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Health Insurance

BigLarry Posts: 86Subscriber
edited July 2014 in Low Content Forum
Hey Everyone,

Just wondering what some full-time grinders suggest at far as health insurance. I lived in Vegas and was grinding for 2 and 1/2 years with no Insurance between July 2008 and November 2010. The majority of guys I met during this period who played full-time had no insurance (a few had "catastrophe insurance") plans. Now I have a job and a HI plan and grind 2-5 part-time 60-80 hours per month but my recent dedication to study, improving my overall game and plugging up some life-leaks that hurt my overall success when I was playing full-time has improved my win-rate and increased my bankroll to the point when I am considering playing full-time again in the future. I just refuse to go at it again without insurance. Any advice appreciated!

Larry
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Comments

  • AdministratorAdministrator Posts: 747Administrator
    "catastrophe insurance" with low monthly premiums to cover you in the event of a major issue, assuming you have no recurring health issues, is probably a pretty good way to go.

    I have an HSA through my company that allows me to put tax-exempt money into a special health savings account in conjunction with a high deductible plan.
  • ThehammahThehammah Posts: 7,086Subscriber
    Most companies will be required to let you buy the same insurance you have for up to 18 months via cobra.. It will be alot more expensive but I would NOT buy just catastrophic insurance. There are plenty of other health issues that could bankrupt you .. even say minor knee surgery could cost 10s of 1000s of dollars..

    I always laugh/cry at "pros" but they live at home and dont have insurance.. as you get older insurance will get more exp so better to keep yourself healthy while you are young and get insurance where you can go to the dr when you need to. Get the type of tests to catch things early.

    good for you for wanting to make sure this is taken care of before you go pro!

    ww
  • BartBart Posts: 5,920AdministratorLeadPro
    edited July 2014
    COBRA will cost you 102% of the actual premium and will be good for 18 months federally and in some states, like California, there is an optional 18 month extension. Depending on your life situation it could be worth it for you to pay higher premiums on COBRA for better coverage with lower deductibles or ditch it and buy individual coverage through Obama care or a state exchange. 10 years ago when I came out of college COBRA ran me $375 a month for a single, healthy 23 year old. This was off of my parents family plan that still covered me while I was in college. Instead I bought a $76 a month plan through Health Net in California where I had to pay my first $5000 worth of medical bills. I didn't go to the doctor 1 time in 3 years. Seemed extremely +ev to go with the lower premium higher deductible plan.

    If you have a family or are thinking about having kids in the next 18 months COBRA might very well be a better choice. If you are a successfully poker player you are going to be able to make a better decision than 99.99% of the general population.

    Bronze individual Health Net PPO plans in California start at $246 per month I think with a $2500 deductible (pay first $2500 of care past visits) and you get 4 doctors visits for free. You can get it down in the low 2s if you do an HMO. This is for California for me in my mid 30s. I'm sure it is much cheaper in Nevada. Basically all of us that played ball and paid into the system are now getting screwed as our premiums have gone up by as much as 50% to pay for the lack of underwriting that goes on now. America at its finest.

    Bart
  • UntreatableFPS Posts: 1,004Subscriber
    I thought bronze was around 5k deductible. And it's silver in the 2500 range

    That being said, I find bronze to be the best practical value
  • BugsyBugsy Posts: 40Subscriber
    BigLarry,
    FYI, Nevada uses their own state exchange which if it's anything like Minnesota's (where I'm from originally), it will be a good choice for you if you decide not to go the Cobra route. In Minnesota you get a lot for what you pay for. Nevada? I don't know from experience but again, I'm sure it's easier to deal with than the "marketplace", healthcare.gov - obamacare. Important note: Larry if you become full time Pro, one thing I've learned from being self-employed most of my life, before Obamacare days and now, shop! Research it. Your options are much different than dealing with a job offering you health insurance. So be thorough.
  • FreeLunch Posts: 1,309Pro
    You need to look at the coinsurance. Most bronze and silver plans are really crap and have coinsurance as high as 40% wih 12k out of pocket. So any care over 30K problem costs you 12k a year on top of your insurance costs. These plans provide most people with limited savings very little protection from real catastrophic expenses.
  • BartBart Posts: 5,920AdministratorLeadPro
    edited July 2014
    In the end the system is rigged. All insurance is -EV. But you really are forced to have health insurance in our country not because of the expense of a catastrophic loss but because the insurance companies prenegotiate rates for services with carriers that can be as much as 5 times less as paying for those services in cash.

    I just checked my plan and Claire is correct my deductible is $5000. I pay $233 per month as a non smoking healthy 34 yer old male. My out of pocket maximum in network is $6250 out of network is $12,700. I get 4 doctors office visits for preventive care and physicals for a $60 co payment. If you aren't familiar with the terminology basically look at it as me paying $233 a month and I have to pay for my first $5000 in medical expenses (surgeries, tests, etc). If some thing out of the box happens I may have to pay for my first $6250 but as long as I stay within my network of providers it stays capped at $6250.

    @Hyena--I totally disagree with you. Choosing an individual health plan is entirely a cost benefit analysis. You can go on a Gold or Platinum plan in my situation and pay an additional $300-$400 per month and have a deductible of $0. But why would I want to do that if I have a healthy history? Seems like just throwing money away.

    And the reason why I thought the Bronze was $2500 before was because before The Affordable Health Care Act it was. I use to pay $187 per month with a $2500 deductible with actually the same network with HealthNet PPO in California through their individual plan. The only thing you didn't get were those doctor's visits. They ended that plan (which was part of the huge controversy at the end of last year) because the plan didn't meet up to the governments standards (the free office visits) and this Bronze plan is the next closest thing. Any bleeding heart liberal here want to tell me that I am better off? Or that I owe something to the people with pre existing conditions when I have been paying into the system all along since I was 23?

    Simple fact of the matter is for healthy people that already had individual insurance Obama Care drastically increased their premiums and decreased their benefits. On an individual and family level. I think our system is screwed up and I don't morally object to a system of universal healthcare but this particular path really sucked.
  • UntreatableFPS Posts: 1,004Subscriber
    edited July 2014
    Why our system sucks? Insurance companies can't deny or charge sick people extra, so they get disproportionate usage of the system by paying the same amount as the rest of us

    Not trying to sound like an asshole or inconsiderate of sick people. A lot of them just ran bad in life. Still, which is more unfair? The guy who ran bad in life is screwed because he ran bad in life? Or everybody has to indirectly pay the guy who ran bad because our system says so? That would be like the casino forcing the entire table to pay a guy who lost a pot when he had 98% equity so he could have his money back because it sucked for him to lose that pot

    Or if car insurance were this way, it would be like saying you pay the same amount if you have zero tickets and accidents on record as the guy who totaled 3 cars in the past year

    Of course, insurance generally works that way. But the math only works out fairly if everyone is paying his own share of the EV of the expected claims he's going to make
  • ThehammahThehammah Posts: 7,086Subscriber
    edited July 2014
    And see claire thats the rub. Everyone isnt paying. And to pay for those that wont pay for themselves the rest of us who have imsurance do.

    Also everyone feels they have a right to cadillac coverage while only paying for a subaru (no offense to subaru owners).

    If you dont want to pay as much on premiums then you should expect to get less service and may have to pay more out of pocket if you so get sick.

    The economics of health insurance is more complicated than say car insurance because you can still get really sick even though you have done everything right. And visa versa. If you are a bad driver amd get a bunch of tickets thats a highly accurate predictor of future accidents

    Does obamacare ignore things like smoking or will that increase your premiums. It should since that was a personal choice and it is a predictor or future health issues

    Oh and you cant legally drive a car wo ins why not health ins?

    Ww
  • BartBart Posts: 5,920AdministratorLeadPro
    edited July 2014
    Wendy--

    Explain how this system is fair when I pay 40% more for my premium (identical coverage) per month and my deductible has gone up 100%? Am I not suppose to complain especially when I have paid into the system all along--and by the way in certain years have had procedures done where I have reached and paid my out of pocket maximum? I see this as another example of the taxpaying middle class getting screwed over.

    Bart

  • FreeLunch Posts: 1,309Pro
    The system is way messed up. When I moved to Florida my family plan was $380 a month. Now, 5 years later after o-care its 1110 a month. Furthermore the plan I have is a true catastrophic plan as it pays for very little under the 6k per person deductible but after that it pays 100% (no co-insurance). It would not be legal to buy that plan anymore but I am grandfathered in.

    The system can be easily gamed. I could save a little and switch to a bronze plan but then something mid cost like a broken leg would be very expensive since I would have a 40% copay. If I got something serious like cancer I can just wait till the renewal period and switch to a gold plan. If I had to wait 11 months because I got sick in Jan I could move states and then reinsure at gold.

    Bart - I agree that its a financial decision - in fact that is what I was saying. I was just saying that for many with limited assets and low income its better to not have insurance as under this system the low cost options don't really save them from real financial hardship.

    FWIW the value of negotiated rates depends on your ability to negotiate and on where you live. In some places, like florida, there are lot of low cost private options. You also can negotiate with hospitals if you are uninsured and this happens quite often as they are happy to settle for the same insurance rates. The only reason they have the higher private rates is because of the messed up way medicare calculates its payments which is too complicated to get into here. As long as they can bill you the high rate so the medicare payment formulas work, the are happy to settle for market rate payments.
  • ThehammahThehammah Posts: 7,086Subscriber
    Bart said:
    Wendy--

    Explain how this system is fair when I pay 40% more for my premium (identical coverage) per month and my deductible has gone up 100%? Am I not suppose to complain especially when I have paid into the system all along--and by the way in certain years have had procedures done where I have reached and paid my out of pocket maximum? I see this as another example of the taxpaying middle class getting screwed over.

    Bart

    Ok I will take the challenge in changing your view ..like Limon did for the chop!

    First of all what is the No 1 predictor of bad health? ...

    Age..


    The older we get the sicker we do. In the past we used to get sick and die within say a few weeks.. In the middle ages up to the beginning of the 20th century many diseases would wipe out millions of people .. most of the bacterial infections went away with the development of antibiotics..

    Now as you get older.. for the most part it takes you alot longer to die from something. studies have shown that the single biggest cost in Healthcare is end of life care.. Like last month.. trying to keep someone alive

    Bart.. Your previous plan I think the few things you told me about might have excluded certain items that you as a man didnt need.. like pregnancy or birth control, etc... It is true that as a single man you probably wouldnt need to use those parts of a plan and therefore you purchased a plan that didnt cover this and therefore your premium was lower.

    With obama care plans have minimum standards that wont discriminate against women and have to include birth control and pregnancy. There are also other items that needed to be included to get to the minimum standard.. To get your plan to the min it would cost the insurance company more so the premium went up... Ok so that explains your current situation. Now lets get back to the economics as a whole..

    When companies try to decide what to charge for say insurance.. they do a risk analysis on having to pay out on that insurance.. based on a certain population, where you live etc.. and over a certain population they figure how much to charge so they make a profit and stay in business.

    If there are pressures on either the size of the population they can spread the risk on , or say costs go up that affects the rate they have to charge to make a profit and stay in business.

    In the us there are some 300 million people who live here. of which something close to 50 -60 million have zero health insurance.. When these people get sick they go to hospital since most public and say religous based facilities have a policy to make them stable and may even treat them without any possibility of getting paid back. To make up this difference they charge the insurance companies more for the same service so they can get reimbursements equal to what it has cost them. This is a vicious cycle.. the fewer people with insurance the higher the insurance fees because the non insurance dont actually pay for the services they get. so we as insured get screwed . The ONLY way to fix this piece of the pie is the require everyone to get insurance so the premiums of the 60 million or so that are not paying now go into the pool and should reduce the premiums for the rest of us as well as increase the risk pool which also reduces our premium..

    Now lets go back to the age thing.. As a young man you tend to be healthy since most diseases will arise in middle to late age. If you paid into the system (and you do to some degree) only based on this ..then your insurance premium would be super cheap when you are young and basically sky high when you get older.. And now we are back to the same issue.. you will drop insurance when you cant afford it yet society will keep you alive and everyone else will have to pay for it. So today you are paying a little extra into the system so when you get to say 70 you are actually not paying your fair share.. but because overall MORE people are paying in your premiums are still lower then they would be..

    Finally costs.. Heathcare is a unique field where most technological breakthroughs are making it MORE expensive not less expensive. We are very good at coming up with quite expensive things to keep us alive. In 1917-1918 there was a worldwide influenza outbreak. Millions died.. and died within a weak of getting sick. Now if you get sick say cancer.. You might get treatments that can keep you alive for 5 10 20 years... and you die of cancer.. My mother was an example of this. She live 17 years after her original diagnosis. had she died in say 6 mos it would have been much cheaper for the healthcare system. But would I or her or anyone else say she should die in 6 mos because I want my premiums to be cheaper? No.. because if was you or your family you would want access to those treaments that kept her alive.. So your premiums are also a bit of a lottery ticket.. If you are the lucky one to get really really sick you can get the stuff that will keep you alive. Further examples are people very old and very sick and stay in the hospital for last few months hooked up to all sorts of stuff at $20-$30k a DAY!...

    HMOs were invented to try and manage costs.. ration costs is probably better.. I have a cadillac plan because I dont want to get rationed with what I can have that may be super expensive and what is not super expensive. My personal opinion is the uninsured should be forced into an HMO for cheaper plan so they get an understanding why its more expensive to get more choices.. Kinda like we should all work as waiters so we know what its like to give and get good service..

    So what would the alternative be like.. Nationalized healthcare like canada and the uk for example. If you are in the national plan you are in the worst kind of HMO you can imagine. yes its way less expensive but certain procedures you might have to wait and wait and wait. talk about 3 -4 mos for a knee surgery to fix a torn meniscus or like what happened to a friend of mine.. misdiagnose appendicitis as just food poisening send him home and he almost dies when his appendix burst and he gets sepsis.. There premiums are way smaller than in the US..but would any of us want that system? No way..

    sorry for the dissertation (you know me by know lol ) but I only touched a few points.. try not to be upset today..but be thankful in 30 years you dont have to pay 1000s more when you get cancer from smoking those cigs you like to when playing poker.. hint hint hint.


    ww
  • BartBart Posts: 5,920AdministratorLeadPro
    ^^^ Sounds like a lot of liberal rhetoric about paying more into the system to help the less fortunate ^^^^. So basically I now pay for a plan that covers pregnancy and other government required standards that have absolutely nothing to do with me because it is for the good of society--even though we are not on a society based health care system. Its like the worst of both worlds. A controlled, unfair, marketplace.

    "So today you are paying a little extra into the system so when you get to say 70 you are actually not paying your fair share". No--You have to be joking, right? Did you just hop out of a time machine from 1935? Logically, this argument could make sense if it wasn't for the largest entitlement program in the history of mankind. Are we not supposed to learn from history and our past mistakes?


    On another note the so called "individual mandate" doesn't really force people to buy health insurance. The penalty for not buying insurance is a 1% tax on income after deductions? So a freeloading citizen making $30K a year is going to all of a sudden rush to buy a plan that is $230 bucks a month after living a life with no insurance and going to the ER as his doctor so that he doesn't get a $300 tax penalty for the year? I can't wait to actually see the data on how many uninsured people actually bought insurance through Obama Care. They keep throwing out numbers in the millions but no one knows if these people where already in the individual market place and had their plans discontinued (which by the way almost all plans were discontinued) like me. I think that we will find that the only new people that purchased insurance were those that had pre existing conditions that could not get underwritten for insurance before. Those that chose to be uninsured continue to be uninsured making even worse on people like me in the individual market as the pool has only gotten bigger with the unhealthy as the penalty for non coverage is not high enough.

    Bart
  • BigLarry Posts: 86Subscriber
    Thanks for all the great responses. Lots or thorough due diligence to do as Bugsey said. The way I look at it is how can I get screwed by the system the least. I don't want to land in the emergency room for an appendectomy with zero coverage.

    Larry

  • RDF Posts: 183Member
    WW: "So today you are paying a little extra into the system so when you get to say 70 you are actually not paying your fair share".

    Bart: "No--You have to be joking, right?"

    This is how life insurance works. When you have a level premium, your early premiums are very -EV and your later premiums are very +EV.
  • BartBart Posts: 5,920AdministratorLeadPro
    edited July 2014
    Health insurance are not level premiums. The Bronze plan on the individual Cali exchange is 3X the cost when you are over 60. You aren't set into paying the same amount per month at this age it goes up as you get older.

    And BTW what the F*** am I paying 2.9% of my income into medicare for? Isn't that suppose to cover me when I retire? I am paying a little more now so that I get nothing when I am over 70 from Obama care because I've paid hundreds of thousands of dollars over the course of my life into medicare?
  • RDF Posts: 183Member
    Yeah but EV premiums in every year doesn't equal EV of benefits + profit.

    Doesn't clear each year.
  • ThehammahThehammah Posts: 7,086Subscriber
    edited July 2014
    bart health insurance is like a lottery ticket bought years earlier if you happen to get sick. thats the point of getting coverage.. Now if you want to pay cheaper out of pocket now by all means dont buy insurance.. the fact you did means you are trying to hedge your bet incase you do get very sick even though you are a health man now. thats the whole point.

    I am generally pretty liberal.. but when it comes to economics I am not. I pisses me off to no end that a checker at a grocery store is upset that they have to pay like $20 bucks a month for cadillac insurance when I pay close to $300. this is because they dont want the HMO and rationed healthcare..

    this new stuff that is way expensive everyone wants and no one wants to pay for it. what obamacare tried to do was to standardize plans so the insurance companies couldnt deny someone coverage like they used to. this is golden for people in those classes.. either they had a pre-existing condition or like with many female preventative things just simply werent included.. It also used to piss me off that a man could get viagra but I couldnt get birth control. whats the fucking difference?

    So the system is broken today and the penalties for obamacare go up each year you dont get insurance to the point that it would pay for the insurance.. at least thats what its supposed to do. I havent read the fine print but thats the idea. so in the next few years many people will opt out because the penalties arent high enough.. when they do then the numbers will increase..

    I also like to bring up another economic principle that many are unfamiliar with but live it every day. Its called opportunity cost.. what is the cost for the next best thing.. with insurance you could save money now by not pay or buying a less expensive play but may to pay more later.

    Say bart you got your cheaper plan.. and so did everyone else. and that bankrupted your insurance company just at the time you got say tuberculosis.. a disease that will take you over a year to treat with very very expensive antibiotics.. You lose your coverage because you dont have insurance anymore.. what happens to you then? No one will cover you cuz you have a serious pre existing condition. what would you do? You would have to go to county hospital like all the other non insured patients or pay out of pocket .. which btw might cost you $500,000 or more to treat..

    thats what insurance is about.. to protect you from financial disaster if you got unlucky and got sick. to do this the insurance company has to pay for YOUR treatment from the premiums of everyone else..

    Now you could try to get insurance for just you and the insurance company could do an individual assessment but you would not get a good price because now they dont have millions of other folks to spread the risk of you getting sick . thats why we need those extra 60 million in the pie.. either that or rationed healthcare..

    if you guys really want me to I will do the math for you on why everyone needs to be forced to pay.. if not we will have no option but all be in HMOs with the exception of the very rich who could pay out of pocket for anything they want...

    wendy

    ba in economics and mathematics just in case anyone was wondering how come I know this stuff..
  • RDF Posts: 183Member
    Regardless, it's pretty obvious health care is screwed up. And Obamacare imposed some good things and some bad things.
  • ThehammahThehammah Posts: 7,086Subscriber
    Bart said:
    Health insurance are not level premiums. The Bronze plan on the individual Cali exchange is 3X the cost when you are over 60. You aren't set into paying the same amount per month at this age it goes up as you get older.

    And BTW what the F*** am I paying 2.9% of my income into medicare for? Isn't that suppose to cover me when I retire? I am paying a little more now so that I get nothing when I am over 70 from Obama care because I've paid hundreds of thousands of dollars over the course of my life into medicare?
    As a society it was decided a long time ago that as americans we would not let our older folks just die because of diseases we could cure but that might be very expensive.. So like many other taxes.. you pay for their care now and future americans will pay for yours. just like social security.. its either that or just let the folks that wont be able to get insurance because their premiums might be $5000 a month just die off..

    are your parents or grandparent rich? could they afford even a $1000 a month premium? most couldnt ..so back to the bankruptcy again.. would your mom dad or you spend all your money keeping your mom dad or grandparent alive? big moral decision right?

    that is what medicare is for. so we dont just let grandpa mike die sooner because we didnt want to spend money for his treatment.. btw.. there are insurance companies that are in the business of covering for things that medicare doesnt..

    oh and the single biggest expense for seniors? drugs.. oh and it was bush that pushed through getting that added to medicare. at the time he was dead against raising taxes to pay for it too. i think the numbers for that piece of medicare is like 100s of billions a year.. only added to the national debt..

    so health insurance isnt a democrat thing or a republican thing.. its really a moral and societal thing..

    we could save alot and I mean like over 50% of healthcare costs if we simply just let grandpa mike die..

    ww
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