Vanity: Need Advice on CA Health Insurance

Obama is the source of my problems ^ | 11/30/14 | Self

[Yaelle]

I was a part of my family member's business, and as an employee of this small family business was able to get myself and 4 kids covered by a private insurance company with a great ppo plan though pricy. Every year, this coverage grew more expensive by a couple hundred a month, until this year when it has gone up by $500 a month. I can't afford it and the business will be closing in 2015.

I don't want to join CA Covered because it's ObamaCare. What do any CA FReepers do for insurance when they aren't getting it paid for through a company?

I am supposed to pay $2500 a month for 5 people. I just can't do this.

Can anyone offer some advice: how to not go to places like Kaiser but not break the bank either? I need to make the change now.

[RedMDer]

We're going to need a big push to
wrap this up. Let's git 'er done.






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[Yaelle]

At $900 per month for crap insurance, how would I have saved anything. My Math says I saved $500 that month!!

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True.... But the $900 was not just for the finger. It was also there for the heart attack and car accident you didn’t have that month. How to tease out that “worth?”

[Yaelle]

The “bronze” plans are effectively catastrophic plans - ~$4000-$5000 deductibles. You can pair that with a HSA. If you really think you might need surgery, you are in a position to use the new system to your advantage and buy a low deductible policy for a year, then drop down if you think you don’t need it.
Health care costs are completely insane, and have been driven up substantially since obamacare. Play it safe and make sure you are covered.

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I have to think like this because of the kids. This seems like it would make the most sense. Should I even bother with the HSA at all?

[martinidon]

I put my daughter on her own insurance years ago because it was cheaper than having her on my company provided insurance. You should go to the website of your current provider and see what the cost of just providing health insurance for your kids.

[Wayne07]

It doesn't work like that. There are high and low deductible obamacare plans, whatever you are willing to pay for. Doctors are part of networks, they either take insurance from a particular insurance company or they don't. It doesn't matter if you have a high or low deductible plan from blue cross.

What did happen, particularly with blue cross in california, is that in order to make the obamacare defined plans work, blue cross cut what they would pay to doctors, so many doctors stopped taking blue cross. So if you were someone like me, who used to have blue cross, you either had to switch doctors, or switch plans. I switched plans.

[kaila]

I used to work in a clinic. If you prescribe a test for a patient who cannot afford to pay, you basically have to act as a social worker with the hospital to work out a payment plan. You cannot ignore someone who potentially has cancer , and needs a test or referral. You can get sued.
Once you accept a patient, and they stiff you, you have to give them a legal notice that you are removing them from your practice. Certified letter. You cannot drop them immediately, you must give them 30 days notice, or you can be charged with abandonment. Therefore, you are forced to treat the patient for 30 days for free.
No one wants their staff to be a social worker ( increases overhead costs), and they want to be paid. That is why high deductible policies make PCPs run away from those plans.

[eyeamok]

It sucks no matter which way you slice it. But I REFUSE to be a SLAVE to the Government Mandated Insurance Scam.

[Yaelle]

I am way ahead of the game by NOT having ObozoCare. Just Bank the Money you would normally pay in Premiums for insurance that NO DOCTOR accepts anymore. I am about $20k ahead so far.
Fortunately neither of us have any medical issues.

If I play this right I will become an Indigent Person for Medical Procedures and Insurance purposes ONLY.

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Politically, you are a hero. We should all go Galt and go back to fee for service. BUT I can’t risk this for my kids, or for me because I am worth more to them than I am to me now.

[A CA Guy]

Walgreens may still have a $20 prescription club that knocks the costs way down.

[Wayne07]

There are some marginal tax benefits with an HSA, but depends on your situation.

[Yaelle]

A way to ferret out the poor plans from the employer based plans ( beside asking for group number) is to ask if your insurance is from work. If it is an individual plan purchased through an exchange or on your own, they know those plans are no good. That is why Kaiser is the best option at this point.

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But what if you don’t have an employer?

[eyeamok]

BUT I can’t risk this for my kids, or for me because I am worth more to them than I am to me now

I fully understand, it sucks.

Maybe you can become an Illegal Alien, in MacArthur Park near downtown LA there is a Police SubStation on 6th, right in front of the Police Station there is a guy that sells Complete ID Packages for $200-$400, Matricula COnsular card, green card, social security card, drivers license, birth certificate...You give him half up front and the next day you pay the rest and get the goods. He does it in front of the Police Station so he doesn’t get robbed anymore, the Police Protect Him.

[Yaelle]

Walgreens may still have a $20 prescription club that knocks the costs way down.

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I’ve been buying from walgreens for 10 years and they never mentioned it.... Hmmm....

[martinidon]

I admire you for your conviction, but making a stand like this could be devastating to you and your family. $20,000 is nothing when it comes to health care cost. That would not cover more than a day of hospital care.

Earlier this year I had out patient elbow surgery and the hospital and physicians bill was well over $40k.

[steve86]

Just Bank the Money you would normally pay in Premiums for insurance that NO DOCTOR accepts anymore.

You seem to be operating on some kind of ideological talking points with limited correlation to the real world. For example, the hospital-affiliated primary care and specialists to which I referred earlier: ALL take Obamacare policies and that is hundreds of them in my metro area. That is the policy of the three hospital systems here -- all insurance policies valid in the state (Washington) will be accepted.

[Yaelle]

I will compare having their own plans to being on mine. Thanks.

[eyeamok]

http://www.surgerycenterok.com/pricing/

You got RIPPED OFF

[kaila]

Then you probably have a high deductible plan, and not a group plan in which the benefits are better. A single plan is much inferior to a federal government employee plan, because those benefits are negotiated.
It is unfortunate, but true. And physician offices have computer systems which tell them right away the details of your policy, and they may elect to only accept certain policies in their practice.

[Yaelle]

Whoa, that is insane.

I don’t think I’d pass the mexican test but I do think young single males should do this!

[Hetty_Fauxvert]

We’re also in California, and I’m afraid I don’t have advice on choosing insurance because we’ve been with the Kaiser HMO for 12 years now. If you don’t have a particular issue with Kaiser, I wouldn’t cross that off your list of options. We have been *very* happy with their service, in general. If you’re interested, PM me and I can give you some tips on dealing with them.