Health Insurance Options
General Topic
Contributors to this thread:
Korey Wolfe 04-Jan-19
drycreek 04-Jan-19
Jaquomo 04-Jan-19
cubdrvr 04-Jan-19
Old School 04-Jan-19
boman 04-Jan-19
Myke 04-Jan-19
spike78 04-Jan-19
Shawn 04-Jan-19
Franklin 05-Jan-19
Quinn @work 05-Jan-19
BULELK1 05-Jan-19
txhunter58 05-Jan-19
SBH 05-Jan-19
SmokedTrout 05-Jan-19
triggertrav 05-Jan-19
Dale06 05-Jan-19
Jaquomo 05-Jan-19
Colomark 05-Jan-19
Colomark 05-Jan-19
Myke 05-Jan-19
StickFlicker 05-Jan-19
Franklin 05-Jan-19
Myke 05-Jan-19
SmokedTrout 05-Jan-19
cnelk 05-Jan-19
x-man 05-Jan-19
triggertrav 05-Jan-19
WV Mountaineer 05-Jan-19
Aspen Ghost 05-Jan-19
Korey Wolfe 05-Jan-19
ground hunter 07-Jan-19
From: Korey Wolfe
04-Jan-19
So here I am again turning to Bowsite for more advice. Basically, here is my situation, I'm self employed, married with three kids. My wife was working up until 18 months ago when she had our third child, after which she quit her job to stay home with the little one (the older two kids are much older and in school). Previously, my wife covered our health insurance through her work, but for the past 18 months I've had to cover it through COBRA. The monthly payment has been $1400 per month! And to boot it's not very good coverage as we have $12,000 out of pocket maximum for our family combined. To give you an idea, our monthly premium is roughly double or a little more of our house payment. So basically it sucks, I'm working myself into the ground to make ends meet and I have very little time to hunt. Also, I had been setting moneys away for larger hunts (like moose and mountain goat) but those funds are needed elsewhere.

So what are you guys doing for health insurance?

How much do you pay per month for what kind of coverage?

I'd like my wife to stay home with our baby as long as possible and any ideas I can get from my friends here on Bowsite would be greatly appreciated. Plus I think it might be interesting to see what some of you are paying for health insurance.

From: drycreek
04-Jan-19
Have you tried Medishare ? I don't know anything about it other than hearing commercials on radio, but I'd look into it if I needed it.

From: Jaquomo
04-Jan-19
If you are a Christian and a nonsmoker, look into the health sharing organizations like Medishare and Liberty. You will save a LOT of money. Prescriptions aren't covered, but with the GoodRX app I save around 80% on my two, and pay less than I did when I was on Anthem with coverage and a copay.

From: cubdrvr
04-Jan-19
Samaritans Ministries

From: Old School
04-Jan-19
I went with Liberty Health Share this past year.

-Mitch

From: boman
04-Jan-19
Ever since Obama care I've been paying $1200/month in health insurance. At first it was a child, my wife and myself. Now it's just my wife and I and still $1200. Every year the coverage gets worse and the premiums higher. Before self employment the company I worked for paid 100% of my family's medical insurance and it was damn good insurance. Just another way the government punishes us for being self employed.

From: Myke
04-Jan-19
I have also heard that the faith based coverage plans out there have saved people money. But new regulations have allowed some short term catastrophic policies to reappear in the marketplace. Beware of the fine print, if the premium is cheap. Much depends upon where you are located in our country. In some areas health insurance companies are very competitive with each other; but if you have a choice of one in your area, well they got ya. In my area of Wisconsin, we have three hospitals and at least a dozen insurance companies operating in our area. But insurance companies will charge individuals as much as they can. The more people in your group, the lower the premiums offered. They need numbers to spread their risk, so employers get the better rates. Really big employers are usually self insured. When I retired, our benefit costs were running about 30-35% of total salary. Good luck in your search.

From: spike78
04-Jan-19
I think the government decided the sheep were starting to get too wealthy and put the kabosh on it. Keep working until your dead.

From: Shawn
04-Jan-19
In NY we have NY state of Health and believe it or not they offer excellent plans based on income, number of family members, mortgage etc. etc. My daughter works for them and based on the limited info you gave here in NY at least you could get a low deductible plan through Fidelis(excellent coverage) for the entire family for around 800 a month give or take a bit.. I told her 3 kids. two adults and guessed and said figure making 70 grand a year and self employed. I would contact your state health department and have them direct you to the service your state may offer. Shawn

From: Franklin
05-Jan-19
Hopefully they get rid of Ovomitcare completely and let people join up into groups from across state lines. Then let insurance companies compete nationwide.

Right now the Trump administration is not enforcing the mandate penalty. I know people that are paying more than you....if you are shelling out this kind of money get the lowest "catastrophic coverage" and do a health savings account.

Make sure your customers are paying for your insurance through your pricing of products and services.

From: Quinn @work
05-Jan-19
I feel for you man. Cobra sucks. I'm fortunate to have great health insurance coverage through my employer. Even though my out of pocket has doubled since ObummerCare I don't even want to know what my employer pays for our family's premium. It's ridiculous what health care costs have become.

From: BULELK1
05-Jan-19
My Single-High Option/w-Dental & Vision went up for 2019 from $358 in 2018 to $398 in 2019 a Month thru my retirement work medical insurance.

I'm just staying with it.

Good luck, Robb

From: txhunter58
05-Jan-19
I am self employed but have enough employees that I can buy "group" coverage for me and my employees. That said, I cover just my wife and myself and am paying $1900 month. Of course we are both 60 years old, so there is that, but any way you slice it, obamacare sucks for those that can afford to buy their own insurance. I had to drop to an HMO plan to be able to afford it and many doctors don't take that

From: SBH
05-Jan-19
Same boat here. Self employed, married, 4 kids. Over $2k month. Makes me want to puke. We haven't hit our deductible since Obama care went into effect. I thought with Medishare and liberty you also couldn't drink? Correct me if I'm wrong on that. Thats not one I'm willing to give up!

From: SmokedTrout
05-Jan-19
Self employed, pay ~$1300/month for me and my daughter, pretty much a rock bottom coverage. That's $15K per year I will never get back. Health Care Savings account is only saving grace, but I'm stoopid and forgot to contribute last year.

Not being able to pool with other states really limits the options in MT.

From: triggertrav
05-Jan-19
Medishare is a great option. Saves me about $1,000 a month.

Good luck.

From: Dale06
05-Jan-19
I feel for you guys. When obummer care kicked in, I lost my policy and had to buy a different one at an increa3 of over $1000 per month, with much higher deductible. My saving grace was I was only a year away from Medicare, wghich helped a lot.

From: Jaquomo
05-Jan-19
SBH, I don't know about Medishare but Liberty only asked a question about how many drinks per week. I answered, "Depends on who pisses me off on Bowsite" and that worked.

However, they won't cover ailments or injuries xprelated to alcohol abuse. Nor will they cover injuries from "high risk" activities like skydiving, rock climbing, etc.. (they have a partial list). I asked about hunting and at first was told it was considered high risk. So I canceled. Then they sent me an email and said they had reviewed it and don't consider hunting in that category, so I rejoined.

As to how well it works, I can't say because I didn't get past the $500 annual unshared amount. But they negotiated my few bills down about 25% from the doctor's uninsured cash price.

From: Colomark
05-Jan-19
2 years ago I received a letter that my insurance was going from 950/ mo for me, my wife and four kids to 1400/mo. I switched Christian Healthcare Ministries. You pay per unit. You are one unit, your wife is a unit, your kids are 1 unit regardless how many you have, ie 5 kids = 1 unit. For the top plan, it’s $150/mo for each unit. So I pay 150 for me 150 for my wife and 150 for all my kids, totaling $450/ mo. That covers you for $125,000 of medical expense per incident. You pay first $500 of any expenses per incident. I also have what they call brothers keeper, an extra 25$ per month but no limit on coverage. You will pay the hospital in full, then submit everything to Christian Healthcare Ministries and they reimburse you minus the 500$ per incident. Has saved me a grand per month for two years. We had a baby 3 mo ago. It will cost me $500. Can’t beat that. We’ve had a couple trips to the emergency room...$500 each. Down side is it takes a couple months to get reimbursed but with the money you’ll save on premiums, save that so you have some saved just in case. I would recommend them regardless but as an added bonus, if I refer someone and they sign up, I get a free month after they’ve paid for 3 mo. Anyone interested pm me your email and I’ll send you a invite link. But even if you don’t use my referral, we’ve been 100% happy with it. $24k save over last two years. Yep I’ll take that

From: Colomark
05-Jan-19
Also, when you pay the hospital you’ll ask for cash pay rate. My wife’s epidural cost about 4500$ we asked for self pay rate when we got the bill, they reduced it to 1500. It will be reimbursed either way, but less you have to pay up front.

From: Myke
05-Jan-19
Health care is a very complicated issue. Most working people do not spend the time to do their own research; if they get it through work, why should they? They trust their HR department to do what's best, and that is their only option anyway. This was the pattern until HMO's arrived on the scene many years ago. Shopping for insurance started way back then. But life and family gets us busy, and short answers on the news are generally there to stir people up more than to provide actual solutions. Here is one that you do not hear enough, but needs to be said more often. Politicians are fighting over who pays the health care bill(invoice/cost), rather than the bill is too high in the first place. Please read through this entire post before you brand me with a socialist view.

The ACA is not really the demon some politicians make it out to be. It needs work, no doubt about it. Remember insurance is shared risk. When it is not shared, then cost shifting occurs. I have a friend who was a small hospital accountant. Costs of people who have no insurance, get shifted to those who do. Hospitals tend to take everyone, as ambulance chasing lawyers would be parked near the ER entrance if they didn't. This cost shifting did not start with the ACA enactment, and has been happening since health insurance became legal under Nixon. If anything, the ACA has insured more people, and less cost shifting at hospitals is occurring now than in the past. Medicare and Medicaid pricing lists have also shifted costs. If we go back to the old days, many local hospitals and clinics, especially in rural areas will close or downsize. That means lost jobs, that means lost medical care for the local area. That is why all the medical associations and group representatives were fighting the Republicans repeal efforts. A suitable replacement was not offered according to almost ALL of the medical industry representatives. They were doing their homework on the bills presented. Dropping the preexisting condition clause is a major cost shift rule change. If companies cherry pick with policy offerings, it is not really an insurance policy. And you cannot buy something that is never offered to you. Think about getting into a car accident, through no fault of your own. You had better hope that it is a rich person who hits you, as congratulations, you could now have a preexisting condition. How many people out there take heart medication?

Most health care providers do not operate as non profits. In addition to that, many middleman exist to add another layer of cost. Locals suppliers tend to provide better care as patients are their neighbors. National concerns do stuff like this:

https://www.axios.com/the-sky-high-pay-of-health-care-ceos-1513303956-d5b874a8-b4a0-4e74-9087-353a2ef1ba83.html

Here is another example: I have stage 4 cancer. I can tell you that one of the drugs most probably in my future annually costs $135,000 per year in the US; $20,000 in Canada; $22,000 in Spain. This is not uncommon given our 'free market' insurance industry in the states. Big pharma is feeding at the trough. Remember my cost shifting statement; still think high costs of health care is entirely the sick patients fault? I am not a poor person, looking for everything to be free. But I can't afford the 1st option, but could buy into the 2nd or 3rd. I am older, my life has been lived. I can make a personal choice; what choice will you make for your family member?

In my working life, I have been an accountant for one pharmaceutical company and one medical media manufacturer. I have also worked in food companies, and in the construction materials industry. I have also been involved in negotiating health insurance for the company that I worked for. My life has been working in the shadow of this industry. I know profit margins of these different industries. Nothing comes close to our health care industries when it comes to spending. This internal pattern of liaise faire cost control increases a companies costs, which is then passed on to the ultimate consumer. Then they can tell a politician how their costs are high. Take that one with a major grain of salt. One bulk pharma company I worked for, a subsidiary of a larger company, turned a 20%+ gross profit after R&D before taxes back to the home office. They did this year after year. And that was at a sales level which included intercompany pricing extended on a cost+ basis. Accounting talk here, but Mr/Mrs self employed does not have that kind of income stream.

I am retired and volunteer on two state archery boards. I love archery and bowhunting and mostly lurk on this site' since the 90's. I have a health industry perspective as a patient, an industry accountant, and a company's benefit negotiator. I am not a registered voter for either party, and I do not want to sound as someone with political bias. I want to call a spade a spade from experience. So much smoke is blown over this problem, which causes turmoil. And with turmoil, they can keep jacking up insurance rates. The majority of us need to buy insurance, somehow, or face a dire future. And the industry knows that, and so do the politicians. When I talk to my representative, I tell them to be careful with it, not to step in it. So far, they are not getting the message. Any of them; blue or red. I hope this post stands, and I have not offended anyone nor the site administrators. This stuff effects all of us.

I'll get off of the soap box now. Thanks for your time. I wish I had a perfect answer for you.

From: StickFlicker
05-Jan-19
SmokedTrout,

I believe that you have until April 15 of the following year to fund an HSA plan (or perhaps until you file your taxes in the following year?). You might look into that if you still wish to contribute for last year.

From: Franklin
05-Jan-19
Myke….does your "20% profit after R&D" also include future expenditures related to lawsuits. There is no way we can get a handle on healthcare/medicine costs without "Tort Reform". Every other commercial on TV is a class action lawsuit flyer.

Ovomitcare took from those that could afford it and gave it to those that couldn`t...pure wealth re-distribution. It`s great for those that qualify for subsidies but SUCKS for those that fall into the abyss that don`t get it from a employer and have to pay it themselves.

Colomark makes a great point about the "cash costs"....you would be shocked what some doctors will do for $$$$.

From: Myke
05-Jan-19
Franklin - Yes and No to your question.

Yes = Most large companies carry product liability insurance. We carried that, and it affected our bottom line, as it does all businesses. Investors demand it, as do customers. The really big ones setup their own insurance companies to be "self insured". But those costs are included in reducing income before taxes. That is allowed by the IRS and the SEC. It involves real cash outlay in the form of business coverage premiums.

No = But that would be as far as "future expenditures" could be covered. You would need an actual lawsuit, probably one where a settlement has been reached before a reserve for such an expenditure could be established on the books. Accounting rules require adherence to GAAP rules on legal liabilities. (Generally Accepted Accounting Principals.) Now it can get much more complicated then my short(ha ha!) explanation here, but also consider that the IRS would accuse a company of noncompliance to GAAP as well as trying to hide income from taxation by setting up large reserves for 'maybe sued in the future' scenarios. If that is what you are implying, it doesn't work that way. Do lawsuits increase costs, all costs in this country? You bet! But as an ex-industry accountant, I can tell you that it is not the driving cost factor in a large pharmaceutical company. If a company would have a large class action suit, or a serious violation by the FDA including a shutdown, they may just file bankruptcy 1st, then reorganize in some fashion and pop up just like Lazarus did. Some might not, but most do in some way. Those that do stay belly up, probably did so because they deserve to be dead, did not follow their own GMP's, and cut corners all for profits, not for product quality or operational efficiencies. (No one wants to reinvest in them.) I could site at lease two cases where things have gone both ways, but will not get into that on an open forum.

Redistribution of wealth happens in this country at a much larger scale and for a very long time than your ACA medical example. If that is your main beef, you are missing the forest for the trees. Scape goating solely on the sick, is not what the above post was about. Pointing out other costs factors was, something you might not hear in the news so much. (Any news source.) Think about this as a problem source for wealth redistribution. Since the early 70's, when medical insurance rules were born, employer wage dollars have been redirected to benefits. That has been a large loss of discretionary spending in lost take home pay over years nationwide. (Again, LOOONNG before the ACA enactment.) Think that is a coincidence that perhaps the erosion of the middle class may have started when medical insurance was born? Kind of weird, as you would think that it was suppose to be a benefit. People now long for the good old days, but the medical industry that has been built up and that we rely on for our health care needs is not in a position currently to go back to the good old days. We have a lot of old people who would protest when actually enacted. Everybody's Grandma has her daily pill planner box, no? And so real changes are not without pain. Pointing the finger at one single group, any of the groups involved, is not the answer. You even said that yourself when you pointed out a need for tort reform, and a cost shift within the classes of users of health care. I guess add two more to the list?

From: SmokedTrout
05-Jan-19
StickFlicker, I looked it up and believe you are correct. Yippee, and thank you.

From: cnelk
05-Jan-19
Maybe there should be a 'Bowsite MedShare' :)

From: x-man
05-Jan-19
Anyone who qualifies as "dependent" on Bowsite will be covered under Pat's group plan.... I like it!

From: triggertrav
05-Jan-19
Medishare is a great option. Saves me about $1,000 a month.

Good luck.

05-Jan-19
If I was going to have insurance, Medishare would be the way I'd go. Or some similar plan

From: Aspen Ghost
05-Jan-19
Maybe there should be a 'Bowsite MedShare' :)

We might all go broke!

From: Korey Wolfe
05-Jan-19
I love the comments, I knew this was an issue that effected us all, but I didn't realize how bad it was.

I've recieved a few PM's with questions related to my specific situation, so here a few details for those that care. I do live in Missouri and my wife is 38 and I'm 36. Kids are 15, 12, and 1.

When I was in Canada this past fall, I found out that health insurance is basically free or totally free, I'm not sure which, but it sounded like finding quality care might be a big issue. Any friends from the North feel free to correct me.

I've started checking into some of the options suggested here. I really appreciate the suggestions.

07-Jan-19
you need to run for the Senate or Congress, serve one term and your set for life..... I can not believe we pay, their insurance for the rest of their lives, they are all millionaires

On the serious side, I have no answer for you, I hope the best, and you find something

This Topic has been locked. Thank you.

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