Is your health insurance worth it?

Maybe ask in a health insurance forum and not in an international diet forum. I pay roughlly 10% of net salary for state insurance but everything is free. In this European country. Apart from 10 Euro per day in hospital, should it come to it, and up to 5ish Euro per prescription.

AdahOats2023 wrote: »

yirara wrote: »

Maybe ask in a health insurance forum and not in an international diet forum. I pay roughlly 10% of net salary for state insurance but everything is free. In this European country. Apart from 10 Euro per day in hospital, should it come to it, and up to 5ish Euro per prescription.

Thanks! I appreciate a global perspective. I don't really do forums..I just check recent discussions when I'm logging in my food, sometimes. & Health and diet seemed sort of related compared to the other catagories. Health and diet becomes more important as our Healthcare system goes downhill, haha

@Sollyn2312 That's true..30% of an emergency room bill would be bad enough as it is!

No problem. And glad to share a more global perspective. I had a proximal humerus fracture last December and the hospital billed roughly 6400 Euro to the insurance (I know, ridiculously low price for the US) and it included everything from ambulance to ER to being picked up at home for surgery, everything related to that and 2 nights in hospital. I only needed to pay 30 Euro for 3 days hospital, and a few prescription fees. Some were free though. The second surgery I had was probably in the same range, and I'm currently planning something different that will likely cost around 7000-9000 Euro. Good value for money, insurance doesn't need to approve anything, and I won't get into debt

Before Obamacare I paid for my own insurance, then I got my insurance on the marketplace, now I get it through Medicare. I have always had a high deductible, which I have never met. I am generally healthy, so mostly it goes to a couple of annual visits or tests which I get free or reduced price thanks to the insurance. Without insurance, the cost for everything is at least double what you pay with insurance. i.e. the doctor charges $200, insurance pays them $50 and you pay $35. Without insurance, you're on the hook for the full amount. This year I got injured while walking my dog. Insurance paid for most of my care, including surgery, PT and follow up visits. It saved me several thousand dollars. Life is very uncertain. You don't know when you'll get sick or have an accident. Having insurance is costly, but if you can afford it, it is worth it.

Just in to endorse the idea that US health insurance (sadly) is not about getting our money's worth in the month to month, but for avoiding disaster in the long run. I wouldn't wish anything bad on you, but a car accident or the like can happen to anyone anytime, not something we plan in.

I don't know about you, but my car insurance and homeowner's insurance don't pay off in the short run, either. I've been glad I had car insurance at times like when that deer jumped out of a ditch in front of my car, though. Thankfully, I haven't had to make a homeowner's claim, but folks down the street had a small fire blow up a portable protein tank in the garage, massive explosion I felt a quarter mile away, and the whole house burned down, was leveled and rebuilt from the ground up. That's what insurance is mostly about.

As others have reported, a serious illness can also have a huge cost, and you may not be able to get better (more expensive) treatment if uninsured, besides. I wasn't planning my cancer (or my husband's), but treatment were literally thousands of dollars each session, in my case times 12 chemo sessions, 30-some radiation sessions, not to mention a major surgery. It would've destroyed me financially.

With insurance, we're pooling risk with other people. We pay in, and some of us take out more than others at any given time, or even lifelong. But it's about managing the risk, for an individual, mostly.

AnnPT77 wrote: »

Just in to endorse the idea that US health insurance (sadly) is not about getting our money's worth in the month to month, but for avoiding disaster in the long run. I wouldn't wish anything bad on you, but a car accident or the like can happen to anyone anytime, not something we plan in.

I don't know about you, but my car insurance and homeowner's insurance don't pay off in the short run, either. I've been glad I had car insurance at times like when that deer jumped out of a ditch in front of my car, though. Thankfully, I haven't had to make a homeowner's claim, but folks down the street had a small fire blow up a portable protein tank in the garage, massive explosion I felt a quarter mile away, and the whole house burned down, was leveled and rebuilt from the ground up. That's what insurance is mostly about.

As others have reported, a serious illness can also have a huge cost, and you may not be able to get better (more expensive) treatment if uninsured, besides. I wasn't planning my cancer (or my husband's), but treatment were literally thousands of dollars each session, in my case times 12 chemo sessions, 30-some radiation sessions, not to mention a major surgery. It would've destroyed me financially.

With insurance, we're pooling risk with other people. We pay in, and some of us take out more than others at any given time, or even lifelong. But it's about managing the risk, for an individual, mostly.

LOL! Propane. I've typed that other word too many times, I guess. Had to correct it, too late to edit.

AdahOats2023 wrote: »

I'm on a value plan paying about $150 per month for a 30% co pay after a $1,600 deductable...might not be worth it unless I do a lot of preventative exams that are 100% paid for. I think it might be better to work 2 part time jobs and get it through the health marketplace.

If you are out of work (unemployed) or close to retirement, you may be eligible for free Medicaid or similar coverage in your state. It is often free or greatly reduced while you are unemployed and is cheaper than marketplace insurance. It only lasts while you are unemployed, but jt might be an option. Try one of the helplines on this topic for your state--just google. My sister is a contract worker and did Cobra or marketplace for years (expensive)--but then she found out she qualified when unemployed for better, free insurance through the government. Just FYI. I can't remember the exact name of it. Kentucky here. Her son when between jobs was able to get it as well. He's got a new job now, but temp coverage was great. Most states have 1800 numbers. I believe it was Medicaid--but I could have the name wrong.

We opt out of health insurance. We take what we can afford and put it into a separate savings account just for health care expenses. We then pay out of pocket for the care we need and what we don’t spend we save.. we see naturopathic doctors which health insurance doesn’t cover anyway. We spend thousands less a year and we are relatively low risk healthy ppl. We don’t skateboard or hike treacherous mountains, our car insurance will cover an automobile accident and hospital stay if needed. Health insurance doesn’t guarantee coverage for things such as cancer cause the ins company can drop you as soon as you get a diagnosis. Which means if something catastrophic happened then we would be filing bankruptcy anyways.. we had affordable health insurance options before Obamacare. Now it’s a one size fits most and I don’t agree with that. A healthy 30yr old male doesn’t require the same coverage as a child or anyone else for that matter. It should be individual for the needs expected for the following year. I wouldn’t be opposed to buying catastrophic ins as that would be for an absolute emergency but that’s not even an option anymore. I’m not willing to pay more than my mortgage every month for so called peace of mind.. where’s the peace of mind when I can’t buy food but I got that health insurance premium paid 😉 nope not for us..

Only you can decide your personal risk tolerance. I didn't think I needed insurance when I was 24. Then I had to go to the emergency room. Just being in the room... not including any testing or treatment or anything else.... was $8000. Sadly, you don't know until you know.[/quote]
So very true.. it’s not that we don’t think we “need” health insurance, it’s just that I think we “need” a different kind of health insurance, one that isn’t available to purchase currently. There are safety nets and programs put in place for such an emergency. We could very likely qualify for uninsured patient programs and payment plans. There also grants available from donors. The hospitals work with uninsured patients to get them state funding. We pay for these services with our taxes and wouldn’t be ashamed to use them as needed. The way the current health insurance system is set up does not benefit me. We have in the past been regular buyers into the pool but the deductible being so high before they even pay their 20% on top of the high premiums just doesn’t make financial sense for my family right now. I don’t personally think the benefit outweighs the cost.

My dog's insurance started "free" for the first six months (or is it year) because she came from doggie jail. It then was something minimal like $35 or something per month. 7 years later it is $350 per month. For the 8th insured year it will be $500 per month if I continue. To insure no more than $20,000 in pay outs. Not counting deductible or co-pay.

Why you ask? Because of market forces and risk. Because an old dog is more likely to require a payout that a young dog in terms of coverage for disease and even more likely to "draw" the basic death benefits these insurance policies pay out.

But, the most important factor to this pricing, is that this is voluntary private insurance.

Which means that the insurance company is in it to make money. And the people who buy the insurance self select as to whether they will pay for (or not pay for) coverage.

This reduces the population of people who are sharing the risk, and also adds a second level of self selection to only pooling people who are more likely to make a claim as compared to what would be the case with a universal mandatory plan. Or, even better, if you will, a universal mandatory plan with a co-pay structure that would discourage frivolous but encourage responsible use of the system-- if such a magical co-pay structure could be devised.

But, fundamentally, if you cannot comprehend that catastrophic insurance requires a level of buy in from a large number of people who will not individually directly cash in on their premiums I cannot help enlighten you. All I can do is hope you don't vote.

Fundamentally, if you only go to buy insurance when you think you are likely to need it and if the insurance system allows you to do so, don't be surprised if the insurance costs more and covers less.

Because we already know that you, my friend, are more likely to cost the insurance companies money as opposed to the poor but healthy slob who had no option but to contribute some of their$'s (either in the form of taxes or premiums) because universal coverage required them to.

And I won't even go into the morality of choosing to rely on bankruptcy as a health insurance plan in order to download your risk to the remainder of the paying public without having contributed anything to the kitty.

The funny part is... I neither have a bone in the human health insurance game nor am I one of the people who would be called upon to fund the bankruptcy seekers through the even more increased premiums the insured are paying. Because where I live there exists extremely good universal catastrophic coverage.

What we seem to have lost this past decade or so up north is the fairly good and comprehensive non catastrophic coverage that we used to have. These days it feels that there is rationing and triaged diagnosis and care that only goes into overdrive once health has deteriorated. Gone seem the days of trying to catch health issues before they become critical.

"And I won't even go into the morality of choosing to rely on bankruptcy as a health insurance plan in order to download your risk to the remainder of the paying public without having contributed anything to the kitty."

This exactly. I was thrown for a loop that the "back up" plan is "meh, I'll just put the cost off on everyone else.".

The healthcare system in the US is horrible, but it would be pretty irresponsible of me to not have insurance given that I have a family to look after which includes two boys who play sports and just in general play pretty rough. I also have a couple of health conditions which require me to see a Dr. a couple of times annually. I also see a therapist on a weekly basis and my insurance actually covers that.

As insurance goes, mine is pretty good and I am fortunate that my employer pays 2/3 of the cost. It's a "Cadillac Plan" so it covers a lot of things other insurance doesn't and I also don't need any referrals to see a specialist.

PAV8888 wrote: »

My dog's insurance started "free" for the first six months (or is it year) because she came from doggie jail. It then was something minimal like $35 or something per month. 7 years later it is $350 per month. For the 8th insured year it will be $500 per month if I continue. To insure no more than $20,000 in pay outs. Not counting deductible or co-pay.

Why you ask? Because of market forces and risk. Because an old dog is more likely to require a payout that a young dog in terms of coverage for disease and even more likely to "draw" the basic death benefits these insurance policies pay out.

loulee997 wrote: »

Instead of doing doggie insurance, I set up a 2nd account through my bank. I have $50 a month or $25 a paycheck automatically put into that account. It provides $600 a year for 'Oh No' Dog insurance. Shop around for shots. If you don't use that money, then it grows. It is my dog emergency fund. For the dog, where costs are lower than a human, it's enough.

I suppose you could do the same for a person. Once you hit a certain amount saved, you could put it in an interest-bearing account...as long as their is no penalty to withdraw. For a person, you'd want to save more and try to put it in a non-penalty CD or money market so it could earn interest while it grew. The minimum is usually $1500 to do the CD. Some banks $2500. It'd take some time to reach that amount. But if you don't use the fund, you can then grow the health fund more quickly. A non-penalty CD/MM allows you to pull it out if you break a leg or get COVID-19. But to be honest, you will probably not be able to save enough to cover something major. It would mostly likely just cover gaps in insurance.

Just a thought.

When my husky was being treated for lymphoma, I saved a lot of money on his meds by shopping around. The vet had the worst prices. I bought antibiotics from Walmart. Sometimes I got cancer meds from an independent pharmacy attached to a hospital, and sometimes I got them from Canada. Thanks Canada!

We did need a prescription, which the vet provided.

Thank god for the NHS

Health insurance wasn't really worth it to us until it was. In his early '40s, my husband suddenly developed recurring kidney infections and stones, and had seven or eight hospital stays, multiple procedures, and it would have cost us more than half a million dollars to pay for them ourselves.

That being said, when I needed physical therapy, after months of physical therapy the insurance community declined payment. Ultimately after many phone calls they did pay for all the appointments, but sometimes with insurance you need to spend a lot of time on the phone and sending documents.

My daughter is currently in the hospital with RSV, and she's been there for over a week. She has had intensive and extensive care, so many treats, and without insurance she would soon be homeless and utterly broke, because as good as her job is, it's not good enough to pay hundreds of thousands of dollars.