Yes, it may be possible to get a zero-premium bronze plan on the exchanges, but I can’t imagine a case where it wouldn’t be a better idea to pay a little and get a silver plan. If you have any medical costs at all, the silver plan will almost immediately be cheaper for you than the bronze. If you want to gamble, you might get away with it. But you should never gamble with your health, and, if you’re going to gamble with your finances, you should only do it in the hope for profit.
About The Author
BooMan
Martin Longman a contributing editor at the Washington Monthly. He is also the founder of Booman Tribune and Progress Pond. He has a degree in philosophy from Western Michigan University.
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I’ll probably be going with a high-deductible bronze plan. In my experience, the competent doctors that I feel most confident in don’t even bother taking insurance.
that’s an odd thing to say.
No, it’s not an odd thing to say, many of my friends have had similar experiences with traditional US doctors 🙂
One way this can play out is with ‘concierge medicine’, which is an option for people who want old-fashioned medical treatment. (where your doctor spends more than 5-10 minutes with you and doesn’t turn to prescription drugs as the first answer for every problem).
It’s an interesting rabbit hole to dig into, if you’re interested: http://www.signaturemd.com/about-concierge-medicine/
Other times physicians and/or psychiatrists just stop taking insurance because it’s such a huge time-sink to argue with insurance companies, and they’d rather spend time helping people. Oftentimes these are the most competent and effective healers, because they’re the only ones who can get away with turning away 80% or more of their potential customers.
I’m not trying to come across as argumentative at all! 🙂 There are other models for health care out there, even within the larger US medical system.
in other words you and your friends are paying the full amount for each [lengthy] visit and tests. Nice if you can afford it. but “concierge medicine” doesn’t do anything for the health care system overall except perpetuate the expensive and inequitable features of it. And you have a lot of [false] assumptions that these are the MOST competent. Most drs have non med staff that deal with insurance cos. And if they only want to see wealthy patients maybe you’re seeing the Mitt Romneys of the profession
Was gonna say the same thing. I think it might be easy to confuse competence with “seeming to give more of a shit”. Similar to why homeopathy shows results not from its ridiculous antiscientific and whacked out claims, but because of a placebo effect whereby doctors give more of their time tending to your care. No way concierge care could be implemented on a cost effective basis. It’s more of something “if you can afford it.”
Thank you for judging my life and decisions without knowing a damned thing about me.
Speak for yourself. Today was payday, and after I did my monthly budget, I got a clearer picture of what I can afford.
I got paid $1400 today. This has to last two weeks. Out of this paycheck comes a number of bills (which I spread out over this paycheck and next). After I pay my bills, I am left with $150 for groceries, gasoline, and personal life.
Now, I could certainly re-adjust a few of my due dates (maybe I should pay the IRS later in the month), but the fact remains that even with a subsidy, I would have no money left for groceries, gasoline, and personal life out of at least one paycheck. In fact, given that the cheapest I’ve seen so far is $175/month (with subsidy) then I’m actually running a negative.
Sure would have been nice to have it run like social security or medicare. This is a HUGE bite into my budget, and i’m hearing similar things from people my age and younger.
It wasn’t all the different in the early seventies for many of us. Couldn’t afford to buy into the employer health insurance plan. Rent was expensive, but most everything else was DIY — including clothes. Plenty of pluses and many minuses to living frugally.
Boo:
Have you tried to sign up? Just wondering since thanks to #OneTermTom PA residents have to use Healthcare.gov … and while I signed up … I still haven’t been able to view prices for any of the available plans
can’t speak for boo, but I have tried to sign up. It took about a week or so before my login worked, and because I had specific subject questions, I’m still waiting for a response from a live in visor before I can continue the application. That said, Boo DID send me to a very helpful website called valuepenguin.com,where I was able to do some pre plan pricing.that’s how I was able to estimate what my monthly cost for insurance could be. Check it out it’s worth your time
Thanks!!
I looked at that site. Interesting to say the least. Are visits to the dentist and eye doctor included under “Specialist”? Does Boo know?
no idea. I need to visit both though.
I went through the application process today in WV (a federal exchange state). It is looking like we can get a silver plan for much less than $100/month, which is less than 1/4 what we are paying now for shitty high deductible coverage on the individual market. We can get a gold plan for half our current price.
Could be related to WV’s aggressive enrollment of pre-ACA Medicaid eligible beneficiaries and approval of the Medicaid expansion.
However, the rates in TN appear to be low and that state hasn’t accepted and isn’t moving forward on Medicaid expansion. Perhaps TN has more hospitals and doctors per capita than other states.
A few years ago when I was out of work, I paid out of pocket for my own Independent Blue Cross Health Insurance. I was a healthy 29 year old and to get the same coverage that I had with my previous employer ($500 deductible) was $130/mo.
I could have selected a lower premium ($50-75/mo.), but I didn’t want to risk wiping out my meager savings account if I needed to cover the higher deductible if needed.
I paid my own insurance for almost a year, and thankfully didn’t need to use my insurance for anything major…however, I also didn’t use the insurance at all. Not even a wellness visit.
In retrospect, I would have been much better off paying less per month in premiums, and putting the difference in savings toward a higher deductible. Assuming that I could have been disciplined enough to do so.
I have looked at the plans on the exchange just to compare with what my work offers. From what I remember, platinum PPO coverage was between 350-385 a month without subsidy. This had no deductible and about $2000-4000 out of pocket max.
At work, an HMO with no deductible and out of pocket max of $2000 for, say, Kaiser is $567 before employer contribution. After employer contribution it’s $170.
My employer is the federal government, also (not USPS, and yes that distinction matters).
So from a quick perusal, it appears coverage on the raw is cheaper through the exchange than through the employer. However, it’s far easier to find zero deductible plans at work. Out of pocket maxes are also more consistently lower at work.
When SF white collar folks first began to be offered and signed up for Kaiser, the bi-weekly twenty-something employee premium was less than $2. (Co-workers on indemnity health insurance plans paid $12 plus a 20% co-insurance). It was $1 (equivalent to less than $5 today) to see a doctor and $1 for a prescription. No deductibles and no other out-of-pocket costs.