re: What exactly am I getting out of my health insurance

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HSA with that HDHP!

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HMA with the HSA so you can use the HSA as a secondary retirement account.

Ok but my high deductible plan for a private policy (we’re both self employees) is $1300 per month.

You are lowering premium costs for people with unhealthy habits.

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Next go find all of the salaries of the administration at your local health system. Bonus points if it's an HCA hospital

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I know you can read the 990 forms for nonprofit. But how do you see the salaries for for profit hospital systems?

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My insurance has paid off in general, but I did pay $25 a piece for three Rx that would have been $20 a piece without insurance.. Found that out after the fact. From what I understand many common medications are cheaper if you don't go through insurance.

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That is why it pays to shop around on recurring prescriptions. I have a prescription for Metformin, and at places like CVS and Walgreens, they were hitting me up for the usual 7 or 10 dollar copays. I switched to Walmart, and my Copay went to free since it was on their 4 dollar a month or 10 dollars for a 90 day supply medication list. I know of Walmart and Publix doing these deals, there may be others. I am also trying another drug that costs 1,000 for a 30 day supply, but I am still in the sample phase. My BCBS copay would be 25 at Walmart for the same drug.

Here’s an example:

My monthly premium isn’t that far off from yours. My individual deductible is $8700. My family deductible is $13,400.


6 weeks ago, my newborn had a trip to the NICU. The insurance paid $65,000 (reread that- the bill wasn’t $65,000. The payment was). This is, of course, in addition to the delivery (which ate through my wife’s deductible).

A day after we got home, my wife became septic and spent several more days in the hospital.


So, on my behalf, my insurance company agreed to about $90,000 of payments for hospital services. I paid $13,400 instead of $90,000.


That’s what insurance is for. You pay something to have a cap on your costs. Low cap? You’re forking out a lot because the insurance company is taking the risk. High cap? Considerably less. No cap? Huge risk, no cost (anymore), but the government has intervened and goes back and pays hospitals for this in many circumstances, and for those that it doesn’t, the hospitals bake the cost of providing care to the community into their rates (which is further regulated by the government as well).


Now, over the next 30 years, I’ll probably pay far more to the insurance company than I’ll ever get out of them. But it’s easy to plan for a $13,400 disaster in any given year - it’s sort of the principle behind the Health Savings Account (opinion: you should be able to contribute at least your family’s MOOP into an HSA annually. It’s presently about half the amount). A $90,000 (or more) disaster would be a huge financial burden on me that would take several years to work off.

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It’s infuriating to go from “lower” costs to astronomically high costs out of pocket for the weekly to monthly needs.

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A $4000 deductible per person is considered weekly to monthly needs?

You have it backwards. Insurance covers checkups. Routine. It is literally a $4000 deductible for everything else. And then a copay kicks in.

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We should be a straight cash payment for routine medical bills, like car maintenance. Then have “sick insurance” instead of “health insurance” when you’re in need of that massive payout, like car insurance.

But that’ll never happen

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Again, you are backwards in your analogy.

Between me and my Company we pay $14,000.00 a year for my son and I. They pay 2/3 and I pay 1/3, My part is $200+ a paycheck.

My kid broke his 4th metacarpal "unfortunately" for me Jan 6th so new ded and max out of pocket.

I'm $4,000.00 in the hole so far


Obama fricked this up for all working Americans.

You need health insurance.

One day you will say thank God I have insurance. People are known to become financially ruined if they have a diagnosis or a major incident. I have seen way too many GoFundme sob stories on Facebook.

Most insurance plans have free wellness checkups/blood work. Be the guy who catches an issue before it becomes a huge problem.

For all the people who think they don't need insurance as they never need to see a doctor, you are being ignorant. I have seen many times of someone relatively young getting cancer, etc that is so advanced there is barely any hope.

I found out I had high cholesterol at 27 and took action. My levels have been great ever since. Imagine if I waited until 40 to find that out?

Be on top of your health.

Add a grand for fam of four and we still pay $60 for a basic kid visit.