Let's talk health plans!

[TexasHusker]

I purchase a plan called Christian Medi-Share. It costs about $560 a month for a family of four. It is not an Obamacare plan, and because it is considered a religious-affiliated plan, it is exempt for ACA requirements.

We love it, but there are a few caveats:

1. There is a waiting period for pre-existing conditions. More of a phase-in period.

2. You don't have prescription coverage.

3 Instead of a deductible and coinsurances, you have a "family household portion". You select this amount when you enroll. Once this portion is paid each year, the plan pays for all covered expenses. My AHP is $5000.

This plan works very well for us. It was a $1500 a month savings from Obamacare.

[disneysteve]

it is exempt for ACA requirements.

We love it, but there are a few caveats:

Another caveat, since it's exempt from ACA, is that it doesn't cover preventative care like mammograms and colonoscopies. You talked about shopping around for that that in another thread.

Otherwise, it sounds like a great option.

[TexasHusker]

Another caveat, since it's exempt from ACA, is that it doesn't cover preventative care like mammograms and colonoscopies. You talked about shopping around for that that in another thread.

Otherwise, it sounds like a great option.

Yes that is correct.

[Thrif-t]

When my DH retires I will no longer be covered on his healthcare :-(.

He is 3 years older than me, so depending on the current situation of healthcare then, I just might have to refer back to this sometime in the future.

I don't think he'll make it to age 68 so I can get on medicare at 65. And I don't see me getting a full time job with benefits at an older age. Hopefully I'll stay healthy and a plan like this would work for me.

Hey when did we get this Health Care sub-forum it must be new, I've never noticed it before??

[TexasHusker]

When my DH retires I will no longer be covered on his healthcare :-(.

He is 3 years older than me, so depending on the current situation of healthcare then, I just might have to refer back to this sometime in the future.

I don't think he'll make it to age 68 so I can get on medicare at 65. And I don't see me getting a full time job with benefits at an older age. Hopefully I'll stay healthy and a plan like this would work for me.

Hey when did we get this Health Care sub-forum it must be new, I've never noticed it before??

Even though it is 3 years away, it wouldn't be a bad idea to start looking at your options in another year, especially if you have ongoing health conditions. Health insurance costs / availability can put quite a dent in retirement plans.

[Thrif-t]

^ oh no he has 8 or 9 more years, he's 53, so just starting to think about when to go. I've said this before he can actually go in 5 years with a full pension but that would leave me and the kids without health insurance so now he's saying maybe till 61, but you know we have to see how his health holds up.

[LivingAlmostLarge]

Employer provided of course. TH do you think that it would make costs more feasible if they uncoupled employement to medical and forced everyone to have to buy their own insurance? I'd be curious how it would affect free market.

[TexasHusker]

Employer provided of course. TH do you think that it would make costs more feasible if they uncoupled employement to medical and forced everyone to have to buy their own insurance? I'd be curious how it would affect free market.

OK so understand you are asking the consummate capitalist this question

But my thoughts are as follows:

If employers want to continue to provide coverage through a group plan, similar to life and AD&D insurance, I've got no problem with that.

Everyone, even those belonging to a group, should be able to buy individual health insurance instead, if they so choose. It's America!

As for individual insurance, there are few players in the market any more, because ObummerCare made a bunch of unwieldy mandates that would render the plans unprofitable (putting it mildly) for insurance companies.

Example: No pre-existing condition exclusions. So...I'm perfectly healthy for two years, then I get cancer. I don't have ObummerCare, but I will sign up for it now! Can you imagine going without car insurance and then you total your car, and you call your insurance co. and say "I need insurance --- I just had a wreck?" They would laugh at you and hang up the phone. Yet this is precisely what ObummerCare mandates on health insurers. And guess what, no one wants to play any more!

Health insurance should be just like any other insurance - you buy the coverage that you WANT and can AFFORD. Understanding that if you are un-insured or under-insured, that hospital you stayed in can put a lien on everything you own!

Should basic health insurance be REQUIRED BY LAW? I think so! You're required to buy car and home insurance in most cases! But....all of these minimum copay and coinsurance requirements are ridiculous.

Minimum coverage:

100% insurance after the first $50,000 in expenditures. That means you're going to have to bust out some savings or go into debt for that first $50K, but at least it's affordable and you're covered from a catastrophe!

Now, many insurance co.s might offer $5K and $10K deductibles, and if you can afford that and want it, BY ALL MEANS BUY IT!

And furthering that point, if you are hell bent on a $10 copay every time you have a sniffle, and want all of your prescriptions paid for after a $10 copay, by all means, you should be able to spend half of what you make every month for that plan!

My individual insurance is a plan exempted from Obummercare. It costs our family around $600 a month. We pay for our own prescriptions, our own wellsness visits and flu and bronchitis visits. For anything else, once we hit $5K a year, the plan pays 100%.

If I could, I'd go with a $10K plan for even less money, but this one is pretty good. No frills. I don't want them or need them.

[LivingAlmostLarge]

Are you guaranteeing coverage? No uninsurable people?

[disneysteve]

100% insurance after the first $50,000 in expenditures. That means you're going to have to bust out some savings or go into debt for that first $50K, but at least it's affordable and you're covered from a catastrophe!

Now, many insurance co.s might offer $5K and $10K deductibles, and if you can afford that and want it, BY ALL MEANS BUY IT!

As for high deductibles, that's already a thing. Our last plan had a $4,700 deductible and I've seen plans that were over 5K or 6K.

As for the first suggestion that there be a 50K deductible, that's great for the wealthy but what about everyone else? That's pretty close to the median income. Do you think the average family can afford to spend a year's salary on medical care if something happens? They'd be bankrupt for sure.

[TexasHusker]

As for high deductibles, that's already a thing. Our last plan had a $4,700 deductible and I've seen plans that were over 5K or 6K.

As for the first suggestion that there be a 50K deductible, that's great for the wealthy but what about everyone else? That's pretty close to the median income. Do you think the average family can afford to spend a year's salary on medical care if something happens? They'd be bankrupt for sure.

When $5K is what some hospitals get for a $150 MRI, you can’t hardly afford insurance anymore with a $5k deductible. That’s pennies in healthcare.

[disneysteve]

When $5K is what some hospitals get for a $150 MRI, you can’t hardly afford insurance anymore with a $5k deductible. That’s pennies in healthcare.

My point was that your suggestion of a 50K deductible wouldn't work for the vast majority of people who simply don't have that kind of money. My patients struggle because of their 2k or 3K deductibles. They often delay care because they don't have the cash to pay those bills.

[LivingAlmostLarge]

$50k deductible? People would really go bankrupt. They barely have enough for a $6500 family deductible now. Middle class people would be hurting. And the rich would have to bail people out. Because hospitals would provide care and people would just not pay because they couldn't.

[msomnipotent]

$50k deductible? People would really go bankrupt. They barely have enough for a $6500 family deductible now. Middle class people would be hurting. And the rich would have to bail people out. Because hospitals would provide care and people would just not pay because they couldn't.

And then medical providers wouldn't get paid, and lose money. So then they raise their prices and less people are able to pay.

[TexasHusker]

My point was that your suggestion of a 50K deductible wouldn't work for the vast majority of people who simply don't have that kind of money. My patients struggle because of their 2k or 3K deductibles. They often delay care because they don't have the cash to pay those bills.

So they don't have that kind of money, but they do have $2000 a month for Obummercare? Hmm.

Why not go the $50K route, pay $500 a month for your health insurance, and if and when you have a catastrophic claim for cancer, etc., you simply take out a home equity loan for the amount of the $50K that you haven't banked? That's going to be a lot less than the other $1500 per month.

Folks "don't have that kind of money" in large part because they are health insurance poor.

When we dropped Obummercare, we were paying $24K a year for premiums, plus another $10K or so before the insurance actually kicked in to any degree.

So the idea of a $50K deductible isn't as far fetched as one might think.