I don't understand what people/the self employed are supposed to do about health insu

Thread starter #1
This has gotten out of hand. Not only has premiums quadrupled but deductibles has also. This is killing the self employed and people in general. I keep thinking it will implode/reset and get better. But it keeps getting worse except for the unemployed. When will this end? Will it end before I worry myself to the grave?
 
the only way we have been able to keep insurance was for my wife to only work part time in our business, and in the lunchroom at the school.

They don't pay much, but we can insure our whole family for ~$300 a money, with a 3500 per person deductible. It ain't ideal, but at least we can make ends meet with it.

I had to have some cancer treatments this year. Chemo/radiation, and 2 surgeries. I met the deductible and max out of pocket real early in the year, but the insurance company has paid out nearly 180K in medical on me.

We would have been broke if not for insurance.
 
Only by a fluke did health insurance become tied to employment. Really makes no sence when you think about it but thats the way it is. Our system would look much different otherwise.
 

ddgarcia

Senior Member
This was the intention of Obamacare all along. Make it COMPLETELY unaffordable so people would demand the gubment step in and take it over.

It's time to get gubment and insurance companies out of healthcare and leave it to people and doctors. Amazingly we got by for many MANY years without health insurance
 

T-N-T

Senior Member
I don't understand the difference between now and then.
Then, unemployed git free healthcare paid for by tax payers.....
Now unemployed get free healthcare paid for by healthcare having tax payers.....
 

sinclair1

Senior Member
Just jumped on my wife's companies insurance. We couldn't afford the small business policy anymore.

It's kinda old school, you get $100 a month off for passing a nicotine test and other health related discounts.

It's exactly 40% of what our new policy was going to be with the small business plan.

Health insurance had a small part of us going back to the workforce. :cheers:
 
Medical insurance is NOT health care. That is a very important statement. What health insurance WAS - before the government stuck their fat fingers in it - was - a collective pool of funds, managed by a third party, to cover the big expenses resulting from accidents and disease. It was a privately managed "social" program that had some popularity among wage earners, kind of like credit unions. In the real world, medical insurance was (and still should be) better thought of as insurance for catastrophic health issues.

"Group" insurance plans, originally promoted by employers as a means of attracting and keeping good employees, added doctor's visits and other recurring expense goodies - WHICH the employers paid for - as competition for those employees increased. But the group insurance benefit was exclusively employer paid - until most employers were required (by government) to provide it - then most employers chose to charge employees a portion of the insurance cost. With "group" insurers competing with Medicare - and forced to pay the government schedule - cost started going up.

The Democrats and socialists now claim that "good health care" is a "right" and then conflate Medical insurance and health care. It is the INSURANCE and the government meddling in the market (Medicare, Medicaid, ACA) that has artificially driven up the cost of health care. And now it is almost impossible to stop the avalanche of bad news from inflated costs, increasing premiums and absurd rules.

The only possible help for an individual who is self employed is complicated. First find a real catastrophic care policy with very low premiums and extremely high deductibles. That policy is your protection from bankruptcy if someone in the family gets cancer or has a serious health issue, or an accident. It will not pay much of anything until a deductible in the thousands has been paid.

Then find doctors who will agree - up front - to accept cash payment from you when you visit at a significant discount from their normal bill. Really, you can find good doctors who will cooperate very easily. In their world they may bill $150 for an office visit, collect a $20 "co-pay," then bill the insurance company for the remaining $130. On average, the doctor waits 90 days for the insurance company to pay him (or her) about $40 to settle the claim. Your doctor billed $150, collected $20 up front and three months and hours of paperwork later got another $40. If you were to instead agree to pay - say $75 - as payment in full for his $150 office visit fee, most doctors are smart enough to say, "yes."

For almost all other medical services, you probably will not have the option to negotiate a price in advance. But you can still negotiate at the time of services and in most cases the medical service provider will be happy to take about half of their billed amount as payment in full. Really, they do that and they do it because it is more money than the contract with the insurance company will pay and they save hours of staff time on paperwork.

I retired early (at 55 and before Obamacare) and the cost of a medical policy like what my wife and I had through our employers was impossibly, absurdly, high. So I did what I described above.

For three years we had nothing but a (then) $90 a month catastrophic care insurance policy with a $10,000 deductible, no coverage for doctor's visits, no vision, no dental, no drug coverage. We paid everything out of pocket. During that time my wife had a minor surgery (bills totaled $18K, I paid $9.5K and everyone was happy), and I encountered two rather serious medical issues (without having to stay in a hospital), in addition to regular visits to the doctor and the usual prescriptions, dental bills, eye checkups, etc.

For those three years we paid out (much of it negotiated prices) about $11,000 a year (including the catastrophic care policy) for an actual total of $33,121. If we had purchased medical insurance as 55, 56 and 57 year old "unemployed" adults the premiums alone would have been (then) over $15,000 PER YEAR. We actually saved money!

Pappy has done almost the same thing, with a high deductible policy to cover the big expenses and paying most of the regular expenses out of pocket. Note that the Pappy's insurance was nearly useless for day to day medical expenses (monster deductible) but has saved his family financially when he hit a BIG medical bump!

Hope this rather long post is helpful!
 

dwhee87

Senior Member
A couple a suggestions for you...

1. Go talk to a health insurance agent. There are 'non-compliant' policies out there that are a lot cheaper than exchange policies. They can also steer you into exchange policies that actually have doctors near you, instead of 50 miles away. They get paid by the insurance company they place you in, so no out of pocket cost to you. There are still 'catastrophic' policies out there. They are just not widely publicized.

2. Call around/google "concierge medicine" or "concierge doctor" in your area. My wife sees one in Cumming. We pay $250 a month, and she can go in any time, unlimited monthly visits, no copay, and actually get 30-40 minutes WITH THE DR. That $250 gets you all the services the doc can do in her office (IVs, xrays, stitches) and discounts with providers (like labs) when she does any bloodwork or outside tests. Not a 'fail safe' like catastrophic, but will take care of all the minor illnesses & injuries.
 
Insurance

A little that I just learned: It may help you to get a Group" policy". A group can be as few as two (you and the wife). New rule is that you no longer have to have 50% participation but you must apply between Nov 5 and Dec 15th of this year.
 

jbogg

Senior Member
Check out Christian Healthcare Ministries Cost Sharing plan. Our family of four monthly premiums went from over $2000 per month to $400 per month. I believe there is a $500 deductible per major medical event, but it’s affordable and protects against a catastrophic event that could bankrupt a family.
 

Miguel Cervantes

GON Severe Weatherman
Married a smokin' hot nurse with great insurance through the hospital....WINNING
That's what I did 30 years ago. I'd be dead by now if it weren't for her job and insurance.
Check out Christian Healthcare Ministries Cost Sharing plan. Our family of four monthly premiums went from over $2000 per month to $400 per month. I believe there is a $500 deductible per major medical event, but it’s affordable and protects against a catastrophic event that could bankrupt a family.
^^^This^^^
 

Duff

Senior Member
Check out Christian Healthcare Ministries Cost Sharing plan. Our family of four monthly premiums went from over $2000 per month to $400 per month. I believe there is a $500 deductible per major medical event, but it’s affordable and protects against a catastrophic event that could bankrupt a family.
This is what we HAD to do. It hurts with regular doctor visit but it will keep us from going broke if something major happened.
 
This is what we HAD to do. It hurts with regular doctor visit but it will keep us from going broke if something major happened.
negotiate with the doc for cash. I'm told they usually get close to what the co-pay was with insurance.
 
Not sure if this a serious thread or not, but I agree with GA Bob's comments above. The problem is obviously not the insurance companies but instead with the exorbitant prices charged by the medical providers. If my family didn't have good insurance for the past 40 years we would have been bankrupted 100 times over.

As others said above, there is a HUGE difference between the retail amount they bill and what most insurance companies agree to pay them. And the providers have written agreements in place, so they know in advance what they are going to get paid by the insurance companies. So I have no idea how someone without insurance goes about negotiating the same lower price as someone covered by insurance.
 
Thread starter #18
Ofcourse I'm serious.

Thanks for all reply. Seems it prob won't get better but everyone will have to get creative about health insurance
 
if it does get better, it will be years away.

nothing moves in a hurry like this. Congress ain't gonna do nothing, and if they ditched Obammycare tomorrow, it would take the market a few years to correct itself.
 
Top