Wellness

[Laura14]

@Mindy D   Thank you so much for all the good info.  It just rubs me wrong to pay out of pocket for something that I've already paid for via premiums all year. 

And I thought you couldn't buy other insurance if your employer offered it.  I'll have to look into that again.  The last time I checked, I was ineligible for ACA because my employer offered and I had to take that whether I wanted it or not.  

[geezerette]

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@Abrowneyegirl wrote:

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@Laura14 wrote:

@geezerette   That's where I am.  My almost $4000 policy is catastrophic only with a $6000 deductible and only one wellness visit 100% covered a year.  I figure if I go without and even paying the $700 one time, I'm up big time.   Only risk is if the catastrophe, god forbid, happens.  And even then, with the insurance they only cover 60-70%.  

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Your policy is VERY good for $4000 a year.  You must have excellent health and be very young to get that plan.

If you may be able to raise the deductible to lower the annual cost.

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@Laura14 

@Abrowneyegirl has a good point about the possibility of lowering the premiums.  I’d go with a higher deductible and lower premiums and pay out of pocket for minor doctor visits.  I’d also look into your state’s insurance backed programs.  Often they are cheaper.  And there are some alternative insurance plans becoming more popular, depending on where you live.  Even discount plans.  Something, just in case of a major illness or injury which can’t be foreseen.

I know it sounds counterintuitive to pay for your own medical visits when you have insurance, but going without any medical insurance is a huge risk.  And even when you have it and need it, it can be a hassle to get it to pay what it should.  It also depends on your financial situation.

It’s obviously your call, and it’s kind of a “darned if you do, darned if you don’t” situation.

[Deb0509]

I'm lucky that I have insurance at work and almost always have. I also wouldn't be able to sleep at night if I didn't. I agree that it's like -  I own a house and I have homeowners insurance and I own a car and I have car insurance. My best friend many years ago didn't have insurance, and unfortunately, suddenly needed surgery. Her bill was huge! She could have had insurance at work, and she worked for a hospital so it was really great, but she decided she was young and bet on the hope that nothing would happen to her. You just never know what's going to happen. Ever.

[Laura14]

@geezerette   I just checked and it looks like I can go into the marketplace and buy off the exchange.  I just won't get a credit or subsidy.  Thank you guys for pointing that option out.  I know a few years ago I tried that and they told me no way jose.  If my employer offered, I had to take it.  

I'll see how expensive the lowest bottom of the barrel plan is around these here parts and that may be my solution.  You guys always have great advice.  

[pigletsmom]

For people comparing this to car or home insurance, they are in no way the same thing. Those don't cover your oil change or new brakes or regualr maintenance of your house. Somehow people decided they wanted their health insurane to pay for every single thing on the planet. And as I've said before that's why we are where we are now. Complain over and over and the next thing you know you get mandates put on your insurance to coer stuff and the cost goes up.

I'm not even sure  you can get a catostrophic plan in my state. We had all of the ACA mandates before the ACA was even a thing so our costs were always high. I think the ACA mostly did away with those plans in other places unless you were very young.

[Mom2Dogs]

@Laura14 ....I do not have traditional insurance.  My policy is thru Medi Share....health sharing organization.  I am 64 my plan per month is about $375.00...deductible is $5,000...numbers are NOT exact but close.   If you visit their website, their lingo is different that typical insurance talk...because they are not an insurance company.

I am healthy, the only med I take is for bone strength, Boniva, and I pay for it out of pocket, using a Good RX coupon.

 The plan does not cover any wellness visits or procedures like mammogram, physicals etc.  If you enroll in their plan and have a pre existing condition you are not covered for x number of  years...not sure the exact number.

My  older health plan had ballooned to $1000.00 a month, something we absolutely could not afford.

The plan I am now on works for me.  They have a website and you can call and speak with a representative, they will answer all questions.

They do have a network of doctors and clinics but the one in my area is not somewhere I want to go so I pay out of pocket.   When you do file a claim, after getting treatment in the network they do try to negotiate the bill for you, because you are responsible for the charges. 

This is not for everyone but it has worked for me and next year I will be on Medicare and will look for a supplement when the time comes...although Medishare does cover seniors, at this time that plan is not something I am interested in.

There is also another health sharing orginization called Liberty Health....same idea as Medishare....

When I have had to see the doctor, have my mammogram, and  I had to have an xray, I paid out of pocket and was given a cash discount.  The scary part is if I needed surgery....nothing is paid until I meet the deductible, but I do have a separate checking account where we keep money for health emergencies and it has grown since I have really not had to use the money,  I am very grateful that I have good health.  

Edited to add:  I did look in to O Care..what a joke, prices were higher for me than the 'traditional' insurance.

[geezerette]

@Mom2Dogs 

Thanks for posting about MediShare.  I’ve heard ads for it for years but have never known anyone on it and I’ve always been curious as to how it works in reality.

[Laura14]

@Mom2Dogs   Thank you so much!  My sister and her family use a health sharing plan and they love it.  Unfortunately for a single person, it's not any cheaper than the employer.  I also just took a swing by the marketplace and again not any cheaper than what I have already.  I will look these up and see if there may be viable options for me.  Thank you!!

[meem120]

One day I had a cough, a week later I had bacterial pnemonia , I was in the hospital for 10 days.  Fast forward one month of IV antiobiotics for a month. Huge bill...thank god for insurance!

[Mom2Dogs]

@geezerette ...every month when I pay my bill the company shares how much in medical charges is NOT covered, but if each member would add around $5.00 additional to their premium (that amount varies each month) all needs would be met...sometimes I do give extra.

Medishare has a lot more members and money on hand than Liberty Health Share, that is one reason why I went with Medishare.