The accountant says we can retire early. Woohoo!!!

[CloverKnollFarms]

We pay under $400/mo for our family, for a non group plan, since we are self employed.

We are about to start paying about $150/mo.

 

[riptides]

We pay under $400/mo for our family, for a non group plan, since we are self employed.

We are about to start paying about $150/mo.

That's incredible. What kind of coverages and deductibles? Or point me at a web site.

I have been raked over coals for a decade due to medical issues within the family. Even went to court and lost. Fine print, ya know.

 

[DarkBlack]

At our age health insurance will be the biggest expense .. $2100.00 per month now and does nothing but go up every year. so over the next 8 years.. Its likely to be north of 3K a year..

You’re paying $25,200/year now , from your #’s. That’s a lot.
You mean $30k? I bet it’ll go up more than 20% in 8 years.

 

[ultrarunner]

Insee it everyday… those that worked years and have coverage and co pays and supplemental paid each month.

Then there is another demographic not worried in the least because home and health insurance covered through low income programs…

The divide I see almost comes down to property owners needing to protect what they work for and others often on assistance programs…

 

[gsganzer]

For a BCBS bronze plan, I was paying $1700/mo.

I now have a BCBS gold plan through the healthcare market place for $1100/mo. What I'll have to be extremely careful of is how much I earn each year, but with a $600/mo savings, I can handle busting the limit a little and still come out ahead. I'll see how it stacks up this year.

Here's the kicker though. I'm finding some places won't accept plans from the healthcare marketplace. How screwed up is that?

Our healthcare system is absolutely in shambles. I went to see a Dr the other month to get a cortisone shot in an arthritic ankle. It was cheaper to pay it out of pocket for $179 (50% discount if payed in full at time of service), then to run it through insurance.

 

[ultrarunner]

For a BCBS bronze plan, I was paying $1700/mo.

I now have a BCBS gold plan through the healthcare market place for $1100/mo. What I'll have to be extremely careful of is how much I earn each year, but with a $600/mo savings, I can handle busting the limit a little and still come out ahead. I'll see how it stacks up this year.

Here's the kicker though. I'm finding some places won't accept plans from the healthcare marketplace. How screwed up is that?

Our healthcare system is absolutely in shambles. I went to see a Dr the other month to get a cortisone shot in an arthritic ankle. It was cheaper to pay it out of pocket for $179 (50% discount if payed in full at time of service), then to run it through insurance.

^^^ This is often the case for minor things…

The delay and expense of coding and submitting and then resubmitting and reconciling is why many sole practitioners are getting out of accepting insurance or very selective…

 

[gsganzer]

^^^ This is often the case for minor things…

The delay and expense of coding and submitting and then resubmitting and reconciling is why many sole practitioners are getting out of accepting insurance or very selective…

25% of US healthcare costs is in administrative. Over 2x what it is to the next highest country.

 

[Snobdds]

So I do actuarial risk stuff for all the BCBS. We are acutely aware of how unaffordable health insurance is.

I was tasked with developing a product, that skirts the heavy benefit burdens of Obamacare or the ACA. We developed a product that is not health insurance, but a financial service product that we just started marketing to medium and large groups. We refer to is as a level funded model, but it is basically insurance without all the socially willed benefits (*** change surgeries etc.), where we project what their claims expense will be for the year. If the claims come in higher than the projection, we eat 50% of the amounts over the projection, the group then has to fund the additional 50%. If the claims come in lower than the projection, the group gets a refund to their premium of 100%. We as insurers have skin in the game to make sure we keep claims amounts in check.

This creates an incentive for groups to push their employees to get healthier through programs we have to get saved premium dollars; like diabetes management, disease management, fitness programs etc. The kicker is, we have to very accurately project claims, Rx rebates, and all other costs that a premium is made up of. We are able to do this now with very sophisticated AI programs that give us data on basically everyone that goes to a doctor.

It's incredibly complex and it's even hard for our sales staff to explain to business manages responsible for the procurement of health issuance. It so complex that I am having to meet with CEO and CFO of large companies to explain how it all works. I hate business travel, but I need to get the big companies to buy in and change how healthcare is financed. The good thing is, we might be able to preserve the health insurance market for the next 20 years and bring back affordably.

 

[Tomtint]

You’re paying $25,200/year now , from your #’s. That’s a lot.
You mean $30k? I bet it’ll go up more than 20% in 8 years.

I just looked at the bill this month.. 2177.00 per month for the 2 of us.. 26124.00 per year. I have no doubt it will be north of 30K in 8 years.

 

[CloverKnollFarms]

I think you could buy coverage on the marketplace for less. Wow

Being retired, my income is something I can control now, so affordable coverage is easy to find on the marketplace. Looks to be $215/mo in 2025.

 

[ericm979]

25% of US healthcare costs is in administrative. Over 2x what it is to the next highest country.

Plus there are middlemen like Pharmacy Benefits Managers in every process who exist only to siphon profits out of patients. AI powered consultants that insurance companies hire to raise their denial rate and thus profits. This is why the US spends twice what any other rich county spends on health care yet we have the worst outcomes. We're the only rich country without universal health care and the only one where people are regularly rendered bankrupt and homeless due to medical bills. We have a system that only works for the 1%.

Sorry for the rant but watching my wife deal with insurance company rejection after rejection is really pissing me off. They usually pay after an appeal but that's an extra hassle that she doesn't need.

 

[Tomtint]

I think you could buy coverage on the marketplace for less. Wow

Being retired, my income is something I can control now, so affordable coverage is easy to find on the marketplace. Looks to be $215/mo in 2025.

In the Peoples Republic of Mass... Insurance is stupid expensive

 

[gsganzer]

Plus there are middlemen like Pharmacy Benefits Managers in every process who exist only to siphon profits out of patients. AI powered consultants that insurance companies hire to raise their denial rate and thus profits. This is why the US spends twice what any other rich county spends on health care yet we have the worst outcomes. We're the only rich country without universal health care and the only one where people are regularly rendered bankrupt and homeless due to medical bills. We have a system that only works for the 1%.

Sorry for the rant but watching my wife deal with insurance company rejection after rejection is really pissing me off. They usually pay after an appeal but that's an extra hassle that she doesn't need.

I understand completely. Not to be political, this is a simple matter of costs and coverage. I fall into the "fiscally conservative, socially moderate", genre and I'm 100% in favor of a universal healthcare system. The current system is on track to bankrupt the US government and is unsustainable.

Anyone that's been to another country and has seen how their healthcare system works, will realize that it might not be perfect, but it's still leaps and bounds better than our system. Especially if it can be combined with private insurance to fill the gaps.

Edit: This chart shows that approximately 70% of the populace of every country that has Universal Healthcare, either are very satisfied or neutral on their satisfaction. Less than 30% are dissatisfied.

Healthcare satisfaction survey

 

[CloverKnollFarms]

We went from an annual income of $300k, to $50k

It's better to be rich, or poor, and not in the middle. The middle is a terrible place.

 

[Snobdds]

Plus there are middlemen like Pharmacy Benefits Managers in every process who exist only to siphon profits out of patients. AI powered consultants that insurance companies hire to raise their denial rate and thus profits. This is why the US spends twice what any other rich county spends on health care yet we have the worst outcomes. We're the only rich country without universal health care and the only one where people are regularly rendered bankrupt and homeless due to medical bills. We have a system that only works for the 1%.

Sorry for the rant but watching my wife deal with insurance company rejection after rejection is really pissing me off. They usually pay after an appeal but that's an extra hassle that she doesn't need.

California is wild when it comes to healthcare.

 

[ultrarunner]

And the battles continue...

Hospital groups that dominate a region might say take it or leave it to Insurance

An area with a mix of providers may find insurance dictates...

I think it's a battle of the Titans.

The middle can mean being squeezed.

In my area a Catholic Hospital did the lion share of under or no insurance and the big players even contributed to make it viable.

The mandates came for reproductive rights and sisters sought religious exemption and denied.

The sisters left California.

The data shows there are many ways to loose money as a provider... especially small regional hospitals that continue to shutter...

 

[Snobdds]

I just looked at the bill this month.. 2177.00 per month for the 2 of us.. 26124.00 per year. I have no doubt it will be north of 30K in 8 years.

That's nothing...

A typical family premium for 2025.

People would be shocked if they knew just how much an employer was paying on their behalf.

 

[Tomtint]

That's nothing...

A typical family premium for 2025.

People would be shocked if they knew just how much an employer was paying on their behalf.

What is complete BS is that with a family plan here.. It makes no difference how many kids are on it.. You can have 1 kid or 30 and it's the same price. It works out to a bit over 1080.00 each for my wife and myself every month..

 

[JJT]

Property taxes are our #1 expense, over $10K/yr, followed very closely by healthcare, at just under $10k/yr. This is for a no deductible, platinum plan with $20 co-pays. We could switch to a $200/mo silver plan, but the out of pocket costs would increase with high deductibles and co-pays.

I have a blood draw/test every two months, with a $20 co-pay, the insurance company gets billed $965/test. One of my prescriptions is $200/month, I pay $10 out of pocket.

It's not health insurance that is too expensive, it's health care...... All it takes is a few frequent flyers, (heart issues, cancer) and the entire insurance pool has to pay more to keep the insurance companies profitable.

 

[Snobdds]

Property taxes are our #1 expense, over $10K/yr, followed very closely by healthcare, at just under $10k/yr. This is for a no deductible, platinum plan with $20 co-pays. We could switch to a $200/mo silver plan, but the out of pocket costs would increase with high deductibles and co-pays.

I have a blood draw/test every two months, with a $20 co-pay, the insurance company gets billed $965/test. One of my prescriptions is $200/month, I pay $10 out of pocket.

It's not health insurance that is too expensive, it's health care...... All it takes is a few frequent flyers, (heart issues, cancer) and the entire insurance pool has to pay more to keep the insurance companies profitable.

We have calculated out, that in 5 years, we have mass people just drop health insurance due to cost.

Then soon after, the medical industrial complex, sees huge lay off as people just forgo care.

It's coming if something doesn't change.

Oh BTW...the obmamacare subsidies sunset at the end of 2025. So everyone with plans that have a precious metal in their naming convention...watch out.