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How to Retire in Your 30s With $1 Million in the Bank

Brett

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I believe what she was saying, and I found the same to be true, was that often (for me always) self pay customers pay less out of pocket than insurance covered people. Obviously, depends on your co-pays, deductible, etc. I was uninsured a few years, and paid doctors less than I paid out of pocket on BCBS. Yes, I did negotiate and tell them I was self pay and it did matter. Now, if I would have needed surgery, could have been a different result. But, going out of network will not always mean paying more and I agree with her comment as I experienced the same thing.

some believe they have more negotiating power (lower prices) than major health insurers. And the prices quoted for certain medical procedures are lower for individuals without insurance than those that have health insurance but I believe an individual will ultimately pay less if they have health insurance. ( ... except for dental 'health' and if one never has a major medical issue )
 

Talent312

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Agree that Plan F is closed to new applicants in 2020.

Plan F and Plan C will be closed if you turn 65 in 2020.
IOW, you won't get the Part B deductible covered.
It's not much, but one more reason to check out Advantage Plans.
 

Steve Fatula

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some believe they have more negotiating power (lower prices) than major health insurers. And the prices quoted for certain medical procedures are lower for individuals without insurance than those that have health insurance but I believe an individual will ultimately pay less if they have health insurance. ( ... except for dental 'health' and if one never has a major medical issue )

No, I don't believe I have more negotiating power per se. But it was definitely factual that I paid less. Though it was worrisome to some degree, was hoping to not get sick. I agree you likely could not get everything cheaper. But the point is you may be in a network but really want to use doctor X for something. And, Doctor X will not necessarily cost you more is the only point. So, why not check if it's important to you in other words. My experience was doctor visits and a few labs.

If you can't afford any insurance, of course you'd want to get a decent deal on any care if possible.
 

Brett

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No, I don't believe I have more negotiating power per se. But it was definitely factual that I paid less. Though it was worrisome to some degree, was hoping to not get sick. I agree you likely could not get everything cheaper. But the point is you may be in a network but really want to use doctor X for something. And, Doctor X will not necessarily cost you more is the only point. So, why not check if it's important to you in other words. My experience was doctor visits and a few labs.

If you can't afford any insurance, of course you'd want to get a decent deal on any care if possible.

sure, but "factually paid less" may not be true if one compares paying insurance vs paying a doctor/ surgeon / hospital directly for a certain medical procedure.
 

Steve Fatula

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sure, but "factually paid less" may not be true if one compares paying insurance vs paying a doctor/ surgeon / hospital directly for a certain medical procedure.

Not sure what you mean. Before I was uninsured, I had doctor visits at various doctors. I know what I paid on top of the premiums, i.e. co pays and deductible. It's on paper, the EOBs. After becoming uninsured, I had visits to the same doctors but as self pay. Those visits were less cost than the discounted BCBS rate. And I was not paying premiums on top of it. Could I have repeated this for my rotator cuff surgery? Not sure, my guess is not.

I have one doctor where they still have me as self pay even though I am health sharing, and I've told them several times now. I had a physical, and labs (bloodwork). The total I paid (well, sharing paid), i.e., the list price provided to the insurance was around $60. Including the labs. I posted the exact number a few months back on some thread. That's less than the BCBS discounted rate from 8 years ago.
 
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Brett

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Not sure what you mean. Before I was uninsured, I had doctor visits at various doctors. I know what I paid on top of the premiums, i.e. co pays and deductible. It's on paper, the EOBs. After becoming uninsured, I had visits to the same doctors but as self pay. Those visits were less cost than the discounted BCBS rate. And I was not paying premiums on top of it. Could I have repeated this for my rotator cuff surgery? Not sure, my guess is not.

I have one doctor where they still have me as self pay even though I am health sharing, and I've told them several times now. I had a physical, and labs (bloodwork). The total I paid (well, sharing paid), i.e., the list price provided to the insurance was around $60. Including the labs. I posted the exact number a few months back on some thread. That's less than the BCBS discounted rate from 8 years ago.

I'm saying if you take a group of people from birth to death and compare health costs, insurance payments vs paying directly those with health insurance probably pay less over a lifetime. Nothing about your personal medical procedures and personal health cost experience !
 
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bluehende

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The problem with these analysis is that you are actually talking two different things. One is health care and the other is insurance. As a whole health care would have to be cheaper without insurance for the whole population. You insure for something that you cannot afford to lose. Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need. Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident. Paying as you go is great until you cann't. At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.
 

Steve Fatula

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The problem with these analysis is that you are actually talking two different things. One is health care and the other is insurance. As a whole health care would have to be cheaper without insurance for the whole population. You insure for something that you cannot afford to lose. Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need. Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident. Paying as you go is great until you cann't. At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.

Sure. And I don't think I (at least) was suggesting it's a great idea to go uninsured. In the context of Medicare or HMOs or whatever and lists of doctors, the point was merely to say you might still be able to go to a doctor outside of the list and not pay more for some given service. Nothing more or less. Please do not read more into it.
 

Brett

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The problem with these analysis is that you are actually talking two different things. One is health care and the other is insurance. As a whole health care would have to be cheaper without insurance for the whole population. You insure for something that you cannot afford to lose. Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need. Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident. Paying as you go is great until you cann't. At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.

right, I'm pretty sure my health insurance payments over the years were a lot more than what I would have paid doctors directly ... right up until I had a $30,000 out-patient medical procedure
 
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bluehende

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Sure. And I don't think I (at least) was suggesting it's a great idea to go uninsured. In the context of Medicare or HMOs or whatever and lists of doctors, the point was merely to say you might still be able to go to a doctor outside of the list and not pay more for some given service. Nothing more or less. Please do not read more into it.

I did not get that from your post at all. There was a post that did seem to start the conversation that way, but it was not yours. The conversation did seem to be drifting to costs with insurance vs those without. Those cannot be compared unless you know your future. We drifted a long ways from the correct point that being in a network does not exclude other drs if you can afford it.

PS It is telling that almost any retirement.employment, or financial discussion eventually ends up in a health care discussion.
 

Steve Fatula

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I did not get that from your post at all. There was a post that did seem to start the conversation that way, but it was not yours. The conversation did seem to be drifting to costs with insurance vs those without. Those cannot be compared unless you know your future. We drifted a long ways from the correct point that being in a network does not exclude other drs if you can afford it.

PS It is telling that almost any retirement.employment, or financial discussion eventually ends up in a health care discussion.

It sure is, and that's sad actually. When insurance just for me on the cheapest ACA plan is $900/mo, that's not insignificant. Plus a huge deductible on top!
 

Brett

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It sure is, and that's sad actually. When insurance just for me on the cheapest ACA plan is $900/mo, that's not insignificant. Plus a huge deductible on top!

very sad indeed. our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
They say they have "liberal" socialized medical care that covers everyone from birth until death
They don't understand 'in network' and 'out of network"
Crazy!
 

PamMo

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...Avoid the middle man and deal with the doctors instead of insurers. If insurance is unaffordable, don't go broke paying for that, go broke paying for the healers instead.

Insurance isn't going to help me, doctors are. I well understand that few view this like I do but I value my health more than my "wealth".

That works for day-to-day healthcare and minor illnesses. Most people could probably handle negotiated self-pay visits to doctors or urgent care clinics for annual physicals, common illnesses and immunizations, but one major medical incident could wipe them out financially. An injury from an uninsured or underinsured driver, skiing (hiking, biking, swimming...) accident, fall, stroke, heart attack, or any number of unforseen but fairly common things would be disastrous for most Americans without insurance.

I plan on hanging around and enjoying my life for a long time, so I won't be gambling with my life's savings or access to healthcare. I just wish there were more affordable insurance options out there.
 

Steve Fatula

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very sad indeed. our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
They say they have "liberal" socialized medical care that covers everyone from birth until death
They don't understand 'in network' and 'out of network"
Crazy!

Yeah, I don't know if they pay less or more over their lifetime, but our problems extend far beyond insurance costs. But that would be OT.
 

Steve Fatula

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... fairly common things would be disastrous for most Americans without insurance.

And, sadly, for many with so called insurance! A friend of mine paid $30k with insurance for his surgery. Wiped him out.
 

Brett

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Yeah, I don't know if they pay less or more over their lifetime, but our problems extend far beyond insurance costs. But that would be OT.

it's easy to compare per capita health care costs with developed countries but quality may vary
it's probably more about what you consider "our" problems beyond health insurance costs !
 

Steve Fatula

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it's easy to compare per capita health care costs with developed countries but quality may vary
it's probably more about what you consider "our" problems beyond health insurance costs !

Just speaking of healthcare issues beyond insurance costs, like drug costs and a dozen or more other things. That would be another thread though.
 

Chrispee

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very sad indeed. our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
They say they have "liberal" socialized medical care that covers everyone from birth until death
They don't understand 'in network' and 'out of network"
Crazy!

We don't "claim" to pay less for health coverage, it's a fact that we pay less. The most recent study I could find shows Canadians pay $4,752 annually per capita, whereas US citizens pay $10,348 annually per capita. While the USA is well set up in a great many ways, you won't find a lot of your foreign friends admiring your current health care system/costs. Just because others are proponents for socialized health care, don't make the mistake of thinking we don't understand for-profit coverage.
 
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vacationhopeful

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I hope many Tuggers have looked into Long Term Care Insurance.

Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.
 

WinniWoman

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I hope many Tuggers have looked into Long Term Care Insurance.

Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.

I know we decided not to purchase it. It is just way too expensive. Heck- reading the above posts people can't even afford health insurance, never mind long term care insurance.

But I agree that if you can afford the premiums- and you can find a decent policy with a stable insurer, it is a good thing to have.
 

Talent312

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Insurance is intended merely for than routine office
visits, but for unexpected, unusually high expenses, for
which individual self-insurance would prove catastrophic.

I have insurance on my house, even though I don't have to.
I can handle routine repair+replace, but not a tree thru the roof.
.
 
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rapmarks

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I am off to call the insurance company to see why they denied all my husbands blood work and why we owe the hospital $678
 

bluehende

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I am off to call the insurance company to see why they denied all my husbands blood work and why we owe the hospital $678

I cann't hit like but this is certainly problem number 2 with our system.
 

breezez

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I know we decided not to purchase it. It is just way too expensive. Heck- reading the above posts people can't even afford health insurance, never mind long term care insurance.

But I agree that if you can afford the premiums- and you can find a decent policy with a stable insurer, it is a good thing to have.
My long term care policy is cruise ships, they cost $450-$1000 a week interior stateroom, they feed you, provide entertainment, will wheel you around in wheel chair if needed, medical on board. You just have to get off and reboard once a week. But in the end still cheaper than assisted living. :whooopie:
 

Passepartout

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I hope many Tuggers have looked into Long Term Care Insurance.

Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.
We are of two minds on LTC insurance. My mom had it, and as she finally expired in a nursing home after living about 3 years in assisted living, her LTC insurance paid out almost exactly the total of the premiums she had paid for it. My DW's father did not have LTC insurance, and had the money to cover his care for any reasonable time period out to his 120's.

LTC insurance is for the large middle of the 'Bell Curve' of income/savings demographic. The poor can't afford it, and if/when they go to long term care, their savings and assets will be liquidated and spent down and they will be covered by Medicaid. It isn't pretty but that's the reality unless they have family that will step up and improve their lot.

Wealthy people- or those who saved significant amounts with the goal of not being dependent on others- and/or the healthy or those with a likelihood that they won't be spending a long time needing care- don't need LTC insurance. They can privately pay for their own care.

The decision of 'to buy LTC or not to buy LTC insurance' should be made as early as possible if one falls within the group that can benefit from it. Say those who have children who are not in a financially secure position- or who have their own medical challenges. I feel that to pay for LTC insurance so that you can leave a large nest egg, while generous, is probably not the intention. Subsequent generations should have no entitlement to their parents' wealth. I'm sure others will disagree, but that's how I feel.

Jim
 
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