American DLers: Do You Have Healthcare?

I have employer-sponsored health insurance.

Yes, through my husband’s job. Thankfully, they allow significant others and not just the opposite sex.

I do. And I am so lucky. I know many who don't. One is my sister. She's healthy, thank god. But pays out of pocket for checkups. Oh, she also doesn't vote. So, I can't really defend her. People who don't vote and then want change are just infuriating. I think we all realize most of our votes don't do that much difference, but you can't bitch if you didn't at least try.

I have a neighbor that is a repub that doesn't have health insurance. I went to the doctor for a stye and he had the audacity to ask me to get extra medication for him.

Like many in America, I have "health insurance" but because of the extremely high deductible plan I have, I don't have any actual "health care" because I can't afford to actually go to the doctor or pharmacy unless the other option is death. I'll probably die from a abscessed tooth because I also can't afford to go to the dentist. Just hoping I can get it to go away on its own. That's my entire health plan...crossing my fingers and hoping whatever is wrong heals on its own. For this, I pay almost $150 a month on a salary of $18000 a year. I wish I was never born every single day.

You make a good point R5. For many it is not about not having health insurance, but being able to afford the deductibles. I changed my insurance plan because the premiums were outrageous. Now I pay less in premiums, but my deductible is $6,000. You either pay upfront or behind. What is outrageous is the administrative cost that we are paying for our health insurance.

Well said R5. What's the point of insurance if it only kicks in after spending 5k? The whole system is so damn wrong. I am not a Bernie supporter (team Pete here, I think. Ask me tomorrow and I might change my mind!).

I have a very good friend who's a surgeon. She hates it as much as her patients. She 100% percent blames the insurance companies. The administrative BS she has to go through just to get paid is insane. We just need to burn it down and start again.

I have Obamacare and it is a godsend. $44 a month and no copays on generic prescriptions. Office visits are 10 bucks. This is because last year I made less than $25K. Dental is $8 a month.

[quote] I pay almost $150 a month on a salary of $18000 a year.

I don’t think you need anyone to tell you what’s wrong with your situation. It’s pretty clear what the problem is. The question is, what are you going to do to change your life so that you get to a job that pays adult wages?

I have both healthcare and insurance. The deductible is $1700, but the company provides health related incentives that it deposits in the HSA to cover it. I don’t spend anything out of the HSA though. I max the annual contribution and let the pre-tax money grow tax free in a mutual fund. It’s currently just 25k, but it’s a nice little extra for avoiding taxes.

I have private insurance off the exchange - I am an independent contractor. I live in SF, have had Oscar Health for the last 2 years, 39, healthy but have ADHD and spend $495/month. It's about $100 more expensive in SF than LA for some reason. Oscar is awesome. I see an amazing shrink once a week, they have MD on call that will call you back in under 60 min or less for minor things like flu, skin irritations, mild things where they can call the prescription in. It covers PrEp for free w/ Gilead card and my ADHD meds are $15. My salary fluctuates due to my job, With Obama care, I'd be in one minute, than kicked out the next if I made too much or too little. Good health is everything to me, so I make it a priority and pay accordingly. Oscar is newer but have been extremely pleased with it. Their call centers and customer service are American based which is a huge plus. I hated dealing with Blue Shields Philippines call center. They always got it wrong and I ended up without coverage for a few months. Never again.

Last January I went from having my own business to now having a salaried job. I feel so lucky as my employer pays my monthly premium in full and I have a $250 deductible. As a small business owner, I paid over $1000 per month (for myself) with a $6250 in-network deductible. Like the poster above, I had insurance but not really health care; I didn't go to the doctor because it cost around $250 each time. We really need to do something about this-- and I believe it IS the fault of the insurance companies who are greedy parasites.

Between the VA and Medicare, I'm good. I have residual coverage(eyes, drugs, dental) from when I worked a union job. I don't want to hear ANYTHING anti-union, if you want good to great health coverage, look for a job where you are in a union.

I have co-pays at the VA, which somehow I get reimbursed for, almost completely. Any 30 days prescription is 9 bucks. My civilian doctor retired, and I have not looked into getting a replacement. Fortunately, I am quite healthy(knock, knock) and for a guy my age, almost 70, I take no prescription drugs.

It seems the people who have done a lot of shopping around find better coverage at lower premiums. You can't be shy about seeking a better deal, health insurance governs our lives more and more as we age. We're certainly not going to get any closer to a national health plan for all anytime soon, I surely won't see it. Do your homework, ask around, there's probably a plan in place right now, somewhere, that will fill your bill, go and find it. The health care companies won't be coming to you, go beat it out of 'em.

2019 was the first tax year for which there's no penalty for not having insurance since the ACA was implemented. (You're still required to have insurance, but they lowered the penalty to zero, so ... ) Anyway, California is reinstating the penalty for 2020 (for Californians only, obviously) so be prepared! The penalties will be roughly the same as the federal penalties were last year.

Blue Cross with a $5000 deductible for the younger, and Medicare with a Blue Cross Supplemental Plan for the elder. Total cost is $1400 a month. This is our second highest expense after taxes. We no longer discuss changing to another insurance company after the younger had a torn aorta and the medical bills were around $200,000 with $10,000 out of pocket. ( If uninsured, the bill would have approached $700,000.) We are afraid to change insurance companies because we don't trust that the protection for preexisting conditions will continue under the Republicans and Trump. Those of you who receive coverage at work are very fortunate indeed!

As I’m self-employed, I have Obamacare for $950/ month with $1,600 deductible. My biggest monthly expense. I don’t know how average families do it. Because I use it a lot - regular checkups, cardiologist, annual colonoscopy - it’s does save me some money vs just paying for everything (I.e., high deductible). It’s also there for emergencies and hospitalization.

What I HATE about Obamacare in NY is ALL plans require referrals. The referrals process is such a scam and exists purely to make everyone’s lives more complicated - which the insurance company hopes will discourage people from actually using it. I am debating getting a salaried job with insurance just for the no-referral insurance - and subsidy to reduce my biggest monthly expense.

I'm a college student and always had one under my parents, but now that I'm an adult and on my own I have nothing. So it's basically a "Do Not Get Injured or Sick" game until I get my first career job or I'm fucked.

R15, you’re the poster child as to why insurance is needed. Please comment freely when applicable. People need to learn. Like R17.

R17, how about Obamacare?

I got employed by Coventry Healthcare, thinking I’d get the gold standard in insurance. Instead, they insure their employees with the kind of plan that is the reason we need Obamacare. It was awful. I used to hear my boss argue on the phone to get his cancer treatment paid for. Everyone there who had a spouse with insurance, used their spouse’s insurance instead of Coventry’s. I wouldn’t do business with them again.

I pay $11,000-$15,000 in medical costs per year, every year. I’m just lucky I’ve budgeted for it.

Yes, OP, every American now has healthcare thanks to Obama.

At least that's what Datalounge said.

I wonder if experiences in Obamacare vary by state. In CA it's called Covered CA and it sucks balls. Your salary needs to be something like 30K - 66K to qualify for any of the decent plans. If you go above 66K the cost is the same as the open market and if you have a bad year below 30K, you are booted to Medicaid which are the shittiest hospitals/care in town. Then the fighting with them to get out of Medicaid if you've been placed there due to an error or rocketing premiums if you have a really good year. The fluctuation made it unreliable for me. Paying directly for the insurer out of the system is more costly but I feel secure. Was the enrollment period always a thing? That you could only enroll from late Oct-Dec. If you miss that period or something changes you are out of luck. It doesn't make any sense to me. I'm glad for the ACA but it's not great for middle income singles who work for themselves.

I've been self employed for 20 years so I've paid my own health insurance all that time. Currently, with Obamacare, I pay $7950 in annual premiums, with a deductible of $6,500. I have seen a doctor exactly twice in the past 20 years -- for two physicals.

Employer sponsored health care with 0$ deductible, 0$ co-pays.

I only work part-time. Is this unusual? I rarely go to the Dr.

Medicaid - I'm disabled. I'm in Houston. I'm happy with the doctors available on my plan. (You have to select from a few plans offering Medicaid in the state.) The biggest annoyance is I cannot get more than a 30-day supply of my medication at a time. I wish I had dental coverage.

I wish Obamacare had been available when I was still working. I couldn't afford to become self employed because of the insurance issue.

R24 - that’s the golden ticket I’m looking for. No it doesn’t exist most places.

I’m grateful for Obamacare - though thankfully I live in NY where we have had guaranteed health care for a long time and always will - regardless of what those Rethuglican assholes do in DC. NY may be expensive but some of the best health care and subsidies for the poor in the country. I pay a lot $15k+/ year but am grateful to be able to get it - which most of the country wouldn’t if it want for Obamacare. Yet the idiots insist on fighting it - perfect example of voting against self-interest just to insure “others” don’t get a subsidy.

I am grateful to have a PPO that I have never had any trouble with, and especially grateful that my employer pays 100 percent of the premium.

I am super-liberal in almost all ways, but because of my personal experience with Lyme disease I am frankly afraid of public healthcare only with no private option, because the treatment that I had (many months of several different antibiotics) restored my wellness after years of MS-like symptoms that were becoming disabling, and public health systems including the UK, Canadian, Dutch, French, Australian and Irish ones refuse to pay for prolonged antibiotic treatment. So people in those countries have to go to the US or Germany for treatment, meaning the treatment is cost prohibitive for most. I’ve discovered our system provides for some options that people can’t receive in all-or-nothing public-medicine systems.

I work for a state government and make $75,000. I pay $200 a month toward my health insurance with a $500 deductible. I also have a $100 deductible for prescriptions.

I should have added, the pre-existing conditions exclusion plus the insurance premium would have made self employment too expensive.

[quote] R22: Was the enrollment period always a thing?

Yes, as far as this 60 year old knows.

Guys, you should get a physical yearly. Warren Zevon attributes his fear of doctors to the cancer that killed him. Poor, poor, pitiful him!

I don't currently have health insurance.

Use to pay $150 a month for Obamacare then Trump took it over and with no change in income it went up to $600 and couldn't afford it. Last month I found out I have an enlarged prostate that feels like 2 fingers are pressing on my bladder all the time, now I'm buying time until I have to sign over my house to get the surgery.

R33. You probably don’t need surgery for an enlarged prostate. Why don’t you get a job that provides health coverage?

VA is primary, Medicare is backup.

Also ACA. Caresource. I pay nothing. I make very little also. But I don't need much.

[quote] Last month I found out I have an enlarged prostate that feels like 2 fingers are pressing on my bladder all the time,

Get your hand out of your ass!

Saw palmetto for prostate is almost as effective the prescription meds I took for reducing enlarged prostate. However you should get a PSA test for prostate cancer.

well, i’ve got apple cider vinegar and cotton balls.

From what I've read Saw Palmetto is dicey at best WebMD says- While several small studies suggest that saw palmetto may be effective for treating BPH symptoms, most larger trials found little or no evidence that saw palmetto affects prostate disease. In 2006, a large study of 225 men with moderate-to-severe BPH found no improvement with 320 mg saw palmetto daily for 1 year versus placebo. NCCAM co-funded the study with the National Institute of Diabetes and Digestive and Kidney Diseases. In 2011, researchers investigated whether doubling or tripling the standard dose of saw palmetto was more effective, but found that it did not lower the urinary tract symptoms of BPH more than placebo.

I got put on Finasteride that may shrink it by up to 20% but it can take up to 6 months before you see any effects, thankfully with Good Meds I can get a monthly dose for $10.00, and fall can't come soon enough.

Try Good Rx also.

[quote] Those of you who receive coverage at work are very fortunate indeed!

Are you somehow barred from working at a company that provides health insurance? I don’t understand people who choose a career or job outside the norm that doesn’t provide insurance and then bitch about it. Even an entry level person with no skills in my company’s mail room gets employer sponsored health insurance. People who need insurance should forget about self-actualization and get an office job.

I am honestly curious, what do you do for a living that you make 18k a year r5? I can understand if this is a temporary situation, but you should be actively working towards getting a job that pays more.

I'm retired and my healthcare is covered by a plan for retirees provided by my former company. The plan is apart from the employee group insurance plan, and managed by a separate administrator of corporate self funded healthcare plans.

[quote]Are you somehow barred from working at a company that provides health insurance? I don’t understand people who choose a career or job outside the norm that doesn’t provide insurance and then bitch about it.

anyone over 50 is effectively barred, since they will never be hired

My sister-in-law doesn't have health insurance and said she'd just negotiate with them and pay $50 a month if she had a major event.

Welcome to America!

I have employer provided insurance that comes with a $500 deductible. It cost me ~200 bucks a month.

I do not. It’s just too expensive and I’m healthy. If I have a need I go to the ER. I got stitches there last year when I cut my leg. I simply don’t pay the bill. I’ll just keep doing this until I qualify for Medicare.

The government paid for my new boobies

I work for the feds and have fabulous health insurance. It doesn’t seem like I have deductibles at all. Hell, I saw a nutritionist for a while and they paid 100%. I didn’t even have a co-pay. I recently had to go to the ER. The grand total for that visit was $3200. My insurance paid $3100.

I wish everyone could have this insurance.

It so ironic that government healthcare is some of the best in US. Hypocrisy. But Deplorables are too dumb to know they need health care - until they need it, then they bitch at the doctors rather than the government.

R50 Just remember the American people are subsidizing your health care. Either we get the health care federal employees get or they get the health care non government employees get.

I have HIV/AIDS and I am on disability. I'm in Louisiana and we actually have the medicade roll out due to our Democrat governor so I pay absolutely nothing. We also have dental too. Pretty good for a deep South dirt poor state.

Oh and I'm on medicare since I was 46 and have a supplement paid for also.

So how much of a difference is there between red states and blue states for ObamaCare? Are premiums lower in blue states? Lower deductibles?

Premiums are mostly higher in blue states. Especially now since Trump has allowed “more choice” by allowing insurers not to cover things and play other games that means Red states now have “cheaper” insurance that is total crap. Blue states require minimum coverage standards - like mental health care coverage. So we get better health care coverage - but it is more expensive.

Red state people will probably only see that they have cheaper insurance options - but the when they actually try to use it, it won’t cover near as much as Obamacare required.

I’m a finance person and even for me, it’s difficult to do the math on how much different plans will cost me all-in. As a mid-level user (about 3 PCP costs, 2 cardiologist visits and tests, 2 GI visits and usually 1 colonoscopy), it makes sense for me to pay the highest premium (about $900/month). My total costs incurred last year were about $21,000 - and I paid about $12,000 in premiums and copays/deductibles.

No average American understands health care billing/costs/coverage benefits. The minimum standards enacted by blue states go a long way to minimizing variability in plans and makes it easier to compare based purely on premium/total deductible.