first child.
Much of this is self-sabotaging behavior driving up healthcare costs. Often we are our own worst enemy.

[disneysteve]

They say the majority of healthcare expenses are lifestyle related. Meaning people's choices are what caused their enormous medical bills in the first place.

Absolutely. I'm a family practice physician and easily 70% of what I treat is self-induced to a large extent. Certainly there are genetic and environmental factors too, but if people would just maintain a healthy weight, participate in regular exercise, and not smoke, I'd probably be twiddling my thumbs a lot of the time.

[LivingAlmostLarge]

But a lot of it goes hand in hand right steve? That people lacking insurance often wait and aren't very self aware and everything but health care is paid first. Hasn't it been proven that under a socialized system people have overall better health because they aren't worried about bills so they just go to the dr more and take better care? I wonder if some people are aware of costs and just don't take care or even go.