can someone please help me understand health insurance?

Post » Sun Mar 30, 2014 12:49 pm

so with this new law that is about to pass if you don't have health insurance you were going to get a fine. The insurance that im looking at, the cheapest that I can afford, is 160 a month. The copayment for any doctors visit is 60. And the deductible is $6000.

if my understanding of a deductible is correct, then I'm going to have to pay 150$ monthly, $60 a visit to the doctor and up to $6,000 out of pocket in scan costs blood tests etcetera before I am ever seeing any insurance. Can anyone please explain to me how I am being insured whatsoever.
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Marie Maillos
 
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Post » Sun Mar 30, 2014 10:44 am

I think the deductible is where if your surgery for example will cost $15,000.00 the insurance will cover up to that amount ($6,000.00 worth)?

I don't know for sure and would like to understand too. I have dental insurance through Delta, but it is nothing like health insurance from what I am seeing as there is no deductible.

EDIT: Actually, I think if you paid up to $6,000.00 through your premiums (monthly payments) then the insurance company will cover the costs entirely.

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Holli Dillon
 
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Post » Sun Mar 30, 2014 5:29 am

The $6000 is what you have to pay out of pocket before the insurance pays for any major procedures. For example if you have a procedure done that costs $12,000 you are responsible for $6,000 of it before the insurance will pay.

Obamacare just like Obama is a joke.

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lolly13
 
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Post » Sun Mar 30, 2014 5:46 pm

You get insured for your health. Maybe.

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Monika
 
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Post » Sun Mar 30, 2014 6:48 am

so that's exactly my point. If I don't have any major medical issues in a year's time I'm paying $150 per month plus I any amount up to six thousand dollars a year. How is that insurance that is not insurance at all.
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Marcin Tomkow
 
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Post » Sun Mar 30, 2014 5:28 pm

I have a feeling DEFRON will have the answer for us all. But I feel with the OP, I am quite confused by this and it is all new to me.

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Sarah Knight
 
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Post » Sun Mar 30, 2014 5:04 pm

Let's say your deductible was $6,000.00. Then let's say your monthly payment was $600.00/month. By ten months time your deductible will no longer be an issue and the insurance company will pay all the costs of medicine, procedures and what-not..... from my basic and underwhelming understanding.

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Star Dunkels Macmillan
 
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Post » Sun Mar 30, 2014 12:20 pm

I'm in perfect health. I do not need $600 worth of medical care every month, I'm not dying
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Kelly Osbourne Kelly
 
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Post » Sun Mar 30, 2014 7:36 am

I think the point is even if your insurance was $5.00/month once it reaches the deductible amount all your health finances are handled by the insurance company. (once again, from my basic and underwhelming understanding of health insurance)

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Jarrett Willis
 
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Post » Sun Mar 30, 2014 6:19 pm

I just don't see how this isn't a scam. I'm literally throwing away thousands of dollars every single year for absolutely nothing. I don't need any health care I don't have any medical emergencies. But I am literally giving sounds in dollars every month and even then when I have to go to the doctor I have to pay thousands more before I see any insurance coverage. That makes absolutely no logical sense
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Chrissie Pillinger
 
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Post » Sun Mar 30, 2014 10:02 am

You only pay the deductible if your procedure or medicine or treatment costs above it. After a few years you will pay off your deductible and have no costs for coverage. And believe me, cash/check/credit card out-of-your-pocket expenses are a 100x more expensive than insurance.

Basically, the scam is the doctor and hospital bills handed over to the insurance companies. (gouging)

Yes, I agree we shouldn't be forced to buy a commercial product. It's different with automobiles as cars/trucks/boats/bikes are a privilege and not a right.

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Amy Masters
 
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Post » Sun Mar 30, 2014 10:49 am

well then I guess I don't understand what a deductible is, because that doesn't make any sense. I am still paying the full amount without insurance even though I have insurance until I reach the $6000 mark correct?
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Melung Chan
 
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Post » Sun Mar 30, 2014 1:14 pm

First let me say it's very complicated.

Depends on your plan. I'm going over the healthcare.gov site right now. Some plans offered to me have better coverage but at a higher premium (premium = monthly payment). The higher the premium the lower the deductible. Obviously, people with bigger health issues would select a plan with a higher premium and lower deductible because they offer more coverage (like 90% coverage of name brand prescriptions with a Blue Cross-Blue Shield plan). Somebody like you or I would get the cheaper plans from Humana. (basics with almost no coverage but emergency situations).

Bah, forgot to answer the main concern. If your operation for example costs only $2,000.00 and your premium is $6,000.00 the insurance will cover it with conditions. The conditions vary from plan to paln, such as $40.00 flat rate doctor visits, etc.

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Marcus Jordan
 
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Post » Sun Mar 30, 2014 8:30 pm

The main idea is that, without insurance, you have to pay so much money when you get sick that you'll go bankrupt. With insurance, you give yourself the peace of mind that you'll go bankrupt whether or not you get sick.

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Haley Cooper
 
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Post » Sun Mar 30, 2014 4:51 pm

you pay a (relatively) small tax penalty for not carrying insurance. But that is assuming you make enough income to be required to file a tax return. Even so, it is much smaller than $150 a month. Unless you make enough income that the insurance is nothing to sneeze at, I would just pay the fine/tax/whatever they officially call it.

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Philip Lyon
 
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Post » Sun Mar 30, 2014 5:26 pm

First year fine is like $96.00. You would be fine eating the fine (no pun intended) for the first year. It will get higher every year after that. By the third year you will see a fine of $250+.

If you get a subsidized plan (like your plan is supposed to cost $180.00/month but turns into $6.00/month after a tax credit) you will get less of a refund after filing taxes. A tax credit as literally defined is what you owe the government. It basically still cost full price to you the insured as it is deducted from your tax refund in Feb. - April.

EDIT: I came into this thread clueless, but I am learning as we go.

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Kevin S
 
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Post » Sun Mar 30, 2014 9:14 pm

Thats how I see the whole situation.

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kasia
 
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