patrick.net

Everything in insurance is about shifting sand, evanescent receding benefits, increasing premiums, and ever elusive claims and service. However a particular policy began, it gradually morphs through codicils and revisions to something a lot more expensive and a lot less inclusive. It is the nature of the beast.

Is this the fault of Obamacare for not covering the premiums anymore, or the fact that the premiums are insanely expensive to begin with? I thank sweet jeebus errday that I've got good employer healthcare because those kind of fucking premiums are just plain cruel.

Evan F. says

I thank sweet jeebus errday that I've got good employer healthcare because those kind of fucking premiums are just plain cruel.

You are most likely paying $1800 for your family per month whether you realize it or not. Your employer can choose to pay 0 to 100% of that premium, but I guarantee you that is coming out of your potential compensation.

I know cause i have these conversations with employers daily.

Rocketmanjoe says

CBOEtrader says

At $82k/yr of family income their family of 4

You realize this is over 300% of the FPL? So you are saying

CBOEtrader says

receives a $1800 monthly subsidy, covering the full premium of the plan.

At around 333% FPL how are they receiving a full subsidy? Something smells fishy around here.

Yup, subsidies are available for anyone making less than 400% of FPL and more than 100%. A family of four will receive subsidies up to $99k/year. The specific amount of subsidy is a function of the lowest priced silver plan in a county, so it can fluctuate wildly between counties for the same income level.

If I tell you anything else, I'll have to charge you a consulting fee or make you sign an NDA. Let's just say if you know how to break down data, you can target very profitable counties.

CBOEtrader says

You are most likely paying $1800 for your family per month whether you realize it or not. Your employer can choose to pay 0 to 100% of that premium, but I guarantee you that is coming out of your potential compensation.

This is what all the Medicare for All crowd doesn't get. Someone has to pay for their healthcare. They think if the government picks up the tab, their employers will funnel all those dollars they don't spend on premiums to the employees.... LOL

The Medicare for All crowd will end up paying for it buy having their Federal taxes double... which is a hell of a lot more then they pay now...

MrMagic says

They think if the government picks up the tab, their employers will funnel all those dollars they don't spend on premiums to the employees.... LOL

They may have a case IF the medicare for all proposition didnt require doubling corporate tax rates. Again, someone has to pay for it. People w any money whatsoever will not be better off, guaranteed.

Actually, I should correct myself. I'm in IATSE, so it's a union healthcare plan. And yes, I understand that it ostensibly comes out of my own pocket, but because IATSE is in general a well run union with reasonable pension and healthcare expenses, it's likely costing me a great deal less than an individual plan.

Rocketmanjoe says

At around 333% FPL how are they receiving a full subsidy?

Lol ok, so it's far more extreme than that. This family is in one of those extremely high prices counties therefore subsidies a proportionally high. My numbers were slightly off above.

If this family files adjusted gross rev at $98399 for the year, they recieve $22392 of total tax subsidies to pay for their marketplace policy. If they file for $1 more $98400, they receive nothing. If annual estimates are off by $50, that difference would land them with a tax bill of $22392 as uncle sam asks for everything back.

MrMagic says

They think if the government picks up the tab, their employers will funnel all those dollars they don't spend on premiums to the employees.... LOL

Econ 101. Profit maximizing companies don't pay benefits for no reason. They do it to attract and retain their employees. Benefits are a part of the overall compensation package and are set by the market. Companies can't cut compensation and pay less than market value without losing their best employees.

Evan F. says

so it's a union healthcare plan.

So, where does the money come from to pay their side of the costs?

CBOEtrader says

Long story short: wife getting a job and increasing family revenue by less than $14k equals extra taxes of MORE THAN $14k.

She is literally losing money by going back to work.

That was the whole point of the Obama administration you can't inject Communist Socialism on a happily gainfully employed population.
Everything that Cock chocker did was to destroy the American Nuclear family. That jive ass mother fucker!

Evan F. says

but because IATSE is in general a well run union with reasonable pension and healthcare expenses, it's likely costing me a great deal less than an individual plan.

Large providers sometime create unique group plans specifically for very large groups, such as teachers unions, etc... it is my understanding that this is coming out of your paycheck while working or built into your pension ("I get it for free"- nope) once you retire.

I can almost guarantee the actual $ per $ that they spend is comparable to what you would find yourself.

After you retire, some seniors stay on these "free" plans, not realizing they can get a far better deal from a medicare advantage or even a medigap plus original medicare option. I switch a lot of seniors off these types of grandfatehred employer plans.

MrMagic says

Evan F. says

so it's a union healthcare plan.

So, where does the money come from to pay their side of the costs?

Out of your dues and/or paycheck and/or pension.

CBOEtrader says

MrMagic says

Evan F. says

so it's a union healthcare plan.

So, where does the money come from to pay their side of the costs?

Out of your dues and/or paycheck and/or pension.

I know that but I was wondering if HE knew that.

CBOEtrader says

Rocketmanjoe says

At around 333% FPL how are they receiving a full subsidy?

Lol ok, so it's far more extreme than that. This family is in one of those extremely high prices counties therefore subsidies a proportionally high. My numbers were slightly off above.

If this family files adjusted gross rev at $98399 for the year, they recieve $22392 of total tax subsidies to pay for their marketplace policy. If they file for $1 more $98400, they receive nothing. If annual estimates are off by $50, that difference would land them with a tax bill of $22392 as uncle sam asks for everything back.

How does anyone think it is ok to charge $1866 PER FUCKING MONTH, for health INSURANCE for a family of four??? It's not Health Care, it's fucking INSURANCE! All of these stupid fucking people need to start negotiating rates for standard services and paying cash for non-catastrophic care. Take the money out of the hands of the insurance companies, take away the power and the necessity of the health care providers to keep raising costs.

I have a case. I was caregiving for my father who was 95. He passed away last year and I had to take his IRA Required Minimum Distribution.

This raised my income so I owed Uncle Sam the Obamacare premium of $7300. I had to pay it to the US Treasury last April along with more taxes.

This year I have to try not to make income so as to avoid paying $8000 this year for my Obamacare.

This year I can drop Obamacare because there is no "mandate". Then, I can buy some "temporary insurance" for much less $ although it will not pay for anything unless I have a large medical problem ($10,000 deductible)

Cboetrader, I've seen this very thing myself...

My insurance is 100% covered by my employer. I don't pay a penny each pay cycle and have a low deductible.

I'm going self employed end of this year, because my wife and I's 3 businesses are doing really well. We already have plans with our accountant to reduce our annual income down to near zero for 2019 through pre tax shelters and business expenses...

This is for if we want to go the ACA route which will literally make our health care free. Only able to do this since we have a pile in savings and have no debt/mortgage or anything other than utilities and property tax.

Other option is to live overseas and rent our house out since healthcare costs are pennies in a lot of other countries. We've wanted to travel more so this may be the perfect opportunity.

It seems trivial, when you can pay out of pocket for a decent health plan, but when you are tired of being screwed by the government/insurance, other options are beginning to look more attractive.

joshuatrio says

Other option is to live overseas and rent our house out since healthcare costs are pennies in a lot of other countries. We've wanted to travel more so this may be the perfect opportunity.

No it's not pennies on a dollar unless you establish residency in almost any place you would want to use the health care. Expat health insurance is complicated with lots of gotcha's, especially for US citizens. If you go this route do your homework very carefully. I've done the getting medical bills paid from 7 time zones away game. Even with a very reputable and helpful insurance carrier it was still a nightmare.

joshuatrio says

healthcare costs are pennies in a lot of other countries.

In Mexico, costs are 10% - 30% of USA prices, which is a reason we got Obamneycare: Americans were going south of the border for medical services, and the AHA didn't want to compete with the American Hospital in MTY, nor the American British Cowdray Hospital in CDMX, nor countless other clinics that catered to Americans. You said overseas though, so maybe Asia (including India), where quality can be high (but variable) and costs are low.

joshuatrio says

We already have plans with our accountant to reduce our annual income down to near zero for 2019 through pre tax shelters and business expenses...

Your accountant probably knows this but you need to at least show FPL level income. For a couple I think 2019 will be around $17k/yr. Any lower and you recieve no subsidy.

joshuatrio says

Other option is to live overseas

Well maybe. I lived in Panama where everyone pays in cash and it worked great. $20 doctors visits, $2 medications, etc...

However that's not your only option. If you dont have pre-x I would look at a classification of insurance called "short term medical". These are the policies that Trump expanded, and since individual mandate is gone, you can get into these plans for about $250/person. I would add in some supplemental protection for out of pocket costs, and bam... for about $325/person you have very solid coverage.

CBOEtrader says

Your accountant probably knows this but you need to at least show FPL level income. For a couple I think 2019 will be around $17k/yr. Any lower and you recieve no subsidy.

Yep. That's not that hard to do if you plan accordingly, do pre tax investments, reinvest back in the business, and leave the money with the business. Win win.

CBOEtrader says

Well maybe. I lived in Panama where everyone pays in cash and it worked great. $20 doctors visits, $2 medications, etc...

Yeah, we're looking at Central America and parts of Asia.

bob2356 says

No it's not pennies on a dollar unless you establish residency in almost any place you would want to use the health care

Bob, if we go overseas I was just not going to carry insurance. When procedures in Mexico and Central America run the cost of copays in the US, there isn't much of a need

joshuatrio says

When procedures in Mexico and Central America run the cost of copays in the US, there isn't much of a need

Yeah I was friends with a few doctors in Panama. They usually come from rich families in Panama, go to med school in the US, work as residents in the US for 3 to 5 years, then go home with enough savings to live the good life while only making $70k/yr in Panama. There may be limitations to their technology, IDK. However, I know my father had a major skin cancer removal surgery there with great results, all paid for with cash from his wallet.

CBOEtrader says

Yeah I was friends with a few doctors in Panama. They usually come from rich families in Panama, go to med school in the US, work as residents in the US for 3 to 5 years, then go home with enough savings to live the good life while only making $70k/yr in Panama.

I'm intrigued. How does someone pay 50-100k tuition a year for 4 years, plus shelter/food/car/etc., then work 3-5 years as a resident at 50-60k still paying for shelter/food/car/etc. (note that residencies are in big, aka expansive, cities) and have enough money in savings to live the good life? That is an amazing trick.

joshuatrio says

Bob, if we go overseas I was just not going to carry insurance. When procedures in Mexico and Central America run the cost of copays in the US, there isn't much of a need

Not a gamble I would take. You can always get in a bad car accident or have some off the wall medical condition pop up that will require large amounts of medical care. I had a friend who ran a kite surfing school. On the water every day, in great shape. Had a heart attack and needed open heart surgery at 34. Totally out of the blue, a genetic thing. You never know.

Some countries won't let you leave with unsettled debt.

joshuatrio says

Yeah, we're looking at Central America and parts of Asia.

I liked Costa Rica a lot, much better than Panama. Its a little over run by expats and there is some low level resentment, but Panama is very overrun. Too much growth too fast. Just came back from a month in Cartagena Columbia. Amazing place, much better than anything I've seen in central America or the caribbean islands. Next summer is locked in already but summer 2020 I'm going back for at least a month and see a lot more of Columbia.