Do you have health insurance?

I haven't had health insurance in about a year, bros. I just applied for a high-deductible plan with no coverage limit and max OOP of like $3500 because shit happens. I haven't worried about it in the past year at all, not even when I had a terribad ear infection and the doctor I was seeing told me I would probably need surgery to repair my ear drum. Couple months of dealing with ear drainage (no pain or anything like that) and it was all better. No surgery. But if I had fallen and broken a bone or gotten deathly ill or had to have an appendectomy or something, I would've had to foot the bill, which is not something I want to do. So I'm working on getting cheap~ish no-frills insurance for peace of mind when it comes to those "what if" scenarios that creep into my mind on occasion.

I have a question for those who work in this industry.. I was under the impression with Obama care that you would get 1 preventative exam a year 100%covered by your medical insurance. That would be 1 medical check up and 1 cleaning/X-ray per year dental? That doesn't seem to be the case.

I believe you are correct regarding the preventative care/physical aspect of it. I am unsure of getting one free dental cleaning/x-ray per year.

I didn't think Obamacare had anything to do with dental coverage.

Most dental insurance will usually pay 100% for cleaning 1 or 2 times a year. Ditto for xrays.

Caliane_sl said:

yeah. Self employed. Can't possibly afford insurance.
Well, couldn't when I looked the last few years. did better this year.

going in next Friday for a biopsy, on a thyroid cyst.
which if even good news probably means that 200/month will be 400+/month if I try to get insurance again. which is back into can't afford range.
comics do not pay that well.

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Thought I would update.

3 months since start of this.
$3067 out of pocket. to tell me, no don't have cancer. cyst is still there, and might still have to have surgery. Which of course would be more like 10-30k or more.

Consider, as stated in jobs thread. Self employed artist. 16-25k/year.

What is so incredibly stupid. It would have cost me MORE out of pocket if I had insurance.
First, bills are reduced if you dont have insurance. would have been over 4k without reductions.
looking at a plan from Anthem. 152/m, 2500 deductible. so, 1824 in premiums, and then 2500 out of my pocket before insurance. fucking brilliant. 4324 if I had insurance.
In fact, might have been more. most insurance reset on jan1. not sure how that is handled. services were all in sept/dec. but bills were done in jan. if bills prior to jan, were in 2012's rates, then 1200 in 2012 out of pocket, and then 2500 for 2013 before hitting deductable max.

Insurance is a racket.

Still looking into it for potential greater concerns. But still, not sure how I'll be able to afford it.

Wow imagine that, an insured loss barely above the deductible isn't such a great outcome.

My heart bleeds.

Caliane_sl said:

Insurance is a racket.

Still looking into it for potential greater concerns. But still, not sure how I'll be able to afford it.

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Insurance is a racket? Have fun paying for that surgery if you end up needing it without insurance. The price of it will probably be greater than your average yearly income.

I'll admit that the health insurance industry is far from perfect, but trying to claim that you are better off without it in your situation is just moronic. Any additional expense for the rest of the year this point would cost you nada, because your deductible would already be met for the year at this point. Also, you're probably screwed for trying to get health insurance now with a cancer scare in your recent history, or if you can get coverage it'll probably be excluding anything cancer related.

Dental is where the real racket is. If only I could go back in time and do pediatric dentistry....

Does anyone get dental on their own, or have a suggestion? I've looked into the discount cards which seem like a great option in a larger city, but around here most aren't accepted. I have great health insurance, but no dental. I've looked into getting it on my own, but by the time premiums and OOP/deductible are factored in it would be more expensive to have it than not. Even this year where my son had 5 cavities (how does a 4 year old that has teeth brushed twice a day get 5 cavities??) and I had 2, it would have been more to have insurance.

A dental plan for a family of 4 ranges from $85-$210 per month. The $85 plan covers like 50%, has a $150 per person deductible, covers up to $1200 per person/year, and has limits like only 2 fillings per year. The part that is frustrating is the dental office bills the insurance company and gives them a 25% discount off just about everything. If I want to pay cash at the time of the appointment I get.... a 3% discount. There are only 2 pediatric dentists in town, and it's the same way with both.

We have dental insurance at work... Delta Dental. $20 a month for my wife and I. I haven't paid for a cleaning or an x-ray once in 5 years. Excess money also rolls over as long as you get one cleaning a year. When my wife had a couple cavities filled last year, my excess money paid for whatever I owed that insurance didn't cover. It's definitely been worth it.

Eyashusa_sl said:

We have dental insurance at work... Delta Dental. $20 a month for my wife and I. I haven't paid for a cleaning or an x-ray once in 5 years. Excess money also rolls over as long as you get one cleaning a year. When my wife had a couple cavities filled last year, my excess money paid for whatever I owed that insurance didn't cover. It's definitely been worth it.

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A similar Delta Plan for a family of 4 if you get it on your own is $149.95 a month btw (one of the quotes I got, although it didn't include any excess rollover).

i pay out of pocket for dental work as well. I originally dropped it back when I was working a more normal job, and the owner of the business stopped paying for dental, and tried swapping to an employee group plan, where we paid for it. I opted out as, the insurance cost more then the cleanings I may or may not have even went to get in any give year.
grew up with flouride in the water. first cavity was at 25, second this year at 35. A point of reference.
Cleanings were 40-60 iirc. The cavity this year cost $120, including xrays.
This is in CT.
If you have serious issues, sure maybe. Dentures, braces, etc. But if you are just getting cleanings. yeah. dental is also really probably not worth it. Root canals cost more as well, athough, still probably less then insurance in many cases.

Melicant, you may want dental for the kids.
Braces as mentioned. and the likelyhood a kid might do something dumb to break their teeth, that you as an adult not running around in streets, playing sports, wont do.

I'm studying for my Life and Health insurance license for the state of Washington. If I learn anything I will pass it on.

Caliane_sl said:

i pay out of pocket for dental work as well... A point of reference. Cleanings were 40-60 iirc. The cavity this year cost $120, including xrays. This is in CT.
If you have serious issues, sure maybe. Dentures, braces, etc. But if you are just getting cleanings. yeah. dental is also really probably not worth it. Root canals cost more as well, athough, still probably less then insurance in many cases.

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You have a damn cheap dentist. Back before I had dental coverage I tried out probably 4 or 5 different dentists as I moved around different areas of my city. Cleanings without insurance were probably $90-$100 on average, and a composite filling for a cavity was like $250ish. Not to mention extra costs for xrays, oral cancer screening, etc. My dad has a lot of dental issues and no dental insurance, crowns usually cost him $800-$900, with bridges and root canals being well over a grand. He grew up on a farm on well water, no fluoride in his water and he's paying for it later in life in dental bills.

Zivany_sl said:

I'm studying for my Life and Health insurance license for the state of Washington. If I learn anything I will pass it on.

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Good luck man, I did all my insurance licensing about 10 years ago, but I thought our states Life & Health exam was WAY more difficult than our property & casualty exam.

Theres just so god damn many health bills, regulations, and laws that its hard to keep them all straight, their official names, what years they came into effect, etc. And then you'll use almost none of that information in your actual job(at least I don't, on the sales side of things)

$200 a month seems pretty damn rough to me. I only pay $96 a month and have a $25 copay. My dental insurance kinda blows with only $1000 a year in coverage.

Actually, what happens when you have Cancer in the US is that you better pray that you either get cured really quick, or die even quicker. If you end up with something manageable that drags on for years, you eventually lose your job because you can no longer work effectively, then your COBRA runs out, then you start paying out of pocket, and then you die destitute and in debt. I've seen it happen and it's incredibly fucking sad. Even when you do have insurance, you're still paying out the nose because unless you go "in network" for everything (meaning newb doctors) you end up footing the difference. My mother had cancer for years and had insurance for the whole time because my stepdad could claim her, yet her total medical out of pocket expense over 9 years was close to a million dollars. He was also a surgeon and got special rates from other docs, so imagine what that cost would have been if he wasn't in the picture.. Not to mention, if she wasn't in chemo or totally sick, she was on the phone with United Deathcare arguing over some bill.

In the case of long term serious diseases, the US medical system is a travesty.

BrutulTM_sl said:

The insurance isn't for that kind of thing, it's for when they tell you that you do have cancer and the bill would financially destroy you if you had to pay it yourself.

That said, yes it is a racket.

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