Affordable Care Act (AKA Obamacare)

[jim]

What is an HDHP?

Ok looked it up, don't know what that means. Don't know what my deductible is. I know I go to the doctor, give them a card, and they check me out. Sometimes they give me an Rx. When I leave sometimes they just say bye, sometimes they say I owe them $10, and when I pick up my medicine I think they just give it to me usually. Sometimes they want like $5. Sometimes I buy a six pack of beer while I'm there and it's $10. But sometimes I just pay for the beer.

Otherwise I don't know.

[Swirls]

High Deductible Healthcare Plan

You get super low premiums for health insurance in exchange for a super high deductible. My deductible is $1,500 with a max annual out-of-pocket of $3,000. That's for me only. Family coverage is $3k deductible/$6k max.

But you can invest pre-tax dollars into a Health Savings Account (HSA) and use that money for all of your medical related expenses. Unlike a Flex Spending Account (FSA), funds aren't lost at the end of the year. They're in an actual savings account earning interest (something stupid and paltry like .01%). I had Lasik done a few years ago and paid the entire thing with my HSA, so it was done with pre-tax dollars and was therefore much cheaper.

[jim]

That seems complicated as hell.

I know in the last 10 years we have had 5 surgeries in hour house - one knee and one kid had a hip operated on 3 times, and my wife's wrist. I think it cost a few bucks but not too much.

[Jocephus]

im single and have no dependents so that may be part of it. its a plan thru the state. i also, if i want a discount, have to earn 30 points thru various tasks such as a blood test (simple test, like BMI, cholesterol, blood pressure, etc), and confirming i got regular checkups. but its a hearty discount so its worth it. also, part of the monthly $30 is because i have a flex spending amount of like, 300, that im voluntarily putting out there. knock on wood, ive been healthy so, shouldn't need a lot.

october is our open enrollment here so its on our minds here. there's a handful of plans but i always stick with the same. i know topeka has said ACA has increased costs for kansas this upcoming year, but im not feeling it. but i know a few coworkers with families/more complex health situation, etc be annoyed, whichever way they lean (more expensive, less coverage).

[Swirls]

It's really not. When you enroll in your benefits, you just choose a different plan. At that point you usually select if you want to contribute any money to your HSA. You get a debit card for your HSA, so whenever you go to buy your meds you just use it to pay the cashier. Done.

The money being deducted from your paycheck for your HSA is no different than selecting how much money you want to be deducted from your paycheck for your 401k.

And actually, most employers offer "seed" money for your HSA. My current company will put $500 into your HSA for you if you are covered as an individual. If your entire family is covered, they'll add $1k. So that's free money towards your deductible right off the bat.

[cardsfantx]

it's the only thing i miss about working in corporate america...health insurance. owning your own business sucks when it comes to that.


we have the lower tier (bronze), pay 1,100 a month, and have a 10k deductible...which means we don't meet the deductible and pay 100% out of pocket for all our visits (approx $150 every time we/the kids go)

only alternative was to get a silver or gold plan, but the one i wanted with a 3k deductible was 1,900 per month. screw that. and the benefits in that tier STILL aren't near as good as the plans i was getting in corporate america.

health insurance premiums shouldn't be equivalent to some peoples mortgage payments per month...i don't care how much money you make; it's ridiculous

[heyzeus]

I'm willing to admit at this point that for most people, the ACA is a huge failure. Costs for insurance have exploded, and all I'm left with now are [expletive] HMOs and mega-high-deductible plans that basically leave me paying out of pocket for all of my family's medical care, in addition to ever-escalating premiums. (Like cardsfantx, I'm technically self-employed, and the only plans available to me are just like the ones he described. Except our deductible is 12k).

This was forseeable. Insurance companies are the cause of, not the solution to, much of our nation's broken healthcare system. They are the middle men profiteering off suffering, they are the death panels denying treatment and denying coverage on claims, resulting in the bankruptcy of the middle class. The ACA's solution was to put everyone in the hands of the insurance companies. This is madness. The solution was to get rid of them altogether and nationalize healthcare, not to force all of us to be their unwilling customers.

[IMADreamer]

I'm willing to admit at this point that for most people, the ACA is a huge failure. Costs for insurance have exploded, and all I'm left with now are [expletive] HMOs and mega-high-deductible plans that basically leave me paying out of pocket for all of my family's medical care, in addition to ever-escalating premiums. (Like cardsfantx, I'm technically self-employed, and the only plans available to me are just like the ones he described. Except our deductible is 12k).

This was forseeable. Insurance companies are the cause of, not the solution to, much of our nation's broken healthcare system. They are the middle men profiteering off suffering, they are the death panels denying treatment and denying coverage on claims, resulting in the bankruptcy of the middle class. The ACA's solution was to put everyone in the hands of the insurance companies. This is madness. The solution was to get rid of them altogether and nationalize healthcare, not to force all of us to be their unwilling customers.

Insurance costs were exploding before the ACA.

I'm also self employed and about to take my yearly screwing where despite not going to the doctor once last year I'll have my rate increased. It's time to destroy the insurance industry. We need something else.

[AWvsCBsteeeerike3]

Well said, zeus.

FTR, I went on an HDHP this year. I forget how all the numbers worked out, but the premiums were like $60/month less than what a regular plan was.

I have about $700 worth of prescriptions every month, but as an individual, I capped out at $3500 out of pocket and then everything was covered at 100%. The RX on a monthly basis with regular coverage was about $100. So....we saved $720 in premiums, my company put $750 into an HSA for all that went HDHP, my wife's former employer contributed $2k/year to anyone with an HDHP, and I bought a $2k device to help me out. All in all, it was about a wash for out of pocket expenses. But, my wife changed employers so that $2k isn't available next year and the $750 the company I work for contributed was a one time thing.

So, we're headed back to the normal plan next year.

One thing I will note with HDHP is it does really open the consumer's eyes as to how much medicine costs. For example, test strips range from $75 for 300 of them on Amazon to $250 for 250 of them at Walgreens. Of course, if you buy them from AMazon, that isn't applied towards the deductible and if you buy them at Walgreens it is. So...i'm forced to buy them from walgreens and my employer (self-insured company with BCBS as the provider or whatever it is called) is forced to pay the Walgreens price.

We're actually working on a work around where they just straight pay for the strips from Amazon and we skip the middle man that is BCBS and Walgreens. But...it sure seems BCBS should be doing that, not the company. Stupid.

[Arthur Dent]

The insurance industry does suck, but besides that, the biggest reason premiums and other out of pocket costs are so high is because the prices charged for medical services are huge and way out of line with prices in the rest of the developed world. Very little progress can be made if hospitals are left off the hook.