What happens if we don't buy health insurance?

[Moxie]

Every time I think about this, I get stabby.

 

If $1500/month is the cheapest we can get (still waiting on one quote) for really crappy coverage, I'm not sure I'm willing to do it. We can afford it (barely) but it would mean no savings, no college funded for a year, no car for a 16yo, etc. It pisses me off. It is legalized theft.

 

Please don't try to sell me on your sharing ministry because it won't work for our family.

 

How much is the fine? And who do I write to to complain?

Edited November 26, 2016 by Moxie

[Spryte]

I don't know the answer to your questions, just wanted to say I'm sorry. This stinks.

[Lady Marmalade]

$695 per adult, $347.50 per child, maximum of $2085 per family.

 

OR 

 

2.5% of income- maximum there is the yearly fee for a national average price of a bronze marketplace plan.

 

You pay whichever of those options is HIGHER.

 

That is, of course, provided your income is enough that they think you can afford healthcare- there is a minimum income to meet in order to get fined.  I want to say it's around $20,000 for a married filing jointly couple, but I'm not sure on that.

 

The fee comes out of your tax return automatically, and if you don't have enough to cover coming back, it will come out of subsequent years.  The plus side is that unlike other fees, there is no provision for the government to collect the fine other than thru the tax refund.  So while future refunds may be at stake, you won't get fined in other ways or have your income garnished.

 

We do not have health insurance, and have paid the fines so far.  It sucked last year to not get a refund, and it will suck again, but I'm hopeful that something is going to be done to fix the healthcare mess eventually.  In the meantime, we are healthy and I already pay out of pocket for any healthcare expenses.  We don't do well-child visits- we only go if necessary.  Our average medical expenses per year for our family are around $500.  I can't even buy one month of health insurance for that.  So we pay the fine and wait for something that makes sense for our family.  

[xixstar]

What happens if you don't? One small moment can bankrupt your family. Be it a new diagnosis or an accident.

 

That is close to our monthly premiums which sucks for sure but we cannot do without. The fine is a joke, the fine is not why we can't have insurance. Life happening is why we cannot have it.

 

I sure don't like it but it is what it is.

[kroe1]

Legalized robbery....amen, sister.

[Guest]

What happens if you don't? One small moment can bankrupt your family. Be it a new diagnosis or an accident.

 

That is close to our monthly premiums which sucks for sure but we cannot do without. The fine is a joke, the fine is not why we can't have insurance. Life happening is why we cannot have it.

 

I sure don't like it but it is what it is.

I agree it is a HUGE risk. We've always sucked it up and paid what we have to. But at what point do I say "enough!"?? A quarter of our income? Half? I know of no other way to register my extreme dissatisfaction with this theft. Maybe DH should quit working 60 hours a week and get a minimum wage job so the taxpayers pay for our insurance? Why work so hard if I'm forced to give it all away??

[OneStepAtATime]

No answers, just  :grouphug:

[TranquilMind]

Every time I think about this, I get stabby.

 

If $1500/month is the cheapest we can get (still waiting on one quote) for really crappy coverage, I'm not sure I'm willing to do it. We can afford it (barely) but it would mean no savings, no college funded for a year, no car for a 16yo, etc. It pisses me off. It is legalized theft.

 

Please don't try to sell me on your sharing ministry because it won't work for our family.

 

How much is the fine? And who do I write to to complain?

Fines.  They escalate every year and I think the full fine has kicked in this year.  For 2016, the fee is $695 or 2.5% of your income — whichever is higher. (and you will do 2016 taxes after the first of the year, so that's for this year). 

So, for example, it will be $2,500 if you make $100,000 per year (unless some members are insured and some not, and the calculation changes a little). 

 

It’s either a percentage of your annual household income or a set amount for each person in your household who doesn’t have health insurance. When you file your federal income taxes, if you’re uninsured for more than 3 months despite having access to affordable coverage, you’ll be required to pay whichever amount is higher. Learn how to estimate the fee you’ll have to pay if you don’t have health insurance based on your situation.

 

I hope Trump eliminates this tax on poor people. 

 

 

https://www.healthcare.gov/blog/the-fee-for-not-having-health-insurance-2016/

Edited November 26, 2016 by TranquilMind

[Rachel]

My FIL has chosen to pay the fine, he does have the VA for some health care needs.

 

Last January he avoided the doctor over minor symptoms which turned into a severe kidney infection and an overnight in the hospital. Total cost was around $3000 which was still cheaper than health insurance. There was a cash discount for not having insurance. My inlaws do have an HSA which they used to pay.

[Matryoshka]

What happens if you don't? One small moment can bankrupt your family. Be it a new diagnosis or an accident.

 

...

I sure don't like it but it is what it is.

 

This.  We must be a bad-luck family, but we've needed so much health care this year, even the high-deductible plan has more than paid for itself.

 

Just in the past few months, one dd was diagnosed with a 15-cm cyst in her abdomen and needed surgery (no symptoms before then except a bit of a tummy pooch), and a second dd recently out of completely nowhere had two small pinpricks on her foot (while her shoe was on!) which turned rapidly into a very aggressive cellultis requiring 2 ER visits and an admit for a full day of IV antibiotics.  The follow-up antibiotics were relatively cheap, but...  And third dd has a chronic health condition that requires ongoing care, and also recently totalled her car which thanks to aribags and crumple frames did not give her any injury, but those things do happen and if things had been even a bit different there could have been crippling bills.

 

The whole situation with health care and insurance in this country totally sucks.

Edited November 26, 2016 by Matryoshka

[JanetC]

And who do I write to to complain?

Your state insurance commissioner would be the one to complain to.

[Guest]

Agree with complaining to the state insurance commissioner.  

I live in a state that had a terrible commissioner for a lot of years, and it was nigh impossible to get non-work-sponsored health insurance.  A few years with a better commissioner got us some choices.  But it is illegal in our state to get insurance from another state...if we could do that, we could cut our bill in half.  

 

As it is, we went with a high deductible (like $10,000 per person per year) for catastrophic coverage.  I came close to topping it out the year I had a cancer removed from my nose and all the plastic surgery...  When we started 7 years ago, this was $475 per month for three of us.  It's now $732 per month for the three of us because the state passed laws mandating coverage for a couple of health care items that we don't use....  Ugh.  And if I could buy out of state, I could take it down to about $450 per month.  Bleah.

 

I'm not willing to go without catastrophic insurance, but I have never gotten the benefit of it, thank God.  We have priced it out every year since ACA came into being and we are still ahead with what we have.  In a year, my dh will go on Medicare, and I will in 4 more, and that same year, my son will not be coverable by us (I hope he is launched before then anyway)...so the costs will go down.  Maybe.  

 

ETA:  I am with you on how expensive this is...and I'm sorry.  Even with the high deductible, meaning lower payment, healthcare is our single biggest expense...even more than our property taxes.  That's saying a lot in this State.  

 

[StephanieZ]

FYI, I believe you are exempt from the fines if the final to-you-after-credits/subsidies cost of insurance (through your employer AND the marketplace) is above a threshold %age (8.13 or 9.5 or somethings like that) of your income. 

 

https://www.healthcare.gov/health-coverage-exemptions/forms-how-to-apply/

 

http://obamacarefacts.com/obamacare-mandate-exemption-penalty/

 

My guess is that the exemption is based on your personal (adult) premium, so you can still get screwed if you can't afford family insurance but could theoretically afford it for the adult(s). 

 

I'm sure there are better websites out there that explain these issues, but these are the first two I found. If you can't afford insurance, then, for sure, google up the alternatives to getting out of the fee if at all possible. 

 

 

[Liz CA]

How do they determine who has insurance? It is self-reporting?

Those who are doing the health share options are exempt from the fine but have to prove somehow they have some type of coverage?

[SparklyUnicorn]

How do they determine who has insurance? It is self-reporting?

Those who are doing the health share options are exempt from the fine but have to prove somehow they have some type of coverage?

 

If you have it through an employer, they report that to the IRS.  If not, you get a certificate or whatever it is called from the insurance company that you then send to the IRS. 

[Mama Geek]

What happens if you don't? One small moment can bankrupt your family. Be it a new diagnosis or an accident.

 

That is close to our monthly premiums which sucks for sure but we cannot do without. The fine is a joke, the fine is not why we can't have insurance. Life happening is why we cannot have it.

 

I sure don't like it but it is what it is.

This can and does happen even if you do have insurance.

[Selkie]

If you have it through an employer, they report that to the IRS.  If not, you get a certificate or whatever it is called from the insurance company that you then send to the IRS. 

 

Yeah, we're employers and we have to do reams and reams of paperwork each year to prove to the IRS that our employees have insurance.

[Crimson Wife]

Have you looked at all your healthshare options? Maybe there's one of them that you can live with.

 

ETA: According to this article, Liberty does not require members to be practicing Christians: http://selfpaypatient.com/2013/10/23/liberty-healthshare-a-health-sharing-ministry-for-all-faiths-or-no-faith-at-all/

Edited November 26, 2016 by Crimson Wife

[VaKim]

This can and does happen even if you do have insurance.

 

Yep. My in-laws have always had insurance, but had to file bankruptcy twice over the years due to medical bills. It is crazy. 

 

We just pay the fine. It is still half the price that the cheapest insurance would be, which comes with a ridiculously high deductible and would then only cover 60%. I had ovarian cancer and had to have surgery 5 years ago. I was given a 60% "discount" due to not having insurance. The amount I was left with, after surgery and a week in the hospital, was less than the deductible on the cheapest insurance. 

[JumpyTheFrog]

Maybe it would work out to not have everyone on the same plan. Perhaps some of you could go on a health share or a short-term policy while others get a regular policy?

[JumpyTheFrog]

The link to the article about Liberty mentioned another health sharing ministry I wasn't aware of. Altrua says you can be a member based on living various biblical principles, regardless of belief. I am going to look more into them.

[Reefgazer]

If you are really not going to buy insurance and need your refund, adjust your withholding so that you get the money during the year and not as a refund, so there is nothing for ht egovernment to take.

 

 

$695 per adult, $347.50 per child, maximum of $2085 per family.

 

OR

 

2.5% of income- maximum there is the yearly fee for a national average price of a bronze marketplace plan.

 

You pay whichever of those options is HIGHER.

 

That is, of course, provided your income is enough that they think you can afford healthcare- there is a minimum income to meet in order to get fined. I want to say it's around $20,000 for a married filing jointly couple, but I'm not sure on that.

 

The fee comes out of your tax return automatically, and if you don't have enough to cover coming back, it will come out of subsequent years. The plus side is that unlike other fees, there is no provision for the government to collect the fine other than thru the tax refund. So while future refunds may be at stake, you won't get fined in other ways or have your income garnished.

 

We do not have health insurance, and have paid the fines so far. It sucked last year to not get a refund, and it will suck again, but I'm hopeful that something is going to be done to fix the healthcare mess eventually. In the meantime, we are healthy and I already pay out of pocket for any healthcare expenses. We don't do well-child visits- we only go if necessary. Our average medical expenses per year for our family are around $500. I can't even buy one month of health insurance for that. So we pay the fine and wait for something that makes sense for our family.

[Guest]

If you are really not going to buy insurance and need your refund, adjust your withholding so that you get the money during the year and not as a refund, so there is nothing for ht egovernment to take.

 

 

 

Bwahahaha!! We're self-employed. We write several fat tax checks every year.

[Amy in NH]

Our penalty is the same as the cheapest bronze plan. But it has a $6000 pp deductible, so we can't afford to use it. If I saved the premium amount we could actually go to the doctor on a sliding scale.

 

I am having a medical problem right now for which I really need a prescription drug, but can't afford to go.

[Scarlett]

Well I am right there with you not knowing what to do. Dh is currently unemployed......but working remodels ect to pay the bills. First of the year I start working a bit more.....and with that extra....and some guess of what Dh might make....,,,it shows we get a full subsidy.......toward a 1116 premium for Dh and me. What if Dh makes more than we expect? We end up paying back the subsidy.....in which case I definitely Italy would just go with paying the fine rather than paying $1116 fr insurance each month.

 

Right now he is trying to get a job and praying hard for one with benefits.

[Georgiana Daniels]

They---whoever THEY may be---should be embarrassed to even print those high premium/high deductibles. Who the crap do they think can reasonably afford that?

 

Anyhoo, it stinks that people are in this situation. But man, insurance is so necessary. Even though we will hopefully never meet our deductible, insurance at least negotiates down the cost of care so that the part we are left to pay is less than someone who has to pay OOP. We are now a reasonably  healthy family, but a few weeks ago our middle daughter had to go to the ER to get something removed from her eye. Still waiting for---and dreading---the bill.

[frogger]

They---whoever THEY may be---should be embarrassed to even print those high premium/high deductibles. Who the crap do they think can reasonably afford that?

 

Anyhoo, it stinks that people are in this situation. But man, insurance is so necessary. Even though we will hopefully never meet our deductible, insurance at least negotiates down the cost of care so that the part we are left to pay is less than someone who has to pay OOP. We are now a reasonably  healthy family, but a few weeks ago our middle daughter had to go to the ER to get something removed from her eye. Still waiting for---and dreading---the bill.

 

 

I always use the high deductible plan.  We are middle class. We cannot even put the entire amount of a regular premium for low deductible plan. But we put in slightly less (than what our premium would be under a regular plan) into our Health Savings Account plus the company we buy through (not our employer but Blue Cross) puts in a percentage of our premium. So for less than the  amount of a regular premium we have over the years (though we have had to use it and have had to use the entire deductible at times) still managed to save enough in our HSA to cover the deductible if we were suddenly to get cancer or something.

Edited November 27, 2016 by frogger

[Jean in Newcastle]

I always use the high deductible plan.  We are middle class. We cannot even put the entire amount of a regular premium for low deductible plan. But we put in slightly less (than what our premium would be under a regular plan) into our Health Savings Account plus the company we buy through (not our employer but Blue Cross) puts in a percentage of our premium. So for less than the  amount of a regular premium we have over the years (though we have had to use it and have had to use the entire deductible at times) still managed to save enough in our HSA to cover the deductible if we were suddenly to get cancer or something. I think Americans just completely fail at math or completely refuse to save. I'm not sure which.

 

Edited to add that I suppose I should be kinder to Americans. It took us hours and hours of looking through health plans, seeing if the company paid into the plan (this isn't always on the first page), and seeing what percentage is paid after the deductible is met which is almost always better with the high deductible plans I have looked at. In other words once you have to have million dollar treatment you are likely to pay less on a high deductible plan.  I suppose not everyone is going to be able to sort that out. Like taxes, it should all be greatly simplified. 

 

It's not that simple.  I had a wonderful HSA with a high deductible plan.  The govt. took it away and there is nothing available here in this area even remotely comparable.  I can do the math just fine. 

[frogger]

It's not that simple.  I had a wonderful HSA with a high deductible plan.  The govt. took it away and there is nothing available here in this area even remotely comparable.  I can do the math just fine. 

 

 

Obviously you could do the math but the idea that no one should ever offer HDHPs because people can't afford it is what is irritating to me and yes, I understand completely the frustration of the government taking away the option. There has been a lot of that going on. Taking it away is politically viable only because others  consider high deductible plans bad. That is what makes me annoyed. 

Edited November 27, 2016 by frogger

[Guest]

It's not that simple. I had a wonderful HSA with a high deductible plan. The govt. took it away and there is nothing available here in this area even remotely comparable. I can do the math just fine.

Our high deductible plan and HSA were awesome before the ACA killed it, too. Grrr...

[Georgiana Daniels]

Our high deductible plan and HSA were awesome before the ACA killed it, too. Grrr...

Ours was too. But sadly our deductible went up and the coverage went down. It used to be that with or catastrophic plan we would be covered at 100% once our deductible was met, now only 80%. If you have a catastrophic medical condition like our son-on-law had, picking up that 20% equates to financial ruin.

[frogger]

If you are really not going to buy insurance and need your refund, adjust your withholding so that you get the money during the year and not as a refund, so there is nothing for ht egovernment to take.

 

 

 

 

Can you really do this? Won't they just send you a bill? Genuinely curious. We once were fined for not withholding enough. We paid well before tax returns were due and we had withheld some but not enough in their eyes so they fined us an extra $500. 

[creekland]

They---whoever THEY may be---should be embarrassed to even print those high premium/high deductibles. Who the crap do they think can reasonably afford that?

 

Anyhoo, it stinks that people are in this situation. But man, insurance is so necessary. Even though we will hopefully never meet our deductible, insurance at least negotiates down the cost of care so that the part we are left to pay is less than someone who has to pay OOP. We are now a reasonably  healthy family, but a few weeks ago our middle daughter had to go to the ER to get something removed from her eye. Still waiting for---and dreading---the bill.

 

Considering "they" are making millions of dollars per year, I'm sure these plans seem cheap to them.  Besides, "they" certainly can't live on less than millions, so this is what the price needs to be.   :glare:

 

 

Can you really do this? Won't they just send you a bill? Genuinely curious. We once were fined for not withholding enough. We paid well before tax returns were due and we had withheld some but not enough in their eyes so they fined us an extra $500. 

 

Similar situation with us.  Hubby underestimated one year - and made sure not to do it again.

[xixstar]

Ours was too. But sadly our deductible went up and the coverage went down. It used to be that with or catastrophic plan we would be covered at 100% once our deductible was met, now only 80%. If you have a catastrophic medical condition like our son-on-law had, picking up that 20% equates to financial ruin.

Pardon if this sounds ignorant, but don't most of these plans also have a set out-of-pocket (OOP) maximum? Our old plan had a max OOP just slightly above the deductible which was reassuring. This year the deductible is much higher, the insurance is covering 10% less and the max OOP significantly higher than our deductible. But I still factor on that OOP to be the most I would spend in a year and use that to compare plans and establish HSA contributions. I really hope I am correct. It is my understanding that once I have spent the OOP that insurance will then cover 100%.

[SparklyUnicorn]

Pardon if this sounds ignorant, but don't most of these plans also have a set out-of-pocket (OOP) maximum? Our old plan had a max OOP just slightly above the deductible which was reassuring. This year the deductible is much higher, the insurance is covering 10% less and the max OOP significantly higher than our deductible. But I still factor on that OOP to be the most I would spend in a year and use that to compare plans and establish HSA contributions. I really hope I am correct. It is my understanding that once I have spent the OOP that insurance will then cover 100%.

 

This is somewhat misleading because often times not everything counts towards the OOP.  Which basically means the OOP could be much higher than they say.

[Matryoshka]

Our high deductible plan and HSA were awesome before the ACA killed it, too. Grrr...

??? We never had a high deductible plan and HSA till after ACA, so I was under the impression that ACA had created the HSA idea.

 

Before ACA, we only had that kind of plan where you have to guess how much money to put into it and then if you don't use it you lose it at the end of the year. Now we can put in as much as we want because it carries over from year to year.

[SparklyUnicorn]

??? We never had a high deductible plan and HSA till after ACA, so I was under the impression that ACA had created the HSA idea.

 

Before ACA, we only had that kind of plan where you have to guess how much money to put into it and then if you don't use it you lose it at the end of the year. Now we can put in as much as we want because it carries over from year to year.

 

Reimbursement accounts.  They still have those.  Which are kinda stupid.  You do get a tax break, but unless you know you will spend the money....  And they used to allow one to count OTC stuff towards that.  Nope, not anymore. 

 

This year we did put some money into it because I am having dental work, but otherwise, we usually don't.  I think it's very bizarre that they can take your money.  It's like one might as well go to the casino. 

[SparklyUnicorn]

Looking at our plan regarding the OOP max.  Deductibles don't count towards this.  Copayments don't (and even routine has a copayment).  Also, nothing paid via pharmacy counts. 

 

Oddly these details are not emphasized.  I remember when we were looking at the HSAs years ago and the "spiel" during benefit selection time was hey look you'll only ever have to spend XYZ in the worst case scenario situation.  EH...wrong.  This is not the full honest truth.  The super high deductible did not count towards that.  Some other things did not count towards that.

 

Insurance is a total racket. 

 

 

[Lady Marmalade]

Can you really do this? Won't they just send you a bill? Genuinely curious. We once were fined for not withholding enough. We paid well before tax returns were due and we had withheld some but not enough in their eyes so they fined us an extra $500. 

 

Oh, they'll probably send you bills in the mail.  Likely get a phone call or two.  But really, of all the things that they left out of the ACA, this is one of them.  There is no provision for actually going after the penalty fine if it doesn't get paid.  They cannot send the amount due to collections and they cannot put a lien on anything.  It comes out of your tax refund and that's the only way you pay the penalty other than sending in a check yourself. 

 

Most years our refund amount has averaged between 2,000 and 3,000.  We have been thinking about adjusting our withholding just a smidge, but I don't want to end up owing taxes.  I am not sure if that might be THEIR loophole for going after the penalty amount.  Say we ended up owing $400 when all was said and done.  Then add the penalty of $2,085 to it and we're getting a bill for $2,485, some of which actually IS taxes we owe.  I'm not sure it gets broken down in that case, and I'm not so sure I want to find out. 

[Guest]

??? We never had a high deductible plan and HSA till after ACA, so I was under the impression that ACA had created the HSA idea.

 

Before ACA, we only had that kind of plan where you have to guess how much money to put into it and then if you don't use it you lose it at the end of the year. Now we can put in as much as we want because it carries over from year to year.

No, you used to be able to get affordable plans with much higher deductibles, like $20,000. But the plans were only a few hundred dollars a month so you could afford to save in an HSA. The plan I'm looking at for next year has a $6000 deductible but it costs $1500/month so there is nothing left to save. Freaking sucks.

[historically accurate]

If you are really not going to buy insurance and need your refund, adjust your withholding so that you get the money during the year and not as a refund, so there is nothing for ht egovernment to take.

 

 

 

I recommend the calculator at paycheckcity.com if you want to come out close to $0 for the year. I think they call it the W4 assistant. It works best if you have a steady pay of course.

 

 

This is somewhat misleading because often times not everything counts towards the OOP.  Which basically means the OOP could be much higher than they say.

 

This is how ours works. So far, most of my dd's stuff has not counted toward the OOP. Co-pays do not, so if you visit the doctor for a standard appointment, that $35 or $50 doesn't count. Her back brace didn't count, but her crutches did when she needed those. Weirdly, this was one of our biggest medical years in a while, and we haven't even reached the deductible amount.

 

Reimbursement accounts.  They still have those.  Which are kinda stupid.  You do get a tax break, but unless you know you will spend the money....  And they used to allow one to count OTC stuff towards that.  Nope, not anymore. 

 

This year we did put some money into it because I am having dental work, but otherwise, we usually don't.  I think it's very bizarre that they can take your money.  It's like one might as well go to the casino. 

 

We use this since we do not have an HSA. It works great for us since we've been paying for braces for 2+ years, and will be paying for about 4 more. It would be hard to estimate if I didn't have that set payment already.

[Matryoshka]

Reimbursement accounts. They still have those. Which are kinda stupid. You do get a tax break, but unless you know you will spend the money.... And they used to allow one to count OTC stuff towards that. Nope, not anymore.

 

This year we did put some money into it because I am having dental work, but otherwise, we usually don't. I think it's very bizarre that they can take your money. It's like one might as well go to the casino.

Still confused... the kind where they take your money at the end of the year is what you now have, and they took the other kind away? Because for us it went in the other direction. We theoretically can use it for anything health related including shopping for band-aids at CVS...

 

The other kind was really stupid. I was always afraid to put too much into it and we still had co-pays then so I'd forget to use it for the co-pay at the doctor's office. I like this one now - we can keep the money in there as long as we want if we don't use it this year... If we don't spend it all, thinking of using it for medical bills after we we're retired especially if Medicare goes poof...

[SparklyUnicorn]

Oh, they'll probably send you bills in the mail.  Likely get a phone call or two.  But really, of all the things that they left out of the ACA, this is one of them.  There is no provision for actually going after the penalty fine if it doesn't get paid.  They cannot send the amount due to collections and they cannot put a lien on anything.  It comes out of your tax refund and that's the only way you pay the penalty other than sending in a check yourself. 

 

Most years our refund amount has averaged between 2,000 and 3,000.  We have been thinking about adjusting our withholding just a smidge, but I don't want to end up owing taxes.  I am not sure if that might be THEIR loophole for going after the penalty amount.  Say we ended up owing $400 when all was said and done.  Then add the penalty of $2,085 to it and we're getting a bill for $2,485, some of which actually IS taxes we owe.  I'm not sure it gets broken down in that case, and I'm not so sure I want to find out. 

 

This would be much harder to control in Moxie's case though because they have to send in payments otherwise they could be penalized. 

 

I adjust mine down as low as I can manage it (this is federal only, there is no way to do this with state).  We usually get about $150 back for federal. 

[QueenCat]

Our penalty is the same as the cheapest bronze plan. But it has a $6000 pp deductible, so we can't afford to use it. If I saved the premium amount we could actually go to the doctor on a sliding scale.

 

I am having a medical problem right now for which I really need a prescription drug, but can't afford to go.

 

Isn't there a either or on the deductible, with both an pp deductible but if you hit the family deductible than all individuals are considered to have met theirs? That's how my sister's bronze works. She gave me the impression that all market place plans had to have a cap of no more than "x" amount for the family, even if there was also a pp.

[SparklyUnicorn]

Still confused... the kind where they take your money at the end of the year is what you now have, and they took the other kind away? Because for us it went in the other direction. We theoretically can use it for anything health related including shopping for band-aids at CVS...

 

The other kind was really stupid. I was always afraid to put too much into it and we still had co-pays then so I'd forget to use it for the co-pay at the doctor's office. I like this one now - we can keep the money in there as long as we want if we don't use it this year... If we don't spend it all, thinking of using it for medical bills after we we're retired especially if Medicare goes poof...

 

No there are HSAs and Reimbursement Accounts. HSA is the one where you can carry over what you put into it.  There is no losing money.  But the other type you can put money in once per year (up to a certain amount) and you can use it for specific medical/dental/vision expenses.  If you don't use it all, you lose it.

 

We had an HSA years ago.  The employer now does not offer such a thing.  The insurance they offer though really cannot be beat.  I have no complaints after hearing about some of the crap plans here. 

[QueenCat]

Looking at our plan regarding the OOP max.  Deductibles don't count towards this.  Copayments don't (and even routine has a copayment).  Also, nothing paid via pharmacy counts. 

 

Oddly these details are not emphasized.  I remember when we were looking at the HSAs years ago and the "spiel" during benefit selection time was hey look you'll only ever have to spend XYZ in the worst case scenario situation.  EH...wrong.  This is not the full honest truth.  The super high deductible did not count towards that.  Some other things did not count towards that.

 

Insurance is a total racket. 

 

Ouch! Our deductible does count toward our OOP max. That'd make me crazy if it didn't. I actually met my pp deductible early in the year, which helped us meet our family deductible pretty early too since the family deductible wasn't much higher than the pp one. I met my OOP max shortly after. Rest of the family hasn't but since deductible's been met, they aren't paying much for anything right now. I'm trying to get what we can done before the end of the year but there isn't much since most of it is predictable and regular. And we can certainly use our HSA for things that go towards the deductible. Since we always meet our deductible, we do that amount plus what we regularly do each year in the HSA.

[SparklyUnicorn]

Ouch! Our deductible does count toward our OOP max. That'd make me crazy if it didn't. I actually met my pp deductible early in the year, which helped us meet our family deductible pretty early too since the family deductible wasn't much higher than the pp one. I met my OOP max shortly after. Rest of the family hasn't but since deductible's been met, they aren't paying much for anything right now. I'm trying to get what we can done before the end of the year but there isn't much since most of it is predictable and regular. And we can certainly use our HSA for things that go towards the deductible. Since we always meet our deductible, we do that amount plus what we regularly do each year in the HSA.

 

Yeah I cannot complain though.   Our deductible is only $500 pp.  Family is $1500 (we have a family of 4).  BUT I have had plans with MUCH MUCH higher deductibles that did not count towards the OOP max. 

 

The company DH works for is self insured.  That basically means they pay insurance companies to administer services (and for the benefit of using their contracts), but they pay all bills from their own pot of money.  I don't know how much this saves them, but I suspect it is one reason they can keep costs fairly low for their employees. 

[QueenCat]

Yeah I cannot complain though.   Our deductible is only $500 pp.  Family is $1500 (we have a family of 4).  BUT I have had plans with MUCH MUCH higher deductibles that did not count towards the OOP max. 

 

The company DH works for is self insured.  That basically means they pay insurance companies to administer services (and for the benefit of using their contracts), but they pay all bills from their own pot of money.  I don't know how much this saves them, but I suspect it is one reason they can keep costs fairly low for their employees. 

 

DH used to work for a company that was self insured. They did it the same way, using the insurance company to administer services. From what I understand, this works best with bigger companies.

[Mimm]

The link to the article about Liberty mentioned another health sharing ministry I wasn't aware of. Altrua says you can be a member based on living various biblical principles, regardless of belief. I am going to look more into them.

 

What "biblical principles" do you have to live by exactly?

[historically accurate]

What "biblical principles" do you have to live by exactly?

 

 

You can download the membership rules on this page. http://altruahealthshare.org/guidelines/ 

 

But I think this sums up the principles http://altruahealthshare.org/become-a-member/:

 

Anyone who meets the Statement of Standards

• Caring for one another.
• Keeping the body clean and healthy with proper nutrition.
• The use of any form of tobacco, illicit drugs and excessive alcohol consumption is harmful to the body and soul.
• According to the Word of God, sexual relations outside the bond of marriage is morally wrong. Marriage is a bond between a man and woman only.
• Abortion is wrong, except in a life threatening situation to the mother.
• Physical, mental or emotional abuse of any kind to a family member or anyone else is morally wrong.

NOTE: Some individuals may not be eligible or have a membership limitation due to certain past or present medical conditions.