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re: Would you personally be able to budget for individual health insurance earning 110k in WV?

Posted on 1/28/26 at 9:48 am to
Posted by Mid Iowa Tiger
Undisclosed Secure Location
Member since Feb 2008
24865 posts
Posted on 1/28/26 at 9:48 am to
quote:

My point in replying to you was the high deductible catastrophic plans that were available pre ACA no longer exist.


Well, I’m on one. It’s a slightly different payout (no longer an absolute max out of pocket) but it’s fundamentally the same plan I’ve been on since they hit the market.
Posted by biglego
San Francisco
Member since Nov 2007
84761 posts
Posted on 1/28/26 at 9:56 am to
Yeah it fricking sucks
Posted by Gorilla Ball
Az via La
Member since Feb 2006
13261 posts
Posted on 1/28/26 at 10:01 am to
I’m retired and cancer survivor and my insurance is $675/month.
I can suggest they should shop around
Posted by Saskwatch
Member since Feb 2016
18215 posts
Posted on 1/28/26 at 10:04 am to
quote:

Maybe health insurance is a fricking scam


It is. So are the billing practices of the Medical and Health industry. Really needs to be reassessed on both sides.
Posted by Neauxla_Tiger
Member since Feb 2015
2109 posts
Posted on 1/28/26 at 10:23 am to
I got a 10% raise at work this year. And I'll be taking home less than I did last year. All because of the increase in my health insurance premiums. Absolutely insane. God knows it'll be years before I see another raise like that, so it's infuriating that when I finally get it, it goes right back out the door. So I continue the grind with no hope of improving my lot in life. Almost HALF of my paycheck is gone to tax/insurance before I see a dime. And that's not even counting paying additional tax/insurance on my vehicles, home, sales taxes, etc.

My wife and I are in our 30s, no health problems, barely even go for check-ups. And she increased to $900+ freaking dollars a month just to put her on my plan. Strongly considering just dropping her and rolling the dice. That would be $10k a year we could then just put in a savings for emergency health issues.

This is a huge crisis and this bubble is going to burst soon. It's completely un-sustainable to pay more than half your income to tax/insurance alone and still be able to feed yourself, pay your mortgage, raise your kids, etc.
This post was edited on 1/28/26 at 10:26 am
Posted by GarmischTiger
Humboldt County
Member since Mar 2007
6938 posts
Posted on 1/28/26 at 10:54 am to
quote:

Wife makes pottery
Found the problem.
Posted by rltiger
Metairie
Member since Oct 2004
2446 posts
Posted on 1/28/26 at 10:56 am to
quote:

They billed the daughter $4k just for being in the room with us.


They tried that crap with me. Claimed my child was uninsured and I was responsible for charges.

I still use the line the admin person kept telling me over and over again for her argument when I talk to my wife about our son today….

“But he’s his own person”….

This was in reference to my argument that he was covered by wife’s insurance since he was just born and wasn’t alive prior to add to insurance policy.
Her argument was he wasn’t on policy and he is a separate person from my wife.


Posted by bird35
Georgia
Member since Sep 2012
13626 posts
Posted on 1/28/26 at 10:56 am to
The Wilson’s insurance was not affordable last year. The difference is last year I helped pay for their insurance with my tax dollars.

Posted by dallastigers
Member since Dec 2003
10623 posts
Posted on 1/28/26 at 11:13 am to
quote:

quote:

Look I’m pro Trump and everything but can’t we agree $2100 a month for health insurance is obscene regardless of what you make?


Yes. The ACA is a disaster and has been since day one. There were a lot of people saying this before it was voted in but they were ignored.

It’s really not a Trump thing. He’s actually been one the few politicians to work to lower costs in the drug market instead of just shifting the rising costs of healthcare to other demographics.


Yeah, I didn’t get the poster saying he is a Trump supporter while seemingly implying $2100 month premiums are on him. Govt subsidies to fix a problem created by the govt just continues to make the problem worse for everyone with inflated prices which will also keep requiring inflated govt subsidies and increase dependency on govt welfare. It is a horrible cycle.

The Dems had full control of Congress and the Presidency and went out of their way to get Obamacare passed completely on their own.

The Dems initially used their filibuster proof 60 seats in the Senate and very large majority in the House from the election right at the start of the mortgage financial crisis to force this initially into us. The senate took a fundamentally different house tax bill and amended the heck out of it to meet the Constitution’s requirement of revenue bills originating in the House and passed it while they still had 60 seats.

When Dems lost their 60th seat with Kennedy dying instead of risking any changes in the House’s version to then have to go back to the no longer filibuster proof Senate, Nancy pushed Dems to pass it as is and then address increasing subsidies & other more liberal changes that they wanted in a 2nd bill using the budget reconciliation process which avoids the filibuster in the Senate (which they did in a bill that also contained the rider of the Dems student aid reform with increasing Pell grants, lower repayments, lower ceiling on years to repay before forgiveness is granted, and billions to support black colleges).

Dems jumped thru legislative hoops to slam dunk this crap onto to us. Obama vetoing, Dems using filibuster in the Senate, Dems in full or partial control at various times, and the RINOs in Congress not pushing the fixes they pushed when Obama was president have all served to keep it in place.

Posted by Pedro
Geaux Hawks
Member since Jul 2008
39173 posts
Posted on 1/28/26 at 11:19 am to
Did you win that argument?
Posted by Pedro
Geaux Hawks
Member since Jul 2008
39173 posts
Posted on 1/28/26 at 11:22 am to
I shopped around when my work sponsored plan came back at 1300 for this year (with 800 contributed) not much better elsewhere. Wife and I are healthy so I did a medical sharing platform for the time being since there’s potential for me to switch jobs at the end of the school year.
Posted by GreenRockTiger
vortex to the whirlpool of despair
Member since Jun 2020
60681 posts
Posted on 1/28/26 at 11:23 am to
quote:

You're not paying for your health insurance. You're paying for everyone else at the hospital's.
this and CNAs, LPNs, nurses, phlebotomists, food service workers, etc etc

You can only bring 2 family members into the labor and delivery room - because half the hospital employees are already in there staring at your hoohah!
Posted by DiamondDog
Louisiana
Member since Nov 2019
13247 posts
Posted on 1/28/26 at 11:28 am to
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


We had ours in September. Haven't received one bill.

I think there are levels to this thing. Can't paint it all with a broad brush.
Posted by ATrillionaire
Houston
Member since Sep 2008
3302 posts
Posted on 1/28/26 at 11:33 am to
quote:

Yes. The ACA is a disaster and has been since day one. There were a lot of people saying this before it was voted in but they were ignored.

It’s really not a Trump thing. He’s actually been one the few politicians to work to lower costs in the drug market instead of just shifting the rising costs of healthcare to other demographics.

If ACA isn't working, how can the party in power skip blame when they control all 3 branches of gov't?
Posted by Everyday Is Saturday
Member since Dec 2025
1614 posts
Posted on 1/28/26 at 11:37 am to
Does the greatest country in the world really have health care games like this?

Posted by rltiger
Metairie
Member since Oct 2004
2446 posts
Posted on 1/28/26 at 11:39 am to
quote:

Did you win that argument?


Yes I did, and it all started with “l’m gonna need to speak with your supervisor.”
Posted by Pedro
Geaux Hawks
Member since Jul 2008
39173 posts
Posted on 1/28/26 at 11:49 am to
Welp looks like I have a call to make when I get home
Posted by Pedro
Geaux Hawks
Member since Jul 2008
39173 posts
Posted on 1/28/26 at 11:50 am to
I mean there is based on policy. The school district I work for just offers shite insurance. It’s a good district though so they know they don’t have to offer good benefits to keep us
Posted by rintintin
Life is Life
Member since Nov 2008
17066 posts
Posted on 1/28/26 at 12:14 pm to
quote:

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


For clarity, you got a a professional fee (for the physicians work) and a facility fee from the hospital. The professional fee is always gonna be much lower because you're essentially paying for the physicians time. While the facility fee is covering the myriad of other expenses and overhead the hospital incurs. Sometimes those are lumped together depending where you go so you won't see them broken up separately.

Also, the charge may have been $178k, but that is essentially a fake number. Nobody (insurance or patient) will ever pay a full hospital charge. It is a made up number and varies wildly hospital to hospital. Your insurance didn't necessarily negotiate your particular bill down, they have pre-negotiated reimbursement rates for all services they've agreed to with the hospital before you ever step foot in the door. That's what the $35k is.

This post was edited on 1/28/26 at 12:19 pm
Posted by LSUA 75
Colfax,La.
Member since Jan 2019
4961 posts
Posted on 1/28/26 at 12:18 pm to
The clinic my NP wife works was bought by a hospital.After a year or so they started charging pt’s a $250.00 facility fee on top of the charges for the visit,any lab work or imaging done.
Medicare won’t pay it nor will insurance.Pt’s are irate as are the Drs.

I did some research and apparently all hospitals are doing that.
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