My individual plan is $654/mo. with a $1,500 deductible, also an HSA plan.
I’ll point out, however, that I’m 64 years old, and it’s unlikely that without the ACA no insurance company would have covered me at all, just as they refused to cover my adult daughter for her preexisting condition.
Broomstick is right. It depends on the urgency.
My wife’s grandfather fell and broke his hip at 85 (while opening the door to the hospital for his wife!!) and had a new hip in 12 hours.
My boss took 16 months to get his new hip. He’d had a snowmobile accident (insert Canada jokes here) and broke his leg badly in his early 20’s. By age 60, walking with one leg slightly shorter than the other, he needed a hip… but it had been coming for 10 or more years, so not urgent. Wait 8 months. 2 months before he’s due for his operation, he goes in for the assessment - they find he’s got two screws in his thigh bone. “Well duh, why do you think I need a new hip?” So off the hip list and onto the screw removal list. 4 months later, screws are removed, he’s ready to go back on the hip list at the back of the pack again. Ah, bureaucracy. I also heard accusations at the time that the province limited the number of hip replacements as a budget measure -hence the waiting list. So, a total of 16 months to get the replacement.
But, he was walking right up until he had surgery, and it was getting more and more painful, he was having trouble riding his Harley… So not quite a wheelchair case.
the real issue is that the doctors, insurance companies, and medical institute executives all get screwed over by Canadian health care - no gravy train. And the drug companies. And advertising companies - your ads for medical institutes seem so weird to us.
Yes I understand that it is paid out before the insurance pays anything. What I’m not sure about and cannot find online is whether that $12,900 is paid out in one lump sum or in installments per month.
It’s not either. It’s paid out as you accumulate medical bills. Say you incur and pay a $1500 medical bill in January. That $1500 goes toward your deductible. You have no bills in Feb - so you pay nothing. In March , you have a $2500 bill- you pay the bill and it counts toward your deductible. Depending on your health, you pay reach your deductible in the first month of the year or you may never reach it ( There have been many years in my life when my family’s medical bills for the year would have been well under $12K.)
Thank you doreen. That makes sense.
Thank you all.
Yes, thank you Doreen. That’s exactly how it works. It really is quite confusing for most people to understand copays, individual deductibles, family deductible and out-of-pocket maximum, let alone properly analyze in-network and out-of-network providers. Even once you get a handle on that, how do you predict what will be best for the upcoming year? It’s absolutely maddening, and jaw-droppingly expensive. Can’t wait until November to figure it all out again, since my current insurance company (and another one, too) is dropping out of the ACA exchange.
The in- and out-of network situation is really frustrating for me. Geographically, we live right where three major insurance and hospital networks sort of meet up. Two are insurance companies that also own hospitals and medical practices (which is another issue). The two that own medical facilities are fighting for market share, and their networks exclude the other provider’s hospitals and doctors. So, if you choose one of these, you are committing yourself to which doctors and hospitals you can use for the next year. The obvious problem is if someone in my family has a critical medical condition, one hospital is better than the other for certain diseases and care, so I would want to go one way for malady X, but the other way for malady Y, and perhaps the third way for malady Z. Nope.
At the very least, states should make all insurance companies cover every provider in the state as in-network. My car insurance doesn’t make me go to only their mechanics and body shops if my car is damaged. My homeowners insurance doesn’t make me choose their contractor to repair my roof if a tree falls on it.
I don’t know about your particular situation, but my understanding is that in general, unless we are talking about an old-style HMO* it wouldn’t be a matter of forcing the insurance companies to cover every provider as in-network, it would be a matter of forcing the providers to join every network. “In network” means that among other things, the provider has agreed to accept the insurance payment as payment in full and not all doctors are willing to do that for all plans.
$651 per month premium and a $3,000 per year deductible. So unless I “get hit by a truck,” I’m paying $7,812 a year just for the privilege of carrying a plastic card in my wallet with the insurance company’s name on it.
The benefit of a no-cost annual exam doesn’t match even one monthly premium. I’m pretty healthy but I have the occasional doctor visit here and there, and I pay out of pocket for them all. I recently went to a specialist for evaluation of a longstanding headache problem and, though I was very satisfied with the doctor’s input, I was shocked that the bill came to $616 just for the 15-minute consultation. My insurance paid exactly zero. The doctor ordered an MRI but after seeing the doctor’s bill I realized I should check what the MRI would cost me. More than $1,000, and not a penny covered by my insurance, so I had to skip the MRI.
Even if I pay for several things like that and get close to meeting my $3,000 deductible, by then it’s almost the end of the year and everything resets to zero. It starts all over again.
To keep things in perspective - in 2014 per capita medical expenditures were $9500.
The problem is that many have become used to thinking it is a free benefit of our jobs and now we are having to face up to the market realities - as well as taking some individual responsibility for our healthcare.
One of the factors that the health systems in Canada takes into account in prioritising is the economic effect of the condition, not just the medical. So if you’re the sole breadwinner and need something, that’s one of the factors bumping you up the priority list.
That’s why pro athletes get quicker medical attention: not that they’re pro athletes, but that they could lose their job without the timely medical intervention.
How long would you have waited for a knee replacement if you didn’t have insurance?
*Our ruling
Trump says Clinton “wants to go to a single-payer plan” for health care.
She has consistently said she would fight efforts to repeal Obamacare and would try to improve it. She said she wants a public option to be “possible” but she has not called for moving to a system of only single payer.
Clinton has not called for a single-payer plan. At times, she has praised the health care systems of other countries that have a single-payer plan, but she has not advocated that plan for the United States. We rate Trump’s claim False.
*
and you’re wrong about all the other stuff, too.
You cant judge a program about what one person claims his experience to be.:dubious:
I know this is GC, so I’ll tread lightly. But using what Hillary said, on any occasion, as a cite is pretty comical.
I used Politifact.
Since this is about political comments by candidates, let’s move this to Elections.
Colibri
General Questions Moderator
Which is lots better. :rolleyes:
Of course not. One can read dozens of newspaper editorials and articles about skyrocketing insurance costs and reduced plan availability. About one-third of the counties in the US will have zero or one option for insurance companies under the ACA exchange, so no competition or choice. And bulletin boards and forums frequented by small business owners and self-employed people are full of posts about the unaffordability of the “affordable” care act.
So no, there’s no reason to rely on what one person claims. Or what one person wishes were true, either. :dubious:
And I think the catchphrase of “getting hit by a truck” to imply the unlikelihood of a situation where medical costs will exceed a several-thousand-dollar deductible is a bit misleading. While relatively few people literally get hit by trucks, it’s not actually all that rare to have an injury or illness that generates over $10,000 in medical bills.
I would for sure far rather have a high-deductible comprehensive insurance plan, even one with $1000/month premiums, than no comprehensive insurance plan at all. (Especially if that’s covering a family of four, it doesn’t seem like such a terrible deal to me.)
Sure, but conservatives in general don’t give a crap about you and your daughter going uninsured. What riles them is having to pay more in healthcare costs and premiums than they themselves can directly “use” on their own medical bills.
From the typical conservative point of view, the fact that the insurance risk pool is broadened to include more of the less healthy who are at higher risk of having disastrously unaffordable medical expenses is a flaw, not an advantage. You feeble losers should have to take your chances of death vs. bankruptcy rather than increasing costs for the more solvent and healthy. :dubious: