Self employed folks; healthcare?

[cj428mach]

Also check with your chamber of commerce, if you are a member it can sometimes get you a lower rate.

Or if you're a member of a trade organization sometimes you can get decent insurance through them.

Our company changed plans after Obamacare was passed so we were going to get nailed by BCBS and each person was going to have to have their insurance premium set based off their age. This is great for young people but older people have to pay $900+ a month for a single policy.

We got in with our local trade organization that we've been a member with for 20+ years. We were able to be grandfathered in this way and have a single set premium that was the same for all employees. This made it possible to insure our older employees.

 

[Ohio Snake]

I asked if your wife can work at a company/place etc and carry who's needed.

If the plan allows that to happen...yes. Most employers will pay something towards the employee premium and discretionary for dependents. Ohio requires minimum 50% employer participation.


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[Ohio Snake]

Or if you're a member of a trade organization sometimes you can get decent insurance through them.

Our company changed plans after Obamacare was passed so we were going to get nailed by BCBS and each person was going to have to go into the insurance premium set based off their age. This is great for young people but older people have to pay $900+ a month for a single policy.

We got in with our local trade organization that we've been a member with for 20+ years. We were able to be grandfathered in this way and have a single set premium that was the same for all employees. This made it possible to insure our older employees.

There are two ways to have group premiums determined. The way I see it mostly is by age banding. The other way is by age based total group premium divided by number of employees and covered dependents. The later works best for older employees with a mix of younger employees.


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[cj428mach]

There are two ways to have group premiums determined. The way I see it mostly is by age banding. The other way is by age based total group premium divided by number of employees and covered dependents. The later works best for older employees with a mix of younger employees.


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BCBS in Kansas made it to where your premiums are based off your age if your plan wasn't in effect before Obamacare. You had no choice but to have premiums set off of age of the employee. 50-60yr old employees were in the $650-950 range. After getting grandfathered in under our trade organization the premiums are in the $350 range for every employee no matter what the age.

 

[Ohio Snake]

BCBS in Kansas made it to where your premiums are based off your age if your plan wasn't in effect before Obamacare. You had no choice but to have premiums set off of age of the employee. 50-60yr old employees were in the $650-950 range. After getting grandfathered in under our trade organization the premiums are in the $350 range for every employee no matter what the age.

Those that have grandfathered plans typically have two great benefits: lower premiums and true PPO network.

Im 54 years old and have a non-group grandfathered HSA PPO plan with Anthem BCBS. The plan has wellness benefit, $5000 deductible/ max out of pocket for $254.00 per month. A similar plan under ACA (Medical Mutual, 6400 deductible/max out of pocket, no wellness, HMO network cost $534.00 pre month.
The ACA is a failing system. You can can clearly see the ACA programs have most Americans paying way more premiums for a lot less coverage.

Those that have a grandfathered plan will want to keep that plan as long as the ACA continues to fail and the Dems and Republicans continue to be in a stalemate over what to do. Both sides need to accept blame for the failing system and work together on a solution to make healthcare truly affordable for all .

Personally, I don’t think the answer lies with just with insurance carriers. I think the master pricing of what facilities charge for products, Rx and services need to be standardized nationwide is a big starting point. As an example, its really bad when one hospital charges $10,000 for a broken arm and another hospital down the road charges $3500 for the same procedure. The person without coverage will be billed for the $10k at the first hospital, if taken there. A covered person may pay $1500 as the negotiated price between the carrier and the in network hospital. Just crazy!


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[cj428mach]

Those that have a grandfathered plan will want to keep that plan as long as the ACA continues to fail and the Dems and Republicans continue to be in a stalemate over what to do. Both sides need to accept blame for the failing system and work together on a solution to make healthcare truly affordable for all .

What blame do the Republicans share? other than not repealing the ACA.

Also standardized pricing isn't a good thing, that eliminates competition and the free market system. If insurance companies could find a way to incentivize saving money by the policy holder that would help.

On Thanksgiving my wife gave birth to our daughter by C-section. The hospital said we were required to stay in the hospital at least 48hrs but we could stay longer if we wanted to or felt it was necessary. We wanted to get home so we left as soon as we could, but others might not. People often feel that they're paying for insurance so who gives a damn what the final bill is. An extra day in the hospital that isn't necessary isn't cheap and that all adds to the cost of insurance.

 

[Ohio Snake]

What blame do the Republicans share? other than not repealing the ACA.

Also standardized pricing isn't a good thing, that eliminates competition and the free market system. If insurance companies could find a way to incentivize saving money by the policy holder that would help.

On Thanksgiving my wife gave birth to our daughter by C-section. The hospital said we were required to stay in the hospital at least 48hrs but we could stay longer if we wanted to or felt it was necessary. We wanted to get home so we left as soon as we could, but others might not. People often feel that they're paying for insurance so who gives a damn what the final bill is. An extra day in the hospital that isn't necessary isn't cheap and that all adds to the cost of insurance.

Republicans share blame for not presenting a solution to repeal healthcare AND solve the inherent issues that plague the system. It would not be wise just to repeal the system and most Republicans recognize a full out repeal would destroy the credibility of the the Party if people are denied coverage.

I disagree with your comment on standardized pricing would eliminate competition and the free market system in healthcare. When some one has an emergency, they dont call care facilities to find out who has the lower cost in their network. This is not a free market system whereas you should go for the lowest cost or negotiate what your willing to pay.

You get to choose whether you go to Walmart or Kroger for your groceries to price comparison shop. Competition works here!

Yes, you do have a choice of where to go for emergencies, but simply....most if not all emergency situations for people end up going to the nearest facility or in network facility regardless of cost. This is where standardized pricing would come into play and is unique to the healthcare industry.

Congratulations to you and your wife on having a baby. A great Thanksgiving present. Maternity is never inexpensive.


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[GM Nitemare]

After reading these premiums, I almost threw up. I live in Alberta, Canada, and my wife and I own an insurance brokerage service. Our monthly premium for our healthcare=$0.00. We sell group and individual healthcare plans. As an example: Married worker with children(however many) with a $0.00 deductible for healthcare:things such as physio, chiropractor, hearing aids etc etc etc, drugs and dental=$300.00 per month. YOUR healthcare system is, of course, better than in Canada. But, you can have a heart transplant and walk out of the hospital without paying anything.

 

[lOOKnGO]

It has become the norm to accept something for nothing. Good for Canada! I on the other hand just want things the way they were, before Obamee f'ed everything up. Now I pay for me and three other illegal families insurance since his meddling.


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[EatonEggbeater]

You're a wealth of information, thanks O/S.

I think (as written above) as a consultant, I can take my payments off my taxes; I'll get the lowest BCBS I can find; $2300 or so.

I'll wait until Friday, though.

 

[Ohio Snake]

You're a wealth of information, thanks O/S.

I think (as written above) as a consultant, I can take my payments off my taxes; I'll get the lowest BCBS I can find; $2300 or so.

I'll wait until Friday, though.

If your self employed ( sole proprietor, S Corp or C Corp) healthcare premium payments are deductible as a business expense. Sole Proprietors will see it under schedule c.

I’m actually certified as an agent on healthcare.gov. I sell individual and group plans as part of my practice. I must admit though: I only sell to those requesting help and are clients within my practice. I actually find selling healthcare as a pain in the rear end and prefer to stick with all other aspects of financial planning and wealth management.....items I can control.


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[Ohio Snake]

After reading these premiums, I almost threw up. I live in Alberta, Canada, and my wife and I own an insurance brokerage service. Our monthly premium for our healthcare=$0.00. We sell group and individual healthcare plans. As an example: Married worker with children(however many) with a $0.00 deductible for healthcare:things such as physio, chiropractor, hearing aids etc etc etc, drugs and dental=$300.00 per month. YOUR healthcare system is, of course, better than in Canada. But, you can have a heart transplant and walk out of the hospital without paying anything.

I hear you on the Canadian system. There is good and bad in all systems.

Of interest:
There is a carrier in South Carolina offering plans with a “medical vacation” intertwined into the policy. Im not 100% on how it works, but I do know the gist of what it does. As an example, an insured needs heart valve surgery. In the US, that procedure can cost $125,000. In Germany, the same procedure may cost $45,000 by doctors trained and schooled in the US. It would be less expensive to have the carrier pay for travel, lodging and surgery in and to Germany than have the procedure done here in the US...hence a medical vacation.

I saw this in a insurance news magazine about three years ago and thought it was interesting.


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[OETKB]

After reading these premiums, I almost threw up. I live in Alberta, Canada, and my wife and I own an insurance brokerage service. Our monthly premium for our healthcare=$0.00. We sell group and individual healthcare plans. As an example: Married worker with children(however many) with a $0.00 deductible for healthcare:things such as physio, chiropractor, hearing aids etc etc etc, drugs and dental=$300.00 per month. YOUR healthcare system is, of course, better than in Canada. But, you can have a heart transplant and walk out of the hospital without paying anything.

Not to stray too far off topic, but I have a question, and this is not a challenge. My wife works in a busy surgical practice in an admin role, and she has a co-worker from Canada, whose parent still live there. She said her dad died waiting to be treated. I don't recall how long he had to wait. Is this a problem in the current system?

 

[Ohio Snake]

Republicans share blame for not presenting a solution to repeal healthcare AND solve the inherent issues that plague the system. It would not be wise just to repeal the system and most Republicans recognize a full out repeal would destroy the credibility of the the Party if people are denied coverage.

I disagree with your comment on standardized pricing would eliminate competition and the free market system in healthcare. When some one has an emergency, they dont call care facilities to find out who has the lower cost in their network. This is not a free market system whereas you should go for the lowest cost or negotiate what your willing to pay.

You get to choose whether you go to Walmart or Kroger for your groceries to price comparison shop. Competition works here!

Yes, you do have a choice of where to go for emergencies, but simply....most if not all emergency situations for people end up going to the nearest facility or in network facility regardless of cost. This is where standardized pricing would come into play and is unique to the healthcare industry.

Congratulations to you and your wife on having a baby. A great Thanksgiving present. Maternity is never inexpensive.


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Here is another great example for us to ponder:

Hospital A and Hospital B both buy the same plastic bed pan from a vendor for $2.00 a piece. Hospital A normal charge is $150 for that bed pan. Hospital B charges $125 for the same pan. Hospital A is in the large network (lets say BCBS) for your healthcare and your carrier has “negotiated” the charge for it’s members (insured) to $45.00. Hospital B is a smaller facility and is in another smaller network (CareSource) and has negotiated a member charge of $75.00.

If you are a member of BCBS and go to Hospital A which is in your network, the carrier or you are charged $45. If you go to Hospital B which is outside your network, you are charged up to $125 based on your plan coverage for out of network cost.

If your a member of CareSource and you go to to Hospital B which is in your network, you or your carrier is charged $75. If you go to Hospital A which is out of your network, your charged up to $150 based on you plan coverage for out of network cost.

As you can see, standardized cost ( on the hospital and carrier level) would stop some of the nonsense in pricing. Hospitals currently can charge what they want, carriers only agree to pay for what is covered in the network. Price gets too steep for carrier to cover, they exclude that service or product from coverage.

As you can see, there is no market driven competition here. The only negotiators are the carriers and the providers....not the consumers.

The closest thing to standardized cost is Medicare...And providers hate what the government is willing to pay.


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[OETKB]

The closest thing to standardized cost is Medicare...And providers hate what the government is willing to pay.

You really never hear anyone complain about their medicare coverage. I mentioned my wife works in a surgeons office. She told me that if they had to accept what .gov pays for ALL their patients, it would be a whole different ballgame.

 

[Buckwheat 1]

May we need the guys that regulate auto body repair to regulate health care.

 

[DaleM]

Retired military, me no cost because of VA my family plan 144 a month with 10dollar co pay.

I can shot talk all these plans like many taxes because I do not experience them.

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[EatonEggbeater]

If your self employed ( sole proprietor, S Corp or C Corp) healthcare premium payments are deductible as a business expense. Sole Proprietors will see it under schedule c.

I'm getting 1099'd by my employer, as an individual, should I incorporate myself to take advantage of the premium removal for sole proprietors?

 

[OETKB]

I'm getting 1099'd by my employer, as an individual, should I incorporate myself to take advantage of the premium removal for sole proprietors?

I don't think you need to, just as long as you have self employed income to deduct from on your 1040. Sole proprietors aren't incorporated.

Axe an accountant, unless we have one in this thread, but I was able to deduct some health insurance with some drips and drabs of self employment income I had last year (I'm mostly retired)

 

[Equalbracket]

What's pathetic is a lot the plans being sold/advertised don't even meet the minimum essential coverage necessary and unless you ask you're just pissing money away. BCBS is my only option, premiums are stupid high, and deductible is still 5,000.

Maybe i'll start identifying as African American, but one that works.