Stay out of the hospital. Proper nutrition and exercise goes a long ways for staying healthy. If you do that your chances of being fat and sick are greatly reduced.
If you want lower healthcare costs
- Thread starter HawkeyeHitman
- Start date
Is that gonna lower my premiums? Is that gonna keep me from getting cancer? Is that gonna keep me from getting hit by a drunk driver? Is that gonna keep me from being a victim of black on black crime?
Rather than deny service I think the key is to require that all people pay. My simple understanding of the ACA is that is how it is supposed to work.
I think the biggest driver of healthcare costs is over utilization. That has many facets. Physicians order too many tests. Pharmaceutical companies push expensive drugs that may not work. Patients demand those tests and drugs because they heard from a friend or a commercial that they are necessary. End of life care has become obscenely expensive.
I believe these are the primary drivers. However, don't have any clue how to fix any of them.
My understanding of the ACA is it's far cheaper to buy in only after becoming sick. If that's true, the ACA fails.
From your avatar I'm tempted to assign some expertise to you on medical matters. Is that warranted?
Move to France. It's troubling how something costs 15,000 there vs. 1,000 here. Live there for five years and you qualify for national medicine.
Obama successfully confused healthcare with health insurance, it's like confusing car payments with car insurance payments, or gasoline payments
Unless you lose your job provided health insurance or something like that you can only buy in for a year during the end of last year and the beginning of that year. I think final deadline is usually Feb 15.
So if you happen to get sick at the right time or you can be sick and somehow wait for next year to roll along so you can buy health insurance then I suppose that is correct.
But you can't go without insurance and then in July find out you have cancer and expect the ACA to be covering you Chemo in August. It just doesn't work that way.
you can't expect the aca to be covering for you anything at all except birth control, and throw in medicare as well, no covering worth a crap: according to the doctor and all the personnel at s office, where I just was -they were complning
This is correct. You can only get insurance coverage during open enrollment (or a qualifying life event, such as a Cobra that runs out). Otherwise, you will have no coverage until the next open enrollment AND you'll pay the tax penalty for no coverage.
and you guys think this plan is cool? btw, I am an agent and I sell non compliant stuff year round. so you can only get the aca garbage during open enrollment. you can get hospital indemnity coverage and basic medical, year round, by answering a few health questions. still.
Once again, you are FOS; utter nonsense here.
When you have coverage, you pay the negotiated rates the insurers will pay out to the hospital/doctor. Without coverage, you will pay the 'sticker price' the hospital lists, which can be easily 3x to 5x the insurer negotiated rates. In other words, a $500 clinic 'bill' from the hospital may only cost you $120 out of pocket (EVEN with a high-deductible plan) because you only pay out what the insurance company would, NOT what the hospital wants to bill you. This is precisely why high deductible plans are a decent option for healthy people; even a few visits to the clinic may only cost you $150 to $200 each. But those plans are about half the annual rate of the co-pay plans, which is often $2000-3000 per year more.
Only if you have a major injury or major health issue will you pay the full deductible; but it's still worth paying attention to the max out-of-pocket expense because you should really have that money in savings somewhere in the event you need it.
Non-compliant stuff is really fraud if you are presenting it as 'medical coverage', because you will be taxed for a non-compliant plan. Plus, most of those 'plans' do not have any rate negotiations with hospitals, so they don't save you any money vs actual hospital bills. They are mostly a sham.
Edit: PLUS, I don't think the non-compliant 'plans' count toward any 'max out of pocket' costs. So they are fairly high risk, financially.
I'm telling you I was sitting in the doctor's office and they were complaining about what the ACA policies of today cover, specifically for c-pap, then he sent me down the hall to the lady to draw blood, and she specifically was complaing about medicare and what it covers. I heard what I heard.
I said it was non compliant so not fine exempt, so yes, the fine would still be in effect. it is in no way a fraud at all. it is similar to Aflac. are you calling Aflac a fraud? it's a hospital indemnity plan: pays so many dollars a day in hospital. if it's 100 dollars a day, you go in two days: it pays 200. not a fraud. and a surgical schedule, say a few hundred or 1500 for an ankle surgery. that's it. check made out to the covered person, not the hospital.
My whole family and I are in great shape due to proper nutrition and exercise.
Our healthcare costs are also higher than they've ever been due to increasing premiums. We have a very high deductible plan and our premiums are still basically a second mortgage... so, NOW what's your advice on how to lower my healthcare costs?
Specifically what did they not want covered or want covered??
For the record I'm glad it has a wide range of coverages. Because the problem with the old system was that a lot of people who didn't need certain services didn't have to pay for it, but those that did need those services had to pay insane premium just to get those services.
Isn't there an extended enrollment period for those that qualify for subsidies? I knew the area very well 8 months ago but I forgot it.
"I heard a hallway conversation that I have no context for, so that means ACA sucks"
Gotcha.
Here's an actual example:
There is a blood draw test which the hospital used to bill $283 for. The insurer has negotiated $15 for that test (they pay it anyway, so the patient doesn't see it). Why so little? Because the insurer has agreed to pay that clinic and lab a 'fixed cost' for most all of their tests, eliminating all the individual bills, so they pay $15 for a $300 test, and they pay $15 for a $1 test. The clinic has guaranteed income to run their lab all year, rather than 'guessing' how many lab tests they'll run. They negotiated a rate that allows them to cover all of their reagents and supplies, so now they don't need to itemize all those bills. If they end up in the red, then next year, they'll negotiate $17 per test or something like that.
And they did something like that already:
Recently, the hospital changed coding to 'add' a $30 phlebotomy charge (for the actual blood draw), so the test/visit is now $313. What did the insurer agree to pay for that added $30 charge? $0.01
So, now they pay out $15.01 for a $313 billed charge.
Uninsured people, or those w/o formal health insurance (non-compliant plans) will pay the full $313. Insured people on compliant high-deductible plans will pay $15.01.
That is how the system works, and why it is very important to have actual health coverage with an actual healthcare insurer who CAN negotiate those rates on your behalf. Because otherwise, you pay what the clinic bills you for.
Exactly. And you can research all kinds of plans (ACA and independent) through many insurers to identify a plan which will cost you the least money. And by picking an appropriate plan for your situation, you can easily save $2000-3000 or more per year in premium costs ($300/month vs. $500 or 600/month)
Nope, they are already getting great health coverage from working for the government.
You are exactly the type of person who gets hurt by the ACA. If your family is as healthy as you claim you would be better served with something less than the ACA mandated minimum policy or perhaps simply paying out of pocket for your health care.....
No. . . the first year it was out they decided to extend the enrollment period for everyone because of how badly things went with the website kickoff.
But outside of that you have to enroll during the open enrollment period or have to have lost your previous health coverage for some reason. You can't sit with no health coverage and then apply in the middle of the year.
Enrollment ends on Dec 15 for those who want coverage to start in Jan., Jan 15 for those who want coverage to start in Feb, and Feb 15 for those who want coverage to start in March. If you don't apply before those dates then you are without coverage for the year.
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Until you have an unexpected health problem - major injury or chronic condition that arises; then you'd end up pretty much bankrupt paying full-rate w/o any coverage.
Best advice I can provide is to look up all of the insurers who operate in your state, check out BOTH the ACA plans offered (if you have a state clearinghouse) AND all of the independent plans each of the carriers offer. You absolutely CAN find >$1000 differences in annual premiums between plans and carriers, if you shop around.
Also, look over your last years' (or two) medical bills - identify what you've paid on the bills, what the clinic/hospital charges, and what the insurer negotiated rate was. Put all that into a spreadsheet so you can compare coverages among plans. Most ACA-compatible plans INCLUDE a free primary care visit for checkups, so you don't pay a cent for those. Most negotiated rate visits to a PCP are <$150-200; specialist visits are often <$250-300. Those probably don't vary a lot between plans, so figure out what those out of pocket costs will be for you with high deductible plan options.
And if you buy through state/federal clearinghouses, you can qualify for subsidized premiums (depending on household income); buying directly from insurers that is not always the case (unless they identify it as such, but I believe you have to purchase through the state/federal websites for the premium subsidies).
I was a paramedic working for a hospital based ambulance service for over 25 years. Served in all capacities including director of that service. I now teach prehospital emergency care for a community college.
Try looking at it this way. Even thought your premiums and deductibles are high your chances for having to use them are a lot lower which is a great thing. Needing to use your insurance is where the real costs and life disruptions come from.
I have never lived in Knoxville. Most of my work career was in Mount Pleasant. I now teach in West Burlington.
