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Just started a new job and got my new Medical Ins rates.....$1080/month for self, wife and kid. This is America....


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How in gods green earth do front office receptionists and MA's pay this earning $30k per year?  I mean....it's disgusting.

 

$2k deductible with $7k ind out of pocket max and $13k family out of pocket max.

 

Here is some advice, do NOT get sick in this country.  Rich coming from a Provider.

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Myself, my wife, and college aged kid =1700/month...I am with you there....this is ridiculous. someday we will have some kind of single payer system like every other industrialized country on earth....

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just interviewed for an urgent care position to learn what the competitive marketplace is looking like

 

yeah over $1000/m for family ins

 

what total crap

 

single payer

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That’s about what I’m seeing for a “Silver” level ACA policy.  I’ve been checking each year just to see what my cost will be for two of us for about two years until I get on Medicare.  I’ll still need to insure my wife for an additional two years UNLESS Biden and the Dems get some variation of Medicare for those <65 y/o.  The key is to stay healthy so that I’m not in an office every other week (twice a year at present and one visit is only $100+ OOP for neuro annual f/u); the other is for a WME.  The short-term policies apparently don’t have the same coverage requirements as ACA approved policies, including those through major insurers.

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Faith based medical cost sharing--no preventative anything, $1m cap, no preexisting conditions covered, no mental health coverage, $400 per incident responsibility before sharing, up to 100% covered after that... $530/month for a family of 3.

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12 hours ago, iconic said:

Our MAs are on Medicaid..
Our healthcare system is a shame and I don't have too much hope it's gonna change 

A former hospital system employer of mine, who also owned their own insurance company, was exposed for suing its own employees over medical bills.

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Well I guess I'm glad to know I'm not alone?  I mean, I make good coin and can absorb it I suppose but FFS I just cry for those making $40k a year at these prices.

Ah well.  With this and our profession turning us into Walmart associates I've got to say...it's been a shitty week.

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11 hours ago, rev ronin said:

Faith based medical cost sharing--no preventative anything, $1m cap, no preexisting conditions covered, no mental health coverage, $400 per incident responsibility before sharing, up to 100% covered after that... $530/month for a family of 3.

I mean how is this good coverage? 

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1 hour ago, iconic said:

I mean how is this good coverage? 

It's great.  3 ER visits in 3 years (one each for 3 covered family members), net $0 out of pocket; at the time, negotiated discounts counted against member responsibility.  I have $0 taken out of my paychecks--I work multiple part time jobs so I get no benefits anywhere--for healthcare, and pay cash for vision, dental, etc.  Instead of paying $1500/month for worse coverage, I probably pay $3-4k per year out of pocket for routine/noncovered stuff. It sucks to have to pay top dollar rather than negotiated rates, but it's still cheaper than anything else out there.

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11 hours ago, iconic said:

I mean how is this good coverage? 

it's not.  States Attorney Generals have investigated these groups for fraud.  Many clearly state that it is not insurance and they will send out letters to other subscribers who are suppose to "pray" over whether to pay your bills or not.  Additionally they will not pay for anything they believe arises out of "immoral" behavior.  Whatever that means.  No thanks.

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22 minutes ago, Cideous said:

it's not.  States Attorney Generals have investigated these groups for fraud.  Many clearly state that it is not insurance and they will send out letters to other subscribers who are suppose to "pray" over whether to pay your bills or not.  Additionally they will not pay for anything they believe arises out of "immoral" behavior.  Whatever that means.  No thanks.

It just sounds like catastrophic coverage, which can be purchased pretty inexpensively 

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24 minutes ago, iconic said:

It just sounds like catastrophic coverage, which can be purchased pretty inexpensively 

What do you mean by catastrophic coverage?  Will it cover 100% of an isolated ER visit?

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48 minutes ago, Cideous said:

States Attorney Generals have investigated these groups for fraud. 

Physicians and PAs, among others, have been found guilty of insurance fraud.  Do we extend guilt by association to all of us? Of course not.  The fact that faith-based cost sharing arrangements have been been so successful is an inherent factor attracting fraud.

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I would say that price is on par with what I pay.  $732 a month with $3500 per person deductible and $11,000 max out of pocket. My employer pays $500 which is not included.  I figured we pay about $16,000 per year out of pocket before the insurance picks up anything.  

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Govt employment has its perks. I hate to even say what I pay for me, spouse and college aged kid.

We have good coverage, low deductibles, good pharmacy coverage, etc.

I cannot complain.

Everything everyone on this thread is experiencing is unacceptable. 

As long as insurance CEOs make 7 figures and bonuses for denying care and "saving money" - we are doomed. 

We don't do Health Management in the US - we do crisis management and response to irresponsibility.

Not sure how to approach that whole paradigm shift. 

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On 5/26/2021 at 12:10 PM, rev ronin said:

Faith based medical cost sharing--no preventative anything, $1m cap, no preexisting conditions covered, no mental health coverage, $400 per incident responsibility before sharing, up to 100% covered after that... $530/month for a family of 3.

What company are you using? Family of 5, $300/month, $300,000 max per incident, $1,500 house hold portion per incident, 90%/10% with max of $13,500 out of pocket.  

I ask providers and others all the time, "What are you getting from you insurance" and they say nothing, so I ask them why are they paying all that money per month? There are lots of better options, sit down, do the math on how much you would save per year and pay cash for 99% of things and have a higher deductible plan or faith based plan and save the rest in a HSA/savings account etc.  

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On 5/27/2021 at 11:16 AM, Cideous said:

it's not.  States Attorney Generals have investigated these groups for fraud.  Many clearly state that it is not insurance and they will send out letters to other subscribers who are suppose to "pray" over whether to pay your bills or not.  Additionally they will not pay for anything they believe arises out of "immoral" behavior.  Whatever that means.  No thanks.

You have not done your research and have "just heard things" from others that are not true. It is great coverage and I could talk your head off about our family and others that have had $20,000 (our family) to $100,000+ and it was ALL covered as described in the contract. I have had two different of faith based insurance companies and never once was told they would pray over the bill and see if it is paid. Please don't come here and spout information that you clearly have no idea about. I have had this insurance for 10 years.

The thing you are missing @iconic is how often do you use your insurance? You pay $1,500/month and go to the ER once or twice and then you still have a bill from them (maybe small) but over the entire year you have paid them a total of $18,000 for 1 year of coverage. I have paid $300/month, $3,600 for a family of 5, we had to go to the ER last year and it was $1,100 (this included 3 follow ups with ortho and all the xrays, casting, supplies, etc). We did not hit our $1,500 out of pocket max so we just paid cash. So $18,000 - $3,600 = $14,400 (that I have saved by not having traditional insurance) so subtract out the ER visit and I am still way a head. We also have went to the dentist, eye doctor, primary care doctor, speech therapy, & chiropractor which has totaled ~ $2,000. So we are still $10,900 net positive. Also, you are TOLD where you have to go or who you can see or what test they can order etc (with most insurances, unless you have a PPO, but then your still told what medications are on formulary etc). Lastly, the other thing people don't understand that ER, hospitals, doctor visits have a cash price (and almost always a same day pay discount) so our ER bill was actually ~$3,000 but they cut it in half due to us not having insurance (as we tell them we don't want to use our insurance and just will pay cash as we submit all claims ourselves). If you get a discount like we did ($1,500) this amount is deducted from the out of pocket max which is very nice. 

@Cideous please do what you want to but you do not see me bashing your insurance (as I believe it is criminal what they do and they take you for your money and our screwing this country up by their high premiums and making people think they HAVE to have insurance). Keep your comments to yourself if you don't know what your speaking about (as in this case you have no idea how these faith based insurances work). 

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2 hours ago, Reality Check 2 said:

We don't do Health Management in the US - we do crisis management and response to irresponsibility.

Even worse--we do COST management.

Right now, I'm seeing insurance companies deny residential treatment for eating disorders patients, putting some very vulnerable, starved brain people in a PHP (6h/day outpatient) with a "try and fail before residential care" guidance.  Not only is it terrible for the patients themselves, PHP is for people with a certain level of coping and self-management, so throwing a single really distraught and catastrophising patient into a group setting really derails progress by the rest of the group who are supposed to be practicing their skills, challenging fear foods, and learning to take back control of their eating.  Maddening.

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I'm just glad to be on Medicare! About two years after I got on it, I was diagnosed with lymphoma and needed 6 bags of a chemo drug that listed for $18K per bag, plus a ton of other stuff: other drugs, imaging, procedures, etc. Fortunately I had very manageable out of pocket costs. 

Our current insurance system makes too many people who can't afford it medically and/or financially to have to gamble. I think people should have to have skin in the game to keep from overusing the system, but a country like ours should be able to tax enough to look out for its own.

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6 hours ago, camoman1234 said:

You have no done your research and have "just head things" from others that are not true. It is great coverage and I could talk your head off about our family and others that have had $20,000 (our family) to $100,000+ and it was ALL covered as described in the contract. I have had two different of faith based insurance companies and never once was told they would pray over the bill and see if it is paid. Please don't come here and spout information that you clearly have no idea about. I have had this insurance for 10 years.

The thing you are missing @iconic is how often do you use your insurance? You pay $1,500/month and go to the ER once or twice and then you still have a bill from them (maybe small) but over the entire year you have paid them a total of $18,000 for 1 year of coverage. I have paid $300/month, $3,600 for a family of 5, we had to go to the ER last year and it was $1,100 (this included 3 follow ups with ortho and all the xrays, casting, supplies, etc). We did not hit our $1,500 out of pocket max so we just paid cash. So $18,000 - $3,600 = $14,400 (that I have saved by not having traditional insurance) so subtract out the ER visit and I am still way a head. We also have went to the dentist, eye doctor, primary care doctor, speech therapy, & chiropractor which has totaled ~ $2,000. So we are still $10,900 net positive. Also, you are TOLD where you have to go or who you can see or what test they can order etc (with most insurances, unless you have a PPO, but then your still told what medications are on formulary etc). Lastly, the other thing people don't understand that ER, hospitals, doctor visits have a cash price (and almost always a same day pay discount) so our ER bill was actually ~$3,000 but they cut it in half due to us not having insurance (as we tell them we don't want to use our insurance and just will pay cash as we submit all claims ourselves). If you get a discount like we did ($1,500) this amount is deducted from the out of pocket max which is very nice. 

@Cideous please do what you want to but you do not see me bashing your insurance (as I believe it is criminal what they do and they take you for your money and our screwing this country up by their high premiums and making people think they HAVE to have insurance). Keep your comments to yourself if you don't know what your speaking about (as in this case you have no idea how these faith based insurances work). 

1.  This is a message board.  I will not keep my opinions to myself.

2.  Faith based medical reimbursement is NOT INSURANCE.  THEY DO NOT FALL UNDER THE ACA GUARANTEED NO MAXIMUM PAYOUT IF YOU OR YOUR FAMILY MEMBER BECOMES DREADFULLY ILL.

3.  I know exactly what I am talking about because I looked into these before.

 

https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

 

I'm sure your next comment will be, "oh but it's the NYtimes!"  blah blah blah.

 

Clip from the article:  

Eight-year-old Blake Collie was at the swimming pool when he got a frightening headache. His parents rushed him to the emergency room only to learn he had a brain aneurysm. Blake spent nearly two months in the hospital. 

His family did not have traditional health insurance. “We could not afford it,” said his father, Mark Collie, a freelance photographer in Washington, N.C. 

Instead, they pay about $530 a month through a Christian health care sharing organization to pay members’ medical bills. But the group capped payments for members at $250,000, almost certainly far less than the final tally of Blake’s mounting medical bills. 

“Just trust God,” the nonprofit group, Samaritan Ministries, in Peoria, Ill., said in a statement about its coverage, and advises its members that “there is no coverage, no guarantee of payment.”

 

 

 

Read the article for the rest.  Like I said..........good luck with this NON-INSURANCE.

 

I'm glad some of you think that faith based insurance works for you, but it is a 1 way ticket to bankruptcy for any family who gets truly sick. Not just some random ER visit.

 

 

 

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On 5/26/2021 at 10:10 AM, rev ronin said:

Faith based medical cost sharing--no preventative anything, $1m cap, no preexisting conditions covered, no mental health coverage, $400 per incident responsibility before sharing, up to 100% covered after that... $530/month for a family of 3.

No pre-existing coverage is a non-starter. I would expect that from insurance companies (until they were forced to cover it by the ACA) but from faith-based "insurance"? I mean correct me if I'm wrong, but I thought Jesus healed the sick. If my wife has Crohn's disease and I have hypertension and high cholesterol even though we don't smoke/drink/etc. then we are not eligible? Or are we eligible but it won't cover an eventual bowel obstruction or fistula or heart attack?

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Yep, it's the NYT.  They love the idea of government-run healthcare for all, and aren't shy about it at all. Which is fine, but it's just one perspective. There's two sides to every story, and the family shared theirs publicly.  Google "Blake Collie Samaritan" and it's the first result:

https://samaritanministries.org/blog/samaritan-member-responds-to-negative-new-york-times-article

Hi, Reed,

Congrats on what seems to have been a very popular article. I’m only sorry that you earned that popularity at our cost. 

Imagine your closest, most loved family member or friend suddenly getting hit by a bus and ending up on life support in ICU. Imagine the reality of the doctors telling you that your loved-one had a high probability of not making it. That was our reality on Sept 1. 2019.

Yet, we chose to hope. And along with a superb medical team, community, wonderful friends and family we are overjoyed to have a son who is alive and a joy to our family.

We also chose to hope when you contacted us, Reed. We hoped that this might be an opportunity for people to see the goodness and beauty that has come out of a very hard place. Unfortunately, you had a political statement to make and you used our story and our family to make that statement. 

I expressly asked that should our likeness be used in your article that it be made clear that we have had nothing but exemplary service from Samaritan. You did not honor that request.

We continue to hope, Reed. That even from this article that has caused hurt to our family (and others) and further polarity on the issues being addressed that good will come. We continue to hope that instead of becoming a more polarized nation we can start moving towards each other and engaging in meaningful and respectful conversations about these issues. 

We hope that you will think about this and we hope that you will approach your next article differently.

All the best,

Mark

-------

The response leaves something to be desired, as it really doesn't explain what the end of the story was, but it does take the NYT to task.


If you want $1m in sharing (coverage) from Samaritan, it's an extra $30/month or so.  If you want $250k, that's what the basic monthly share is set at.  It's not insurance, big deal: it's a covenant between members to send money directly to each other to cover verified bills for covered medical costs.  Insurance is looking for all sorts of reasons to deny care for profit motive; faith based cost sharing systems don't restrict care on the basis of procedure.  One of my biggest gripes with Samaritan is that they'll share Naturopath care as if it were actual medical care... but then, so do most insurance plans, unfortunately, and in the case of Samaritan, such decisions are made by a mostly-member-elected (the founder gets a seat for life, and the right to appoint two more directors. Oh, and you have to subscribe to a literal six-day young-earth creation to run) board of directors.  So it's far from perfect, but it's better than insurance in many key aspects.  Again, our experience is 3 ER visits, net $0 out of pocket, and we've probably sent others a net $6-8k over the shares sent to us over the past 3 years.

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