No Employer Supplemented Inurance - 2020 Health/Dental/Vision budget for 56 yo couple

[TexasHusker]

The insurance market arguably worked a lot better pre-ACA. You had to work pretty hard to have interrupted coverage beyond the COBRA period.

That is because, at least in Texas, if you wanted insurance, you could get it. Even if you were self employed, there were associations, trade groups co-ops, etc. that you could easily plug into and get on a group plan.

Many uninsureds were uninsured by choice, just as they are now.

[TexasHusker]

One additional thought: when you changed jobs, you were eligible to hop onto their insurance with no pre-ex by providing a letter of credible coverage. Federal law.

[disneysteve]

One additional thought: when you changed jobs, you were eligible to hop onto their insurance with no pre-ex by providing a letter of credible coverage. Federal law.

Except at many jobs, you aren't eligible for coverage until after your 3-month probationary period. Most people can't afford COBRA so changing jobs means going uninsured for 3 months. Then the waiver of pre-existing conditions probably didn't apply because you weren't going from one plan directly to another.

[disneysteve]

Many uninsureds were uninsured by choice, just as they are now.

If by "choice" you mean they couldn't afford it and still be able to pay rent and buy food, then yes, it was by choice.

[disneysteve]

at least in Texas, if you wanted insurance, you could get it.

Just understand that the insurance landscape was and is very different in different states. As I said, most of the states in the northeast didn't have the pools you spoke of earlier, just as one example.

[TexasHusker]

Except at many jobs, you aren't eligible for coverage until after your 3-month probationary period. Most people can't afford COBRA so changing jobs means going uninsured for 3 months. Then the waiver of pre-existing conditions probably didn't apply because you weren't going from one plan directly to another.

COBRA was certainly no more expensive than ACA.

IIRC, there was no probationary period when credible coverage was evidenced.

We will have to agree to disagree on ACA. I believe it was designed as a new tool for bureaucrats and elitists to “help”, thereby control, the electorate. I know that you have seen benefits from it.

But bureaucrats creating health insurance plans is akin to them creating a care plan for your patients.

The government is in place to govern, not fetter. Sadly, once the fettering is done, it isn’t easily undone.

Most of the financial crises that have occurred in our country can be traced back to government reaching into and disrupting free markets.

- housing crisis - loose underwriting
- student loan guarantees
- buying back its own bonds to artificially keep interest rates low and the stock markets soaring
- Obamacare

The next recession should prove interesting, as several of these interventions are certain to come home to roost.

[ua_guy]

The insurance market arguably worked a lot better pre-ACA. You had to work pretty hard to have interrupted coverage beyond the COBRA period.

That is because, at least in Texas, if you wanted insurance, you could get it. Even if you were self employed, there were associations, trade groups co-ops, etc. that you could easily plug into and get on a group plan.

Many uninsureds were uninsured by choice, just as they are now.

Ah, the uninsured by choice. You mean the people that can't pay their bill when they become very sick? It's not as if they say, you know what, no thanks, I'm uninsured so I really shouldn't receive care. No, they take the care anyway and the cost becomes a burden on everyone else and the hospital and the provider get nothing.

My latest LOL was hearing about someone on Medishare, one of those "technically not insurance" faith-based insurance coverage groups. These people's kid got sick and racked up a $55,000 bill, and Medishare wouldn't pay after reviewing the claim. They're not obligated to, but to be in their program, you must pay. If that isn't the scam of the century and fake-Christian business enterprise, I don't know what is.

The cost of care is high because the free market allows it to be.

[disneysteve]

My latest LOL was hearing about someone on Medishare, one of those "technically not insurance" faith-based insurance coverage groups. These people's kid got sick and racked up a $55,000 bill, and Medishare wouldn't pay after reviewing the claim. They're not obligated to, but to be in their program, you must pay. If that isn't the scam of the century and fake-Christian business enterprise, I don't know what is.

Yep. I've heard a number of horror stories about those programs. They aren't insurance but they kind of sell themselves as if they are, but they apparently don't cover a lot of stuff that insurance would cover. Buyer beware.

[TexasHusker]

Ah, the uninsured by choice. You mean the people that can't pay their bill when they become very sick? It's not as if they say, you know what, no thanks, I'm uninsured so I really shouldn't receive care. No, they take the care anyway and the cost becomes a burden on everyone else and the hospital and the provider get nothing.

My latest LOL was hearing about someone on Medishare, one of those "technically not insurance" faith-based insurance coverage groups. These people's kid got sick and racked up a $55,000 bill, and Medishare wouldn't pay after reviewing the claim. They're not obligated to, but to be in their program, you must pay. If that isn't the scam of the century and fake-Christian business enterprise, I don't know what is.

The cost of care is high because the free market allows it to be.

there is no free market in healthcare any more, other than in the partially-self-insured space. Maybe that’s why the partially-self-insured market is exploding.

And i don’t believe your “someone” story about Medi-share. Someone is filling you full of it. They haven’t grown exponentially by acting fraudulently.

We are on Medi-Share as are a number of folks we know. No problems that I’ve heard. Even if there were issues, claims denial isn’t any sort of new thing.

[disneysteve]

We are on Medi-Share as are a number of folks we know. No problems that I’ve heard. Even if there were issues, claims denial isn’t any sort of new thing.

Does your plan have a long pre-existing exclusion? I've read that some have 3-year exclusion periods which makes it pretty worthless for anybody but the perfectly healthy folks. It may be a good option for young unemployed folks but for many older folks like early retirees, a long exclusion period could be deal breaker. My wife is on blood pressure medicine so she'd be out.

[TexasHusker]

Does your plan have a long pre-existing exclusion? I've read that some have 3-year exclusion periods which makes it pretty worthless for anybody but the perfectly healthy folks. It may be a good option for young unemployed folks but for many older folks like early retirees, a long exclusion period could be deal breaker. My wife is on blood pressure medicine so she'd be out.

Underwriting is a part of any insurance product. You can’t insure your home with a new carrier with a dilapidated roof.

Medishare isn’t the option for everyone. But with obummercare taking away virtually all of the options by deeming them illegal, sharing plans are about the only alternative out there. Sad.

[disneysteve]

Underwriting is a part of any insurance product. You can’t insure your home with a new carrier with a dilapidated roof.

Medishare isn’t the option for everyone. But with obummercare taking away virtually all of the options by deeming them illegal, sharing plans are about the only alternative out there. Sad.

You didn't answer my question.

[TexasHusker]

You didn't answer my question.

I’m sorry. Yes, there are pre-existing conditions. I don’t believe it’s a 3 year wait, however. I’ll check. And it’s more of a medical insurance concept than health / lifestyle wellness plan - it doesn’t pay for doctor visits or prescriptions.

But my wife had a neck fusion surgery of over $75K and it paid the whole thing no questions asked. They actually had the opportunity to deny that claim based on pre-ex, but they did not. I was impressed by that.

[disneysteve]

I’m sorry. Yes, there are pre-existing conditions. I don’t believe it’s a 3 year wait, however. I’ll check. And it’s more of a medical insurance concept than health / lifestyle wellness plan - it doesn’t pay for doctor visits or prescriptions.

I understand that. It's more of what health insurance should be, just as auto insurance doesn't pay for oil changes or new brakes.

[TexasHusker]

I understand that. It's more of what health insurance should be, just as auto insurance doesn't pay for oil changes or new brakes.

Yes. The cost difference between medishare and Obamacare for us was about $30,000 a year back when we made the change. That’s worth a lot of oil changes and brakes

I figure we’ve saved $120-130K in premiums now, after 4-5 years.