Author Topic: Health insurance...ridiculous for 25 y/o non-smoker/drinker?  (Read 21175 times)

undercover

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Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« on: November 01, 2015, 05:17:26 PM »
I haven't had health insurance up until this point. It's became even more unaffordable since Obamacare. I can technically afford it, I'm just hesitant about paying as much as even the basic catastrophic plan is.

My cheapest option as a 25 y/o non-smoker/drinker with no subsidy is $180/mo. This is with a $6,850 deductible/max out of year cost. That just seems silly. What are others similar in age/no subsidy seeing? I'm assuming the same, but man...

sparkshooter

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #1 on: November 01, 2015, 05:25:16 PM »
$180/year seems silly until you are diagnosed with brain cancer and need $100k worth of treatment in a year...

But yeah, I do get that it sucks. Does your job not offer any sort of corporate plan? If you are making so much that you don't qualify for a subsidy, I assume you have a job...

Zamboni

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #2 on: November 01, 2015, 05:37:29 PM »
At 25 I'd always been blessed with good health too, so I feel where you are coming from. Then I slipped on ice and tore up my knee. As injuries go, it was very easy to fix. So no worries, I was back on my feet soon after a quick surgery and a few months of physical therapy to the tune of $30K.

If you can afford, then be thankful you can afford to buy it and then be thankful again if you never end up needing it.

rockstache

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #3 on: November 01, 2015, 05:43:38 PM »
Please get insurance. Someone close to me (age 27) who has always been very healthy ended up in the emergency room this year and spent 12 days in the icu on breathing and feeding tubes. They went from perfect health to that in about 48 hours. After that there was a rehab facility before they could return home. The bills were 6 figures. You just never know when you're going to need it and you don't want your family to be worrying about money when they need to be focused on your health.

Paul der Krake

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #4 on: November 01, 2015, 06:00:54 PM »
I was on the catastrophic plan the first year of the exchange (2014), it was $140/month and I was 24 at the time of underwriting. A close friend who works for the company who underwrote my policy told me that they had to significantly raise premiums the following year because they had vastly overestimated the number of healthy people like me without employer coverage who wouldn't balk at paying their prices.

Just like you, I was extremely pissed at how little I was getting for the price as well, but it was still the best deal by far for a young healthy person. The plan in question had 3 doctor visits per year at $35 copay each, and I ended up using only one. This was my only health expense that year.

A modest bump to a bronze plan would have cost more in additional after-tax premiums than the potential out of pocket maximum difference between the bronze plan and the catastrophic plan. Essentially, and this largely true for many insurance products, low deductibles are a tax on people with no savings to cover emergencies.

reddityeah

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #5 on: November 01, 2015, 06:05:38 PM »
25 year olds dont ever get into accidents or end up in the ER.
You need insurance. it's pretty much financially irresponsible to not have coverage

La Bibliotecaria Feroz

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #6 on: November 01, 2015, 07:36:37 PM »
Remember that the cost isn't a full $180/month--it's that minus whatever you would have to pay in penalty taxes. And you should be able to get an HSA.

Why don't you have coverage through work? Is getting a job an option? At the library where I work, our insurance for half-time (20 hour per week) employees costs a little more than what you are seeing, but is MUCH better (lower deductible, lower out of pocket maximum). That includes shelvers and other no-degree-required positions.

Broken legs happen.

lbmustache

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #7 on: November 01, 2015, 07:53:15 PM »
The cheapest plan is about the same for me too. :\

mxt0133

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #8 on: November 01, 2015, 08:37:26 PM »
If your parents have health insurance you can stay on their plan until you are 26.  It should be cheaper to add you to their plan and just pay them the difference.  If they are open to it do the math and see if it makes sense.

ShoulderThingThatGoesUp

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #9 on: November 02, 2015, 04:27:58 AM »
This is the point of the ACA. Charging the young and healthy more. Only way to subsidize the older and sicker.

Kroaler

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #10 on: November 02, 2015, 04:37:20 AM »
Maybe I'm the oddball but I remind myself that my higher premiums are "hopefully" helping someone who was getting screwed before. Don't know if thats true, but thats how I like to imagine it.

At my employer insurance has been free for 0$ deductible ppo plan for the last 20 years,  that changed the year ACA went into affect. Oh well.

Gray Matter

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #11 on: November 02, 2015, 05:19:11 AM »
Maybe I'm the oddball but I remind myself that my higher premiums are "hopefully" helping someone who was getting screwed before. Don't know if thats true, but thats how I like to imagine it.

Love that perspective!  And yes, that's pretty much what's happening.  I try to be smart about how much insurance I need (e.g., for my house, life insurance), but rather than feeling "cheated," I try to feel blessed if I pay premiums for insurance that I never have to use.  That's the best case scenario, really.

Malum Prohibitum

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #12 on: November 02, 2015, 08:53:40 AM »
I haven't had health insurance up until this point. It's became even more unaffordable since Obamacare. I can technically afford it, I'm just hesitant about paying as much as even the basic catastrophic plan is.

My cheapest option as a 25 y/o non-smoker/drinker with no subsidy is $180/mo. This is with a $6,850 deductible/max out of year cost. That just seems silly. What are others similar in age/no subsidy seeing? I'm assuming the same, but man...

Count yourself as lucky.

I am a middle aged man with a family of 5, and a basic HSA eligible plan ($12,500 family deductible) is over a thousand dollars a month with no subsidy.  Since it is an HSA plan, I pay everything for my family out of pocket up to 6500 per individual and 12500 family.  I have never seen a dime of benefit from that over 1000 monthly.  It is just there to (1) avoid the penalty for not having insurance, (2) in case something really expensive happens, and (3) to get the insurance negotiated contract reduced rate on medical services.

Imagine sinking over a 1000 a month . . . and its getting worse.

My 2016 premium showed up in the mail with more than a 20% increase . . .

frugaliknowit

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #13 on: November 02, 2015, 08:58:43 AM »
You NEED health insurance at any age.  This is not something you can afford to self insure, unless you are a billionaire.

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #14 on: November 02, 2015, 09:01:55 AM »

Count yourself as lucky.

I am a middle aged man with a family of 5, and a basic HSA eligible plan ($12,500 family deductible) is over a thousand dollars a month with no subsidy.  Since it is an HSA plan, I pay everything for my family out of pocket up to 6500 per individual and 12500 family.  I have never seen a dime of benefit from that over 1000 monthly.  It is just there to (1) avoid the penalty for not having insurance, (2) in case something really expensive happens, and (3) to get the insurance negotiated contract reduced rate on medical services.

The reduced negotiated rates are a huge benefit that lots of people don't realize.  And it's reduced a lot.   Maybe at $1000 a month, that still doesn't help much.  Sorry 'bout that part.

Imagine sinking over a 1000 a month . . . and its getting worse.

My 2016 premium showed up in the mail with more than a 20% increase . . .

Ours went up over 30%.  However, we also just pulled the FIRE cord, so subsidies also massively kicked in.

monstermonster

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #15 on: November 02, 2015, 09:05:04 AM »
Nope, health insurance is never ridiculous. Thank your lucky stars that it's available to you now and pay for it. If you're too wealthy to get a subsidy, $180 is simply the cost of doing business.

I pay $180/month just for my portion of my employer-sponsored health insurance, and I consider that a good deal. And I'm a ridiculously in-shape 28-year-old. When I didn't have insurance when I was younger (couldn't get it before obamacare), I ended up having to pay off $30K of bills for breaking my wrist in a crash, on a $15K annual salary.

The number of fundraisers I've had to hold for 22-year-old friends who got in a bike crash or fell down walking on ice or had appendicitis because they didn't have insurance.... you don't want to be staring down a $50K medical bill because of a single slip and fall or an appendix that decided it didn't like you anymore.

zephyr911

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #16 on: November 02, 2015, 09:05:15 AM »
As you may know, MMM considers most insurance to be a tax on people who suck at math, but he has health insurance. As low as the odds of disaster may be, the impact can be devastating - life-altering or even life-ending.

Unless the cost of catastrophic coverage is going to dramatically hinder your investment plans, it's worth the risk mitigation. I've been extremely lucky in my adult life to never need major medical services, but I know people who have. One ER visit can run you $20K. One long inpatient stay can cost more than the average forum member needs for full retirement.

Bellatrix

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #17 on: November 02, 2015, 09:06:19 AM »
It's strange that your quote is so high. I live in an expensive area and my quote last year was $175/mo with a 4 or 6 k deductible. I'm in my early 30's and healthy. 

I work in an ER and have seen young, previously healthy people come in with all sorts of bad things that require expensive surgeries and lengthy hospital stays.  I would be really scared to go without health insurance. 

Schaefer Light

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #18 on: November 02, 2015, 09:21:35 AM »
I think the pricing has more to do with the amount of competition in your state than it does the cost of living.  And yes, it would really suck to have to pay that much as a young, healthy individual.  I think insurance is a racket, but it would be a huge risk not to have health insurance given the costs associated with certain types of injuries and illnesses.

MerryMcQ

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #19 on: November 02, 2015, 10:51:15 AM »
As a benefit manager for a mid-sized employer, we paid around $500 per month for our single employees on an HSA. I would say your rates are a bargain!

beltim

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #20 on: November 02, 2015, 10:57:30 AM »
Most people dramatically underestimate their risk of needing/using health care.  This is particularly true for young people.  Someone in your age group has a roughly 5% chance of requiring medical care at a hospital in any given year and a roughly 0.5% chance of being diagnosed with cancer.  And these require expensive treatments on average.  Here's a thread where we discussed this issue before:

http://forum.mrmoneymustache.com/ask-a-mustachian/obamacare-role-call!/35/

And here's some data on hospitalizations:
http://www.cdc.gov/nchs/data/nhsr/nhsr029.pdf

Paul der Krake

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #21 on: November 02, 2015, 11:12:49 AM »
The reduced negotiated rates are a huge benefit that lots of people don't realize.  And it's reduced a lot.
I realize exactly the benefits of the negociated rate. I also realize that the negociated rate represents enough for the provider to make a profit while making the insurer look like the good guy for negociating a price that should never have been allowed to be so inflated in the first place.

There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.

Malum Prohibitum

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #22 on: November 02, 2015, 11:59:30 AM »
The reduced negotiated rates are a huge benefit that lots of people don't realize.  And it's reduced a lot.
I realize exactly the benefits of the negociated rate. I also realize that the negociated rate represents enough for the provider to make a profit while making the insurer look like the good guy for negociating a price that should never have been allowed to be so inflated in the first place.

There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.
  Good post!

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #23 on: November 02, 2015, 11:59:55 AM »
The reduced negotiated rates are a huge benefit that lots of people don't realize.  And it's reduced a lot.
I realize exactly the benefits of the negociated rate. I also realize that the negociated rate represents enough for the provider to make a profit while making the insurer look like the good guy for negociating a price that should never have been allowed to be so inflated in the first place.

There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.

There is some truth to what you say.  But also consider:
* They are buying in bulk.  That always is a discount
* Sadly, for the higher non-insured rates, the hospitals are expecting to not get their money at all.  They're billing a big rate that they're expecting to write off as a loss on their income/expense statements.  In a way the lower $1000 cost actually *IS* paying for the higher $3000 cost.  It's the folks that do pay via insurance that bear a pretty huge chunk of the costs.  Most hospitals will also get a pretty good chunk of federal funding from taxes.  Keeping those unpaid bills high will likely land them more federal funds.

monstermonster

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #24 on: November 02, 2015, 12:08:05 PM »
The reduced negotiated rates are a huge benefit that lots of people don't realize.  And it's reduced a lot.
I realize exactly the benefits of the negociated rate. I also realize that the negociated rate represents enough for the provider to make a profit while making the insurer look like the good guy for negociating a price that should never have been allowed to be so inflated in the first place.

There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.

There is some truth to what you say.  But also consider:
* They are buying in bulk.  That always is a discount
* Sadly, for the higher non-insured rates, the hospitals are expecting to not get their money at all.  They're billing a big rate that they're expecting to write off as a loss on their income/expense statements.  In a way the lower $1000 cost actually *IS* paying for the higher $3000 cost.  It's the folks that do pay via insurance that bear a pretty huge chunk of the costs.  Most hospitals will also get a pretty good chunk of federal funding from taxes.  Keeping those unpaid bills high will likely land them more federal funds.

Additionally, medical purchasing is a complicated series of decisions required specialized knowledge. Do you know which manufacturer or titanium for repairing broken femurs is the most reliable and cheapest? Would you know where to research that?   The advantages of having someone who is a medical insurance professional negotiate rates for everyone is that you don't need to know the ins and outs of this to get the negotiated rate.

...Which is not to say that medical prices in this country aren't totally fucked. Because they are. But I'm really glad at least thanks to the ACA I can now buy professional medical negotiators to work for me and work with the hospitals and doctors to reduce my bills. I couldn't before ACA

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #25 on: November 02, 2015, 12:19:46 PM »

Additionally, medical purchasing is a complicated series of decisions required specialized knowledge. Do you know which manufacturer or titanium for repairing broken femurs is the most reliable and cheapest? Would you know where to research that?   The advantages of having someone who is a medical insurance professional negotiate rates for everyone is that you don't need to know the ins and outs of this to get the negotiated rate.

...Which is not to say that medical prices in this country aren't totally fucked. Because they are. But I'm really glad at least thanks to the ACA I can now buy professional medical negotiators to work for me and work with the hospitals and doctors to reduce my bills. I couldn't before ACA

I think we (Americans) also have a totally different idea about health care than other countries.  (I'm generalizing... this won't be true for all and particularly probably not for mustacians.)  Americans have some sort of obsession with "only the best" ... when often "good enough" is fine.  We're also really lawsuit happy -- again driving the price up. 

And, gosh darn it, we just seem to love going to the doctor.  I'm amazed at how often my friends and their kids are getting checked out for one thing or another.  When I was growing up, my parents pretty much counted limbs.  If there were 4, we were told "you'll be fine" and told to buck up and stop crying.  I'm not saying that extreme is the right approach... but it's really odd to see friends going to the ER 2 or 3 times a year for little things.

acroy

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #26 on: November 02, 2015, 12:27:32 PM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #27 on: November 02, 2015, 12:31:09 PM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

I thought this was effectively illegal now under ACA.   (Yeah, I know, it's just a tax penalty... but it will eventually go up.)   And I thought they capped deductibles to $6.6.

...but I get what you're saying.  And I actually agree it's a reasonable path for a healthy person (especially one that is building a big stash of cash).  I just don't think it works that way now.

hops

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #28 on: November 02, 2015, 12:49:44 PM »
It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

So many personal stories have been shared on this forum over the years, in this thread and others, by people who were healthy right up until the moment they unexpectedly weren't. Few things will shave a burgeoning 'stache faster than massive medical bills.

I'm in the wealth accumulation phase and even if I were healthy (and I'm not, I lost the genetic lottery, have been sick my entire life, and repeatedly incurred medical costs as a child that would've bankrupted my parents had they not been insured), having health insurance of some sort would be one of my highest financial priorities.

I've seen too many "young and healthy" acquaintances get injured in freak accidents, or receive a cancer diagnosis out of the blue, to feel comfortable jeopardizing my family's financial security over not wanting an extra monthly bill. I'm mustachian enough that I can find a way to make that payment (and also mustachian enough that I wouldn't want to unnecessarily burden others with my healthcare costs by not carrying insurance).

acroy

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #29 on: November 02, 2015, 12:52:44 PM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

I thought this was effectively illegal now under ACA.   (Yeah, I know, it's just a tax penalty... but it will eventually go up.)   And I thought they capped deductibles to $6.6.

...but I get what you're saying.  And I actually agree it's a reasonable path for a healthy person (especially one that is building a big stash of cash).  I just don't think it works that way now.

I've not looked into it extensively, but there are still some private options such as http://www.chministries.org/programs.aspx
I did not read all the fine print but looks like $45/mo for $5k deductible for a single person if you are eligible to join

Obamacare: Reducing your options. great stuff (grrrr)....

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #30 on: November 02, 2015, 12:55:38 PM »
I've not looked into it extensively, but there are still some private options such as http://www.chministries.org/programs.aspx
I did not read all the fine print but looks like $45/mo for $5k deductible for a single person if you are eligible to join

Obamacare: Reducing your options. great stuff (grrrr)....

I looked briefly at them.  I got to this statement "participating adults must be Christians living by biblical principles".  It looks like I am excluded by being non-religious.  It also has a make-me-queasy feel of "if we don't think you're not living up to our standards we ain't going to cover you."

monstermonster

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #31 on: November 02, 2015, 01:58:02 PM »
I've not looked into it extensively, but there are still some private options such as http://www.chministries.org/programs.aspx
I did not read all the fine print but looks like $45/mo for $5k deductible for a single person if you are eligible to join

Obamacare: Reducing your options. great stuff (grrrr)....

I looked briefly at them.  I got to this statement "participating adults must be Christians living by biblical principles".  It looks like I am excluded by being non-religious.  It also has a make-me-queasy feel of "if we don't think you're not living up to our standards we ain't going to cover you."

Those plans are also not ACA-compliant by the way. And if you are "living in sin" they can cancel your coverage. If you need coverage for birth control (even for the numerous non-reproduction uses as a hormonal regulator) or abortion or STI testing, it isn't covered.

Edit: I forgot they also have a lifetime coverage maximum of $1mill for most people, which no ACA-compliant plan is allowed to have now. Say you have a kid, and that kid needs to be in the NICU for the first 10 days of their life. You've hit lifetime max at 10 days old. Doesn't really help on the catastrophic front.
« Last Edit: November 02, 2015, 02:01:24 PM by monstermonster »

use2betrix

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #32 on: November 02, 2015, 01:59:16 PM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

Medical costs are the number one leading cause of bankruptcy in the country. But if you believe it's simply an unneeded "calculated risk," then by all means, go ahead. My health insurance has already paid for itself due to having an active lifestyle and things out of my control at 27 years old.

monstermonster

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #33 on: November 02, 2015, 02:06:10 PM »
Insurance of any kind is a bet against yourself.


Sure, that's true. But I'm the only insurable thing I truly need to work to keep working. Houses, cars, those are all replaceable.  My life? My lungs? Not so much. Bankrupted because I end up as a pancake due to a stranger's bad choice at a red light? That's not a bet I want to take.

Axecleaver

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #34 on: November 02, 2015, 02:13:47 PM »
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There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.
Exactly right, the issue you're describing is called "price transparency," and it's why two hospitals within a few blocks of each other may have prices that vary by 100x or more for the same service. This is one of the most hotly debated issues in American Healthcare policy today.

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Most hospitals will also get a pretty good chunk of federal funding from taxes.  Keeping those unpaid bills high will likely land them more federal funds
That's not actually how the program works. Hospitals don't receive tax dollars directly for providing service to the uninsured, they are reimbursed from the Disproportionate Share for Hospitals (DSH) program. which runs under the state Medicaid program. This redistributes dollars at the state level based on how many Medicaid and uninsured people combined that a hospitals serves. Inner city hospitals tend to get more, the affluent hospitals actually have to pay into the fund. Under this program, the services are all calculated as if they were using Medicaid reimbursement rates, which are the lowest rates. Further reading: http://www.medicaid.gov/medicaid-chip-program-information/by-topics/financing-and-reimbursement/medicaid-disproportionate-share-hospital-dsh-payments.html

Argyle

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #35 on: November 02, 2015, 02:18:26 PM »
One reason that premiums are so high is that in most cases health insurance is a for-profit enterprise.  If your investments include insurance companies, you are profiting from the fact that they impose these higher rates on people.

Another reason for the high rates is the sheer amount of bureaucracy generated by having hundreds of insurance companies (rather than, for instance, a single-payer system like the UK).  The American public, specifically the voters, have decided that the system we have now, including its higher rates, is preferable to changing to a single-payer system.   So your dollars are going to support that decision too.

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #36 on: November 02, 2015, 02:18:53 PM »
I've not looked into it extensively, but there are still some private options such as http://www.chministries.org/programs.aspx
I did not read all the fine print but looks like $45/mo for $5k deductible for a single person if you are eligible to join

Obamacare: Reducing your options. great stuff (grrrr)....

I looked briefly at them.  I got to this statement "participating adults must be Christians living by biblical principles".  It looks like I am excluded by being non-religious.  It also has a make-me-queasy feel of "if we don't think you're not living up to our standards we ain't going to cover you."

Those plans are also not ACA-compliant by the way. And if you are "living in sin" they can cancel your coverage. If you need coverage for birth control (even for the numerous non-reproduction uses as a hormonal regulator) or abortion or STI testing, it isn't covered.

Edit: I forgot they also have a lifetime coverage maximum of $1mill for most people, which no ACA-compliant plan is allowed to have now. Say you have a kid, and that kid needs to be in the NICU for the first 10 days of their life. You've hit lifetime max at 10 days old. Doesn't really help on the catastrophic front.

I'm not advocating these by any means... But it depends on what you mean by "compliant".   You're correct in that they don't have the same rules.  But they're specifically mentioned as exemptions -- so some ways they do comply with the law, just not with the insurance guidelines set out by the law. 

monstermonster

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #37 on: November 02, 2015, 02:21:43 PM »
I've not looked into it extensively, but there are still some private options such as http://www.chministries.org/programs.aspx
I did not read all the fine print but looks like $45/mo for $5k deductible for a single person if you are eligible to join

Obamacare: Reducing your options. great stuff (grrrr)....

I looked briefly at them.  I got to this statement "participating adults must be Christians living by biblical principles".  It looks like I am excluded by being non-religious.  It also has a make-me-queasy feel of "if we don't think you're not living up to our standards we ain't going to cover you."

Those plans are also not ACA-compliant by the way. And if you are "living in sin" they can cancel your coverage. If you need coverage for birth control (even for the numerous non-reproduction uses as a hormonal regulator) or abortion or STI testing, it isn't covered.

Edit: I forgot they also have a lifetime coverage maximum of $1mill for most people, which no ACA-compliant plan is allowed to have now. Say you have a kid, and that kid needs to be in the NICU for the first 10 days of their life. You've hit lifetime max at 10 days old. Doesn't really help on the catastrophic front.

I'm not advocating these by any means... But it depends on what you mean by "compliant".   You're correct in that they don't have the same rules.  But they're specifically mentioned as exemptions -- so some ways they do comply with the law, just not with the insurance guidelines set out by the law.

True, you get out of the penalty, you just don't get nearly any of the benefits. Also you need to attend church every week.

Red Beard

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #38 on: November 02, 2015, 03:00:02 PM »
As a benefit manager for a mid-sized employer, we paid around $500 per month for our single employees on an HSA. I would say your rates are a bargain!

This. A lot of times people compare their premiums to the premiums others pay even though those premiums are subsidized by an employer. The HDHP plan we provide costs us around $350 per person with an abnormally young, abnormally healthy (knock on wood) employee population.

Also, my choice to have insurance isn't a bet against myself - its a hedge on the bet I have made on living in a distracted society where buses run red lights and car doors open in bike lanes.

marcela

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #39 on: November 04, 2015, 11:11:23 AM »
I was thirteen years old when all of a sudden my body decided to rebel. I spent 48 days in the hospital, several weeks of that time in ICU and had numerous tests and procedures done. Months after I was allowed to go home, I was diagnosed with Still's disease and entered a lifetime of specialist doctor's visits, $1,000/months prescriptions and a future filled with surgeries. Before this I had not been in a hospital since birth. My mom said she stopped opening the bills when they crossed $140k.
Luckily I was covered under the Florida Healthy Kids insurance program. When I was 19 and about to age out of the program, my father had to change careers so he would be working somewhere the insurance would cover me. I had tried to shop around on the individual insurance market and all but one disqualified me due to my pre-existing condition. That one originally quoted me at $1,500/ month before they changed their minds and determined I wasn't eligible anyway. 

Get the insurance.

Eric

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #40 on: November 04, 2015, 11:23:57 AM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

No one is recommending excess health insurance either.  Just the minimum needed to not end up with a six figure bill at the time when you can't pay it because you're out of work due to have a six figure health issue.  It's not inconsistency at all.  You should carry insurance on what you can't afford to pay for out of pocket.

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #41 on: November 04, 2015, 11:24:05 AM »
Quote
Quote
There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.
Exactly right, the issue you're describing is called "price transparency," and it's why two hospitals within a few blocks of each other may have prices that vary by 100x or more for the same service. This is one of the most hotly debated issues in American Healthcare policy today.

Allow me to put my complainy pants on for a moment...

Who is actually trying to do anything about this lack of price transparency?  I have never heard of a politician with a plan to make it better or even bring it up as a topic of discussion.  How often do we say, "at least we have our health"?  Is it asking too much to be able to afford it, especially things outside of our control like a genetic illness.

Ahem, okay I have no plan to make it better so complaining won't fix anything.  For being in likely the most developed country in the world, why is this an issue while it isn't in other countries (or is it?)
« Last Edit: November 04, 2015, 11:26:10 AM by Bettis »

bogart

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #42 on: November 04, 2015, 11:25:08 AM »
Maybe I'm the oddball but I remind myself that my higher premiums are "hopefully" helping someone who was getting screwed before. Don't know if thats true, but thats how I like to imagine it.

At my employer insurance has been free for 0$ deductible ppo plan for the last 20 years,  that changed the year ACA went into affect. Oh well.

Thanks.  For years we struggled to find (not afford, fortunately we were able to do that on his behalf, but only because we're reasonably high earners -- he sure wasn't able to) health insurance for one of my stepkids who has an autoimmune condition.  We were fortunate that COBRA, at $500 per month, was available both before (low-income employment) and during grad school (the school offered student insurance, but nowhere near enough if things went horribly wrong, and unlike the OP I'm uninterested in having myself or a family member be un- or under-insured), and after, until said kid found a "real" job.  While not currently relevant (possession of "real" job persists), knowing that this pre-existing condition would no longer be an issue thanks to the ACA is such a relief.

Spork

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #43 on: November 04, 2015, 04:08:51 PM »
Quote
Quote
There is no excuse for forcing this "protection money" onto consumers. Nobody would put up with this bullshit if the autoshop down the road charged $3,000 dollars for a new bumper but Geico could have them all day everyday for $1,000.
Exactly right, the issue you're describing is called "price transparency," and it's why two hospitals within a few blocks of each other may have prices that vary by 100x or more for the same service. This is one of the most hotly debated issues in American Healthcare policy today.

Allow me to put my complainy pants on for a moment...

Who is actually trying to do anything about this lack of price transparency?  I have never heard of a politician with a plan to make it better or even bring it up as a topic of discussion.  How often do we say, "at least we have our health"?  Is it asking too much to be able to afford it, especially things outside of our control like a genetic illness.

Ahem, okay I have no plan to make it better so complaining won't fix anything.  For being in likely the most developed country in the world, why is this an issue while it isn't in other countries (or is it?)

This isn't a perfect plan, but you'd be surprised how well it works:  Ask price questions up front.  It's going to be hard because you're going to find out in a lot of cases they actually don't know.  (Someone else does the billing for them.)  But if you say up front you're trying to save, there are actually a lot of docs/hospitals that will work with you.  And if you start saying "$8000 seems like too much for that"...  some of them will actually negotiate downwards.

This is especially true of prescription drugs.  There are often multiple choices and the doctor prescribing them is not likely to know the price differences.  Ask what your choices are and then shop the prices.  You can also sometimes buy prescriptions cheaper by having the Doc prescribe a larger pill and physically cut it in half.  (I.e. one half a 50mg pill once a day is the same dosage as a 25mg pill and sometimes can be purchased cheaper.)

It's just something we're trained not to do in the USA. 

Ocelot

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #44 on: November 05, 2015, 01:31:19 PM »
I'm moving to the US from New Zealand next month, and the healthcare system is the scariest thing about it. Like many here, I've never had insurance for anything in my life up until this point, so the idea that I'll be paying hundreds of dollars for something I'm used to receiving cheap or free is a big shock. Obviously this system is ingrained in US culture, and despite "socialized" (read:"sane") systems working extremely well in many (most?) other developed countries, any attempt to change it would be political suicide.

At the end of the day, it doesn't cost any more to provide care in the US than it does in Canada or the UK or NZ. Those countries prove that state-funding doesn't result in a gigantic tax bill. All this is funding is a giant insurance industry, with hugely inflated hospital bills for everyone uninsured.

Imonaboat

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #45 on: November 05, 2015, 01:42:13 PM »
Insurance (and all the people required to run and deal with it) is just a middle man in there soaking up a majority of the money and providing no real value in return.

Also, everyone is always healthy until they are not. I thought I was immortal when I was 25 too. One bad slip, one bad trip, one car accident or a bad roll of the dice and you will be singing a much different tune.

Schaefer Light

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #46 on: November 05, 2015, 02:03:00 PM »
I've never had insurance for anything in my life up until this point, so the idea that I'll be paying hundreds of dollars for something I'm used to receiving cheap or free is a big shock.
I don't want to debate the merits of one country's healthcare system vs. another's, but the health care you've been getting is not really free.

justajane

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #47 on: November 05, 2015, 02:10:40 PM »
Insurance of any kind is a bet against yourself.

It's very surprising so many Mustachains don't get this. We agree it's silly to carry excess insurance on a car, house, whatever. Medical insurance? well, gotta have that! why the inconsistancy, mustachios? You have been brainwashed by salesmen and are unworthy of your handlebar.

Young, healthy - consider going without, or with just true 'disaster' insurance (i.e. 25k deductible) if such a plan is available.

No one is recommending excess health insurance either.  Just the minimum needed to not end up with a six figure bill at the time when you can't pay it because you're out of work due to have a six figure health issue.  It's not inconsistency at all.  You should carry insurance on what you can't afford to pay for out of pocket.

Plus, whereas with other types of things like cars and houses that have a finite replacement value, health bills are almost infinite. I know someone personally who racked up $1 million in bills in one year. She had a medical emergency that required her to be in the ICU for three months. She had multiple surgeries and an advanced blood treatment daily that costs god knows how much. Yes, it is unlikely that this will happen to you, but it's not impossible. You run the risk of losing your entire stash and having to declare bankruptcy by not being insured. If you're okay with that, go ahead. My friend had a 500K cap on her insurance (way before Obamacare). For years afterwards, she was hounded to pay the rest. I'm not sure how it all ended up, because I lost touch with her.

Argyle

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #48 on: November 05, 2015, 02:12:03 PM »
It's not free, but the ultimate cost to the consumer is about half in other countries.  For instance, the average annual expenditure on health care in the U.S. is USD $9,146, in New Zealand, USD $4,063.  (http://data.worldbank.org/indicator/SH.XPD.PCAP) Health outcomes are no worse in most other developed countries, and often better.  What does the extra money in the U.S. go for?  The huge bureaucracy of insurance companies and payments to stockholders.  I also can't tell you what a wonderful experience it is to have a doctor say, "Your temperature hasn't gone down, I'm worried about your kidneys let's send you down for a scan," and your first thought isn't, "OMG how much is it going to cost?  Don't do it until I get preapproval!  OMG what a nightmare!"  And when they find something on the scan, you don't think, "Now I'm going to be bankrupt."

forummm

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Re: Health insurance...ridiculous for 25 y/o non-smoker/drinker?
« Reply #49 on: November 05, 2015, 02:20:04 PM »
I haven't had health insurance up until this point. It's became even more unaffordable since Obamacare. I can technically afford it, I'm just hesitant about paying as much as even the basic catastrophic plan is.

My cheapest option as a 25 y/o non-smoker/drinker with no subsidy is $180/mo. This is with a $6,850 deductible/max out of year cost. That just seems silly. What are others similar in age/no subsidy seeing? I'm assuming the same, but man...

A friend of mine (~30) is undergoing treatment for cancer. His 3rd episode in the past few years. It's "insurance" and healthcare is absurdly expensive.