The insurance debacle

[angeltrue]

After Obama got his hands on our insurance our deductible spiked to $6k - did others have their rates go so high?

 

[Christie insb]

No. I got insurance, which I hadn't been able to get before because I had too many "points." We stay in network for the most part so we don't get into our deductible. So now... I will be 65 in less than six years, and I hope I can get insurance then. I just hope he doesn't get bored and demolish Medicare too.

 

[angeltrue]

No. I got insurance, which I hadn't been able to get before because I had too many "points." We stay in network for the most part so we don't get into our deductible. So now... I will be 65 in less than six years, and I hope I can get insurance then. I just hope he doesn't get bored and demolish Medicare too.

My husband said we struggled through paying these high deductibles and Medicaid will probably be reduced by the time we reach eligibility.

What are points? Did you buy an Obamacare policy?

 

[Christie insb]

I am talking about Medicare, which should be fine if the money isn't plowed under into the general budget. Medicaid is the program for the poor which gives them insurance. Points were what they used to determine if you had a pre-existing condition. I think they counted something that I did not have but I would be surprised if I can get insurance at all next year with the mess Trump has made of everything, cutting off subsidies less than a month before open enrollment.
I did buy an Obamacare policy. We were getting a supplement but now our income is too high and we have to pay part of it back. I have to tell you though, expensive insurance is so much better than no insurance, just knowing you won't wipe your family out with a minor health problem.

 

[Winken]

Medi-Share | Christian Care Ministry


Medi-Share is a community of Christians who have agreed to live as the early church (Acts 2 & 4) when it comes to sharing each other’s burdens. Members share each other’s eligible medical bills and, most importantly, encourage and lift one another up in prayer. ...

 

[miamited]

Hi angeltrue,

In your first post you mix deductible with rates. In your second post you mention struggling through until you're eligible for Medicaid. Are you sure you know what you're talking about?

Deductibles are not the same as rates. Generally, the insurance with the lower rates will have higher deductibles. It's how they keep the rate low. By making you pay out of pocket for most of your basic healthcare costs, you won't touch your plans eligibility unless you have some major medical expense. It's technically just swapping apples for apples. If you buy a higher rate plan - meaning you pay more in premiums each month - your deductible will generally be lower because you're paying the insurance company more money to cover your healthcare costs through premiums. It's a balancing act that can be tough to figure what's best for an individual.

Generally speaking, if you're a healthy individual who only has maybe a couple of well care visits a year, then you'd likely want to get the lower premium/higher deductible plan. However, don't get sick! At least not seriously sick. If, on the other hand, you use a lot of medical services, then you'll probably want the higher premium/lower deductible plan. The problem is that most of us, who don't have pre-existing conditions, don't have a crystal ball and we don't honestly know whether we're going to have some large medical expense over the next 12 months. It's a crap shoot. But, just like in craps - sometimes you win.

Now, if you're eligible for medicaid, then you likely aren't struggling through until you're eligible. If, on the other hand, you're speaking of medicare, then yes, you'll have to struggle through with the current insurance system until you reach age 65, generally. There are some exceptions. However, my wife is turning 65 early next year and we've checked out what medicare offers and it isn't cheap. Medicare, which pretty much only covers major medical, runs a couple of hundred dollars a month, pretty much like those low premium/high deductible plans do for you now. But if you want all the bells and whistles that pay for basic doctor visits and prescription drugs and such, you can expect to cough up several hundred dollars more a month for that coverage.

Right now, our family premium under our employer retirement plan costs us $190/month to cover myself, my wife and our 25 year old son. It has co-pays for most office visits. I'm not sure what the deductible is as we've never hit it. It does include a prescription plan. We'll be dropping our son in this enrollment as he's now on his own and covered under his employer plan. Those college days are officially over!!! My wife just spoke with medicare last week and they're telling us that to keep something similar to what she's got now will likely cost her about $500.00/month. I'm not 65 yet so I'll be staying with the more affordable employer plan. So basically, starting early next year we'll be paying separate premiums for our healthcare and instead of getting cheaper in retirement it's going to just about quadruple.

Then when I turn 65 it will likely go up substantially again. However, from what I've heard of all this jerking around that Donald Trump is doing, those premiums may go up even more. We'll see. I'm hopeful that in that not to distant future we'll adopt a universal healthcare system and be done with all this angst and noise.

God bless,
In Christ, ted

 

[angeltrue]

I am talking about Medicare, which should be fine if the money isn't plowed under into the general budget. Medicaid is the program for the poor which gives them insurance. Points were what they used to determine if you had a pre-existing condition. I think they counted something that I did not have but I would be surprised if I can get insurance at all next year with the mess Trump has made of everything, cutting off subsidies less than a month before open enrollment.
I did buy an Obamacare policy. We were getting a supplement but now our income is too high and we have to pay part of it back. I have to tell you though, expensive insurance is so much better than no insurance, just knowing you won't wipe your family out with a minor health problem.

I would have as difficult a time as you getting insurance because of my physical problems. I took good care of myself but was injured - and it has wiped us out. My husband had to retire a year early to help care for me. We switched to COBRA and had to pay $17k - we can't keep up with it. I don't blame Trump for all of it - Congress should have fixed it. I hate being worried about whether you'll be able to afford healthcare. Congress should have the same insurance as us.

 

[angeltrue]

I would have as difficult a time as you getting insurance because of my physical problems. I took good care of myself but was injured - and it has wiped us out. My husband had to retire a year early to help care for me. We switched to COBRA and had to pay $17k - we can't keep up with it. I don't blame Trump for all of it - Congress should have fixed it. I hate being worried about whether you'll be able to afford healthcare. Congress should have the same insurance as us.

Who is making you pay the supplement back???

 

[angeltrue]

Medi-Share | Christian Care Ministry


Medi-Share is a community of Christians who have agreed to live as the early church (Acts 2 & 4) when it comes to sharing each other’s burdens. Members share each other’s eligible medical bills and, most importantly, encourage and lift one another up in prayer. ...

I heard about Medi-Share - is that your insurance?

 

[Winken]

I heard about Medi-Share - is that your insurance?

No ..... I've often thought about shifting to it, but I am 82, my wife 84.

 

[angeltrue]

Hi angeltrue,

In your first post you mix deductible with rates. In your second post you mention struggling through until you're eligible for Medicaid. Are you sure you know what you're talking about?

Deductibles are not the same as rates. Generally, the insurance with the lower rates will have higher deductibles. It's how they keep the rate low. By making you pay out of pocket for most of your basic healthcare costs, you won't touch your plans eligibility unless you have some major medical expense. It's technically just swapping apples for apples. If you buy a higher rate plan - meaning you pay more in premiums each month - your deductible will generally be lower because you're paying the insurance company more money to cover your healthcare costs through premiums. It's a balancing act that can be tough to figure what's best for an individual.

Generally speaking, if you're a healthy individual who only has maybe a couple of well care visits a year, then you'd likely want to get the lower premium/higher deductible plan. However, don't get sick! At least not seriously sick. If, on the other hand, you use a lot of medical services, then you'll probably want the higher premium/lower deductible plan. The problem is that most of us, who don't have pre-existing conditions, don't have a crystal ball and we don't honestly know whether we're going to have some large medical expense over the next 12 months. It's a crap shoot. But, just like in craps - sometimes you win.

Now, if you're eligible for medicaid, then you likely aren't struggling through until you're eligible. If, on the other hand, you're speaking of medicare, then yes, you'll have to struggle through with the current insurance system until you reach age 65, generally. There are some exceptions. However, my wife is turning 65 early next year and we've checked out what medicare offers and it isn't cheap. Medicare, which pretty much only covers major medical, runs a couple of hundred dollars a month, pretty much like those low premium/high deductible plans do for you now. But if you want all the bells and whistles that pay for basic doctor visits and prescription drugs and such, you can expect to cough up several hundred dollars more a month for that coverage.

Right now, our family premium under our employer retirement plan costs us $190/month to cover myself, my wife and our 25 year old son. It has co-pays for most office visits. I'm not sure what the deductible is as we've never hit it. It does include a prescription plan. We'll be dropping our son in this enrollment as he's now on his own and covered under his employer plan. Those college days are officially over!!! My wife just spoke with medicare last week and they're telling us that to keep something similar to what she's got now will likely cost her about $500.00/month. I'm not 65 yet so I'll be staying with the more affordable employer plan. So basically, starting early next year we'll be paying separate premiums for our healthcare and instead of getting cheaper in retirement it's going to just about quadruple.

Then when I turn 65 it will likely go up substantially again. However, from what I've heard of all this jerking around that Donald Trump is doing, those premiums may go up even more. We'll see. I'm hopeful that in that not to distant future we'll adopt a universal healthcare system and be done with all this angst and noise.

God bless,
In Christ, ted

When Obamacare was enacted our insurance deductible shot up to $6k. I was injured and my husband retired a year early to stay home to help me but we lost our insurance through his job (they paid half we paid the other half) but they allowed us to stay on their group plan but we had to pay out of pocket for the entire amount. He paid $17k for the next coverage period, but he's concerned that when we become eligible for Medicare legislators will have made changes to that too. I, like you, hope that they adopt a universal type coverage so this struggling is over - it does cause angst. The only thing that I hesitate on is I spoke with a nurse from Canada about how lucky she was to have gotten that. She told me she moved to the U.S. to escape it. She said the universal health care applies a high rate of taxation on their income.

Your plan is cheap! We were paying $175 a week. Can I ask what plan you use? I'm afraid we're going to have to shop around for another policy now. We struggled really hard because I needed his help and we couldn't afford to pay for help so he had to leave work early. You don't realize how vulnerable you are until something like that disables you.

Can one get Medicaid in retirement prior to eligibility for Medicare? I'm facing all these new challenges.

 

[angeltrue]

No ..... I've often thought about shifting to it, but I am 82, my wife 84.

Do you pay for an additional policy in addition to Medicare?

 

[Christie insb]

Who is making you pay the supplement back???

Oh I think it's the IRS.

 

[Winken]

Do you pay for an additional policy in addition to Medicare?

Yes. It costs $1100 monthly for the two of us. It pays part of our prescription costs.

 

[angeltrue]

When Obamacare was enacted our insurance deductible shot up to $6k. I was injured and my husband retired a year early to stay home to help me but we lost our insurance through his job (they paid half we paid the other half) but they allowed us to stay on their group plan but we had to pay out of pocket for the entire amount. He paid $17k for the next coverage period, but he's concerned that when we become eligible for Medicare legislators will have made changes to that too. I, like you, hope that they adopt a universal type coverage so this struggling is over - it does cause angst. The only thing that I hesitate on is I spoke with a nurse from Canada about how lucky she was to have gotten that. She told me she moved to the U.S. to escape it. She said the universal health care applies a high rate of taxation on their income.

Your plan is cheap! We were paying $175 a week. Can I ask what plan you use? I'm afraid we're going to have to shop around for another policy now. We struggled really hard because I needed his help and we couldn't afford to pay for help so he had to leave work early. You don't realize how vulnerable you are until something like that disables you.

Can one get Medicaid in retirement prior to eligibility for Medicare? I'm facing all these new challenges.

LOL - I don't know a lot - when I got hurt my husband handled everything. Now I'm trying to do some research on how we can navigate the insurance maze and what's going on now the country's insurance problems doesn't help anything. We were overpaying at $175 a week and then had to pay a $6k deductible on top of it which is a lot. We also had to pay deductibles on our prescriptions. The insurance company, in spite of paying so much for our policy, denied me a medication I need, and they just denied another. So I'm trying to find out how to navigate this. I'm wondering how others are handling it.

 

[angeltrue]

Yes. It costs $1100 monthly for the two of us. It pays part of our prescription costs.

That's not too bad. Can I ask how you found your policy - did you shop around for the best rates?

 

[Winken]

I was entitled to the policy upon retirement, having paid a percentage of income for it for many years. It covers both of us. I was stunned to learn that we still owed money after all those years. I dropped all the brand-name prescriptions, settling for generics. Multiply $1100 times each month since retirement at age 65. Our insurance does pay about 90% of hospitalization bills, which is a real blessing. We determined at age 65 to pay off our home loan and two cars. We haven't bought a new car since!

My wife was denied the use of brand-name prescriptions. We appealed, and after multiple complaints, telephone calls and letters, and debates with the pharmaceutical company, she was granted an exemption. Each month we are "reminded" that generics are "not so expensive." So far we have disregarded the reminders.

 

[angeltrue]

Oh I think it's the IRS.

That's a shame. I really wish they could come up with a reasonable nationwide plan that's available for everyone. I can't understand why they can't do it - what is so hard? I spoke with a man from England - where they have a program similar to Canada's and he told me he doesn't know why Americans put up with it. He said he knew people from here who lost everything from medical bills. We were hit very heavily and my husband had to work two jobs to keep us afloat - it was very hard. Now we just entered a new chapter.

 

[angeltrue]

I was entitled to the policy upon retirement, having paid a percentage of income for it for many years. It covers both of us. I was stunned to learn that we still owed money after all those years. I dropped all the brand-name prescriptions, settling for generics. Multiply $1100 times each month since retirement at age 65. Our insurance does pay about 90% of hospitalization bills, which is a real blessing. We determined at age 65 to pay off our home loan and two cars. We haven't bought a new car since!

My wife was denied the use of brand-name prescriptions. We appealed, and after multiple complaints, telephone calls and letters, and debates with the pharmaceutical company, she was granted an exemption. Each month we are "reminded" that generics are "not so expensive." So far we have disregarded the reminders.

Be a little careful with generics - they switched my father's coumadin to generic and he wound up in the ER. The doctor told him the generic drugs potencies are sometimes off.
You would think you paid enough in to the system and would get a pass at 65.

I'd like to pay off our house but my husband just retired and we may try to move to a warmer climate. We're trying to figure out where the most cost-effective place to live is that has year-round warm weather. He lost his work truck and we have to buy a car now. It will be our last car probably so we shouldn't have that expense after this next purchase. We've lived frugally but everything has gotten so expensive.

 

[Winken]

Be a little careful with generics - they switched my father's coumadin to generic and he wound up in the ER. The doctor told him the generic drugs potencies are sometimes off.
You would think you paid enough in to the system and would get a pass at 65.

I'd like to pay off our house but my husband just retired and we may try to move to a warmer climate. We're trying to figure out where the most cost-effective place to live is that has year-round warm weather. He lost his work truck and we have to buy a car now. It will be our last car probably so we shouldn't have that expense after this next purchase. We've lived frugally but everything has gotten so expensive.

I would sit down at the computer to ask the question about the most cost-effective location. You'll have to be certain that the result takes ALL expenses into account.

Sitting down to dinner. Thanks for the chat!