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Health Insurance Premiums -- not Medicare related

b2bailey

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Just spoke with my 40 year old professional daughter, mother of two young boys. She has been shopping for health insurance after receiving word that her current coverage is ending.

Her best find will cost $1,500 per month and has a $3,500 deductible.

I asked if it was so high because of her income. Apparently not.
Who can afford this?
Fortunately she can.

But, wow.
 

Brett

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Just spoke with my 40 year old professional daughter, mother of two young boys. She has been shopping for health insurance after receiving word that her current coverage is ending.

Her best find will cost $1,500 per month and has a $3,500 deductible.

I asked if it was so high because of her income. Apparently not.
Who can afford this?
Fortunately she can.

But, wow.

yes, my son is encountering the same situation - health care insurance premiums are shockingly high even with high deductibles
 
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Panina

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Just spoke with my 40 year old professional daughter, mother of two young boys. She has been shopping for health insurance after receiving word that her current coverage is ending.

Her best find will cost $1,500 per month and has a $3,500 deductible.

I asked if it was so high because of her income. Apparently not.
Who can afford this?
Fortunately she can.

But, wow.
Actually that price isn’t that bad, for what is out there, the deductible ok in comparison of other plans.

Yes very high for many years. This is why the middle class Is getting poorer. The poor are covered, the well to do can afford it. The middle class if they buy it usually have a huge premium and large deductible so I know many who walk around without insurance and if they get sick they are bankrupted
 

geekette

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Just spoke with my 40 year old professional daughter, mother of two young boys. She has been shopping for health insurance after receiving word that her current coverage is ending.

Her best find will cost $1,500 per month and has a $3,500 deductible.

I asked if it was so high because of her income. Apparently not.
Who can afford this?
Fortunately she can.

But, wow.
If this covers the family, that's a great price and relatively low deductible.

Is she not eligible for COBRA? If she was insured through her job, she should be. Even if her company went bk, her contract is with the insurer. I never found COBRA to be any kind of great deal, but she should wait for that info before deciding.


eta.... re-reading, I see that Coverage is ending, not employment. disregard COBRA mention.
 

klpca

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For two of us our employer coverage is roughly $11k per year for a high deductible plan. Our cost is about half of that. In addition to the premiums, our deductible is $6,000; $3,000 each before coverage kicks in. Glad that we have it but I can't believe what we are paying for insurance that doesn't kick in until we have individually spent $3k. I know that I think long and hard before I call the doctor, and when I do call I am actively trying to find the least costly way to receive care. We had Kaiser (HMO) before this year for about the same cost, only we just paid co-pays. The company took that option away. I suspect it is because they are large enough to be self insured and they don't want us accessing health care on a regular basis.
 

VacationForever

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It has been high for many years. We have been paying for our own health insurance since 2008 when we left our big corporation jobs. My husband went on Medicare several years ago and it really helped keep the cost down for him. For me, I will have to keep paying the high premiums until I get to Medicare age.
 

Patri

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People should look into Christian Healthcare Ministries and Samaritan Ministries. They are a different approach but very cost effective. If your claims go over $500 or so, the program covers all your costs. The extra work is asking for private pay rates on any expenses you accumulate, and routine prescriptions are not covered. I've been using them for 2 1/2 years after my COBRA ran out, which I only kept since I had such good insurance. Compare all medical expenses with insurance vs. these sharing programs, and it is hard to defend traditional insurance. The drugstores gave me great discounts with GoodRX. I'll be going on Medicare in May, but cannot believe how much money I saved by researching CHM and trusting it to work.
 
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FYI, the Medi-Share plans are not all that they are cracked up to be. Many of them have pre-existing conditions, so they will not cover anything you are currently suffering from. They also will deny coverage for high-cost things like cancer. They say that if they deny coverage to call the provider and see if they will accept a lower cost settlement. In terms of Coronavirus, again they do not have to cover it, they can deny it. The plain and simple reason is they rely 100% on premiums. So, if they have a lot of members, then a large percentage get cancer, they won't have the money to cover others.

Real insurance agencies rely on a minimum 80% of premiums on healthcare, but if their reserves are depleted, they have re-insurance, where other insurers will pay them (insurance for the insurance). In terms of insurers having high deductibles, the plain and simple reason is to cut costs. The PPACA ("ObamaCare") mandated everyone get insurance, so those who have expensive chronic conditions like cancer took a lot of their profits, which were minimized under the 80/20 part of the act. They figure the higher the deductibles, the less the insurance agency must pay for. Most plans with the high deductibles use HSA (Health Savings Account), where you can deposit a certain amount in the bank for medical expenses until you hit the yearly deductible. If you want smaller deductibles, find a Union job, they pay phenomenal and give better benefits, but most positions are labor and work outside.

TS
 

Brett

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People should look into Christian Healthcare Ministries and Samaritan Ministries. They are a different approach but very cost effective. If your claims go over $500 or so, the program covers all your costs. The extra work is asking for private pay rates on any expenses you accumulate, and routine prescriptions are not covered. I've been using them for 2 1/2 years after my COBRA ran out, which I only kept since I had such good insurance. Compare all medical expenses with insurance vs. these sharing programs, and it is hard to defend traditional insurance. The drugstores gave me great discounts with GoodRX. I'll be going on Medicare in May, but cannot believe how much money I saved by researching CHM and trusting it to work.

Like the other poster mentioned, Christian Healthcare ministries is not health insurance -
https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html


"there is no coverage, no guarantee of payment and they are not legally bound to cover their members’ claims"
"they operate with no government oversight"
You have to depend on the generosity of the program

"Families who have joined the groups recount winding up with medical bills not covered by the ministries, with no legal way to appeal decisions to reject coverage for care."
 

bogey21

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yes, my son is encountering the same situation - health care insurance premiums are shockingly high even with high deductibles
My Son, age 53 and single, pays Blue Cross/Blue Shield Illinois $514.27 per month for his policy with has a relatively high deductible...

George
 

Patri

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The sharing programs have been around for decades and they do pay out. Anyone should read the rules before signing up, as with any regular insurance. Pre-existing conditions are excluded until you are on maintenance for a year. They are a great option and absolutely will save you money. People paying out-of-pocket likely did not read the materials ahead of time. But many of those bills are still paid under a voluntary progam for members to donate, and they are quite generous. These programs are a substitute for insurance. People can compare, and choose how they wish to spend their money for healthcare. But it saddens me that people slam them when they truly do work. There are horror stories with traditional insurance, too. These programs are faith-based. Maybe that is what bothers people. And cancer is absolutely covered, if you did not have it before you signed up. Consumers should just do their research.
 

Brett

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The sharing programs have been around for decades and they do pay out. Anyone should read the rules before signing up, as with any regular insurance. Pre-existing conditions are excluded until you are on maintenance for a year. They are a great option and absolutely will save you money. People paying out-of-pocket likely did not read the materials ahead of time. But many of those bills are still paid under a voluntary progam for members to donate, and they are quite generous. These programs are a substitute for insurance. People can compare, and choose how they wish to spend their money for healthcare. But it saddens me that people slam them when they truly do work. There are horror stories with traditional insurance, too. These programs are faith-based. Maybe that is what bothers people. And cancer is absolutely covered, if you did not have it before you signed up. Consumers should just do their research.

It's more than simply "reading the materials"

A recent Wall Street Journal article said states were suing religious health sharing ministries because consumers were misled about claims for coverage.
https://www.wsj.com/articles/groups...-drawing-more-membersand-scrutiny-11560177134

and other publications have reported examples where medical costs were not covered
https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

“Just trust in God,” Samaritan Ministries, in Peoria, Ill., said in a statement about its coverage,
and advises its members that “there is no coverage, no guarantee of payment.”
 

geekette

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Yes. Research and reading will have nothing to do with any one person's outcome.

I certainly know this from "regular" insurance. Says it's covered. At this place. Surprise, unwritten loophole.
 

bogey21

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I looked into a couple of Sharing Programs before we went with BC/BS IL. One in particular looked OK. We passed on it because the cost differential between it and BC/BS was not big enough to entice us to choose it over BC/BS IL...
 

Patri

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I think why some people aren't getting their bills paid is the level of coverage they picked. The monthly cost is not that different for the unlimited plan, so it makes the most sense, but not all choose it. That one company getting sued I have never heard of. My materials are very clear it is not health insurance, and they list specifics for each state, so no one is misled. All the information is transparent. When I compared the cost of insurance premiums, deductibles and co-pays, sharing was a no brainer. My routine exams are not covered, but the medical offices give a self-pay discount. The monthly publication we get always repeats all the parameters of the program. They are not hiding anything. It is a leap of faith just because it is different, but it is based on solid principles and action.
 

Brett

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I think why some people aren't getting their bills paid is the level of coverage they picked. The monthly cost is not that different for the unlimited plan, so it makes the most sense, but not all choose it. That one company getting sued I have never heard of. My materials are very clear it is not health insurance, and they list specifics for each state, so no one is misled. All the information is transparent. When I compared the cost of insurance premiums, deductibles and co-pays, sharing was a no brainer. My routine exams are not covered, but the medical offices give a self-pay discount. The monthly publication we get always repeats all the parameters of the program. They are not hiding anything. It is a leap of faith just because it is different, but it is based on solid principles and action.

I suppose we both agree it takes "a leap of faith" .... and staying well
https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html
 
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