Getting Ready to Take the Plunge -- What to Do About Health Insurance

[Stephenedwardgraphic]

I have been running my sign business on nights and weekends for the last 5 years and working my day job that provides pretty good health insurance. Just curious what others are doing for health insurance. Getting burnt out and ready to just to signs full time.

I talked with an insurance guy and the sign up to get on Obama Care is in November --- not really liking the idea of being on Obama Care -- what are the other options -- any groups you can join to get better rates?

 

[Christian @ 2CT Media]

"Obama Care" is just a defined plan outline. We recently switched from a Business Group Insurance to "Obama Care" because we are getting much better insurance at a much better price (About 38% less then group insurance). If you have a major life change (Change/loss of job, marriage, divorce, birth, or death) you can apply for "Obama Care" at any time.

 

[Stephenedwardgraphic]

So would quitting your day job to run your own business count as a a "change/job loss"

For those of you who have Obama Care have you ever been denied any services or have they refused to pay for something they should have?

 

[TimToad]

I just signed up on my state's exchange with the help of a broker and while it was a little hard filling all the stuff out because of technical glitches with the website, the broker managed to power right through all that and get us a decent policy and help with the premiums to boot. We've paid a lifetime of healthcare premiums, taxes, outrageous medical bills for minor procedures, etc. and are very light healthcare consumers, so this little bit of subsidy has been both earned and already paid for in part.

I didn't tell the 200 healthcare executives to take millions and millions in pay and perks the last couple decades and frankly, they are still raking it in. Or to bloat the overstaffed benefits departments of most insurance companies and hospitals, so screw 'em.

But at least, more of us can get coverage regardless of pre-existing conditions and we can get the kind of simple, basic preventative care we need BEFORE we succumb to something that will bankrupt us. The typical, ignorant American view of bankruptcy is that of lazy, shiftless people overusing their credit cards, but the reality is that overwhelming medical bills are and have always been the #1 cause of personal bankruptcy.

Is it perfect, or the single payer Medicare for all, cradle to grave type program I support and exists in EVERY other industrialized country on earth? No, but at least the little stuff we use the most of, like preventative care, basic testing, lab work, my wife's mammograms/pap smears, etc... are all included no matter what type of plan you choose.

 

[rjssigns]

Geographic area has a lot to do with premiums on the "exchange". But I see you're in WI so check into Prevea 360. Nice coverage for small coin. $210 a month for me and the missus. We got it through one of our HBBA members.

We had Golden Rule before that, which had amazing coverage.(zero deductible even for shop "mishaps") But the premiums were in the $350+ range and climbing. Wasn't worth it for two people that see the doctor exactly once a year for physicals.

 

[threeputt]

We had Golden Rule before that, which had amazing coverage.(zero deductible even for shop "mishaps") But the premiums were in the $350+ range and climbing. Wasn't worth it for two people that see the doctor exactly once a year for physicals.

Unbelievably cheap insurance! My wife and I were paying $1100. per month, until just recently. Went from about $800 a few years ago and steadily climbed to what it is today.

Always groused and whined about the premiums (we're both pretty fit and healthy) until Pancreatic Cancer came along looking for me last summer.

Then I was extremely grateful for the full coverage. My advice is not to go too cheap on the plan you select.

 

[fresh]

I just signed up on my state's exchange with the help of a broker and while it was a little hard filling all the stuff out because of technical glitches with the website, the broker managed to power right through all that and get us a decent policy and help with the premiums to boot. We've paid a lifetime of healthcare premiums, taxes, outrageous medical bills for minor procedures, etc. and are very light healthcare consumers, so this little bit of subsidy has been both earned and already paid for in part.

I didn't tell the 200 healthcare executives to take millions and millions in pay and perks the last couple decades and frankly, they are still raking it in. Or to bloat the overstaffed benefits departments of most insurance companies and hospitals, so screw 'em.

But at least, more of us can get coverage regardless of pre-existing conditions and we can get the kind of simple, basic preventative care we need BEFORE we succumb to something that will bankrupt us. The typical, ignorant American view of bankruptcy is that of lazy, shiftless people overusing their credit cards, but the reality is that overwhelming medical bills are and have always been the #1 cause of personal bankruptcy.

Is it perfect, or the single payer Medicare for all, cradle to grave type program I support and exists in EVERY other industrialized country on earth? No, but at least the little stuff we use the most of, like preventative care, basic testing, lab work, my wife's mammograms/pap smears, etc... are all included no matter what type of plan you choose.

I have the same experience and outlook as you. I LOVE MY AFFORDABLE HEALTHCARE PLAN. As with ANY insurance plan, there will be things that are covered and things that are not covered. My plan is awesome, and is about 1/4 the total out of pocket costs (and more is covered, too!) of an equivalent plan prior to the AHCA. I will tell you that I finally took care of a lingering health issue this year, and I had ZERO issues with going to specialists, lab work, imaging, or a surgery center. My small medical issue is resolved, and its all because of Obama. I was never denied service, overcharged, or had an issue due to my health care exchange plan. Its truly the best thing that has come from our government in my adult life.

As an aside, I know of three people this year that choose to keep their individual, open-market healthcare plans instead of going through the Healthcare Exchange. Each one of them is complaining about their higher premiums and lack of services. All because they were too lazy or too bull-headed to fill out a form online and research what was available. They aren't going to be lazy this year though, and they will probably save a boat-load of money to boot. I suggest you do the same.


edit: Prior to the Affordable Healthcare Act, the cost of an equivalent plan that we now pay $650 a month for was closer to $1400 a month. In addition to paying more than 2x the monthly premium, less was covered, the copays were $25/$50 instead of the $10/$20 we now pay, and the deductible was 2.5 times higher than our current plan. So for all of you that live in states where healthcare isn't ASTRONOMICAL, I can maybe understand why you didn't think it was necessary. But in NJ, we were desperate for the help. And we still probably pay a lot more than if we lived in Wisconsin.

 

[OldPaint]

and the there are US.......WHO GET THE BEST HEALTH CARE.........MONEY CANT BUY THE VETERANS HEALTH CARE SYSTEM.!!!!!!!!!!
2004, diagnosed bladder cancer local hospital E.R. $5000.00 visit. went to VA the following monday, SAW A DOCTOR THAT DAY, nov 30.
dec 6 had 1st appointment with urologist/surgeon. jan 18th had surgery to remove tumors. followups and cystos and 9 more surgeries, been cancer free for 5 years!!!!! 2010, open heart surgery(VA RUSHED me to local hosptial)double by-pass. july 2013 major back surgery done at local hospital covered by VA.

 

[CES020]

I wish I could share the enthusiasm. I lost my healthcare because of it. Had a very good, affordable plan that was scrapped and the rates more than doubled with the deductibles going up 10x.

 

[threeputt]

been cancer free for 5 years!!!!!

Good for you, ol' timer. Glad you made it. Cancer's a b*tch. They tell me I'll live, that I'm cured, but I still watch everyday for some signs that it's back. I had so many CT scans in the first year that I actually became concerned that the amount of radiation I was receiving would kill me faster than the cancer. But they've got to be able to see inside your liver and pancreas.

Kaiser insurance covered my bill, except now the enzyme treatments have been costing me an arm and a leg each month. My co-pay is $752 (each month) Draining savings.

Again I say get the best plan you can get. Be sure to notice what the drug portion pays. The drugs are what can really cost you!

 

[fresh]

I wish I could share the enthusiasm. I lost my healthcare because of it. Had a very good, affordable plan that was scrapped and the rates more than doubled with the deductibles going up 10x.

Did you get those rates from the Healthcare Exchange website, healthcare.gov?

Or were those the rates directly from the insurance company? There is a HUGE difference between the two.

 

[Christian @ 2CT Media]

Yes Quitting a Job is a life change event.

We pay $375/mo for Platinum PPO coverage in AZ on Me, My Wife, and My Daughter. It jumps to $395 once my son is born. We get $750 deductable ea and $1250 max out of pocket, or $1250 Family Deductable / $2500 Family MOP. CoPay is $15 IN or $35 ON, Specialist is $35/$55, ER is $250, Urgent is $55. After Deductable is goes to 90/10 (they pay 90%) or CoPay which ever is less. That price for insurance is Through HealthNet of AZ and is less then half of the rates I was quoted out of the market by other carriers. I have yet to find a doctor/specialist that is not in network.

 

[cajun312]

I was looking forward to ACA because of a pre existing condition. I just turned 60, I'm single and a smoker, live in a rural area. When I got a quote last fall, the bronze plan would have cost me $800 a month plus a 50% surcharge for being a smoker. Deductible was $6,750 which had to be paid in full before the policy would pay anything, although some hospitals will let you pay the deductible over a three month period. So I was looking at around $18,000 out of pocket before the policy would pay a penny. The closest hospital to me that was in the network at the time was 100 miles away. The Blue Cross agent told me I should just work two days a week so then the majority of the premium would be subsidized. I still have no insurance.

 

[CES020]

Did you get those rates from the Healthcare Exchange website, healthcare.gov?

Or were those the rates directly from the insurance company? There is a HUGE difference between the two.

Both.

It was a horrible thing for me to go through, and I called everyone I could, and all I got was a bunch of politicians telling me that I was better off now. I asked her (Senator's representative) how not having insurance now was better than having full coverage before. All I got was a lot of "Well, it's unfortunate". Well, it's all well and good to want coverage for everyone, but it's wrong to take mine away (that worked) and give it to someone else, while I'm left with nothing.

I don't qualify for subsidies, so I went without insurance. Luckily, I had a trip to the ER which cost left me with a $14,000 bill. $14,000 with no insurance, where I had a perfectly good, working policy before that would have cost me about $1000 out of pocket for that event, at the most.

I'm apparently one of those people that "don't exist" and are "made by by the right wing nub jobs to make the plan look bad". I couldn't give a rats butt about any politician, I just think it's wrong to force me out of something that worked for me.

 

[fresh]

Both.

I'm apparently one of those people that "don't exist" and are "made by by the right wing nub jobs to make the plan look bad". I couldn't give a rats butt about any politician, I just think it's wrong to force me out of something that worked for me.

That is really unfortunate, I hope that you can obtain a more affordable plan in 2015.

I also want to note that health insurance companies decide their rates on their own. They could have brought their current plans into compliance without overcharging their customers, but they choose to continue screwing their customers over. Its understandable that you are upset that you lost your plan, but try not to misplace the blame. I have a dental plan through AHCA that SUCKS. Its seriously the biggest waste of money and I'm so mad that I choose it last year. BUT it completely sucks because its a terrible company that over charges and refuses covered procedures and then makes you spend HOURS and HOURS and HOURS on the phone trying to resolve a $100 dentist bill. This is only the government's fault because they allow it to go on. FYI, don't ever get United Concordia Dental. They are TERRIBLE!!!

Again, I hope you can find a more cost effect plan in 2015. Good luck.

 

[TimToad]

I wish I could share the enthusiasm. I lost my healthcare because of it. Had a very good, affordable plan that was scrapped and the rates more than doubled with the deductibles going up 10x.

I know that was the popular refrain at the time, but you can blame your insurer for not being willing to simply add the preventative care features of the AHCA to your existing plan at a reasonable cost. A primary component of the AHCA is the requirement that ALL plans include preventative care, simple lab work & testing, etc..

President Obama didn't tell the greedy owners of your insurance company to NOT come up with a reasonable plan to include those in your already existing plan.

There was just as much pressure to dump you coming from your insurer themselves as there was from the AHCA to pressure your insurer to cover those basic, logical, fundamentally essential features that make up most people's annual healthcare consumption. Unfortunately, doing so would have taken a few hundred dollars out of the CEO's pockets and prevented them a target (Obama) to blame any shortcomings on. Which we can all see was very effective and in hindsight for most people's experiences the last year, completely in error.

The AHCA has resulted in the slowest growth in healthcare costs in decades, has more people signed up for less money than ever and even those in the healthcare delivery fields are boasting about the positive outcomes. Millions of Americans are finally getting basic healthcare for a cost that they can afford and the anxiety surrounding being crippled by overwhelming medical bills is far lower for the average American and especially small business owners.

 

[CES020]

That is really unfortunate, I hope that you can obtain a more affordable plan in 2015.

I also want to note that health insurance companies decide their rates on their own. They could have brought their current plans into compliance without overcharging their customers, but they choose to continue screwing their customers over. Its understandable that you are upset that you lost your plan, but try not to misplace the blame. I have a dental plan through AHCA that SUCKS. Its seriously the biggest waste of money and I'm so mad that I choose it last year. BUT it completely sucks because its a terrible company that over charges and refuses covered procedures and then makes you spend HOURS and HOURS and HOURS on the phone trying to resolve a $100 dentist bill. This is only the government's fault because they allow it to go on. FYI, don't ever get United Concordia Dental. They are TERRIBLE!!!

Again, I hope you can find a more cost effect plan in 2015. Good luck.

Tim, I'll tell you like I told everyone else. I don't care who's to blame. The fact is, I had health insurance. The fact is, I don't now. What changed? I don't care. Blaming someone doesn't give me healthcare. I don't care who's fault it is, someone needs to fix it for people like me so we can get insurance again.

I hope so to, but with a $14,000 bill left to be paid out of my pocket, it's seriously doubtful I'll be ending up with anything this coming year.

You can't blame the insurance companies, the law set it up so they win. Look at it this way, you're an insurance company, you're going to be forced to cover pre-existing conditions, and it's been mandated that people buy your plan. So more customers, higher deductibles, and higher rates. Sounds like a winner for them. Now it's easy to understand why they supported it. How the heck people with low incomes can afford $6,000 deductibles is hard to fathom. How some morons in DC didn't see that is also hard to fathom.

I'm not a rocket scientist, but I think someone could have come up with a far better plan to help everyone.

I also know that there are millions of people like me that aren't reported on the evening news. And in 2015, what hit us, is going to hit the group plans. What's going to happen then (and it's already starting) is that the group policy holders are going to stop covering people's families. That means companies are going to start only offering coverage for their direct employees. I have a number of family and friends that have already been told that's what's happening to their plan Jan.1, 2015. Their options are to pay about $800 out of their pockets to add their family. $800 a month, or $9,600 a year. How many people you know that are living paycheck to paycheck can afford an additional $9,600 a year in expenses for something you were getting as a benefit for free or maybe a fraction of that before? I honestly have friends and family who have no idea what they are going to do, how they are going to provide health care for their family.

That's what's coming. That's not a myth, or some political posture I'm taking, that's a fact. When what happened to people like me starts happening on the group scale, you're going to see the biggest mess you've ever seen. It's coming. Just wait for it.

 

[TimToad]

I can blame the insurers because it was at their insistence that the plan be passed just the way it was, and it was their millions in campaign contributions and scare tactic advertisements that further tweaked it until they got it exactly the way they wanted it. Its flawed, and it isn't perfect, and they still make enormous profits and can blame any weaknesses in it on the black dude. In the end, its driving down costs, covering more people, its giving millions more people basic access to healthcare, prohibiting personal bankruptcy from ruining anymore families and lowering up front costs to millions of us. It also has a little known feature in that if your insurance company doesn't spend at least 80% of its total revenue on HEALTHCARE for its insured, the insured get rebates for the difference. [/COLOR]

I'm not a rocket scientist, but I think someone could have come up with a far better plan to help everyone.

There were many people including prominent congressional leaders screaming for a single payer, Medicare for all, universal coverage plan, but they were drowned out by the big monied interests that rule the day on all issues.

I also know that there are millions of people like me that aren't reported on the evening news. And in 2015, what hit us, is going to hit the group plans. What's going to happen then (and it's already starting) is that the group policy holders are going to stop covering people's families. That means companies are going to start only offering coverage for their direct employees. I have a number of family and friends that have already been told that's what's happening to their plan Jan.1, 2015. Their options are to pay about $800 out of their pockets to add their family. $800 a month, or $9,600 a year. How many people you know that are living paycheck to paycheck can afford an additional $9,600 a year in expenses for something you were getting as a benefit for free or maybe a fraction of that before? I honestly have friends and family who have no idea what they are going to do, how they are going to provide health care for their family.

That's what's coming. That's not a myth, or some political posture I'm taking, that's a fact. When what happened to people like me starts happening on the group scale, you're going to see the biggest mess you've ever seen. It's coming. Just wait for it.

You might be right, that's why it was such a tragedy that the single payer, universal plan got defeated. Unless you are making some pretty fantastic money, I think you'd be surprised at the help folks can get with their premiums in the form of a subsidy.

 

[CES020]

You might be right, that's why it was such a tragedy that the single payer, universal plan got defeated. Unless you are making some pretty fantastic money, I think you'd be surprised at the help folks can get with their premiums in the form of a subsidy.

Yeah, don't think so, I entered all my data and it says I get $10 a month help. WOOOO Hooooo!

I just wish people, the general population understood how many people like me lost our coverage and can't afford it. It's awesome that 4,000,000 got it, or 8,000,000 or whatever, but did 1,000,000 of us really need to lose our coverage for that to happen? We weren't the fat cats with gold coverage plans. We were the working class, just making a living. You didn't take it from someone rich and give it to someone poor, you took it from working class people and gave it to someone else.

So now we're the one's with the problem. When other's didn't have insurance, the SOB's in DC stood in line to help them. So where's the line of them trying to fix the problem for us, the one's that were truly hurt by it? Yeah, don't wait for that answer because there isn't one.

Mark my words, chaos is coming. Soon. Just watch. I don't wish it on anyone, but they pushed off the group covered until 2015, and when that hits, it's going to be really terrible for a lot of families. Walmart announced the other day they are cutting health care benefits for workers with less than 30 hours, so that's the beginning of some of the changes that are going to wreck the entire industry.

I wish it wasn't so, but I'm afraid it is.

 

[TimToad]

Yeah, don't think so, I entered all my data and it says I get $10 a month help. WOOOO Hooooo!

I don't want to dive into your personal story or financial picture, so I'll just have to accept that you did look into it and make too much money to get a subsidy. That being said though, if you are a business owner and aren't taking full advantage of the tax benefits of providing yourself with healthcare, than you need to talk to your accountant.

I just wish people, the general population understood how many people like me lost our coverage and can't afford it. It's awesome that 4,000,000 got it, or 8,000,000 or whatever, but did 1,000,000 of us really need to lose our coverage for that to happen? We weren't the fat cats with gold coverage plans. We were the working class, just making a living. You didn't take it from someone rich and give it to someone poor, you took it from working class people and gave it to someone else.

You and the others lost it because your insurance company would rather cut you off and create a million angry, outraged at Obama advocates than improve your coverage to include the required preventative care, lab work, testing, etc.. I've read some studies of all those "great" plans that people got tossed from and the truth is that the overwhelming majority were garbage. Polls are showing that most of the folks who lost their coverage have found better coverage at better costs since the whole dust up over it.

I'm not sure who the "you" is you refer to, but it ain't me. I've been a fierce, vocal defender of the working classes my entire life. I've lost many a friend and even family member's affection for being "too radical" about fighting too hard for the average Jane and Joe.

So now we're the one's with the problem. When other's didn't have insurance, the SOB's in DC stood in line to help them. So where's the line of them trying to fix the problem for us, the one's that were truly hurt by it? Yeah, don't wait for that answer because there isn't one.

Mark my words, chaos is coming. Soon. Just watch. I don't wish it on anyone, but they pushed off the group covered until 2015, and when that hits, it's going to be really terrible for a lot of families. Walmart announced the other day they are cutting health care benefits for workers with less than 30 hours, so that's the beginning of some of the changes that are going to wreck the entire industry.

Wal-Junk only recently started offering their part-timers insurance as a PR ploy because of the hit they were taking about having a majority of their employees on public assistance in one form or another. Sales are still lagging, so they have to pull in their benefit package in order to make sure the 29 Walton family members don't miss a beat.

I wish it wasn't so, but I'm afraid it is.

Time will tell, what the outcomes will be.