1. Nov 23, 2014

One thing you can be happy about: you are super healthy and rarely have to visit the doctor. People like Spawn of Evo don't choose to be chronically ill and it makes sense to spread the costs over society, but that's my socialist view. I pay less than €100/m, or $120/m for mandatory insurance, to give an indication. Hopefully you can find a better deal, otherwise time will probably bring the cost down. 6. Nov 24, 2014 ### jtbell ### Staff: Mentor My understanding is that you can bypass the exchange (healthcare.gov or a state exchange if you have one) and deal with an insurance company directly. The main difference is you can't get a subsidy if you do that, but if you make too much to be eligible for a subsidy anyway, that's not a problem. There are requirements that all insurance plans have to meet, whether they're on the exchange or not, e.g. not being able to deny coverage because of a pre-existing condition. I think I remember reading that those requirements eliminated the catastrophic plans with super low premiums. 7. Nov 24, 2014 ### Greg Bernhardt ### Staff: Admin That's likely what's hurting me. I bet this is why they are having trouble getting young people to sign up. A healthy person under 30 is going to have a real problem paying$250/m when they never see the doctor.

8. Nov 24, 2014

### Staff: Mentor

Does your wife's employer not offer insurance Greg?

9. Nov 24, 2014

### Greg Bernhardt

No because she is technically not full time :(

10. Nov 24, 2014

### Staff: Mentor

I would like to see employers give part time employees the option to benefit from an employer's group policy, even if they pay a larger premium, it's still got to be better than buying an individual policy.

11. Nov 24, 2014

### Danger

I haven't signed up. Being Canadian, I already have something even better. :p

If I were a Yank, though, I definitely would.

12. Nov 25, 2014

The bill of $225/person/month is a lot in my opinion, but it's well known that medical care in the USA is very expensive (maybe that's where change is needed). Can you opt for a certain amount of own risk? That will reduce your monthly bill and saves money when you don't need any care. Last edited: Nov 25, 2014 15. Nov 25, 2014 ### Greg Bernhardt ### Staff: Admin The point of obamacare was to mandate coverage. Either you sign up or pay a penalty. This is a big problem. Many young people are choosing to pay the cheaper penalty. The thing that gets me is the deductible. The plan I am looking at has$9000 annual. So pretty much unless I get cancer, I'm paying $500/m and out of pocket for everything. To get value I better get in a train wreck. Last edited: Nov 25, 2014 16. Nov 25, 2014 ### Medicol Oh you may become interested in this http://dealbook.nytimes.com/2014/06...o-consider-investments-in-united-states/?_r=0 That you buy a health package from them is also meant to save your money at a very low interest rate. They also pay your checkup fee at a low percentage. Go with your own country's policy. Life span is in the US also higher than that in many others. 17. Nov 25, 2014 ### SteamKing Staff Emeritus That's what everyone thinks. But Obamacare's little surprise, which was carefully concealed until after the recent elections, is that the premiums for most plans are going up. Merry Christmas and Happy Birthday. Also, plans are priced in part on your age. Someone 25 years old is not going to pay the same premium as someone 50 years old. As you get older, even if you are healthy, you can expect to see an increase in your premiums. Obamacare may have repealed the laws allowing denial of coverage for preexisting conditions, but it didn't do anything about this. 18. Nov 25, 2014 ### Monique Staff Emeritus Gee, you pay$9000 out of pocket before any coverage? Yes, that's ridiculous. Apparently the system needs to go through a serious reform, I'm glad I'm not part of it. You can come to the Netherlands, we have good insurance plans ;)

Don't speak of getting value, you don't want to get value for your money when it comes to insurance.

19. Nov 25, 2014

### Monique

Staff Emeritus
That's how it goes, I'm working with a lawyer now (again) to find a way that I don't have to go into unemployment, while I pay myself with a government subsidy. It's easy to become vicim of rules that are supposed to be there to help you.

20. Nov 25, 2014

### SteamKing

Staff Emeritus
While the ACA mandates that coverage be purchased, there is no similar mandate that physicians or hospitals are required to accept that coverage to pay for your treatment. If the coverage is turned down or not accepted, you still get a bill.

http://americanactionforum.org/insi...ers-are-opting-out-of-obamacare-exchang-plans

Reimbursements to physicians and hospitals, even should they accept the coverage, are very low currently and subject to going lower.

21. Nov 25, 2014

### Monique

Staff Emeritus
Why would physicians or hospitals reject coverage? They don't make enough profit from the plan?

22. Nov 25, 2014

### SteamKing

Staff Emeritus
If the reimbursements from the plans don't cover the cost of coverage, who makes up the difference? Hint: it's not the government.

Private physicians and hospitals must make enough revenue to pay the utility bills, pay the staff, buy supplies and medical equipment, etc. If it costs, for example, $100 to treat a given patient, but you can expect a reimbursement of only$60 for that treatment, how long before that missing $40, multiplied by the number of patients who are treated, adds up to real money? For every$1.00 paid by private insurance, Medicare pays about $0.80, and most ACA plans pay about$0.60. In fact, the trend is to tie ACA plan reimbursement rates with prevailing Medicaid reimbursement rates, which are rock bottom as it is.

For those of you not from the US, Medicare is the federally-administered healthcare program for those who are 65 and older.

http://en.wikipedia.org/wiki/Medicare_(United_States)

Medicaid is a health care program set up and administered by the individual state governments to care for the indigent or others with low incomes or limited resources:

http://en.wikipedia.org/wiki/Medicaid

The reimbursement rates for physicians and hospitals are set by the Centers for Medicare and Medicaid Services, the department inside the Department of Health and Human Services of the federal government which administers Medicare. Various fee schedules for treatment have been set up over the years, but because Medicare is administered by the federal government, these fee schedules and the reimbursements provided are subject to revision by Congress when it comes to drafting the federal budget. In general, over the last decade or so, the trend is to provide smaller reimbursements to doctors and hospitals for their services.

As of 2008, Medicare alone consumed 13% of the federal budget. Over the period 2010-2019, this share is expected to increase to just under 15%.

23. Nov 25, 2014

### Monique

Staff Emeritus
Does that mean that Greg actually should be paying more to the insurance plan? Why does it work in other countries, but not the USA?

24. Nov 25, 2014

### Staff: Mentor

Greg, have you actually checked with companies like Humana, United Healthcare, Kaiser Permanente, Aetna, Coventry, Blue Cross Blue Shield, etc... I had individual insurance policies with no deductible, included prescription meds and was only \$400 a month for the two of us. Of course it was top of the line coverage, you might not need a plan with that much coverage. That was two years ago, so, I would assume the premiums are a bit higher now, but you probably don't need as much coverage as I carried.

25. Nov 25, 2014

### SteamKing

Staff Emeritus
Long story short, Greg is already paying more for his insurance plan, to cover the cost of treating those who cannot be denied coverage.

In other countries, like the UK with its NHS, the cost of hospitals and physicians is a budget item, i.e., the government pays for health care. Now the money for these programs can come from only one source: the taxpayer. You have an elaborate national taxation system to collect revenue, in the form of income taxes, fees (like the National Insurance), and a particularly burdensome Value Added Tax system on goods and services, i.e., a tax on consumption.