Do you live self insured?

[Jackie762]

I was wondering, how safe is it to live self insured in today's world? I do figure there's a little insurance on my car if in a car accident.....but what about major things like cancer? heart attack? broken bones? you know.......things happen in life we never know..... Also fees if you don't get insurance....my options are since recently divorced I can supposely get COBRA from my ex's insurance that I have been on for like 18 years okay (unitedhealthcare now) But Florida where I live doesn't like United Healthcare much for some reason, anyone not agree with that?? also, I had a call after filling out lots of those health.gov things and on was some rep and found me insurance at Aetna open choice PPO for $245 pretty good for my needs, except no prescription coverage at all, not even under the deductible, that's scary, what if you need a super pricey drug out there, I don't want to be stuck with $1000 a month meds or anything.....so, what about that? And then obamacare, you know the medals....bronze and silver and etc...... they were around $500 a month, with a $233 subsidy maybe for me.....are these bad? or what...it was Humana that was under obamacare.......anyway, very confusing how to go about even getting health insurance....

Would anyone else have any suggestions? Also, is it true that the subsidies you get if you get obamacare type insurance is counted as income on your taxes? Someone said that it was, I wondered?? I know you do get fined if you don't get insurance too, which is very sad too....;o( Could use imput and experiences regarding health insurance and best way to get it for a single person. Thanks all!!

:thankyou:

[Tybee]

Jackie, I don't know what to tell you although you ought to get health insurance, or you could lose everything you have.
As to prescriptions, I have health insurance and it doesn't cover my medicine anyway--just regular asthma meds run around 400 dollars a month. And I have "good" health insurance.
It frankly seems like a racket these days.

[sweetana3]

The ACA subsidies are not included as income on the Federal income tax return. However, if you get subsidies based on a certain income or family size and that changes during the year, you could be required to repay some or all of the subsidies that were used to pay down your health insurance if you got too much. They are considered advance payments of tax money to lower payments during the year.

It is complex and hard for anyone to understand. What a mess.

Best way for someone who does not understand it or have an employer who provides it, is to go to a broker or several and discuss what is available for you in your state. It is a state by state and often county by county selection process. Some plans are offered in only local markets.

[Miss Cellane]

No, the subsidy for the ACA is not counted as income on your taxes.

The subsidy is basically a tax credit. You can use it towards paying for your insurance, or as a tax credit when paying taxes.

Which insurance plan you end up choosing depends on a lot of things. How old you are, how healthy you are in general, etc.

The quality of the insurance under the ACA varies. You need to do the research and figure out which level of cost-coverage you are comfortable with--Bronze, Silver, Gold or Platinum, and how much you are able/willing to pay. The Bronze plans are basically catastrophic coverage--the deductibles are so high that the plans are almost useless unless you are hit by a car or get cancer. The Platinum plans are expensive, but cover much more--but you might not need that amount of coverage if you usually only visit the doctor 4-5 times a year.

[ApatheticNoMore]

I think by self-insurance you maybe just mean a non-ACA health insurance plan. This is an option. But I don't think you can get subsidies if you do that and what the plan contains may not be as regulated as with the bronze, silver, etc. options so it may be harder to compare plans (under the ACA the levels give some basis for comparison).

I have never heard of true self-insurance on health care, I don't think there is any such thing, there is merely being without any insurance coverage (I have heard of self-insurance on automobile insurance where you just pledge some massive sum of cash as collateral as it were, but I don't think any equivalent exists with health care). There are however non-ACA plans like I said.

I don't think just having insurance provides ANY guarantee that you won't "lose everything you have" if you are trying to protect whatever assets you have. The thing is with HMOs is there is often NO out-of-pocket-maximum for out-of-network providers. This means you could lose everything with a hospital visit if some expensive out-of-network person is involved even if the hospital is in-network. Now I believe PPOs (maybe EPOs I don't understand those though) provide better coverage in that they usually have an out-of-network maximum as well as an in-network maximum.

[iris lilies]

I was wondering, how safe is it to live self insured in today's world? I do figure there's a little insurance on my car if in a car accident.....but what about major things like cancer? heart attack? broken bones? you know.......things happen in life we never know..... Also fees if you don't get insurance....my options are since recently divorced I can supposely get COBRA from my ex's insurance that I have been on for like 18 years okay (unitedhealthcare now) But Florida where I live doesn't like United Healthcare much for some reason, anyone not agree with that?? also, I had a call after filling out lots of those health.gov things and on was some rep and found me insurance at Aetna open choice PPO for $245 pretty good for my needs, except no prescription coverage at all, not even under the deductible, that's scary, what if you need a super pricey drug out there, I don't want to be stuck with $1000 a month meds or anything.....so, what about that? And then obamacare, you know the medals....bronze and silver and etc...... they were around $500 a month, with a $233 subsidy maybe for me.....are these bad? or what...it was Humana that was under obamacare.......anyway, very confusing how to go about even getting health insurance....

Would anyone else have any suggestions? Also, is it true that the subsidies you get if you get obamacare type insurance is counted as income on your taxes? Someone said that it was, I wondered?? I know you do get fined if you don't get insurance too, which is very sad too....;o( Could use imput and experiences regarding health insurance and best way to get it for a single person. Thanks all!!

:thankyou:

Jackie, with your assets do not even THINK about not having enough health insurance to cover million dollar hospitals stays. You do not want to risk your assets, do you?

Take the cheapest Obamacare plan insurance like that Aetna plan. If it turns out that you need expensive medication later on, you can to pay for it until the next enrollment period (no more than 12 months) then you can get a plan that better covers medication. I am assuming here that you have no known medical need for expensive meds, you are just playing the "what if" game.

Or, I suppose you can, as ANM says, get a non-ACA plan, but
don't know how those work.

You should also have umbrella liability insurance to protect your assets.

ANM--I have a friend who truly "self insures" for health care and she has had surgery after surgery, cancer treatment after cancer treatment. She is stubborn and has her reasons for paying cash for these. I think she is a little crazy for it, but I also admire her independance in staying out of "the system." It was entertaining when the social worker came to visit her as she was recovering from being hit by a car. My friend lives VERy modestly and the young social worker took in her circumstances in a very old, small apartment in a modest part of town. social worker earnestly explained several social programs that my friend should apply for. My firend has mega personal and family resources, has a PhD in Nuclear physics from any ivy league college, and wants to stay far away from gubmnt programs.

[Gardenarian]

Hi,

It is super confusing!

I used an insurance agent, and she helped me figure out what plan would work best for me.

There is no charge; the agents get payback from the insurance companies. I feel the person I work with is very honest. She has helped me sort out various issues.

It's really nice to have someone to call who will pick up the phone, and has immediate answers.

I just looked in the yellow pages under insurance and then googled to get reviews on health insurance agents. I'm not eligible for subsidies; our health insurance iis $1100 per month for 3 people. It is a bronze plan - not a lot is covered, but you get a free physical every year. $5000 deductible.

[Teacher Terry]

Gard: that is terrible rates. We pay slightly less for 2 but because it is through my former employer it covers most things with a small co-pay. Although, that may change next year and right now the union is fighting the proposed changes.

[Gardenarian]

It's less than 1/2 of what were paying before the ACA :-/

[ToomuchStuff]

At least partially. Everytime you have something with a deductible, you are in part, self insuring. So far I have one control medication that I am on, that it costs x a month if I buy it, and 3x if they charge it to an insurance company. I view it as a responsibility to keep costs down, and pay that lower cost, then have it come back as premiums for all. Not everyone does (seen that argument at the pharmacy).