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Old 12-26-2010, 05:00 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,286,691 times
Reputation: 3873

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Quote:
Originally Posted by Beth56 View Post
My husband just turned 66 and has been on Medicare for one year. But just prior, he had a Blue Cross PPO 80/20 insurance plan with a deductible of $1,000 and out-of-pocket max of $2,500. The plan cost him $460 per month, or every two months he paid $920. Yes, it is a lot of money, but not thousands per month.

I am retired (age 57) and on a special insurance plan due to pre-existing conditions. It has its limitations and costs me $575 per month. But it was the only insurance available to me and I'm glad to have it.
Are you in a state high risk health plan? I am. Very thankful for it .

I am in Florida - and this plan has been closed to new admissions for about 20 years. Now there are only about 250 of us left in it (most people have either gone on Medicare or died).

And they sent me a great Christmas card this year - very beautiful - with the following inscription:

"One of the real joys of the Holiday Season is the opportunity to say Thank You and to wish you the very best for the New Year."

They're thanking *me* for buying insurance from the only entity in the whole world that will sell me health insurance??? *I* should be sending them flowers once a year . Robyn

 
Old 12-26-2010, 05:25 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,286,691 times
Reputation: 3873
The simple fact of the matter is that health insurance is expensive. And the older you get - the more expensive it becomes (unless you're in some huge employer group). Simply because you're more likely to need more care and more expensive care as you age.

And there are other factors too. My husband was ruled uninsurable when he was diagnosed with MS when he about 40 (25 years ago). We asked why - about all that could be done then was an occasional course of cheap steroids. And the health insurance people said things would change in the future. More available treatments. Not that they would work in terms of a cure - or even making things better for a particular patient. All they knew is they would be expensive. Those insurance companies were right - on all counts IMO - at least when it comes to MS.

Also - what you may think of as "minor" may be minor in a medical sense - but reasonably expensive in terms of the bills. I had 2 minor medical things this year. Removal of 2 benign pelvic cysts. Diagnosis and surgery (outpatient - spent about 12 hours in hospital room - anything less than 23 hours is outpatient) cost about $20k. Removal of a somewhat bad skin cancer on my upper lip that cost about $4k (Mohs surgery - so the cancer was 100% gone and the cosmetic result was great). FWIW - I thought the costs of both surgeries were pretty reasonable. The MRI to diagnose my cysts (my first MRI) cost $4k - and I can just see people screaming about that. But it was a 2 hour procedure (took longer than the surgery) - equipment costing I don't know how many millions of dollars - and 6 people there - including 2 doctors. Very very high tech. But you know what. As a result of that high tech MRI - my surgeon pretty much knew 100% what I had (almost 100% chance not cancer) and exactly where it was before she did anything to me. A surgery that might have taken 1-2 hours years ago could now be done in 30 minutes. It's like doing surgery with a GPS.

There's a lot of great medical care in this country. But it doesn't come cheap. Neither does an iPhone. On my part - I'd rather pay for high tech medical care than high tech toys. Robyn
 
Old 12-26-2010, 05:55 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,286,691 times
Reputation: 3873
Quote:
Originally Posted by emilybh View Post
I think I'd find a better health insurance agent if I were you. I just found a Health Savings Account qualified plan that is a PPO, meaning you can go outside of the network and there are no primary care physician requirements, in the 97086 zip code, with a $3000 deductible and 100% coverage after that-- for everything including prescriptions for $344 per month for a 54 year old female. This is based on standard rates for someone in average health. That comes to a total of $4128 for the year and the deductible is $3000 not $7500.

Or, for even less money, $247/mo, you could have a $1500 deductible and then 50% coinsurance until you have a total of $5000 out of pocket INCLUDING your deductible. In other words, after your deductible is paid you'd split the next $7500 of medical expenses, 50/50 with the insurance company. After that they'd pay 100% for all expenses beyond that for the rest of the year.

I think you can do a lot better than you are doing now. Too bad I'm not licensed in your state. I'm sure I could find you a much better health insurance value than you have now.

Here's a tip that might help though: AVOID plans with co-pays for office visits and prescriptions like the PLAGUE! Not only are they a rip off but the coverage isn't nearly as strong as the Health Savings Acct qualified plans WITHOUT co-pays. You end up getting FAR better protection for your money for a plan without co-pays- with no exceptions!

Also don't get sucked in to plans with bells and whistles that aren't worth the extra costs....a plan that might pay for an eye exam or something, for example. These plans might charge $5000 more a year and all you get for that is a $100 value from the eye exam they throw in. (I'm not kidding.) Do yourself a favor and save yourself the $5000 in extra health insurance costs and pay for your own eye exam.

Insurance companies aren't stupid. They know that health insurance is for most people an emotional decision rather than a financial one as it should be. Even human resource directors are clueless as to how to evaluate health plans. Sadly, health insurance agents are mostly order takers for whatever type of plan the client wants.
They don't take the time to educate and point out which plans provide the best coverage for the money and explain why and how they are. If they did, we wouldn't have so many small businesses with overpriced co-pay plans and insurance premiums in the stratosphere and there would have been no health insurance crisis.
I don't qualify for a HSA - so I can't discuss that.

But I can agree with other posters that plans and what they cost vary quite a bit from state to state.

Also - there are many different flavors of PPOs. I'm in a state high risk health plan - but it's a PPO - a really good one (actually the PPO is not from my insurance plan - it's subcontacted from my insurance plan to First Health Network). I live in the JAX area - and Mayo is in the PPO (so is Mayo in Rochester for that matter - as long as I'm willing to pay to travel - I can visit providers in the PPO anywhere). Other PPOs may be more stingy in terms of their participating providers.

(Note that I'm not saying I go to Mayo to get my blood pressure checked - or to have my annual check-up - it's not a primary care institution - but it's nice to know that I have access to an institution that provides excellent secondary and tertiary care.)

I do agree with you about things like eye exams. My husband and I go to an optometrist once a year for complete eye exams. He's excellent - and charges about $85/visit. And when I say excellent - he even checks my husband's eyes in terms of his MS. Probably routine physicals too. We go to an excellent primary care provider who charges about $150/year (list price) for a comprehensive physical.

As for blood tests - here's where we get the ones we need on an annual basis:

Online Lab Tests: blood work, blood testing and laboratory tests

They don't take insurance - and they're cheap as dirt. About $60/year for everything a female my age needs (a bit more for a guy who wants a PSA).

IOW - you wouldn't pay big bucks to buy insurance to check the pressure on your car tires (whenever you're supposed to check it - who knows - I'm a woman and don't know beans about tires ) - and it should be the same with health insurance. You buy health insurance to cover the big unexpected bills (like when your car is totalled).

BTW - just curious since you're in the SE - what do you think it would cost to place health insurance for a 63 year old woman like me with minor health problems (no cancer - heart problems - etc.). $10k deductible - 20% co-pay up to an additional max of $3k - so max out of pocket $13k a year. I realize Florida costs more - perhaps a lot more - than SC - but I am just curious. My premium is supposed to be a % of what a "normal" person my age would cost where I live (in my case - it's 125%). Robyn

P.S. A lot of the differences in costs from state to state depends on state mandates in insurance policies. Like I really need IVF benefits .
 
Old 12-27-2010, 04:25 PM
 
144 posts, read 192,388 times
Reputation: 153
Quote:
Originally Posted by MadManofBethesda View Post
No, you can afford to pay for health insurance because the government is paying about 70% of your monthly premium! Your situation (and mine as well) is completely irrelevant to the OP's question. We were able to retire without considering what health insurance we would have for the simple reason that our health insurance costs are exactly the same as when we were working. Most people in the private sector don't have that perk. They have to scramble around and hope that some company will offer them insurance. If they can't find one, or can't afford an individual policy, then they must keep working until Medicare kicks in at age 65. That's what this thread is about.
Very good point. Too many people who oppose healthcare reform just don't know the true cost of health care. Our healthcare system is broken, the reform does not fully address the cost control aspect of health insurance but it's a start. I'm sure sooner or later we will get to a point where reform is unavoidable and it doesn't matter which side of the fence you're on. When the cost is just too high to bear for our economy. Even the greedy insurance executives will have to face it.
 
Old 12-27-2010, 05:04 PM
 
Location: California
2,060 posts, read 5,744,368 times
Reputation: 2840
Quote:
Originally Posted by Robyn55 View Post
Are you in a state high risk health plan? I am. Very thankful for it .
Yes. There was nothing else, anywhere. I am also thankful. The plan only allows around 6,000 or so at a time. I was on a waiting list for 4 months before being accepted.
 
Old 12-27-2010, 10:06 PM
 
43,209 posts, read 47,082,143 times
Reputation: 13684
Insurnace is something that needs to be planned long before retiring. igf retireing before medicare it can mean alot to have a health savings plan goinhg long before like any planning.
 
Old 12-28-2010, 05:41 AM
 
Location: We_tside PNW / CO / SA TX / Thailand
11,280 posts, read 18,945,577 times
Reputation: 8158
Quote:
Originally Posted by texdav View Post
...needs to be planned long before retiring. igf retireing before medicare... have a health savings plan goinhg long before ..

And having a Crystal Ball helps too.


Last I heard, Obamacare will do away with your well planned HSA or equivalent AFFORDABLE options.

Exile seems to be our only alternative for those 'under-age' or not keen on spending $1200+ / month for minimal care.

Maybe Mexico can get straightened out so we can again get meds and procedures there. Otherwise I will be keeping a few hundred $$ or "star-alliance" miles to get me to Thailand.

BUT... I can see TSA checking medical premium status BEFORE letting us FLEE the USA.
 
Old 12-28-2010, 06:33 AM
 
Location: Tennessee
22,987 posts, read 17,947,197 times
Reputation: 32518
Quote:
Originally Posted by MadManofBethesda View Post
No, you can afford to pay for health insurance because the government is paying about 70% of your monthly premium! Your situation (and mine as well) is completely irrelevant to the OP's question. We were able to retire without considering what health insurance we would have for the simple reason that our health insurance costs are exactly the same as when we were working. Most people in the private sector don't have that perk. They have to scramble around and hope that some company will offer them insurance. If they can't find one, or can't afford an individual policy, then they must keep working until Medicare kicks in at age 65. That's what this thread is about.

I'm only going to be paying $431/month beginning next month, with the government kicking in an additional $875/month. (If you have a self only policy, then you'll be paying $187/month, with the government kicking in another $391.) That's quite different than someone having to figure out how to pay the entire premium every month - assuming they can qualify for one.
I'm sorry but if I had to pay 3x $431 per month I could still afford it and I would do it. The idea being that health insurance is important to me and because of decisions I have made in retirement, like where to live, it frees up the money to pay for it.
 
Old 12-28-2010, 07:58 AM
 
Location: New England
12,391 posts, read 8,627,485 times
Reputation: 8960
Quote:
Originally Posted by LauraC View Post
I'm sorry but if I had to pay 3x $431 per month I could still afford it and I would do it. The idea being that health insurance is important to me and because of decisions I have made in retirement, like where to live, it frees up the money to pay for it.
Not everyone (actually, perhaps few) have that kind of money even if they ate rice and beans and gave up their car. People have to remember that what they can afford, many (or perhaps most) cannot.
 
Old 12-28-2010, 10:05 AM
 
Location: WA
4,068 posts, read 13,372,339 times
Reputation: 2957
Quote:
Originally Posted by LauraC View Post
I'm sorry but if I had to pay 3x $431 per month I could still afford it and I would do it. The idea being that health insurance is important to me and because of decisions I have made in retirement, like where to live, it frees up the money to pay for it.
It is not really that easy... in my area a plan that still has a $3,000 family deductable and $25 co-pays for two people over 60 that includes drug coverage (no vision, no dental) can cost you over $1900 a month.

The health industry does everything it can to keep billings up and the insurance industry simply masks over the charges.

I feel a lot of this would change if people were responsible for paying themselves (still getting vouchers from employers, government, or insurance) so that each are aware of the charges.

We shopped and bargained to get the best deal on a colonoscopy and finally settled on a $1200 procedure while we had quotes for the same thing up to $4700.

Third party payers is creating much of the problem.
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