Vanity: Need Advice on CA Health Insurance

Obama is the source of my problems ^ | 11/30/14 | Self

[Yaelle]

I was a part of my family member's business, and as an employee of this small family business was able to get myself and 4 kids covered by a private insurance company with a great ppo plan though pricy. Every year, this coverage grew more expensive by a couple hundred a month, until this year when it has gone up by $500 a month. I can't afford it and the business will be closing in 2015.

I don't want to join CA Covered because it's ObamaCare. What do any CA FReepers do for insurance when they aren't getting it paid for through a company?

I am supposed to pay $2500 a month for 5 people. I just can't do this.

Can anyone offer some advice: how to not go to places like Kaiser but not break the bank either? I need to make the change now.

[Wayne07]

There still are medical savings accounts, and they are a decent complement to insurance, but not a replacement. You definitely need an insurance plan, especially with kids, and potential surgery. You will pay a lower rate for procedures, just by having insurance than if you didn't.

http://www.treasury.gov/resource-center/faqs/taxes/pages/health-savings-accounts.aspx

[Yaelle]

Thanks. So you’re saying that no one in ca can avoid the ObamaCare that doctors aren’t liking? I will hold my nose and look at covered ca.

[eyeamok]

Aint life great now with obamacare??

Self Employed, I carried Catastrophic Care Insurance from Blue Cross for my Wife and I and my 25 yr old daughter. It had a $10,000 deductible with 100% coverage after deductible satisfied up to $5 Million and was $200 per month, when Obamacare was passed it went up to $300 per month. In October last year before Obamacare took effect, They Cancelled it because of the Obamacare Mandates. They offered me a new Policy with a 60% CO-PAY and a $7500 Deductible for a REDUCED rate of $900 Per Month.

Needless to say WE DO NOT HAVE HEALTH INSURANCE anymore. So I pay to go the Doctor, which is fine I have been doing that all along. I have quite a few Doctor Friends that will perform many minor procedures in their living room for me, stitches,broken bones,..Should something MAJOR come up I have $50k in the bank for medical expenses and WE will be on the First Plane to OKLAHOMA for Care. NO I DID NOT PAY THE FINE and NEVER WILL, I am self employed and the LAW does not allow them to come after me, they can only Attach a TAX REFUND, which I do not get.
see http://www.surgerycenterok.com/

Currently I am in the process of REDUCING my TAXABLE INCOME as much as possible in order to NOT FEED THE WELFARE CLASS. I have cut down my income from almost $200K to $75K and will go far enough to qualify for FOOD STAMPS next Year. I am doing this INTENTIONALLY.

Come January I will transfer ALL PROPERTY WE OWN into an LLC just so that I have No Attachable Assets.

I do not carry ID EVER, should I be in an accident that requires immediate care at the “Emergency Room” my name is Jose Smith and I am an Illegal Alien.

I strongly encourage everyone to do the same.

[Yaelle]

Is there some way to do the health savings accounts and then just get a catastrophic policy?

I am so grateful for your advice.

[RedStateRocker]

Kaiser.

[Wayne07]

What gets me in to all the best docs?

The cheaper the insurance plan, the fewer doctors that will take it. Blue Cross is notoriously cheap, and tons of doctors have stopped accepting it. Blue Shield is more expensive, and has much larger provider network. FIgure out what doctors you want to see, ask what insurance they accept, and buy the cheapest plan that they will take, at the deductible level you feel comfortable with.

[peteyd]

If you can go through a clinic ,you most likely will be eligible for a discount.For example at UCSF,
I was able to get a steep discount of nearly 80% (though this was years ago) and many of the hospitals will give you a discount you need to ask and speak with their financial services and you may be eligible for Medi-Cal.
Please don’t be ashamed to use those services.All the illegals get their medical services covered and also walk away with additional services and still ask for more

[eyeamok]

What gets me in to all the best docs?

Walk in with at least $5000 in CASH and see how you are treated, You will go Right to the front of the line

[Lorianne]

If it’s not emergency care, consider medical tourism.
There are some very talented specialists and good hospitals in other countries.

The problem is emergency care. But even there, you will be charged less if you have no insurance than you will be if you have insurance.

[EQAndyBuzz]

Move to Texas.

[Wayne07]

The "bronze" plans are effectively catastrophic plans - ~$4000-$5000 deductibles. You can pair that with a HSA. If you really think you might need surgery, you are in a position to use the new system to your advantage and buy a low deductible policy for a year, then drop down if you think you don't need it.

Health care costs are completely insane, and have been driven up substantially since obamacare. Play it safe and make sure you are covered.

[Wayne07]

$5000 will definitely get you to the front of the line, but then you are out $5000.

[kaila]

From what I can tell, most docs will not take Obamacare. That means you will not be able to easily find a primary care physician under Obamacare. You could pay cash to see a PCP, but even PCPs do not like to see cash paying patients. They wind up with a situation in which the patients need specialty care or testing, and while the patient could afford to pay cash for the PCP visit, they may not be able to afford the rest. As a result, the liability falls on to the PCP who has to beg specialists to take the cash paying patient. People who can afford concierge care most likely have back up insurance.
However much you dislike Kaiser, you just have to know how to play the system.If you see a physician, be direct and simple with your symptoms. Do not demand pain meds. Ask them if you need a certain test ( example- MRI) and if they dont think you need it, ask them why. If you come off as reasonable, you will get what you want.If you are perceived as a high quality patient, they will most likely order what is right for you.
Kaiser most likely contracts super specialty services ( like brain surgery) out in the community, anyway. Please look at the Kaiser contract, and see if outside specialist are contracted with them. If they are contracted, you will be treated nice because the outside specialists want the referral business.

[Yaelle]

Wow! Doing the “I’m Not Worthy” dance to you!

Very impressive, Mr. Galt. Scared to go as far as you did, but I like the way you think. I’d like to start paying my insurance “coverage” to an account to be used for medical, and pay cash.... Except for things that cost LESS with insurance.

I get meds for migraines. $50 a month for 9 pills. Without insurance it’s $300 a month. Like the guy said upthread, procedures are radically cheaper with insurance as well. I need MRIs.

I wish I could be like you!

[Gen.Blather]

My understanding is that Indian hospitals are first rate. It’s called medical tourism. You can get a hip replacement, for example, at a fraction of the price. I’d look into that. The trip, operation and recuperation is usually less than buying insurance here.

Formerly, when unemployed, I’d get a catastrophic care policy. But Obama made those illegal.

Incidentally, you’ll most likely be looking at prices next year that you really can’t afford, so you’ll lose it anyway then.

[Yaelle]

What do you mean by going through a clinic? Do you mean loyalty to a certain hospital?

Also, isn’t MediCal supposed to be for the truly poor? Wouldn’t that be going against our principles here? And don’t they check your bank accounts? Or something?

[eyeamok]

Before my father passed away last year I was Purchasing ALL HIS Prescriptions from CANADA over the Internet, the cost was about 20% of what the Pharmacy charged. Yes you read that right it was an 80% DISCOUNT.

“Like the guy said upthread, procedures are radically cheaper with insurance as well. I need MRIs.”

NOT TRUE, to have 12 stitches put in my finger it was $400 CASH at my Doctors Office, If I had Insurance it would have been $2500 billed to Insurance Company after I paid the Office Visit of $100

[Wayne07]

From what I can tell, most docs will not take Obamacare.

That is not exactly right. There is no "obamacare" insurance plan - you still buy insurance from the same private insurance companies as before. The difference is the plan benefits are now federally regulated (and potentially subsidized) by obamacare, which messed a lot of stuff up. So you just need to know whether your PCP takes Blue Shield/Blue Cross/Health Net/etc, and then buy the "obamacare" plan from the insurance company that your PCP will take.

[Yaelle]

Omgosh, I love this idea. Saving your link for the OK Surgery Center. Fantastic.

[martinidon]

I am sort of going through the same thing myself. It sucks but it looks like my only option will be to sign up with obamacare. I can not get an individual policy because I have an heart issue. So I am forced to go through Obamacare and it is expensive with high deductibles. I thought about going without but with a wife and 12 yr old I can not risk being uninsured and have a major heart issue. I do not want to put my assets and life savings at risk and a heart bypass would just about do that. So I am doing what is best for my family and signing up. I even discussed with my wife of 32 yrs of possibly getting divorced on paper and putting all of the assets in her name. She can get better insurance as a single mom than with us being married.
One thing you might want to consider is getting your kids on their own individual policy. I did this with my 12 yr old and it is like $150 month.
Good luck, but make sure your decision is based on what is best for your family.