Confused About Health-Dental-Eye Insurance Thread

[eliquid]

Wanted to ask about health insurance here.

I truly want some insight from other entrepreneurs for now before I talk to another agent which gets really confusing and irritating.

Being self employed and in a state that did away with their state ran program ( Kentucky ) a few years ago, I'm pretty much ( I feel like ) left to healthcare.gov for my options, which are basically limited to nothing.

For the past decade, I've pretty much defaulted to a high monthly premium on Anthem for the low co-pay and Rx. The only doctors in town take Anthem and none of the dentists here take any of the plans offered. My kids wear glasses so I typically just pay out of pocket full price on vision too.

I'm kinda sick of it so I am looking for options.

Right now, I pay $1500 a month for me and wife and 2 kids and we almost never go to the doctor. My wife did have a precancerous polyp removed last year, but I paid the majority of the deductible for that so that was out of pocket as well.

As far as everything else.. we are never sick. Dental and vision exams are cheap so I don't mind paying for those as much. But the health insurance just seems wasteful for the PPO plan we are on.

I've looked into:

1. HSA - but I don't get it or understand it. No matter how many times I read about it or ask an agent, I can't seem to really understand it or how it will benefit me.

2. Religious insurance plans - The ones where you pay in and everyone pays everyone else's bills. I might have this wrong.


So here are my questions:

1. Is there anything else available than the above I pointed out on the 2 other options? Am I missing anything I should be looking into other than HSA or some religious group plan? I want to make sure I know all the options.

2. Anyone here just have catastrophic plans? If so what does it cover? I almost feel I could bank the $1500 a month and pay out of pocket for normal stuff instead.

3. Anyone on a HSA? Maybe you can explain a bit how it works for you in comparison to normal PPO.

4. Anyone on one of the religious insurance plans? Has it worked out OK for you and how does it really work?

5. If I am missing any other option, can you explain it and let me know where I can check into it?

I am interested in people who are single, married with no kids, and those married or unmarried with kids. I want to start searching now before the end of the year when I typically have to renew and feel like I am uneducated and have to default pick the PPO plans on Healthcare.gov again which I feel like I need to get off of.

Thanks for any advice you can give.

.

 

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[CareCPA]

An HSA works with a high-deductible health plan (this is actually defined. You should be asking the agent if the health plan is HSA eligible), it is not a standalone account.
If you have a qualifying health plan, then you can funnel pre-tax dollars into the HSA to pay for your medical bills. Think of it like a 401k, but for health costs, and no age restriction.

 

[markK]

Wanted to ask about health insurance here.

I truly want some insight from other entrepreneurs for now before I talk to another agent which gets really confusing and irritating.

Being self employed and in a state that did away with their state ran program ( Kentucky ) a few years ago, I'm pretty much ( I feel like ) left to healthcare.gov for my options, which are basically limited to nothing.

For the past decade, I've pretty much defaulted to a high monthly premium on Anthem for the low co-pay and Rx. The only doctors in town take Anthem and none of the dentists here take any of the plans offered. My kids wear glasses so I typically just pay out of pocket full price on vision too.

I'm kinda sick of it so I am looking for options.

Right now, I pay $1500 a month for me and wife and 2 kids and we almost never go to the doctor. My wife did have a precancerous polyp removed last year, but I paid the majority of the deductible for that so that was out of pocket as well.

As far as everything else.. we are never sick. Dental and vision exams are cheap so I don't mind paying for those as much. But the health insurance just seems wasteful for the PPO plan we are on.

I've looked into:

1. HSA - but I don't get it or understand it. No matter how many times I read about it or ask an agent, I can't seem to really understand it or how it will benefit me.

2. Religious insurance plans - The ones where you pay in and everyone pays everyone else's bills. I might have this wrong.


So here are my questions:

1. Is there anything else available than the above I pointed out on the 2 other options? Am I missing anything I should be looking into other than HSA or some religious group plan? I want to make sure I know all the options.

2. Anyone here just have catastrophic plans? If so what does it cover? I almost feel I could bank the $1500 a month and pay out of pocket for normal stuff instead.

3. Anyone on a HSA? Maybe you can explain a bit how it works for you in comparison to normal PPO.

4. Anyone on one of the religious insurance plans? Has it worked out OK for you and how does it really work?

5. If I am missing any other option, can you explain it and let me know where I can check into it?

I am interested in people who are single, married with no kids, and those married or unmarried with kids. I want to start searching now before the end of the year when I typically have to renew and feel like I am uneducated and have to default pick the PPO plans on Healthcare.gov again which I feel like I need to get off of.

Thanks for any advice you can give.

.

I am single and I joined "Liberty HealthShare" a few years ago.
I try to stay healthy and go to a naturopathic doctor when needed. They allow many naturopathic services.
- Liberty HealthShare costs me $249 a month as Single ($399/mnth for couple, $529/mnth for family)
- $135 initial enrollment and $75/yr annual renewal
- My plan has a $1000 deductible (aka. AUA= Annual Unshared Amount).
- Covers eligible medical bills up to $1,000,000 per incident
- The plan covers one "wellness visit" per year at a cost up to $400.
- It is a faith-based "Christian" organization that requires that you agree to some general guidelines.
- I've only had one non-wellness claim... a trip to the ER and they were able to reduce the bill by $2000.

For my wellness visits, I scan my documents and submit online at their website.
For the ER visit, the hospital sent the claim to them and they called me to ask a few questions to verify the claim. I'm able to see all of the processing on my account page.

If you have any questions, let me know and I'll try to help you out.
If you think that you want to join, let me know...they have a "refer-a-friend" program and I can send you my member ID number and receive a $100 VISA gift card.

 

[Envision]

Get the insurance through your business via a insurance broker.

I pay $750 ish for all, health dental vision life and it covers myself and my employee extremely well. Well worth it.

 

[YoungPadawan]

My parents are both self employed and on a religious healthcare called "Samaritan Ministries" and they said they saved over $17,000 this year. All in all, they've had a good experience with it. You just have to prove you go to church.

 

[amp0193]

I use medishare.

$275/mo for me, my wife, and 2 kids.

Deductible is $10,500.

No vision. No dental.


I just view it as, I'll pay everything out of pocket always,while paying very little for monthly premium. It's there to protect me when shit hits the fan.

Which it did a few weeks ago when I severely fractured my ankle, and the pre-insurance bills were upwards of $120k for hospital stay and surgery.


As far as I can tell, it's the same as insurance, everything is just called by a different name. Definitely better than alternative options (healthcare.gov).

 

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[amp0193]

Get the insurance through your business via a insurance broker.

I pay $750 ish for all, health dental vision life and it covers myself and my employee extremely well. Well worth it.

Is that $750 for just you or you and your employee?

 

[amp0193]

You just have to prove you go to church.

For medishare, I just said "yes" when they asked me the questions.

 

[splok]

1. HSA - but I don't get it or understand it. No matter how many times I read about it or ask an agent, I can't seem to really understand it or how it will benefit me.

Not an insurance expert, but an HSA is basically a bank account you can open at any HSA provider, but you have to have a high-deductible insurance plan to get an HSA. You can deposit up to a certain amount per year ($7k for a family plan), which you can then use to pay for your medical expenses (or you can pay them however you want and then reimburse yourself via a withdrawal).

Contributions are tax deductible, so you're basically paying your medical bills with pre-tax income. Your balance also rolls over and can be invested, earning tax-deferred interest, and at 65, you can withdraw for any purpose without penalty. So it acts sort of like an additional IRA.

 

[Envision]

Is that $750 for just you or you and your employee?

Me and my employee.

My business partner owns an insurance brokerage that links into blue cross which is the primary network provider in my area.

 

[FierceRacoon]

By the way, if you have an HSA, don't use it immediately. Instead wait until later in the year and reimburse yourself later and only if it makes logical sense to do so. The reason is, if you hit the medical deduction limit, it is better to not use your HSA as everything above the medical deduction threshold is tax-free anyway; then contribute to the HSA instead. For example, you have $15,000 in medical expenses and $10,000 of it is above the medical deduction limit, making it tax-free. If instead you use $1,000 from your HSA, now you have $14,000 in medical expenses of which only $9,000 is above the medical deduction limit. So you've just used $1,000 of your HSA without reducing your tax bill at all. Instead hold on to the HSA until the year when you cannot reach your medical deduction limit.

Also, if this year your income is low, you should definitely try and hit the medical deduction. E.g. if you are making 30k in self employment income while mostly using savings to jump start your business, absolutely do not use the HSA, it's a waste, as the medical deduction is so close with a low income. Better use your credit cards. Now, if you end up broke and have to go back and get a relatively high-paying job, then go ahead and use that HSA.

 

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[FastNAwesome]

Another option - tourism.

Many people visit my country for things like dental tourism. Even with the travel expenses, it turns out much cheaper for them, and it's possible to get high quality service, so long as one knows where to look.

 

[amp0193]

Another option - tourism.

Many people visit my country for things like dental tourism. Even with the travel expenses, it turns out much cheaper for them, and it's possible to get high quality service, so long as one knows where to look.

This is my plan if I ever need extreme dental work. It is SO CHEAP in other countries. Medical tourist sites have reviews of all the dentists and you can easily research them before you travel.

By the way, if you have an HSA, don't use it immediately. Instead wait until later in the year and reimburse yourself later and only if it makes logical sense to do so.

I don't know if I did this incorrectly when I used to have an HSA... but I would never contribute anything to it. When I had a Doctor visit and it cost $300 or whatever, I would then transfer $300 to my HSA, and immediately transfer it back to my bank account. I never put anything in there beyond what my med bills were.


Maybe the advantage of saving money in there, is if you have a big bill ($10,000), that you might not have on hand, if it were to happen randomly. I never found myself in that situation though.

 

[Kak]

I use medishare.

$275/mo for me, my wife, and 2 kids.

Deductible is $10,500.

No vision. No dental.


I just view it as, I'll pay everything out of pocket always,while paying very little for monthly premium. It's there to protect me when shit hits the fan.

Which it did a few weeks ago when I severely fractured my ankle, and the pre-insurance bills were upwards of $120k for hospital stay and surgery.


As far as I can tell, it's the same as insurance, everything is just called by a different name. Definitely better than alternative options (healthcare.gov).

I do the same thing.

It is important to note that the deductible is annual. So you only have to hit it once, not per instance. Some of the health sharing companies have a deductible per instance.

I pay 200 for me and my wife, we have the healthy discount and a 7500 dollar deductible.

I pay out of pocket for eyes and dental. They are both pretty cheap if you shop around. Medishare does offer discounts for eyes and dental at various providers, but I haven't found the need. Costco has always been a good bet for eyes out of pocket.

 

[splok]

When I had a Doctor visit and it cost $300 or whatever, I would then transfer $300 to my HSA, and immediately transfer it back to my bank account. I never put anything in there beyond what my med bills were.

If you don't care about using as a saving account, you don't even need to deposit the money first. You could pay your medical expenses on a rewards cc for example to get a couple of bonus%, and then you can basically make a deposit at the end of the year for all of your expenses up to the cap (technically until tax time of the next year) and immediately withdraw it. You don't even need to make the withdrawal during the same year. It sounds like a loophole that may be closed at some point, but some people basically track their expenses for years to withdraw at some later date.

 

[DanaInvests]

@Kak and @amp0193 so if I read this right, you pay your monthly "share" and then pay for up to your say $10500 out of pocket for medical bills as if you had no insurance? Assuming it is a big bill like $25000 for a surgery or something like that it then gets published for sharing? Are your bills above the $10500 for sure to be shared or it is just sent for sharing and you hope someone agrees to help you and if not you are then responsible for the difference?

We are paying $1785 a month for COBRA right now for our family and I just applied for healthcare.gov and it looks like $1200 a month plus a $15000 deductible is the starter plans...

I HATE shopping healthcare more then anything! Gotta do something as I can't keep paying $1800 a month.....

 

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[Kak]

@Kak and @amp0193 so if I read this right, you pay your monthly "share" and then pay for up to your say $10500 out of pocket for medical bills as if you had no insurance? Assuming it is a big bill like $25000 for a surgery or something like that it then gets published for sharing? Are your bills above the $10500 for sure to be shared or it is just sent for sharing and you hope someone agrees to help you and if not you are then responsible for the difference?

We are paying $1785 a month for COBRA right now for our family and I just applied for healthcare.gov and it looks like $1200 a month plus a $15000 deductible is the starter plans...

I HATE shopping healthcare more then anything! Gotta do something as I can't keep paying $1800 a month.....

Medishare has an AHP or Annual Household Portion. This is the annual household deductible basically. Anything over that is published for sharing.

My AHP is $7500 and my monthly for me and my wife is like $250.

You will save a lambo payment by switching.

 

[Bertram]

Wanted to ask about health insurance here.

I truly want some insight from other entrepreneurs for now before I talk to another agent which gets really confusing and irritating.

Being self employed and in a state that did away with their state ran program ( Kentucky ) a few years ago, I'm pretty much ( I feel like ) left to healthcare.gov for my options, which are basically limited to nothing.

For the past decade, I've pretty much defaulted to a high monthly premium on Anthem for the low co-pay and Rx. The only doctors in town take Anthem and none of the dentists here take any of the plans offered. My kids wear glasses so I typically just pay out of pocket full price on vision too.

I'm kinda sick of it so I am looking for options.

Right now, I pay $1500 a month for me and wife and 2 kids and we almost never go to the doctor. My wife did have a precancerous polyp removed last year, but I paid the majority of the deductible for that so that was out of pocket as well.

As far as everything else.. we are never sick. Dental and vision exams are cheap so I don't mind paying for those as much. But the health insurance just seems wasteful for the PPO plan we are on.

I've looked into:

1. HSA - but I don't get it or understand it. No matter how many times I read about it or ask an agent, I can't seem to really understand it or how it will benefit me.

2. Religious insurance plans - The ones where you pay in and everyone pays everyone else's bills. I might have this wrong.


So here are my questions:

1. Is there anything else available than the above I pointed out on the 2 other options? Am I missing anything I should be looking into other than HSA or some religious group plan? I want to make sure I know all the options.

2. Anyone here just have catastrophic plans? If so what does it cover? I almost feel I could bank the $1500 a month and pay out of pocket for normal stuff instead.

3. Anyone on a HSA? Maybe you can explain a bit how it works for you in comparison to normal PPO.

4. Anyone on one of the religious insurance plans? Has it worked out OK for you and how does it really work?

5. If I am missing any other option, can you explain it and let me know where I can check into it?

I am interested in people who are single, married with no kids, and those married or unmarried with kids. I want to start searching now before the end of the year when I typically have to renew and feel like I am uneducated and have to default pick the PPO plans on Healthcare.gov again which I feel like I need to get off of.

Thanks for any advice you can give.

.

Keep it a no-brainer at a high premium. You will have no regrets if God forbid you find it was a good call. Financial questions should never taint the discussion of a child or mate's wellbeing and health. I kept high premiums so there would never be any second guessing. We're lucky that after 22 years of coverage I can say that I could have flipped three houses for the cost of our health insurance and the dental and the braces. We're lucky that this was the outcome. Another family had four years of respiratory medicine in a children's ICU and THEN four years of surgery, chemo, radiation, rehab, and therapy (same child) at upwards of 650K. In such situations the cruelest thing a parent can do to himself is be weighing costs of treatment.
Your child would already be dealing with memory loss, impairment, suffering, depression, and the last thing you should do is be distracted in any way by the cost of care.
So I know what the outcome is: I would have been three houses richer with low cost insurance. I also know that doesn't mean much of anything compared to really, absolutely having the means to save someone's life and bring them back to complete recovery. Don't put a price tag on it. Just laugh and grimace. We have Anthem.

 

[amp0193]

@Kak and @amp0193 so if I read this right, you pay your monthly "share" and then pay for up to your say $10500 out of pocket for medical bills as if you had no insurance? Assuming it is a big bill like $25000 for a surgery or something like that it then gets published for sharing? Are your bills above the $10500 for sure to be shared or it is just sent for sharing and you hope someone agrees to help you and if not you are then responsible for the difference?

We are paying $1785 a month for COBRA right now for our family and I just applied for healthcare.gov and it looks like $1200 a month plus a $15000 deductible is the starter plans...

I HATE shopping healthcare more then anything! Gotta do something as I can't keep paying $1800 a month.....

I just got billed $140kish for a hospital stay and ankle surgery. So far looks like the $10500 is holding. Hospital says I don’t owe anything to them, and medishare has paid them.

Pretty ok with medishare. This was the first true test and they passed.

 

[DanaInvests]

I just got billed $140kish for a hospital stay and ankle surgery. So far looks like the $10500 is holding. Hospital says I don’t owe anything to them, and medishare has paid them.

Pretty ok with medishare. This was the first true test and they passed.

Wow, I may have to call them. I saw the website and requested info but it sounded too good to be true. I just got the bill in the mail today for next months $1787 COBRA payment so gotta make a change or make the payment.... Thanks!

 

[amp0193]

Wow, I may have to call them. I saw the website and requested info but it sounded too good to be true. I just got the bill in the mail today for next months $1787 COBRA payment so gotta make a change or make the payment.... Thanks!

Read reviews on Medishare. When I was shopping around, what sold me on them was the lack of "horror stories" out there. They have a track record, and it's mostly positive.

Technically, they aren't insurance, and I think if shit hit the fan and they went out of business or something you could be exposed in a way that you wouldn't if you were using a traditional insurance provider.

You have to weigh that possible risk against the guaranteed negative outcome of paying $1787 a month right now though.

 

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