Health insurance premiums

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This topic contains 13 replies, has 9 voices, and was last updated by  Nw Prepr015 11 months, 4 weeks ago.

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  • #2717

    Molly Malone
    Participant

    If I dropped my health insurance, my monthly fixed expenses would drop to $1,200. I am seriously considering dropping it and putting the premium money into my savings account. Of course, that will be when I get diagnosed with some hugely expensive illness. The fear of that is what has kept me paying this premium.

  • #2719

    Daisy
    Keymaster

    We don’t have health insurance for this reason. Based on my income from all sources, we don’t qualify for any of the subsidies. So for my daughter and myself, we’d be paying $1800 a month for health insurance. Then there’s a deductible of $10,000 after that, and then the insurance would cover only 60%.

    I just hope we never get cancer or I don’t have a heart attack. It’s definitely a gamble.

  • #2721

    Anonymous

    Not referred to your situation but as general information since I saw several people missing this when they evaluate if getting health insurance. When you are insured you pay for services the amount agreed between insurance and doctors which can be discounted as much 70-80% vs what uninsured people pay.

    Getting on the soap box, I think this is a very unfair practice because that level of discount is not justified by the higher volume of patients accepting any insurance bring into a doctor office. If Obama was serious about affordable health care, he would have addressed that issue for example mandating that uninsured patients cannot be charged more than x% above insured rates. It makes me think that uninsured people pay for what insurance companies and Medicare/Medicaid do not want to pay.

    • #2726

      Molly Malone
      Participant

      Dark Future, you are right. One major benefit of having insurance is that the providers are forced by the insurance company to give discounts. When I look at my insurance Explanation of Benefits forms, I see that my insurance company (Blue Cross Blue Shield) forces my providers to give big discounts anywhere from 30% to 50%. So yes, uninsured people pay full freight.

      Crowbar, I don’t have any providers who will give me a discount if I pay in full on the spot with cash, check or credit card. They only give discounts as forced to by my insurance company.

  • #2724

    Crow Bar
    Keymaster

    You may want to look into a health savings account.
    Also, when paying cash, you will get better rates. It just may more financial sense to take the money you would spend on health insurance, put that money into savings, and then just pay cash.

  • #2729

    Crow Bar
    Keymaster

    Ugh.
    Sorry to hear.
    Yeah, the ACA was anything but affordable. Prior to the ACA, our premiums went up like $20-50 a year, the deductible did not go up and was reasonable.
    Now . . . we cannot afford to use our health care. Premiums go up by double digit % every year, the deductible is sky high. Someone is benefiting, but it is not the average American.

  • #2730

    Anonymous

    @Crow-Bar, to qualify for an HSA you must have insurance so it is another scam to funnel money toward the financial institution that our dear government supports. Additional disadvantage, you put money in a savings account that can be only used for health expenses so you can have money there you don’t need and have no money to pay for food. Probably HSAs work for people who have money to spare also known as the one who do not need them.

    On the paying cash, you’re lucky if you have a provider who accepts cash. Some do not take payments in the office at all because all their billing is outsourced.

  • #2732

    I find it quite shocking what medical aid costs in the States.

    For a good family plan for 4 people one looks at $400-$500 which gives you full medical cover for hospitalization, Dr’s visits, even some specialist Dr’s, full dental, prescription glasses, chronic decease and medication – the whole shebang.

    For less than half of that one can opt for just a hospital plan with chronic decease and medication. If you are healthy, you can save a packet.

    With just a hospital plan, one then pays for your own Dr’s visit / Dental etc. We always ask for quotes first, shop around, and what discounts if paid by EFT (electronic fund transfer).

    As credit cards are a cost to the seller of 3-5% of the transaction value.

    @MM, shop around maybe?

    • #2743

      Molly Malone
      Participant

      Terrible Triplet, I am curious, where do you live?
      My health insurance plan costs me $9,000 a year. That’s just for me. I live alone.
      About estimates. There are a lot of health care professionals and specialists who will be upfront about their prices because they are offering services that they know insurance won’t cover at all or will only inadequately cover.
      But I have never in my life known a regular doctor, surgeon or hospital willing to give me a price estimate. If there are such doctors and surgeons in the U.S., I have never met them. If you ask a doctor for an estimate, he just looks incredulously at you and grins and chuckles at your naivete. If you ask over the phone, his front desk clerk will say curtly that they don’t give estimates.
      The really scary thing is that you have no control over who your doctor consults with, which lab he uses, etc. Your doctor does not care if these people/businesses take your insurance or not. You will get bills in the mail and wonder who these people/businesses are and why they are billing you. You will find out that your doctor consulted with them, used their lab, sent your tests to them to be read, etc.

  • #2734

    Anonymous

    I was thrilled with what I thought the ACA was supposed to be. Very disappointed in what it is. My oldest has eplipsy and he was dropped from Medicaid the day he turned 19. Regular insurance is not even an option unless he becomes a milliinare, he doesn’t qualify for medicaid since he isn’t disabled. So no insurance at all. He gets his meds thru the drug company and everything else is cash. Several grand mals and no ER visits since none of us have 5 grand in a drawer somewhere. To say life is medically scary is such a mild statement!

  • #2750

    Osito Arelano
    Participant

    I have known several people who go the route of an insurance co-op. I don’t use one personally so I don’t know if it’s cheaper, better, or worth it in any way, but it’s an alternative that’s out there. The people I know that use it here in the US are “Own my own business” types (translation: barely scraping by) so I know they don’t have a lot of spare change to throw at it.

  • #2786

    @Molly Malone, I’m from South Africa. Medical aid here is also expensive, compared, but nowhere near what you guys are paying.

    $9000 is like R 129,082.95 South African rands. That is R10 756.92 per month, more than a lot of peoples salaries. At R10k pm salary, one would pay like R1500 for medical aid.

    That is crazy!

    I do agree that most people in SA, all over the world, do not negotiate or shop around for medical prices. I learnt it from my aged mother, decades ago. She saw the pattern and said no, shop around for prices. We’ve all been doing it for a long time now.

    Medical “Profession”? A mechanic, IT person, Dr, Dentist, groceries, attorney are all professional “business” people offering their services. Why pay them what they ask because they say so? It is our hard earned cash that we can spend how and where we believe we will get the best value.

    Start a revolution, ask for quotes/estimates that includes discounts. If the person looks funny at you, go to the next one until someone sees where you are heading and jumps on-board. Offer to go to social media and tell everyone else you have a Dr / Dentist that can negotiate their prices. You save and the Dr / Dentist gets more clients.

    And cash versus credit card, in SA, about a 3-5% saving right there, for the medical professional. Find out if the same applies there.

    Hospitals are a wee bit more complicated as one is not talking to the financial person. Try and get to them, same recipe. First child we had we had to pay in about R20 000 on top of the medical aid. Not covered they said, specialist rates they said. So we learnt. Second child we made a “profit”, we saw how they worked, the buddy system, so we played by their rules on our terms by asking over and over, so how much will that cost? Is there a cheaper option, why do we need this, what is that for, why why why? When big unpronounceable words where used, we said nope, break it down, make it understandable, start again Dr.

    Tests and extra consultations. We negotiate with our Dr what she tests for and what not, and where she send the tests, as I am the one paying. Extra consultations, we ask her, can you “fix it” or can we go straight to the specialist? She is a single mother, fully understands the cost implications.

    Many years ago my wife was in the maternity ward next to another new mother. The new mother was a Dr. So typical me, I asked her, male / female Dr’s, who does it for the love of the job and who does it for money? She said, in her classes, most of the males where there for the money, most of the females, the vast minority, wanting to make a difference. Maybe find a female Dr and start there?

    Change the way you view “The Medical Profession”. It is a business, like every other business in the world. You need a service rendered, get the best price.

  • #2908

    Red Carnation
    Participant

    My husband and I go through Christian Healthcare Ministries and pay $45 a month each for hospitalization needs. At, $150/month, the highest level, a birth is covered 100%.

    Others that I know have Samaritan ministries for around $200 per person per month.

    There are requirements for these healthcare alternatives, such as being a member of a church, no smoking, no drinking, etc.

  • #4809

    Nw Prepr015
    Participant

    I have worked in healthcare for 12 years in the southeastern US. I will say that there is room to negotiate just about every doctor visit, lab test and procedure. The key is to know the medical language to ask. If they know you have any kind of insurance the business (or billing person on the other end of the phone) is going to tell you they do not negotiate. This is usually false. What they really mean is if you are a “cash pay, uninsured” then they will negotiate. It is true that there are some private doctors who won’t accept cash pay patients, but not for the reason you think. The reason is the patient will usually not do the necessary testing being prescribed and that actually makes them a liability. If anyone wants to try to get an estimate and they are cash pay, get the CPT codes associated with the test, procedure, or doctor/specialist visit being recommended. Then call the billing departments for all the facilities that may provide that service and explain very politely, your situation. Ask if they can “help you out”. As a referral coordinator I performed this service for all my cash pay, uninsured clients. Was I a little “pushy” sometimes, sure. If I didn’t get a reasonable price, I would just say (insert name of local doctor/facility) quoted me 200.00 less than you.Just a random example of course,but you get the point. Nine times out of ten one of them would extend a nice discount. Be assertive, play on the “sick role” and always be nice. This seems to work well with the cost sharing ministries. But never, ever tell them you participate in the cost sharing ministries because they will assume it is health insurance. If it doesn’t work in your individual case at least you know you have tried.

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