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Old 03-11-2019, 11:34 AM   #21
daveinaz
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We have good health insurance now through our employer. The current state of medical insurance is atrocious. It is already, basically, a health sharing plan. The difference is that under traditional medical insurance, there is no incentive for healthy living. It was just recently that health insurers started providing coverage with no deductible for preventive care. In the past they wouldn't pay for preventive care but would pay for when you were sick --- not paying your costs toward not getting sick in the first place. Then "Obamacare" came along forcing people to buy Cadillac policies with coverage they neither needed nor wanted, pricing many people out of real coverage -- yes, they had insurance, but to meet the new higher requirements, they had to get deductibles that were astronomical, effectively pricing them out of the market.

So, current , traditional health insurance is, in effect, a health sharing system -- where the healthy pay for the cost of the unhealthy -- that was the whole premise, cornerstone of the ACA -- they counted on healthy young adults to buy into the system and subsidize the costs of unhealthy adults. But they didn't, choosing to pay the penalty instead which was still cheaper than buying a health plan they didn't need.

To me, a similar analogy would be when a group of people go to a restaurant. The majority are ordering expensive meals and they suggest that they all split the bill. Of course, those ordering steak and lobster and adult beverages are in favor of the idea. But those content with a hamburger, fries, and soda aren't. But they all vote on it and of course the measure passes. So the burger and fries crowd are forced to subsidize the expensive tastes of the others.

Both traditional health insurance and "health sharing plans" are sharing the costs of everyone's medical treatment among members of the group. The difference is that "health sharing plans" limit membership to those who avow to make healthy lifestyle choices and aren't subsidizing those who choose otherwise.

As others have mentioned, I have also looked at the explanation of benefits forms that come back from the insurance companies. Their "negotiated" amount is under 50% of the billed amount. It's a racket. They intentionally inflate their bill knowing that the amount paid is going to be negotiated down. That's way more and more providers have a separate fee schedule for cash where they can afford to charge less by bypassing all the expense and tedium of the insurance maze.

It's all about choices. Sort of like whether or not to get an extended warranty. I have chosen to refuse extended warranties and instead put that money aside to cover break downs should they occur and so far, I haven't regretted that approach.

We would rather have enough set aside to cover a large deductible and only have health coverage to cover the catastrophic events as opposed to paying thousands a month for coverage we don't need.

I know it's "to each his own," and that this a debated topic. But I think that when people are more directly involved with the costs of their health care, they are more careful about what they choose. In the traditional system, most people don't shop around despite the fact that the cost of procedures can vary by thousands of dollars from one place to another. But they don't care because they aren't paying for it -- well, not directly at least.

I would certainly like to keep the nice coverage we have. I know we've gotten spoiled by it these past 15 years. In fact, losing that coverage was the one thing keeping up from retiring. The only reason we were still working was for health insurance, but we've finally decided that it's not worth it. We would rather get out of the rat race without the current coverage than stay in it and keep putting up with it.

I've also started looking into prescription costs since the sharing plans don't cover them. I've found that I can go to Walmart or Costco and pay cash for the same Tier 1 meds I'm getting now for either less or about the same as my co-pay is now. But the insurance companies are paying the top price for the same meds plus I pay the co-pay.

The cynical side of me smells a rat. Someone's getting rich off this current scheme /set-up and I know it's not me!
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Old 03-11-2019, 12:51 PM   #22
richfaa
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Originally Posted by pyoung47 View Post
There is a reason medical insurance is very expensive. There is a reason that regular insurance companies are regulated by state insurance commissions.

And the reason is what????
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Old 03-11-2019, 12:55 PM   #23
tjndsa
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Originally Posted by daveinaz View Post
We have good health insurance now through our employer. The current state of medical insurance is atrocious. It is already, basically, a health sharing plan. The difference is that under traditional medical insurance, there is no incentive for healthy living. It was just recently that health insurers started providing coverage with no deductible for preventive care. In the past they wouldn't pay for preventive care but would pay for when you were sick --- not paying your costs toward not getting sick in the first place. Then "Obamacare" came along forcing people to buy Cadillac policies with coverage they neither needed nor wanted, pricing many people out of real coverage -- yes, they had insurance, but to meet the new higher requirements, they had to get deductibles that were astronomical, effectively pricing them out of the market.

So, current , traditional health insurance is, in effect, a health sharing system -- where the healthy pay for the cost of the unhealthy -- that was the whole premise, cornerstone of the ACA -- they counted on healthy young adults to buy into the system and subsidize the costs of unhealthy adults. But they didn't, choosing to pay the penalty instead which was still cheaper than buying a health plan they didn't need.

To me, a similar analogy would be when a group of people go to a restaurant. The majority are ordering expensive meals and they suggest that they all split the bill. Of course, those ordering steak and lobster and adult beverages are in favor of the idea. But those content with a hamburger, fries, and soda aren't. But they all vote on it and of course the measure passes. So the burger and fries crowd are forced to subsidize the expensive tastes of the others.

Both traditional health insurance and "health sharing plans" are sharing the costs of everyone's medical treatment among members of the group. The difference is that "health sharing plans" limit membership to those who avow to make healthy lifestyle choices and aren't subsidizing those who choose otherwise.

As others have mentioned, I have also looked at the explanation of benefits forms that come back from the insurance companies. Their "negotiated" amount is under 50% of the billed amount. It's a racket. They intentionally inflate their bill knowing that the amount paid is going to be negotiated down. That's way more and more providers have a separate fee schedule for cash where they can afford to charge less by bypassing all the expense and tedium of the insurance maze.

It's all about choices. Sort of like whether or not to get an extended warranty. I have chosen to refuse extended warranties and instead put that money aside to cover break downs should they occur and so far, I haven't regretted that approach.

We would rather have enough set aside to cover a large deductible and only have health coverage to cover the catastrophic events as opposed to paying thousands a month for coverage we don't need.

I know it's "to each his own," and that this a debated topic. But I think that when people are more directly involved with the costs of their health care, they are more careful about what they choose. In the traditional system, most people don't shop around despite the fact that the cost of procedures can vary by thousands of dollars from one place to another. But they don't care because they aren't paying for it -- well, not directly at least.

I would certainly like to keep the nice coverage we have. I know we've gotten spoiled by it these past 15 years. In fact, losing that coverage was the one thing keeping up from retiring. The only reason we were still working was for health insurance, but we've finally decided that it's not worth it. We would rather get out of the rat race without the current coverage than stay in it and keep putting up with it.

I've also started looking into prescription costs since the sharing plans don't cover them. I've found that I can go to Walmart or Costco and pay cash for the same Tier 1 meds I'm getting now for either less or about the same as my co-pay is now. But the insurance companies are paying the top price for the same meds plus I pay the co-pay.

The cynical side of me smells a rat. Someone's getting rich off this current scheme /set-up and I know it's not me!
Well said.
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Old 03-11-2019, 01:12 PM   #24
DebNJim B
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I also sit on the Board of a Not-for-profit that provides health insurance for our employees, about 400, with employees paying 15%.

We switched to a high deductable plan ($1500/$3000) and set up HSA's for everyone. We cut their premiums share to 0% and fully funded their HSA's for them. The premiums were so much lower we still saved money overall and now that the people have ownership in their cost, they pay the deducable out of their HSA that they own, the overall usage dropped by more than 50%. When they retire what ever is left in their HSA is converted to an IRA and goes with them. In the end everyone saved money including the insurance co. Just shows that when something is perceived as free the usage skyrockets. When polititians offer "free" universal health for everyone I shutter to think how that's going to turn out.
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Old 03-11-2019, 01:12 PM   #25
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Originally Posted by daveinaz View Post
We have good health insurance now through our employer. The current state of medical insurance is atrocious. It is already, basically, a health sharing plan. .........!
That is a simple economic fact of life. Any insurance coverage be it health, auto, home, life, etc., requires that there be far more people paying into the system and not using it than those paying in and actually using it. In that sense, all insurance is a sharing plan.

No matter what route you take, it is imperative that you have a plan with sufficient financial backing that it will cover you in case of an extreme medical event, unless you are personally wealthy enough to be able to cover huge unexpected and unforeseen medical events that can change your entire life and personal financial status.
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Old 03-11-2019, 04:31 PM   #26
pyoung47
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And the reason is what????
1. Money for coverage has to come from members. With an insurance company, members share the risk among themselves. Under current law, you cannot be refused coverage for pre existing conditions. I'm guessing about everyone reading this has one or more pre-existing conditions. I'm not sure what the requirements are for membership in these sharing organizations.

But, insurance companies must make a profit, and this, of course adds to the cost of premiums.

2. I'm not sure -- but I doubt it -- if these sharing organizations are regulated. You would have little protection against groups that were not legitimate. Furthermore, who would you appeal to if you felt the coverage was not fair or adequate?

The current system of health care in the US is a terrible mess. It's a patchwork of Medicare, VA, private insurers, and unlucky private pay individuals. The US spends more money on healthcare than about any other first world nation and the outcomes are very poor. There seems to be a huge fear of a single payer system, but most folks are very protective of their VA, Medicare, and, of course Medicaid services.
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Old 04-02-2019, 09:03 PM   #27
footz1941
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As DebNJim B Post# 19 negotiated costs I had an accident last summer resulting in a medavac helicopter ride. Statement from service provider was $37,500 $22,500 basic charge plus $159/mile. Medicare and insurance paid about $9,000 I did not have to pay anything but if I did not have insurance I would have been responsible for the entire cost
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Old 04-03-2019, 10:27 AM   #28
richfaa
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We have had employer provided BC/BS health care for years and now includes medicare. We have excellent coverage and never a problem. It is not cheap but one hospital stay can bankrupt you example Helens bill of nearly 70K two years ago of which our out of pocket was 3,300.00 for services like TV in the room that we chose to have. What ever works for the individual is fine our total Healthcare premium BC/BS and medicare is over 8K a year but well worth the price.
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Old 04-03-2019, 03:18 PM   #29
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definitely not for us
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Old 04-03-2019, 03:56 PM   #30
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Interesting.

I asked to hear from those who have had EXPERIENCE with medical sharing plans, not the opinion of such plans from those who haven't used them.

Kind of like asking for how to repair a Chevy and instead of telling me how to fix it, people replying that they'd never own a Chevy...

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Old 04-03-2019, 05:12 PM   #31
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On the Share Plans - check with a few key service providers and ask if they accept the share plan ... i have a few friends that swear by it, but have not had any major claims either.
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