5 ms·

10 years ago I could see my doctor when I was sick. Like, the same day. Now if it can't be done at the Target or CVS, it's the emergency room. I didn't even get

10 years ago I could see my doctor when I was sick. Like, the same day. Now if it can't be done at the Target or CVS, it's the emergency room. I didn't even get an annual checkup last year because my doctor had to cancel, and the earliest I can be seen again is this summer. I'm now at the age where this is probably starting to matter. And I pay like... $30,000 a year minimum for this?

bongodongobob 2y ago
I know insurance can be pricey, but $2500/month? Who's your provider? Do you have a family of 6 or something?
- elif 2y ago
  Premium + deductible + prescriptions + out of network care I believe 30k is possible for a healthy single American.
  - elif 2y ago
    I didn't think so back when I was in a startup insurance program where it literally covered stuff. But i've been on a "normal" health plan through my wife's job for the last 5 years. The American health system is experienced totally differently by different classes of people.
  - antisthenes 2y ago
    Just because it's possible, doesn't mean it's typical, or even common.
    - elif 2y ago
      I mean my wife and I pay $700/mo premium, we both hit our $2500 deductible this year already, my physical therapy is out of network and costs me $800/mo That's $23k already before prescriptions and we are in our 30s with no major health issues.
      - mrguyorama 2y ago
        > my physical therapy is out of network and costs me $800/mo That part doubles what you are paying yearly and is EXTREMELY uncommon. For most Americans, an appointment that costs $800/mo is one you don't schedule because you quite literally cannot afford that and will go through bankruptcy attempting to.
      - antisthenes 2y ago
        You literally proved my point. You spend $11500 per person, while the original statement alluded to $30k for a single adult. Do you honestly not see the difference or are you that well off that $18500 is not a significant amount of money to you?
        elif 2y ago
        I said I believe 30k is possible You are free to argue against whatever strawman you desire... Chasing your own shadow though
- nsxwolf 2y ago
  Yes, I have a family of 6.
  - bongodongobob 2y ago
    In that case consider it a carbon tax.
- _heimdall 2y ago
  I pulled insurance quotes for my wife and I recently. Both of us are young and with no known health issues. Our monthly premiums for the cheapest plan was around $800 per month, but that was with very limited coverage and a deductible of around $15,000 before they would cover any major expenses. The premiums would be $9,600 a year but all in we could spend around $25,000. We had options for higher premiums and lower deductibles as well, but the total max out of pocket was almost identical.
  - PaulDavisThe1st 2y ago
    Make sure you are fully aware of federal subsidies for your insurance premiums. It's a bit complicated to explain the details, but basically you won't pay more than about 8.3% of your AGI for insurance, no matter what your income level is. Alas, these subsidies may expire next year if Congress does not renew them (they don't actually vanish, they are just income-capped at 400% of the federal poverty level).
    - tzs 2y ago
      To save people a lookup, 400% of the federal poverty level in 2025: Household Size 400% FPL 1 $60240 2 $81760 3 $103280 4 $124800 5 $146320 6 $167600 An annoying aspect of the subsidies is that they have an abrupt drop as you cross 400% FPL. From 133% (if you are below 133% you are supposed to use extended Medicaid instead of a subsidized marketplace plan) to 400% the amount of the subsidy goes down bit is still substantial at 400%. This can result in a situation where if your income is a little over 400% FPL you might come out ahead by taking a pay cat to get under.
      - PaulDavisThe1st 2y ago
        There is no abrupt drop at this time. There is a smooth gradient in the percentage of AGI that "the 2nd most expensive silver plan in your state" can cost. Next year, if Congress does not renew the expansion above 400% that was started during COVID, then there will the most abrupt drop possible at 400%: from something to absolutely zero. My wife and I save at least $6000/year thanks to these subsidies, which put our health insurance into the same general realm as most other industrialized nations (typically 8-12% of AGI on health insurance of some kind).
- defen 2y ago
  My employer pays $3,575.49 per month for my HDHP ($12,000 deductible). Family of 3. It's Aetna, through one of the large small-business payroll providers. Are we getting ripped off?
  - kbolino 2y ago
    You're probably not getting ripped off (relatively speaking). When I quit my job to take some time off 3 years ago, and signed up for COBRA, the out of pocket expense for 2 adults came to around $2000 per month, also for an HDHP plan.
  - mapt 2y ago
    Kaiser's "platinum-level" (90% average coverage, no deductibles) plan for a young nonsmoking adult runs about $450/mo in my state marketplace, and most of that is further subsidized for someone who isn't making middle class wages. The medium-deductible, 70%-average-coinsurance "Silver-level" plan is about half that. I don't even understand the concept of a $12,000 deductible when the ACA established maximum out of pocket at: > "For the 2024 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,450 for an individual and $18,900 for a family." What are you even paying for?
    - kbolino 2y ago
      The individual marketplace plans seem to exist in a totally different world from employer-provided plans. When I went from my old employer's COBRA to an MD Health Connection plan, my premium dropped nearly fourfold even with no subsidies.
    - defen 2y ago
      > What are you even paying for? I have no idea! High-deductible plans give you access to HSAs, which are the "don't pay taxes" cheat code (you put in pre-tax money, it gets invested in the market and grows tax-free, and you can spend it tax-free if it's on medical expenses; if you're over 65 you can use it for anything and pay regular income tax). But I'm paying 42,000 per year pre-tax for that privilege + insurance; maybe it's better to just get paid that as salary, take the income tax hit, buy coverage on the open market for far less, and then invest the leftover money.
deleted 2y ago
[deleted]
JumpCrisscross 2y ago
> 10 years ago I could see my doctor when I was sick. Like, the same day Have you tried telemedicine? I've done it through One Medical, and it's a charm for little things that require a quick check-up.
- polalavik 2y ago
  I sort of find telemedicine to a be a scam. I’m sure it has its use case, but most of the time it feels like they are trying to limit liability so they just tell you to go see a doctor in person.
  - s1artibartfast 2y ago
    I think they are hugely valuable if/when people are in the drivers seat for their own medical care. If someone wants bloodwork done, to try a drug, or change dosage, it is a faster way to get an appointment. If they want to get a general inspection and tune-up, it seems less fit for purpose.
    - nradov 2y ago
      Most routine bloodwork you can order yourself if you want to without going through a physician. https://www.questhealth.com/ https://www.questhealth.com/
      - s1artibartfast 2y ago
        do you still get insurance coverage if it isnt requested by a physician? Edit: answered my own question. Per questhealth.com "Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance. " I was excited for a minute
        nradov 2y ago
        You can still submit your own claim to your health plan even if the provider doesn't do billing. They may or not pay depending on coverage policies. You can also probably use an HSA or HRA to pay for these services.

bongodongobob 2y ago

I know insurance can be pricey, but $2500/month? Who's your provider? Do you have a family of 6 or something?

elif 2y ago
Premium + deductible + prescriptions + out of network care I believe 30k is possible for a healthy single American.
- elif 2y ago
  I didn't think so back when I was in a startup insurance program where it literally covered stuff. But i've been on a "normal" health plan through my wife's job for the last 5 years. The American health system is experienced totally differently by different classes of people.
- antisthenes 2y ago
  Just because it's possible, doesn't mean it's typical, or even common.
  - elif 2y ago
    I mean my wife and I pay $700/mo premium, we both hit our $2500 deductible this year already, my physical therapy is out of network and costs me $800/mo That's $23k already before prescriptions and we are in our 30s with no major health issues.
    - mrguyorama 2y ago
      > my physical therapy is out of network and costs me $800/mo That part doubles what you are paying yearly and is EXTREMELY uncommon. For most Americans, an appointment that costs $800/mo is one you don't schedule because you quite literally cannot afford that and will go through bankruptcy attempting to.
    - antisthenes 2y ago
      You literally proved my point. You spend $11500 per person, while the original statement alluded to $30k for a single adult. Do you honestly not see the difference or are you that well off that $18500 is not a significant amount of money to you?
      - elif 2y ago
        I said I believe 30k is possible You are free to argue against whatever strawman you desire... Chasing your own shadow though
nsxwolf 2y ago
Yes, I have a family of 6.
- bongodongobob 2y ago
  In that case consider it a carbon tax.
_heimdall 2y ago
I pulled insurance quotes for my wife and I recently. Both of us are young and with no known health issues. Our monthly premiums for the cheapest plan was around $800 per month, but that was with very limited coverage and a deductible of around $15,000 before they would cover any major expenses. The premiums would be $9,600 a year but all in we could spend around $25,000. We had options for higher premiums and lower deductibles as well, but the total max out of pocket was almost identical.
- PaulDavisThe1st 2y ago
  Make sure you are fully aware of federal subsidies for your insurance premiums. It's a bit complicated to explain the details, but basically you won't pay more than about 8.3% of your AGI for insurance, no matter what your income level is. Alas, these subsidies may expire next year if Congress does not renew them (they don't actually vanish, they are just income-capped at 400% of the federal poverty level).
  - tzs 2y ago
    To save people a lookup, 400% of the federal poverty level in 2025: Household Size 400% FPL 1 $60240 2 $81760 3 $103280 4 $124800 5 $146320 6 $167600 An annoying aspect of the subsidies is that they have an abrupt drop as you cross 400% FPL. From 133% (if you are below 133% you are supposed to use extended Medicaid instead of a subsidized marketplace plan) to 400% the amount of the subsidy goes down bit is still substantial at 400%. This can result in a situation where if your income is a little over 400% FPL you might come out ahead by taking a pay cat to get under.
    - PaulDavisThe1st 2y ago
      There is no abrupt drop at this time. There is a smooth gradient in the percentage of AGI that "the 2nd most expensive silver plan in your state" can cost. Next year, if Congress does not renew the expansion above 400% that was started during COVID, then there will the most abrupt drop possible at 400%: from something to absolutely zero. My wife and I save at least $6000/year thanks to these subsidies, which put our health insurance into the same general realm as most other industrialized nations (typically 8-12% of AGI on health insurance of some kind).
defen 2y ago
My employer pays $3,575.49 per month for my HDHP ($12,000 deductible). Family of 3. It's Aetna, through one of the large small-business payroll providers. Are we getting ripped off?
- kbolino 2y ago
  You're probably not getting ripped off (relatively speaking). When I quit my job to take some time off 3 years ago, and signed up for COBRA, the out of pocket expense for 2 adults came to around $2000 per month, also for an HDHP plan.
- mapt 2y ago
  Kaiser's "platinum-level" (90% average coverage, no deductibles) plan for a young nonsmoking adult runs about $450/mo in my state marketplace, and most of that is further subsidized for someone who isn't making middle class wages. The medium-deductible, 70%-average-coinsurance "Silver-level" plan is about half that. I don't even understand the concept of a $12,000 deductible when the ACA established maximum out of pocket at: > "For the 2024 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,450 for an individual and $18,900 for a family." What are you even paying for?
  - kbolino 2y ago
    The individual marketplace plans seem to exist in a totally different world from employer-provided plans. When I went from my old employer's COBRA to an MD Health Connection plan, my premium dropped nearly fourfold even with no subsidies.
  - defen 2y ago
    > What are you even paying for? I have no idea! High-deductible plans give you access to HSAs, which are the "don't pay taxes" cheat code (you put in pre-tax money, it gets invested in the market and grows tax-free, and you can spend it tax-free if it's on medical expenses; if you're over 65 you can use it for anything and pay regular income tax). But I'm paying 42,000 per year pre-tax for that privilege + insurance; maybe it's better to just get paid that as salary, take the income tax hit, buy coverage on the open market for far less, and then invest the leftover money.

deleted 2y ago

[deleted]

JumpCrisscross 2y ago

> 10 years ago I could see my doctor when I was sick. Like, the same day Have you tried telemedicine? I've done it through One Medical, and it's a charm for little things that require a quick check-up.

polalavik 2y ago
I sort of find telemedicine to a be a scam. I’m sure it has its use case, but most of the time it feels like they are trying to limit liability so they just tell you to go see a doctor in person.
- s1artibartfast 2y ago
  I think they are hugely valuable if/when people are in the drivers seat for their own medical care. If someone wants bloodwork done, to try a drug, or change dosage, it is a faster way to get an appointment. If they want to get a general inspection and tune-up, it seems less fit for purpose.
  - nradov 2y ago
    Most routine bloodwork you can order yourself if you want to without going through a physician. https://www.questhealth.com/ https://www.questhealth.com/
    - s1artibartfast 2y ago
      do you still get insurance coverage if it isnt requested by a physician? Edit: answered my own question. Per questhealth.com "Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance. " I was excited for a minute
      - nradov 2y ago
        You can still submit your own claim to your health plan even if the provider doesn't do billing. They may or not pay depending on coverage policies. You can also probably use an HSA or HRA to pay for these services.