Welcome guest, is this your first visit? Click the "Create Account" button now to join.

To disable ads, please log-in.

Shop at TeamEstrogen.com for women's cycling apparel.

Page 1 of 2 12 LastLast
Results 1 to 15 of 21
  1. #1
    Join Date
    Sep 2008
    Location
    Twin Cities, Minnesota
    Posts
    487

    If I am going to keep riding my bike I need health insurance!

    To disable ads, please log-in.

    Actually I need health insurance no matter what.

    I need help with selecting a health insurance policy. COBRA is really expensive. Can anyone give me advice. I looked on eHealth. I talked to a customer service person and he really helped me out. He provided reasonable quotes, I just don't know what to select.

    Should I select a high deductible and lower premium?

    Cobra will be 443 a month! I would have a 1000 deductible with 10% co-insurance. There is no limit of Dr visits. Co Pays are $25. It does include prescription benefits. All other plans don't.
    The other plans have a limit of 4 visits with co-pays between $30 -$40. After that you pay a discounted rate. Those plans are between $258 and $301, but they have a deductible of anywhere between 5000-7500. The co-insurance is 0 which means once I reach the deductible, I don't have any more costs. the plans do have prescription coverage

    I can handle, with only some difficulty, a $7500 deductible. I just hate knowing the inheritance from my Dad will be spent on medical insurance. :-(
    Obama care is supposed to start in October. Premiums will be based on your income. I wonder if they will look at your current income. If so, I will come out great . . . I don't have any income -- unless unemployment comes through.
    Last edited by kajero; 07-31-2013 at 02:18 PM.
    kajero
    2013 Trek FX 7.6 WSD
    2012 Specialized Ruby WSD
    2004 Schwinn (I think that is the year)

  2. #2
    Join Date
    Apr 2011
    Location
    perpetual traveler
    Posts
    1,302
    Keep in mind that under the new health care law eligibility for subsidies depends on joint income, for both you and your spouse if you are married. There is some basic information about subsidies here: http://www.businessweek.com/articles...ance-subsidies The effective date is the first of the year but the exchanges where you can shop will go into effect in October. Unlike many states who are dragging their feet, Minnesota is ahead of the game in setting things up.

    Here is a good worksheet for comparing different health insurance plans: http://healthinsuranceinfo.net/manag.../worksheet.pdf

    You can also talk to a insurance agent who may be able to find any other options for you that you haven't been able to find through eHealth.
    Last edited by goldfinch; 07-31-2013 at 03:09 PM.
    Trek Madone 4.7 WSD
    Cannondale Quick4
    1969 Schwinn Collegiate, original owner
    Terry Classic


    Richard Feynman: “The first principle is that you must not fool yourself and you are the easiest person to fool.”

  3. #3
    Join Date
    Sep 2007
    Location
    Uncanny Valley
    Posts
    14,645
    It really depends on your personal needs and risks, and you don't want to be talking about those in a public forum. If you have no pre-existing conditions and no known risk factors, you could take a chance. But if you have any health care utilization now, or any risk factors, add up what it is costing pre-insurance, or what one of those risk factors is likely to cost if it develops. That's the only way you can have a reasonable basis for knowing what to spend. I'm guessing that since you have options at all outside of COBRA before your state exchange goes into effect, you must not have any pre-existings, though.

    Also, you can be too poor to qualify for the subsidy. Has your state approved the Medicaid expansion?
    Speed comes from what you put behind you. - Judi Ketteler

  4. #4
    Join Date
    Apr 2011
    Location
    perpetual traveler
    Posts
    1,302
    Minnesota has approved the Medicaid expansion. Things are really screwed up for some people in states that are not approving the expansion. No mandate, but no insurance either.
    Last edited by goldfinch; 07-31-2013 at 03:17 PM.
    Trek Madone 4.7 WSD
    Cannondale Quick4
    1969 Schwinn Collegiate, original owner
    Terry Classic


    Richard Feynman: “The first principle is that you must not fool yourself and you are the easiest person to fool.”

  5. #5
    Join Date
    Sep 2008
    Location
    Twin Cities, Minnesota
    Posts
    487
    The only pre-existing condition: I tend to crash my bike more often than I should. LOL
    kajero
    2013 Trek FX 7.6 WSD
    2012 Specialized Ruby WSD
    2004 Schwinn (I think that is the year)

  6. #6
    Join Date
    Sep 2008
    Location
    Twin Cities, Minnesota
    Posts
    487
    Quote Originally Posted by goldfinch View Post
    There is some basic information about subsidies here: http://www.businessweek.com/articles...ance-subsidies The effective date is the first of the year but the exchanges where you can shop will go into effect in October. Unlike many states who are dragging their feet, Minnesota is ahead of the game in setting things up.
    This link was really good. eHealth had a lot of info on what will happen in October. I can't find when they will look at your income. I had a really good income until July 9. Now I only have dividends from my stocks. I can withdraw from my ROTH if I need to. And I can get Social Security February. Hopefully I can hold off on that.
    kajero
    2013 Trek FX 7.6 WSD
    2012 Specialized Ruby WSD
    2004 Schwinn (I think that is the year)

  7. #7
    Join Date
    Apr 2011
    Location
    perpetual traveler
    Posts
    1,302
    I am currently on Minnesota's risk pool due to pre existing conditions, which will be closing down at the end of the year. So I will be shopping on the exchange too. If you want to compare notes via email come October I would be glad to chat. My current plan is to work with an insurance agent when shopping. I am also thinking about shopping in other states as there is no particular reason I need to remain a Minnesota resident.

    To be eligible for any subsidy you will need to buy on the exchange. The absolute cutoff for subsidies at a certain income level means that my spouse and I will not be getting any subsidy. Oddly, it makes sense for some people to divorce in order to get a subsidy. I know a person who has health insurance through work but no family coverage for her spouse. They are not eligible for a subsidy because her income is too high. If they divorce he could get a significant subsidy.

    Health insurance reform needs tweaking, it did from the get go. But it isn't going to happen in the near future.
    Trek Madone 4.7 WSD
    Cannondale Quick4
    1969 Schwinn Collegiate, original owner
    Terry Classic


    Richard Feynman: “The first principle is that you must not fool yourself and you are the easiest person to fool.”

  8. #8
    Join Date
    Apr 2011
    Location
    perpetual traveler
    Posts
    1,302
    Quote Originally Posted by kajero View Post
    This link was really good. eHealth had a lot of info on what will happen in October. I can't find when they will look at your income. I had a really good income until July 9. Now I only have dividends from my stocks. I can withdraw from my ROTH if I need to. And I can get Social Security February. Hopefully I can hold off on that.
    http://healthinsurance.about.com/od/...bsidy-Work.htm

    . . . Most people won’t want to wait; they’ll choose the advance payment option. However, consider opting to get the subsidy along with your tax refund if:

    Your income is very close to 400 percent of FPL.
    Your income varies from year to year so you’re not sure how much you’ll make.
    When the subsidy is paid in advance, the amount of the subsidy is based on an estimate of your income for the coming year. If the estimate is wrong, the subsidy amount will be incorrect.

    If you earn less than estimated, the advanced subsidy will be lower than it should have been. You’ll get the rest as a tax refund.

    If you earn more than estimated, the government will send too much subsidy money to your health insurance company. You’ll have to pay back part or all of the excess subsidy money when you file your taxes. Even worse, if your actual income ended up more than 400 percent of FPL, you’ll have to pay back every penny of the subsidy. This could be thousands of dollars.

    If you get your subsidy when you file your income taxes rather than in advance, you’ll get the correct subsidy amount because you’ll know exactly how much you earned that year. You won’t have to pay any of it back.


    Basically, you can get an estimated subsidy but may have to pay all or part back if you actual income for the year is larger than estimated. Your income for 2014 is what is going to be relevant for your 2014 insurance premiums.
    Last edited by goldfinch; 07-31-2013 at 03:33 PM.
    Trek Madone 4.7 WSD
    Cannondale Quick4
    1969 Schwinn Collegiate, original owner
    Terry Classic


    Richard Feynman: “The first principle is that you must not fool yourself and you are the easiest person to fool.”

  9. #9
    Join Date
    Sep 2008
    Location
    Twin Cities, Minnesota
    Posts
    487
    I spent all morning on the phone with internet insurance brokers. The are extremely helpful. I could never have done what they helped me with on my own. They found two really great policies for me. I applied for both and was denied. Apparently, some of the medication I am on points to a pre-existing condition. The brokers had other policies that were only $100 less than COBRA. The coverage is not as good as my COBRA and I don't even know if would be approved for those.

    So I guess I will have to remain on COBRA. Thank goodness I can just "barely" afford it.

    I wonder what will happen to insurance premiums for me come January 2014.
    kajero
    2013 Trek FX 7.6 WSD
    2012 Specialized Ruby WSD
    2004 Schwinn (I think that is the year)

  10. #10
    Join Date
    Sep 2008
    Location
    Twin Cities, Minnesota
    Posts
    487
    After all the work I did researching policies it was discovered that I have a pre-existing condition and qualify for nothing, so I must enroll in COBRA. It will be interesting to see what happens in October. I have been told that I might wind up paying $200 more or 10% less.

    I really shouldn't complain about the premium.. I was hospitalized for a week in 2011. In addition to that I had two bike accidents one requiring an ambulance and 4 day hospital stay, the other was outpatient surgery. Both accidents were a result of stupidity of my part. I have since learned how to be VERY CAREFUL AND OBSERVANT! (plus I got a new bike)

    I have also seen a mental health doctor numerous times.
    I've used the prescription co-pay at least five times a year.

    In the last 5 years I bet I have had nearly 85k in claims.

    So today I am happy about having the insurance even if it is expensive.

    Note: One of my friends is paying $562 a month. She said it the premium went up the minute she hit 62. She told me that one of her prescriptions was around $400. Her plan paid $0.44. Not a typo. She also has a pre-existing condition so she also has limited insurance options. I wonder how Obama care will affect her and me.
    kajero
    2013 Trek FX 7.6 WSD
    2012 Specialized Ruby WSD
    2004 Schwinn (I think that is the year)

  11. #11
    Join Date
    Nov 2007
    Location
    Western Canada-prairies, mountain & ocean
    Posts
    6,981
    I continue to be amazed (shocked) by the U.S. health care system in terms of cost to the resident if they don't an employer to cover part of it as a benefit.
    My Personal blog on cycling & other favourite passions.
    遙知馬力日久見人心 Over a long distance, you learn about the strength of your horse; over a long period of time, you get to know what’s in a person’s heart.

  12. #12
    Join Date
    Apr 2013
    Posts
    131
    Quote Originally Posted by shootingstar View Post
    I continue to be amazed (shocked) by the U.S. health care system in terms of cost to the resident if they don't an employer to cover part of it as a benefit.
    \

    I continue to be shocked that people I know choose not to insure, I can assure you that countries with UHC take your money (in the UK, NI was 11.5% last time I looked). Insurance requires spreading the risk and not just allowing people who need the care to pay in. Health care in the US is set up as a consumer activity but it is totally ripe for a two tier system. Obamacare has it's hands tied behind it's back unless insurance is mandatory. I don't think the American people have the taste for that, even the poor. It is such a shame.

  13. #13
    Join Date
    Nov 2007
    Location
    Western Canada-prairies, mountain & ocean
    Posts
    6,981
    Quote Originally Posted by Skippyak View Post
    \

    I continue to be shocked that people I know choose not to insure, I can assure you that countries with UHC take your money (in the UK, NI was 11.5% last time I looked). Insurance requires spreading the risk and not just allowing people who need the care to pay in. Health care in the US is set up as a consumer activity but it is totally ripe for a two tier system.
    Of course, if you live anywhere in Canada: you have no choice but to register with the govn't for publicly funded health care insurance card. (The insurance card is tied to some key personal ID government card numbers.) Otherwise....you pretty well WON'T get medical treatment in Canada. Yes, a Canadian doctor will ask for then for your private insurer's info. It's that simple. As long as Obamacare still includes the private insurance companies as driving the fee schedule, it will not solve significant inequities in the U.S. health care system.

    Nothing wrong with that in my opinion: mandatory registration for universal health care provided by govn't funds.. and if required, a monthly premium payment to the provincial govn't. (Actually under $65.00 for a single person every 3 months for some provinces.) In Canada you register for public health care with the provincial govn't where you live. If you choose to add on additional private insurance, you can if you wish. Why can't the U.S. make the health care insurance system that simple for the public.?

    People are incredibly naïve to think they are invincible and may choose in the U.S. not to be insured. It astounded me to know that ie some university students in the U.S., choose not to be insured. Are they crazy? Sorry, life is full of unpleasant medical/health care surprises.

    Last week, I asked my father if he had to pay for his cancer drug treatments (and I know he doesn't have to pay at all for his oncologist appointments..averaging every 2-3 months now. It is a long wait, several hrs. But he's retired. No point, getting into a fit over wait times if you know you'll see a very good specialist physician.) He said no. He's been taking these drugs for last 3 years plus all these appointments.

    He's a senior and low income. He didn't have to go through a 3rd private party for being screened for pre-existing conditions, etc. before he got medical care.

    People may argue how can one spend such money on an elder?: my response is this a patient who hardly ever got sick at all for about 5 decades in Canada, before his cancer. And thankfully a patient who is dying of cancer but has no additional heart, respiratory, etc. problems.
    My Personal blog on cycling & other favourite passions.
    遙知馬力日久見人心 Over a long distance, you learn about the strength of your horse; over a long period of time, you get to know what’s in a person’s heart.

  14. #14
    Join Date
    Feb 2005
    Location
    Concord, MA
    Posts
    13,101
    I just don't get why people think that health insurance is optional. I don't mind the government being involved at all. I agree, as long as we see it as a business, and not a right, this will continue.
    What bothers me the most is that some people I know (in other states, not here) will pay 200.00 a month for cable TV, but not for insurance. And quite a few of my son's friends, opted to risk the tax penalty for not having insurance, when they first got out of school, rather than hook up with one of the very good plans offered through our health care connector. We insisted our son buy it, as he had no benefits with his first job.
    2015 Trek Silque SSL
    Specialized Oura

    2011 Guru Praemio
    Specialized Oura

  15. #15
    Join Date
    Sep 2007
    Location
    Uncanny Valley
    Posts
    14,645
    Y'know, considering how high the premiums are, and how little is actually covered when you get down to it, I've really considered going bare. I haven't taken that step yet, but I don't unthinkingly choose *to* have insurance, either. Yeah, if I were in an awful accident and had to have major orthopedic surgery, that would be mostly covered. But very little of the rehab would be, and over time that would be the bulk of the expense anyway. I could probably pay for surgery and a week in the hospital with what I've paid in premiums in the last five years.

    Did y'all catch the article in the NYT Magazine a couple of weeks ago - which was really about end of life/quality of life issues, about the severely impaired quadriplegic guy (who was injured in a bicycle accident, incidentally) and his wife? It was mostly about how the couple dealt with the emotional issues surrounding his quality of life and whether or not he wants to continue, and whether or not she can cope with it if he decides he doesn't want to. But it mentioned in passing that even though they have extremely generous insurance that covered pretty much all of the initial expenses and much of his rehab, they are now paying $250,000 a year out of their pockets for the ongoing care he needs.

    Most people, needless to say, don't get that choice. I wouldn't even get that choice, and I'm the one who can afford insurance on the private market. But I wouldn't be able to pay for the care that that insurance doesn't cover. It really does make me wonder whether it's worth having insurance at all.
    Speed comes from what you put behind you. - Judi Ketteler

 

 

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •