Author Topic: Health Insurance Advice (Read 4250 times)

Ladislaus · « **Reply #15 on:** August 04, 2023, 09:42:17 AM »

Quote from: josefamenendez on August 04, 2023, 08:53:00 AM

Not something to count on, but hospitals can and do reduce payments SIGNIFICANTLY, and many times just write them off since they get an enormous amount of government money to do just that, especially after COVID. I was uninsured for 2 years and every procedure that I had at the hospital was reduced by at least forty% upon request and some were even completely forgiven without me even asking. The upcharge on insured patients is well over 100-200% mostly to cover for all the losses. Now with COViD money the losses are much less and frequently forgiven. I'm not saying don't get insured but if for some reason you are uninsured and in an emergent situation they usually will negotiate. With elective procedures they will negotiate up front for a substantial reduced cost.

Seem to be somewhat immoral, though, to deliberately go uninsured when you could afford it, since the costs are being passed along to those who are paying for insurance, who are therefore having to pay higher premiums as a result. I'm not saying that was your situation, but I wouldn't advise going uninsured just to save money (hoping your debts will get written off or reduced), since you'd be passing the costs onto others, which is the equivalent of theft.

Minnesota · « **Reply #16 on:** August 04, 2023, 02:46:00 PM »

Avoid public insurance. It's a bureaucreatic mess that won't get any better. There's people who want this in the United States for everyone like the NHS in Britain and we're nowhere near ready for that.

So enroll in private insurance. It's better. It's not perfect but better than the alternative.

MaterDominici · « **Reply #17 on:** August 04, 2023, 03:12:50 PM »

We've used Christian Healthcare Ministries for about 15 years now and are happy with it. The costs have increased lately, but so has the cost of literally everything, so it's to be expected.

If you're unfamiliar with health-sharing programs, you pay for your own low-level medical like a routine doctor visit and they share costs of major medical. How "major" it has to be depends on which level of participation you choose when you sign up.

Our kids have always qualified for CHIP or Medicaid, so we only use CHM for the adults.

Matthew · « **Reply #18 on:** August 04, 2023, 05:08:57 PM »

Quote from: Vincancino on August 03, 2023, 10:22:06 PM

Hello members of Cathinfo, I need some advice please. My wife and are looking for a private health insurance for our family, but are also considering remaining cash paying patients. We are both in our early 40's and have 3 kids under 5 yrs and rarely visit the doctor. We live in California and I am self employed with modest income. If you were in my situation, would you shop for and insurance or continue paying out of pocket when necessary? If having private insurance is better, are there insurance that are Catholic or does it matter? I would like to know your thoughts, I've notice almost all members are very knowledgeable on the forum. Thank you very much.

In theory, being "self insured" would work.

HOWEVER, the reality is that our salaries are priced in pennies, and medical procedures are priced in 10s of dollars.

Imagine a group of 3 dozen children with 30 pennies each, trading with each other for different things, buying and selling trinkets, beads, pinecones, cups of lemonade. Now imagine one of them wanted to sell enough pinecones or beads to buy a NEW CAR for $30,000. Would it be possible? no. The two economies are not on the same scale; one is orders of magnitude more than the other. One of those children could get ALL the other kids' pennies and STILL not be able to afford to buy a new car.

That's what healthcare is like. Normal people can save $50 here, $100 there, maybe even a few thousand here or there from the yearly IRS refund. But a single procedure can be $30,000, or $50,000, or even $500,000. All the frugality and hard work in the world isn't going to be enough for one major operation or extended hospital stay. It's screwed up, yes, but Healthcare is not on the same scale as the average person's income or savings. In short, it's impossible to self-insure. Unless your income is over $500,000 a year AND you can manage to save a huge chunk of that.

Hence, you NEED at least catastrophic or Major Medical insurance, to cover those potential astronomical hospital bills. And no one can know what lies in their future. We all have frail bodies post-Fall, and even if you're healthy in your 20's that might not continue into your 60's. Know what I mean?

How many people own their own home free-and-clear in their 20s? That's only $100K, or $200K. Heck, most people don't even own their cars outright, and cars can be had for $3K to $20K. How could they ever expect to pay astronomical hospital bills out-of-pocket, from their savings? Some operations, hospital stays, and treatments cost MUCH MORE than a house.

Matthew · « **Reply #19 on:** August 04, 2023, 05:17:07 PM »

PS I'm usually against insurance. To me it's like gambling. But for the reasons I listed above, I am forced to acknowledge reality and use some kind of health insurance.

moneil · « **Reply #20 on:** August 04, 2023, 06:02:45 PM »

Some things to consider:

While the Affordable Health Care Act created some basic standards applicable in every state (such as insurance policies can’t red line out preexisting conditions), the insurance industry is still largely regulated independently by each state, and federal programs such as Medicaid (not Medicare) are administered independently by each state. What companies are allowed to operate, what policies are available, what premium costs are can vary widely, depending on where you live.

Nobody is forced to carry health insurance, that is a myth. There used to be a federal tax penalty for those who didn’t have health insurance but that was eliminated in 2019. Some states still impose a penalty but not the federal government. Under the old rule nobody was required to pay more than a certain percentage of their income (8.5% I believe) for health insurance, and if one couldn’t find a policy for less than that there was no tax penalty. From 1999 until I went on full Medicare (Parts A and B) my health insurance was provided by my employer (with a premium co-pay). Before that I paid for my own insurance, but the rates weren’t that bad and I was “grandfathered” on an old policy that was no longer offered for sale. I’ve never had to shop on the exchange or open market, but my understanding is that often premium subsidies are available depending on one’s income. This may depend on which state one lives in.

Regardless of its faults California has a reputation for having generous safety net programs and you should look into what subsidized health plans might be available for families of modest income.

If one is on a “Consumer Directed Health Plan” (i.e., with a higher deductible) they may be able have a Health Savings Account into which one can make tax exempt deposits. At my work I had a choice of choosing a plan with a $1,800 deductible (versus a standard plan with a $250 deductible) and a lower premium co-pay and was eligible to have a HSA. I could pay medical and dental expenses, and for certain over the counter products, out of this savings account. Once I went on Medicare Part A (required at age 65) I was no longer allowed to make additional deposits to the HSA but I got to finish using what was already there. A HSA (not to be confused with Flexible Spending Accounts, or FSA) perhaps can be a good asset in conjunction with a high deductible plan.

I agree with Ladislaus that those who refuse to carry health insurance or make no effort to find plans they can afford, if they should have a medical emergency and can’t pay for it, just force up the costs for the rest of us.

Always · « **Reply #21 on:** August 04, 2023, 06:58:21 PM »

Quote from: Ladislaus on August 04, 2023, 09:42:17 AM

Seem to be somewhat immoral, though, to deliberately go uninsured when you could afford it, since the costs are being passed along to those who are paying for insurance, who are therefore having to pay higher premiums as a result. I'm not saying that was your situation, but I wouldn't advise going uninsured just to save money (hoping your debts will get written off or reduced), since you'd be passing the costs onto others, which is the equivalent of theft.

But that's the "64 thousand dollar question" (for those old enough to remember the expression) -- can you afford it or not. It's often said that the one who frames the issues wins the argument. What if you were to frame the issues by saying health insurance is one big immoral racket/scam and nobody should support a big immoral racket/scam by paying premiums to support it and keep it going. If things are framed that way, then the bad guys are the ones who support the immoral system by paying their insurance premiums and the good ones are the ones who hold the insurance racket/scam in contempt and go uncovered regardless of whether they can afford it or not. I'm not falling into either camp of going insured or uninured, but rather I'm giving a different perspective on the matter.

St Giles · « **Reply #22 on:** August 04, 2023, 09:23:56 PM »

Does the healthcare industry have to cost as much as it does? If not, then they might not have to rely on those who have insurance to cover the cost of those who don't and can't afford to pay the full cost.

Should we rather have sufficient faith in God and let Him be our heath insurance, let Him be our protector and our God, and His will be done, whether it is to be sick, die early, maimed, or miraculously healed whenever pleases Him. To what extent is our obligation to seek treatment and set aside money for it? May the Blessed Mother and all the angels and saints pray for us and help us that we always remain in the state of grace, so that we may merit no evils in this life, and be prepared to die whenever and however. Amen

MaterDominici · « **Reply #23 on:** August 04, 2023, 09:29:06 PM »

Quote from: Always on August 04, 2023, 06:58:21 PM

But that's the "64 thousand dollar question" (for those old enough to remember the expression) -- can you afford it or not. It's often said that the one who frames the issues wins the argument. What if you were to frame the issues by saying health insurance is one big immoral racket/scam and nobody should support a big immoral racket/scam by paying premiums to support it and keep it going. If things are framed that way, then the bad guys are the ones who support the immoral system by paying their insurance premiums and the good ones are the ones who hold the insurance racket/scam in contempt and go uncovered regardless of whether they can afford it or not. I'm not falling into either camp of going insured or uninured, but rather I'm giving a different perspective on the matter.

Along those same lines, I don't think it's been proven here that an uninsured person increases the costs for the insured. The amount billed is never the amount paid -- whether by an insurance company or an individual. The main driving factor in how much is billed is that it needs to be as high as the highest possible receipt. So, if you have a procedure code and Humana is contracted to pay you $500, BCBS will pay you $700 and United will pay you $850, then your "charge" for that procedure is going to be $900. When an uninsured person comes in and asks for a discount, giving them 40% or 50% is just acknowledging that you weren't actually expecting to get $900. Also, the uninsured will only get the bill entirely written off if they show financial need which means they arguably "couldn't afford it" to begin with. (Of course there's room here for fraudulent reporting, but that's a different issue.)

Always · « **Reply #24 on:** August 04, 2023, 09:32:59 PM »

Quote from: St Giles on August 04, 2023, 09:23:56 PM

Does the healthcare industry have to cost as much as it does? If not, then they might not have to rely on those who have insurance to cover the cost of those who don't and can't afford to pay the full cost.

Should we rather have sufficient faith in God and let Him be our heath insurance, let Him be our protector and our God, and His will be done, whether it is to be sick, die early, maimed, or miraculously healed whenever pleases Him. To what extent is our obligation to seek treatment and set aside money for it? May the Blessed Mother and all the angels and saints pray for us and help us that we always remain in the state of grace, so that we may merit no evils in this life, and be prepared to die whenever and however. Amen

Amen. Christianity survived for centuries without the "necessity" of insurance. You got any extra money? Support worthy efforts in the Church, set aside some money (if you can) for your funeral expenses and for your dependents, and always give money for alms if you can. And do whatever you can to stay out of debt.

Mark 79 · « **Reply #25 on:** August 04, 2023, 09:33:32 PM »

Quote from: SimpleMan on August 04, 2023, 02:23:23 AM

…My mother has Medicare Part B and she doesn't pay nearly as much as the lady whom you mention.

Not clear what you mean by "I infer then that your retirement bargain is directly a benefit of 'get a job that provides insurance' " No offense taken, I just don't understand the sentence. I am partially disabled, and on top of that, have elder caregiving and full-time parenting and homeschooling responsibilities, so getting a job wouldn't work right now. After my son finishes high school, I may try to get some kind of work-at-home hustle.

I am not on Medicare and do not want Medicare, so I only know what I was told. Popular misunderstanding aside, Medicare is not an "I'm getting back what I paid in" deal; it is another Ponzi fraud like "Social Security."

Quote from: SimpleMan on August 04, 2023, 02:23:23 AM

Not clear what you mean by "I infer then that your retirement bargain is directly a benefit of 'get a job that provides insurance' " No offense taken, I just don't understand the sentence. I am partially disabled, and on top of that, have elder caregiving and full-time parenting and homeschooling responsibilities, so getting a job wouldn't work right now. After my son finishes high school, I may try to get some kind of work-at-home hustle.

In that perhaps opaque statement I meant to convey:

(1) I described a few options to the OP: go "naked," self-insure, qualify for a governemnt handout, or "get a job that provides health coverage."

(2) Your described costs for health insurance are low because they are subsidized, in part because it's part of your retirement package, which…

(3) Is a direct result of having "gotten a job that subsidized your health insurance," so…

(4) I consider your low insurance premiums a subset of "getting a job that provides health care."

If you had not taken "a job that provides health care," you wouldn't have that particular subsidy. You might or might not qualify for a different subsidy.

Mark 79 · « **Reply #26 on:** August 04, 2023, 09:50:22 PM »

Quote from: B from A on August 04, 2023, 07:18:58 AM

I know several people who use this type of option, and are very happy with it.

Not to be flip, but many people are also happy with Kaiser (the HMO archetype).

Those people fall mostly into two categories:
(1) young healthy people who take care of themselves, don't get sick, so never need to deal with Kaiser's obstructions and
(2) people with catastrophic medical problems who have been successfully plugged into Kaiser's system and all the costs are borne within Kaiser (as Kaiser dictates, "our way or no way").

Unfortunately, most people and most families are in the middle of those extremes, families with some health problems, so have to negotiate the roadblocks and maze of requirements that lead, last time I saw numbers, 70% of Kaiser patients pay out-of-pocket for care outside of Kaiser. So, that 70% pays their Kaiser premiums, Kaiser is out of pocket nothing, and the patients has the additional expense of using the provate system, e.g., "urgent care cebters" and the like.

I looked at the Protestant (not "Christian") plans and concluded it was just a variant of Kaiser's roadblocks and mazes. We took the "get a job that provides…" option.

MaterDominici · « **Reply #27 on:** August 04, 2023, 10:07:52 PM »

Quote from: Mark 79 on August 04, 2023, 09:50:22 PM

I looked at the Protestant (not "Christian") plans and concluded it was just a variant of Kaiser's roadblocks and mazes. We took the "get a job that provides…" option.

The programs might sound complicated at first, but in my experience, CHM has been easy to work with.

Mark 79 · « **Reply #28 on:** August 04, 2023, 10:19:17 PM »

Quote from: St Giles on August 04, 2023, 09:23:56 PM

Does the healthcare industry have to cost as much as it does? If not, then they might not have to rely on those who have insurance to cover the cost of those who don't and can't afford to pay the full cost.…

Well… "industry" says it all, doesn't it? All of the "for profit" middle men are feeding at the same trough.

In my youth, it cost $7 for an office visit. If you needed an x-ray or EKG or a shot, there was no extra charge, the doctor absorbed the extra costs.

When Medicare was foisted on the nation (by the money-worshippers' lobby), the government started asking, "What are these charges for?" Doctors reacted to the .gov/.ZOG questions and started thinking… "Hey, I have to pay for that x-ray machine, the film, the tech and the electricity and maintenance and the developer and the chemicals to run the machine. I have to pay for that EKG machine, the paper, the nurse, and the electricity and maintenance to run the machine. I have office rent, billing staff, malpractice, etc."

This unintended (?) consequence of .gov/.ZOG intervention in your health care led to doctors unbundling those services that were previously bundled in that $7 office visit fee. Who can be surprised that the routine charge is not longer $7 or even the 2023 equivalent of pre-Medicare dollars?

Jew lawyers and their goy clients saw a quick buck in any unwelcome outcome. Malpractice costs soared and those costs were passed on to patients and/or their surrogates.

Then in the 1990's Kaiser's 1940's experiment with managed care exploded in our faces. Within a decade managed care took over and monolithic profit-oriented (((big business))) passed on not only the actual costs of health care, but the costs of their own lavish edifices and armies of minimum wage employees and cover-their-ass attorneys started denying your medical bills, denying imaging or recommended procedures.

And, of course, marvelous technological advances like that $1million CT scanner, $2million dollar MRI, and $2.5million PET/CT, $1billion proton beam, etc. wrought diagnostic marvels at an enormous increase in cost.

And then there is the inflation caused by patients and families. In the past Mom would keep you home with your sore throat, give you hot tea and honey, and see that your sore throat went away in a day or so. Not so with modern metrosɛҳuąƖ men and entitled women. Now everything is "urgent" or an "emergency." Everyone wants the quick fix, so they rush to the most expensive providers of instant care. What costs $50 in a GP's office, now costs $2000 (minimum) in the ER.

Having "first dollar" coverage means patients and families have no disincentive to go to the most fastest and most expensive source of [dubious] care. They don't see the $2,000 ER visit coming out of their pocket because those costs are hidden from them.

No longer do most doctors take any oath to be advocates and defenders of their patients. Instead self-aggrandizement becomes primary. "Managed care" withholds from doctors about 50-70% of the already discounted fee and the doctor will never see that 50-70% if he orders "too many" scans, lab tests, or prescriptions.

There is plenty pf blame to go around. In short, health care and health costs reflects the general decline in society.

gladius_veritatis · « **Reply #29 on:** August 04, 2023, 10:21:34 PM »

Never had insurance. Never plan to get it. Eat right, live right. No issues.

Like all insurance, it is a gigantic scam. Just as an unjust law is no law at all, an insane/unjust bill is no bill. They MUST treat you, but that does not mean you MUST ruin your life to repay them. Send them a few bucks a month, they cannot object or harm you.

Author Topic: Health Insurance Advice (Read 4250 times)

Ladislaus

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Minnesota

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MaterDominici

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Matthew

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Matthew

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moneil

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Always

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St Giles

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MaterDominici

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Always

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Mark 79

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Mark 79

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MaterDominici

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Mark 79

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gladius_veritatis

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