Author Topic: Obamacare Master thread  (Read 199459 times)

Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #420 on: January 04, 2018, 12:07:31 AM »
Hope i'm in the correct thread. I just went over my health insurance bill for this year and am feeling ripped off. Maybe someone here knows better...

We are a couple under 30 with 1 kid and expecting 1 more BH.

Live in Jersey, am off the charts for Jerseycare for anyone in fam.

My company's Gold Plan (in-network) is $16K a year of which I pay half and they pay half.

We went to the doc maybe 3 times this year and never filled a prescription. I PAID $8,000 FOR 3 VISITS!

To not have insurance is irresponsible. Paying the bill for a birth is only $2-3K (i've heard).

Anything I can do to pay less?

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Re: Obamacare Master thread
« Reply #421 on: January 04, 2018, 04:43:11 AM »
Hope i'm in the correct thread. I just went over my health insurance bill for this year and am feeling ripped off. Maybe someone here knows better...

We are a couple under 30 with 1 kid and expecting 1 more BH.

Live in Jersey, am off the charts for Jerseycare for anyone in fam.

My company's Gold Plan (in-network) is $16K a year of which I pay half and they pay half.

We went to the doc maybe 3 times this year and never filled a prescription. I PAID $8,000 FOR 3 VISITS!

To not have insurance is irresponsible. Paying the bill for a birth is only $2-3K (i've heard).

Anything I can do to pay less?
I'm pretty sure that is incorrect (unless your talking about only the hospital itself maybe). But keep in mind that there could be complications. When my newborn baby was in the NICU for less than a week, the hospital bill was close to $10,000 (which insurance covered). And the NICU MDs, who were all out of network, cost close to $800/day (yes, you read that right.) That was not covered by insurance. It sucked. But what choice did I have.
Then keep in mind that the OB get paid as well as many other providers.
Lastly, with 2 small kids, you never know when you'll have an emergency and will have to go to the ER. Even w/o any complications, I would say pretty confidently that you would spend more than $8k on bills if you don't have insurance.

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Re: Obamacare Master thread
« Reply #422 on: January 04, 2018, 08:16:42 AM »
Lastly, with 2 small kids 4 people in the family, you never know when you'll have an emergency and will have to go to the ER If, or when any family member might be faced with significant medical expenses.. Even w/o any complications, I would say pretty confidently that you would spend more than $8k on bills if you don't have insurance.
Even the healthiest people can get sick or injured out of the blue. I know it doesn't feel good to pay $8,000/year when your expected expenses on an average annual basis are far less, but it's insurance, and it can save you from being financially wiped out (and possibly gain you access to doctors).

We have a broken system, and Obamacare was a step in the wrong direction. A healthy person (family) should in theory do better with a high deductible plan and an HSA.

Though not HSA eligible, healthy people under 30 often do best (financially speaking, as well as great simplicity) with a catastrophic plan.
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Offline shaulyaakov

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Re: Obamacare Master thread
« Reply #423 on: January 04, 2018, 12:40:47 PM »
High Deductible plan could be good. The other benefit is access to the negotiated rates, so even if you have a high deducible/co-insurance, at least your base prices are fixed and should be much lower than the posted rates (without having to worry about negotiation).

Also, childbirth in NYC with a standard hospital stay + OB + Ped for our daughter was more like $20k before insurance or any hardship adjustments for lower income and uninsured. With insurance - $250 total. So that more than made up for 2+ years of premiums on its own.

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Re: Obamacare Master thread
« Reply #424 on: January 04, 2018, 12:46:54 PM »
Be happy your company pays half. $8,000/year is gold for insurance for the whole family these days. Keep it, you'll have a child birth this year IYH.

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Re: Obamacare Master thread
« Reply #425 on: January 04, 2018, 12:55:35 PM »
Hope i'm in the correct thread. I just went over my health insurance bill for this year and am feeling ripped off. Maybe someone here knows better...

We are a couple under 30 with 1 kid and expecting 1 more BH.

Live in Jersey, am off the charts for Jerseycare for anyone in fam.

My company's Gold Plan (in-network) is $16K a year of which I pay half and they pay half.

We went to the doc maybe 3 times this year and never filled a prescription. I PAID $8,000 FOR 3 VISITS!

To not have insurance is irresponsible. Paying the bill for a birth is only $2-3K (i've heard).

Anything I can do to pay less?

YOu are getting caught in the difference between provision of health care and insurance. Insurance is to protect against a risk not to pay for your 2 doctors visits. It is all of the requirements that are causing insurance to be so high.
Feelings don't care about your facts

Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #426 on: January 04, 2018, 09:51:02 PM »
I'm pretty sure that is incorrect (unless your talking about only the hospital itself maybe). But keep in mind that there could be complications. When my newborn baby was in the NICU for less than a week, the hospital bill was close to $10,000 (which insurance covered). And the NICU MDs, who were all out of network, cost close to $800/day (yes, you read that right.) That was not covered by insurance. It sucked. But what choice did I have.
Then keep in mind that the OB get paid as well as many other providers.
Lastly, with 2 small kids, you never know when you'll have an emergency and will have to go to the ER. Even w/o any complications, I would say pretty confidently that you would spend more than $8k on bills if you don't have insurance.
I thought the same, until a my CPA (bit of a unconventional guy-doesn't believe in ANY insurance, as its a form of gambling) told me that you can walk into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill. The same way the insurance companies themselves don't pay the billed amount..

Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #427 on: January 04, 2018, 09:53:30 PM »
Even the healthiest people can get sick or injured out of the blue. I know it doesn't feel good to pay $8,000/year when your expected expenses on an average annual basis are far less, but it's insurance, and it can save you from being financially wiped out (and possibly gain you access to doctors).

We have a broken system, and Obamacare was a step in the wrong direction. A healthy person (family) should in theory do better with a high deductible plan and an HSA.

Though not HSA eligible, healthy people under 30 often do best (financially speaking, as well as great simplicity) with a catastrophic plan.

The plan i'm on is the cheapest the company offers. if I do catastrophic I wouldn't get their match.

Besides, isn't someone offered health insurance by an employer no longer eligible for Obamacare?

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Re: Obamacare Master thread
« Reply #428 on: January 05, 2018, 08:57:40 AM »
I thought the same, until a my CPA (bit of a unconventional guy-doesn't believe in ANY insurance, as its a form of gambling) told me that you can walk into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill. The same way the insurance companies themselves don't pay the billed amount..
Please don't get me started on CPAs (no offense to those around here).

I will currently limit my comments to saying that a vast majority of CPAs (the type that do your tax return) might understand numbers very well, but don't understand economics. Try a discussion with your CPA about behavioral economics.

But without getting into that, ask your CPA how many times did he ACTUALLY "walk into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill"?

Many times you won't even get past admission without insurance.

Are you going to read through everything you are given to sign and start trying to haggle about the legal documents you are handed with a low level employee handing them to you, who can't even read them?

Insurance is a FINANCIAL TOOL of risk pooling.

To quote Ben Feldman (not verbatim): there are two kinds of problems, the small ones you can swallow, the big ones will swallow you!

Your CPA might be excellent at what he does (though I've seen plenty of "excellent" CPAs that are clueless about certain items that go on a 1040!), but doesn't seem to be very competent when it comes finance and economics.

In an ideal world, a high deductible plan would be the right form of insurance for everyone (and possibly the only permissible form). What is currently mostly sold as health insurance is a combination of insurance, buying club, and prepaid medical.

If you are an expert at game theory, maybe "walk[ing] into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill" might work (as long as you are poor or have proper asset protection), but for most people the huge insurance companies do a better job at negotiating fees*. But when faced with a major (or even not so major) medical issue, are you going to wait and put your haggling ability to the test?

__________________
* Interestingly, I have what is considered an excellent HDHP that gives me in and out of network access. However, probably because it's "excellent" in the access, it has higher negotiated rates. Which is why when I go (rarely) to my PCP for anything but a well visit, I tell them I no longer have insurance and negotiate a cash rate. I am also fed up with the way they treat my time, and tell them that if I have to be in the waiting room (as opposed to an exam room) for more than 5 minutes, I will reduce the amount I pay them. Hasn't been put to real test yet, because since I started with that approach I never had to be in the waiting room for even 5 minutes (except with my kids, that have different insurance).
« Last Edit: January 05, 2018, 11:55:42 AM by ExGingi »
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Re: Obamacare Master thread
« Reply #429 on: January 05, 2018, 09:04:03 AM »
The plan i'm on is the cheapest the company offers. if I do catastrophic I wouldn't get their match.

Besides, isn't someone offered health insurance by an employer no longer eligible for subsidized Obamacare?
FTFY.

Catastrophic plan is never subsidized under Obamacare, and is only available until age 30.

At this point it is all theory, as you probably can't change anything until your employer's next open enrollment.
« Last Edit: January 05, 2018, 09:12:55 AM by ExGingi »
I've been waiting over 5 years with bated breath for someone to say that!
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Re: Obamacare Master thread
« Reply #430 on: January 05, 2018, 09:39:00 AM »
Feelings don't care about your facts

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Re: Obamacare Master thread
« Reply #431 on: January 05, 2018, 09:55:07 AM »
I thought the same, until a my CPA (bit of a unconventional guy-doesn't believe in ANY insurance, as its a form of gambling) told me that you can walk into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill. The same way the insurance companies themselves don't pay the billed amount..
1) I doubt that is true. You might get 25% or similar amount off but not 80%.
2) Even if it was true (which it's not), MDs and and ancillary providers (labs, radiology, etc) are even less generous than hospitals, which have deeper pockets and certain regulations about having to treat even for free at times. 
I'm telling you from personal and professional experience as I'm in the healthcare field and deal with it on a regular basis.

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Re: Obamacare Master thread
« Reply #432 on: January 05, 2018, 11:40:43 AM »
1) I doubt that is true. You might get 25% or similar amount off but not 80%.
2) Even if it was true (which it's not), MDs and and ancillary providers (labs, radiology, etc) are even less generous than hospitals, which have deeper pockets and certain regulations about having to treat even for free at times. 
I'm telling you from personal and professional experience as I'm in the healthcare field and deal with it on a regular basis.
How dare you challenge the math of a CPA with the reality of facts?
« Last Edit: January 05, 2018, 11:56:21 AM by ExGingi »
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Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #433 on: January 10, 2018, 02:31:57 PM »
FTFY.

Catastrophic plan is never subsidized under Obamacare, and is only available until age 30.

At this point it is all theory, as you probably can't change anything until your employer's next open enrollment.

Correct. I'll look for options then.

Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #434 on: January 10, 2018, 02:33:01 PM »
Please don't get me started on CPAs (no offense to those around here).

I will currently limit my comments to saying that a vast majority of CPAs (the type that do your tax return) might understand numbers very well, but don't understand economics. Try a discussion with your CPA about behavioral economics.

But without getting into that, ask your CPA how many times did he ACTUALLY "walk into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill"?

Many times you won't even get past admission without insurance.

Are you going to read through everything you are given to sign and start trying to haggle about the legal documents you are handed with a low level employee handing them to you, who can't even read them?

Insurance is a FINANCIAL TOOL of risk pooling.

To quote Ben Feldman (not verbatim): there are two kinds of problems, the small ones you can swallow, the big ones will swallow you!

Your CPA might be excellent at what he does (though I've seen plenty of "excellent" CPAs that are clueless about certain items that go on a 1040!), but doesn't seem to be very competent when it comes finance and economics.

In an ideal world, a high deductible plan would be the right form of insurance for everyone (and possibly the only permissible form). What is currently mostly sold as health insurance is a combination of insurance, buying club, and prepaid medical.

If you are an expert at game theory, maybe "walk[ing] into the hospital finance office and ask to pay "the cash rate" and that's about 20% of the bill" might work (as long as you are poor or have proper asset protection), but for most people the huge insurance companies do a better job at negotiating fees*. But when faced with a major (or even not so major) medical issue, are you going to wait and put your haggling ability to the test?

__________________
* Interestingly, I have what is considered an excellent HDHP that gives me in and out of network access. However, probably because it's "excellent" in the access, it has higher negotiated rates. Which is why when I go (rarely) to my PCP for anything but a well visit, I tell them I no longer have insurance and negotiate a cash rate. I am also fed up with the way they treat my time, and tell them that if I have to be in the waiting room (as opposed to an exam room) for more than 5 minutes, I will reduce the amount I pay them. Hasn't been put to real test yet, because since I started with that approach I never had to be in the waiting room for even 5 minutes (except with my kids, that have different insurance).

How much % do you typically end up paying when you negotiate?

Offline YesThatsMe

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Re: Obamacare Master thread
« Reply #435 on: January 10, 2018, 02:36:58 PM »
https://www.nytimes.com/2018/01/03/world/europe/uk-national-health-service.html

Coming soon to single payer near you....

Maybe the UK, but Canada, Israel (from my own experience) & the Scandinavian nations + Belgium seem to manage very well.

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Re: Obamacare Master thread
« Reply #436 on: January 10, 2018, 02:57:50 PM »
Maybe the UK, but Canada, Israel (from my own experience) & the Scandinavian nations + Belgium seem to manage very well.
Israel manages well, so do the Scandinavian countries, personal experience in Israel and Norway.
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Re: Obamacare Master thread
« Reply #437 on: January 10, 2018, 03:08:51 PM »
Maybe the UK, but Canada, Israel (from my own experience) & the Scandinavian nations + Belgium seem to manage very well.
Canada?hahahshahaha
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Re: Obamacare Master thread
« Reply #438 on: January 10, 2018, 07:31:35 PM »
How much % do you typically end up paying when you negotiate?
Haven't done it often (BH don't go often to Doctor. But if I tell my PCP I have no insurance and am paying cash, they'll charge around $80 for the visit) but when I just let them bill insurance and I had to pay OOP, I think I got charged $150 for the visit + a nice sum for minor surgery (ear wax removal that the Dr decided was necessary while he was examining me, without informing me of cost - I would have never consented to the obscene charge for that).
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Re: Obamacare Master thread
« Reply #439 on: January 10, 2018, 07:52:17 PM »
Maybe the UK, but Canada, Israel (from my own experience) & the Scandinavian nations + Belgium seem to manage very well.
Canada?hahahshahaha
Coming soon to a provider near you.....

http://www.huffingtonpost.ca/2017/11/03/canada-doctor-patient-wait-times_a_23266026/?utm_hp_ref=ca-homepage

My wife's grandfather had a wait of a few weeks for some emergency heart tests after having suffered a heart attack. Israel? What was your experience with non-routine procedures? It is not for no reason that so many Israelis come to the states for acute care. Scandanavian nations subsidise healthcare from oil exports. That makes a very big difference. Unfamiliar with Belgium.
Feelings don't care about your facts