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Started By
Message
re: Would you personally be able to budget for individual health insurance earning 110k in WV?
Posted on 1/28/26 at 8:38 am to HailHailtoMichigan!
Posted on 1/28/26 at 8:38 am to HailHailtoMichigan!
quote:10/1 odds they have this faded sign in their yard
Husband is IT business owner Wife makes pottery
0
Posted on 1/28/26 at 8:39 am to DiamondDog
quote:
Send her butt to stock shelves at Walmart. Then they'll get access to group health insurance.
Walmart intentionally keeps almost everyone who works there as part time just so they don’t have to include health insurance benefits
Posted on 1/28/26 at 8:40 am to TheArrogantCorndog
quote:
In a hospital, $15 for a single pill of Tylenol is insane
In my experience, billing from actual doctors and the work they do isn’t as surreal as you get from medical facilities.
I had surgery last year that required a hospital stay from Saturday through Wednesday.
Bill from the hospital: $178,000. Insurance negotiated this down to $35,000.
Bill from the surgeon: $2000
Posted on 1/28/26 at 8:40 am to TheArrogantCorndog
quote:
Maybe health insurance is a fricking scam and we should abolish the system and come up with something better
In a hospital, $15 for a single pill of Tylenol is insane... not to mention the cost of birthing a child... its out of control and needs to be addressed
Thanks health insurance!!!
Definitely. This shite needs to be flushed down the toilet yesterday.
Posted on 1/28/26 at 8:40 am to Dire Wolf
Baby born last January via C section. We thought we paid everything post insurance (roughly $6k) only to get a bill six months later for $8k! I called and disputed, month later I get a bill saying it's only $2k. I just threw it in the trash, the system is so complicated they don't even know what they charge.
Posted on 1/28/26 at 8:50 am to Tiger Prawn
quote:
Sounds like his wife needs to go look for a real job that provides health insurance. Do the pottery stuff as a side job / weekend hobby.
Or just a bullshite job for local hospital or a health insurance company. My wife works 2 days a week as a nurse. Doesn’t make a ton of money part time but when you add the $30k value of her benefits it’s a big help. Best hack as a business owner to get your family good benefits until you can scale the business enough for the cost to make sense.
Posted on 1/28/26 at 8:52 am to TheArrogantCorndog
quote:
Maybe health insurance is a fricking scam and we should abolish the system and come up with something better
yeah it's getting crazy.
A couple of weeks ago I cut myself on some rusty tin. Didn't need any stitches but I called the doc to see about getting a tetanus shot. I asked if I could just go in and pay out of pocket for it since a doc wasn't available. They said for insurance purposes I had to see a doctor and if they just gave me the shot without going through insurance it could be considered insurance fraud or some shite. Doesn't make sense to me.
Posted on 1/28/26 at 8:53 am to Dire Wolf
quote:
Two c-sections
Hospitals pushing c sections so they can run more efficiently and make more money isn’t talked about enough.
Posted on 1/28/26 at 8:54 am to Tiger Prawn
quote:
like his wife needs to go look for a real job that provides health insurance. Do the pottery stuff as a side job / weekend hobby.
She could get good health insurance working at Starbucks.
Posted on 1/28/26 at 8:57 am to Loup
quote:
A couple of weeks ago I cut myself on some rusty tin. Didn't need any stitches but I called the doc to see about getting a tetanus shot. I asked if I could just go in and pay out of pocket for it since a doc wasn't available. They said for insurance purposes I had to see a doctor and if they just gave me the shot without going through insurance it could be considered insurance fraud or some shite. Doesn't make sense to me.
You have to see a provider in order for provider to bill for services. No provider is just take the patients word for any medication request they wish without an assessment.
Posted on 1/28/26 at 9:01 am to HailHailtoMichigan!
This couple could have gotten similar coverage for about a 1/3 of that prior to ACA. Guaranteed issue, banning pricing for risk and coverage mandates are the main reason ACA policies are so expensive.
You can be diagnosed with cancer and enrollment in a policy during the OEP and you’ll be covered for the same rate as a perfectly healthy person who’s been insured for years.
ACA mandated ALL policies include coverage for preventative care, birth control, pregnancy and maternity care (even males), and pediatric services (even if you don’t have children).
Imagine how expensive auto insurance would become if you get obtain coverage AFTER an accident, everyone was charged the same rate regardless of driving record, policies vehicle maintenance like oil changes and tire rotations and every policy covered teen drivers regardless of having a teen on the policy?
You can be diagnosed with cancer and enrollment in a policy during the OEP and you’ll be covered for the same rate as a perfectly healthy person who’s been insured for years.
ACA mandated ALL policies include coverage for preventative care, birth control, pregnancy and maternity care (even males), and pediatric services (even if you don’t have children).
Imagine how expensive auto insurance would become if you get obtain coverage AFTER an accident, everyone was charged the same rate regardless of driving record, policies vehicle maintenance like oil changes and tire rotations and every policy covered teen drivers regardless of having a teen on the policy?
Posted on 1/28/26 at 9:03 am to HailHailtoMichigan!
This is the end result of ridiculous Obamacare mandates requiring young healthy people to have coverage for everything because it isn’t ‘fair’ they don’t require as much health care as older, sicker people. Very popular low cost/catastrophic plans were outlawed. Add in absurd rules like mandatory maternity coverage for males, post menopausal women, and prepubescent children and this is what we get. Costs have skyrocketed for everyone.
Posted on 1/28/26 at 9:05 am to TheArrogantCorndog
quote:
In a hospital, $15 for a single pill of Tylenol is insane... not to mention the cost of birthing a child... its out of control and needs to be addressed
Had knee surgery in 1999 and I remember seeing on the bill they charged $5 for the BIC pen used to draw an X on the knee that was going to be scoped. $7 for the disposable razor used to shave my knee. Completely blew the mind of a 17 year old kid.
Posted on 1/28/26 at 9:12 am to Dire Wolf
I don't really f with insurance much, but where does the max out of pocket come in? Are these charges applied towards that goal or somehow outside of that calculation?
Posted on 1/28/26 at 9:12 am to bee Rye
quote:
Walmart intentionally keeps almost everyone who works there as part time just so they don’t have to include health insurance benefits
OK that answers my question
Posted on 1/28/26 at 9:19 am to HailHailtoMichigan!
This is fantastic , if only they could get a catastrophic plan with a 10k deductible and self fund their health.
Oh wait , Obamacare eliminated those.
Oh wait , Obamacare eliminated those.
Posted on 1/28/26 at 9:23 am to Pedro
quote:
Wife and I are $10k in debt after the birth of our daughter in August. They billed the daughter $4k just for being in the room with us. And that was with pay $850/month for insurance
Insane. Just over 20 years ago I actually got money back from the hospital after our first child was born. And that was from a private hospital. Our 2nd child was born 4 years later and we maybe had to come out of pocket a couple of hundred dollars.
Posted on 1/28/26 at 9:32 am to HailHailtoMichigan!
quote:
During the pandemic, Congress expanded subsidies for ACA plans to many households earning more than 400% of the poverty level
During the real pandemic the covid subsidies expansion was to end after 2022. During the manufactured pandemic Dems expanded it another 3 years and also purposely ended it after 2025 and into the next elected President’s term. They shouldn’t have been extended, but at most any extension should have seen annual reductions stepping down to zero starting in 2026. Instead Dems created another dependency.
Pandemic is over. How was this couple paying for health insurance in 2019 and before? They should have planned for this and saved some of the additional money the government gave them for 3 extra years to help.
Additionally the post 400% cliff drop off for those earning one dollar or more extra is just more horrible Obamacare policy (penalizing earning more is bad but doing so while rewarding people to earn less is much worse), but the covid temporary solution isn’t the fix. It just spends more money taxpayer money to hide that problem along with trying to hide the overall unaffordable healthcare problem created by Obamacare (while actually inflating prices for everyone else) and creates more people dependent on govt subsidies. The original subsidies should have been built without a cliff with steeper reductions as incomes approached 400% creating a step off afterwards with no penalty for earning more or no benefit for earning less.
Posted on 1/28/26 at 9:33 am to Dragula
quote:
You have to see a provider in order for provider to bill for services. No provider is just take the patients word for any medication request they wish without an assessment.
I get that, but this was right after they looked up when my last tetanus shot was and told me yeah I needed one.
Posted on 1/28/26 at 9:42 am to Pedro
quote:
Wife and I are $10k in debt after the birth of our daughter in August. They billed the daughter $4k just for being in the room with us. And that was with pay $850/month for insurance
And if you guys weren’t married and your wife was poor would have been free with Medicaid
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