5 ms·

I mostly got burned by ACA -- I had $80-120/mo HSA+HDHP which was awesome, and then got forced into $280/mo inferior coverage (a "Bronze" plan) with fewer docto

by rdl 12y ago

I mostly got burned by ACA -- I had $80-120/mo HSA+HDHP which was awesome, and then got forced into $280/mo inferior coverage (a "Bronze" plan) with fewer doctors. (I ended up canceling all coverage a month later, getting a $750k "insurance, temporary" plan for 364 days at $30-60/mo, and ended up having a job with employer care before that expired.) Now I have employer-provided health care which is "free" but objectively the worst insurance I've ever had (in terms of number of doctors, etc.) HRA rather than HSA, so not very useful there, either. I hate the idea of employer-provided healthcare. If I had "interesting" medical issues, I'd probably just pay for insurance out of pocket vs. sharing health data with an employer. I'm pretty sure my coverage costs employer more than $300/mo, too.

itbeho 12y ago
Similar experience for me. Had insurance I was happy with. Had the plan forcefully cancelled out from under me. Then found less benefits for more money. Now I can't see one of my doctors without paying cash [1]. Nothing affordable about this for me. http://www.huffingtonpost.com/2014/04/10/obamacare-patients-without-doctors_n_5044270.html http://www.huffingtonpost.com/2014/04/10/obamacare-patients-...
- tptacek 12y ago
  If you're young and relatively healthy and you're not paying out of pocket for at least most of your first year's worth of medical expenses, you're paying too much in insurance premiums. You want an HSA-qualifying high deductible plan, and you want to manage the pool of money that finances the deductible yourself, rather than signing it over to an insurer as a higher premium every month.
  - snuxoll 12y ago
    This. I'm only saving $100 gross per month right now by getting a HDHP+HSA through my employer, but they also contribute a sizable portion to my HSA each month for the cost they save. Assuming nothing catastrophic happens in the next few years, I will have a sizable pool of money set aside in my HSA earning interest, and I can choose to lower my monthly cost at that point if I want. I should point out that I am also married and have a single child, since routine care is covered even under HDHP thanks to the ACA I don't expect to need to spend much out of my HSA unless something major happens.
phkahler 12y ago
>> I hate the idea of employer-provided healthcare. Yup. The most obvious problem is that when you change jobs, you change providers. That alone is undesirable and contributed to the problem of rejections due to pre-existing conditions. The less talked about aspect is that large companies are self insured. Meaning they cover all the costs and just have an outside company manage the plan. The issue with self insured companies is that on average, working folks are healthier than non-working ones. That means it shifts the higher costs to the non-corporate plans - medicare/medicaid. Just taking away the incentives for this and having people get their own plan would have gone some way toward a better system.
tptacek 12y ago
All my reasonable Bronze options in Illinois as HSA/HDHP-qualifying, and they have the same doctor networks as the Silver or Vanadium or whatever plans.
rasz_pl 12y ago
As an European >in terms of number of doctors what does that even mean?
- rdl 12y ago
  Out of the 2k doctors in SF (?), only 200 or so seem to take Cigna (my current insurer); 1500 would take Blue Cross/Blue Shield (previous). If your doctor doesn't take your insurance, it's considered "out of network", and you end up paying ~50% of the cost, vs. 0-10%.
  - rasz_pl 12y ago
    This is sad. I was under the impression whole reform was supposed to turn healthcare from business into utility.
    - rdl 12y ago
      I have no problem with a subset of doctors choosing to price themselves above the point where I should be forced to pay for someone else's use of them -- differentiating on ease of scheduling, etc. I'm just annoyed when this is a majority. A lot of the "ACA individual plans" are even WORSE than my company-provided plan for coverage.

by rdl 12y ago

itbeho 12y ago

Similar experience for me. Had insurance I was happy with. Had the plan forcefully cancelled out from under me. Then found less benefits for more money. Now I can't see one of my doctors without paying cash [1]. Nothing affordable about this for me. http://www.huffingtonpost.com/2014/04/10/obamacare-patients-without-doctors_n_5044270.html http://www.huffingtonpost.com/2014/04/10/obamacare-patients-...

tptacek 12y ago
If you're young and relatively healthy and you're not paying out of pocket for at least most of your first year's worth of medical expenses, you're paying too much in insurance premiums. You want an HSA-qualifying high deductible plan, and you want to manage the pool of money that finances the deductible yourself, rather than signing it over to an insurer as a higher premium every month.
- snuxoll 12y ago
  This. I'm only saving $100 gross per month right now by getting a HDHP+HSA through my employer, but they also contribute a sizable portion to my HSA each month for the cost they save. Assuming nothing catastrophic happens in the next few years, I will have a sizable pool of money set aside in my HSA earning interest, and I can choose to lower my monthly cost at that point if I want. I should point out that I am also married and have a single child, since routine care is covered even under HDHP thanks to the ACA I don't expect to need to spend much out of my HSA unless something major happens.

phkahler 12y ago

>> I hate the idea of employer-provided healthcare. Yup. The most obvious problem is that when you change jobs, you change providers. That alone is undesirable and contributed to the problem of rejections due to pre-existing conditions. The less talked about aspect is that large companies are self insured. Meaning they cover all the costs and just have an outside company manage the plan. The issue with self insured companies is that on average, working folks are healthier than non-working ones. That means it shifts the higher costs to the non-corporate plans - medicare/medicaid. Just taking away the incentives for this and having people get their own plan would have gone some way toward a better system.

tptacek 12y ago

All my reasonable Bronze options in Illinois as HSA/HDHP-qualifying, and they have the same doctor networks as the Silver or Vanadium or whatever plans.

rasz_pl 12y ago

As an European >in terms of number of doctors what does that even mean?

rdl 12y ago
Out of the 2k doctors in SF (?), only 200 or so seem to take Cigna (my current insurer); 1500 would take Blue Cross/Blue Shield (previous). If your doctor doesn't take your insurance, it's considered "out of network", and you end up paying ~50% of the cost, vs. 0-10%.
- rasz_pl 12y ago
  This is sad. I was under the impression whole reform was supposed to turn healthcare from business into utility.
  - rdl 12y ago
    I have no problem with a subset of doctors choosing to price themselves above the point where I should be forced to pay for someone else's use of them -- differentiating on ease of scheduling, etc. I'm just annoyed when this is a majority. A lot of the "ACA individual plans" are even WORSE than my company-provided plan for coverage.