Andy, you are correct about Quebec vs. the other provinces, quite a few years ago we visited an ER for our daughter, I had a doctor's invoice mailed to me and had it paid through the Ontario's provincial insurance plan at that time, same cost just more bureaucracy. I didn't realize it hadn't changed over the years.
I'd be interested to hear comments from the US folks about insurance companies "pulling the plug" on a person's coverage if he/she develops a serious (costly) medical problem. Does this happen? As Canadians who purchase out-of-country top up coverage the insurance companies sometimes try hard to find wiggle room to deny coverage by going through your previous medical history. One example of this occurs when you answer a medical questionnaire for the coverage and answer "no" to the question "have you had any recent operations?", as an example if you had a colonoscopy, the answer is no, if you had a polyp removed during the colonoscopy the correct answer is yes, if you answered incorrectly any coverage can and will be denied only after you make a large claim for something completely unrelated.
Andy, you are correct about Quebec vs. the other provinces, quite a few years ago we visited an ER for our daughter, I had a doctor's invoice mailed to me and had it paid through the Ontario's provincial insurance plan at that time, same cost just more bureaucracy. I didn't realize it hadn't changed over the years.
I'd be interested to hear comments from the US folks about insurance companies "pulling the plug" on a person's coverage if he/she develops a serious (costly) medical problem. Does this happen? As Canadians who purchase out-of-country top up coverage the insurance companies sometimes try hard to find wiggle room to deny coverage by going through your previous medical history. One example of this occurs when you answer a medical questionnaire for the coverage and answer "no" to the question "have you had any recent operations?", as an example if you had a colonoscopy, the answer is no, if you had a polyp removed during the colonoscopy the correct answer is yes, if you answered incorrectly any coverage can and will be denied only after you make a large claim for something completely unrelated.
US...
When you obtain "insurance", you generally receive a lifetime limit (family or individual). It might be $1M or $5M. Whatever it is, once you reach that limit, the insurance is done. There is really no Government help afterward unless you can qualify for Medicare or Medicade or some VA package you might have earned from the military (good luck there).
Let's say you get some kind of catastrophic cancer (Stage 4). Let's say the treatment would be $1.5M and you only have a $1M policy. Over the course of your life (with this policy) you previously used $500K for other services. You then only have $1M left. Anything else would come out of your pocket. AND I don't know for absolute sure, but it's a pretty good bet that insurance companies would not renew you or extend additional coverage. It's also a safe bet that many (not all) doctors would refuse you further additional treatment (even though they have the "oath" they take). In any case, you best be ready for long, enduring payments or give up your assets including which include your house.
Many have finally figured out that they don't need to own anything. There are ways around that by selling off everything you have and keeping the cash in your mattress. Or, you can do like the rich and put everything in a TRUST Fund. Some prefer to keep there money off-shore, but the Government has increasingly found ways to shut that down.
With private policies, the insurance companies will always find a way to "pull the plug" (and put you on a death spiral) on you somewhere. They can increase the premiums to make them out of reach. They can limit your services. They can just drop you for no good reason. They can just drag out your case until doctors, clinics and hospitals sue you.
If you obtain insurance through your employer, it makes it a little tougher.
And regarding questionnaires...thanks to OBAMA-Nation Care, the doctors are now FORCED to ask you personal questions totally unrelated to your medical condition. Be careful even in general conversations. I once had a doctor ask me how old I was when I started driving. Thinking this was an odd question, I asked him why he asked. He stated he was now required to under the new Act. I told him that you may be required to ask, but I am not required to tell you anything. I came here for treatment. If you refuse to treat, I'll move on. Yet another reason to pay cash for all services...
Interesting that we were discussing insurance and paying with cash instead of insurance... 🙂
Read this article that just came out today...
http://finance.yahoo.com/news/cut-health-care-bill-pay-031100852.html#
"As consumers get savvier about shopping for health care, some are finding a curious trend: More hospitals, imaging centers, outpatient surgery centers and pharmacy chains will give them deep discounts if they pay cash instead of using insurance...."
In preparation for full-timing while retired, I came across this interesting ACA Healthcare Calculator. It is changing the dynamics for how we will "retire"...
http://kff.org/interactive/subsidy-calculator/
Basics show that in Texas, in order to qualify for "subsidies", we'll HAVE to make $16,200 a year in "income" before we qualify from maximum subsidies.
Assuming that there is NO "Income", we would not qualify for the ACA and instead, we would have to apply for Medicare. However, Texas is one of the States that has not expanded Medicare yet. We may or may not be eligible if we show a "0" income.
So, I began exploring how much "time" we would have to dedicate to "working" as a Campground host at $8 an hour. This assumes that we could get the $8 and hour and still somehow pull off a free campsite. In this scenario, we would have to work a total of 2025 hours a year (total). Split that between 2 and that means 2 people would have to put in 6 months and be off 6 months.
What would that get you you ask? According to the website above, that means you would be entitled to the Silver Plan at $28 a month or $330 a year. The subsidies could also be applied to the Gold and Platinum plans which cover 80% and 90% costs respectfully. The Silver plan covers up to 70%. There are still co-pays with this when used out-of-State. The maximum out-of-pocket for 2017 is $4,700.
The other option would be to not work at all and try Medicare. That would be free but would likely come with a lot of strings attached. AND, the coverage may not be as good.
The other option would be to just get an out-of-network plan at a much higher cost. The advantage there is that many more options become available and the overall coverage is also better.
The other alternative is the Medi-Share type plans. We're not opposed to that but it's hard to get an estimate on that cost.
We would like to hear your thoughts and costs on what you are doing...
Oh, what to do...
Greg,
Are you talking about Medicare or Medicaid?
Greg,
Are you talking about Medicare or Medicaid?
That would be Medicaid:
In response to your initial question about your insurance costs, it looks to me like you are in line with our costs. Our full timer insurance and truck insurance is slightly higher at about $1,400 each and it probably is because we are registered in Arkansas instead of Texas.
Medical insurance is our highest monthly cost in retirement. We are not old enough for Medicare (starts at 65) and do not have employer-provided insurance in retirement, so we opted for Medishare. It works the same as a catastrophic, high-deductible plan. Our annual out-of-pocket is $10,000 and our monthly "share" (the same as a premium) is just under $400. This is half the cost of purchasing an insurance policy for us. Plus, medishare has pre-negotiated prices for a doctor's visit - $35. DW went to ER in Florida and our cost was $130. So far, we are saving on our monthly premium and our few medical costs. We do pay more for prescriptions now, though.
And now for my personal opinion: I am quite conservative but realized I have been brainwashed against a socialized system. I have changed my views on socialized medical. After working at Disney World for the winter and meeting guests from all over the world, the US system is completely screwed up and most from Canada, Australia and U.K. are quite happy with their method. If we went to a similar system I bet we as consumers wouldn't be paying too much more, especially if EVERYONE paid in to the system. And, as in UK, if you want private care and private insurance, you pay for it! I really don't know how we get out of the mess Obama started. End of opinion, back to enjoying our Redwood 🙂
And now for my personal opinion: I am quite conservative but realized I have been brainwashed against a socialized system. I have changed my views on socialized medical. After working at Disney World for the winter and meeting guests from all over the world, the US system is completely screwed up and most from Canada, Australia and U.K. are quite happy with their method. If we went to a similar system I bet we as consumers wouldn't be paying too much more, especially if EVERYONE paid in to the system. And, as in UK, if you want private care and private insurance, you pay for it! I really don't know how we get out of the mess Obama started. End of opinion, back to enjoying our Redwood 🙂
An interesting comment! We have been accused of living in a socialist country a few times, we just smile and move on. I've probably mentioned it before but I'm sad to say there probably isn't a solution to the health care issue in the US. Here in Canada we sorted it out 60 years ago before "big insurance" and the doctors got a hold of it.
Here doctors "double dipping" private and public is illegal, we can still go across the border and pay however.
And now for my personal opinion: I am quite conservative but realized I have been brainwashed against a socialized system. I have changed my views on socialized medical. After working at Disney World for the winter and meeting guests from all over the world, the US system is completely screwed up and most from Canada, Australia and U.K. are quite happy with their method. If we went to a similar system I bet we as consumers wouldn't be paying too much more, especially if EVERYONE paid in to the system. And, as in UK, if you want private care and private insurance, you pay for it! I really don't know how we get out of the mess Obama started. End of opinion, back to enjoying our Redwood 🙂
An interesting comment! We have been accused of living in a socialist country a few times, we just smile and move on. I've probably mentioned it before but I'm sad to say there probably isn't a solution to the health care issue in the US. Here in Canada we sorted it out 60 years ago before "big insurance" and the doctors got a hold of it.
Here doctors "double dipping" private and public is illegal, we can still go across the border and pay however.
What did we do before "Insurance" became an entitlement? We paid cash and the doctors came for house calls. Now we pay insurance, pay a deductable, pay a co-pay and pay for anything the insurance feels they are not responsible for (electives in their eyes).
It's just an opinion, but I wonder what would happen if we all dropped insurance and went back to paying cash? Hear me out first...
I may have already posted this somewhere but we experienced paying cash and receiving a SUBSTANTIAL discount for it. A standard MRI was $220 with cash. With insurance, it was an out of pocket expense of $1008 for our deductible and another insurance payment of $800. Guess what? You pay more and your drive your own insurance rates right thru the roof. Its an endless cycle.
The staff stated that with insurance, many others get involved in keeping up with all of the paperwork and regulations. It takes an army to keep that going. With cash, doctors are paid immediately. They don't have to wait 6 months to collect. Prescriptions are also reduced when paying cash. Some prescriptions are free if your income is at a certain threshold.
The next thing is to create laws that force clinics to post their rates for all services. When was the last time you went to the grocery or gas station and there were no prices posted? Then you received a bill in the mail based on whatever they decided to charge you afterward? How are we supposed to "shop" our rate around? Where is the competitive market? And with conglomeration, it's more of a monopoly. Where is the Securities and Exchange Commission? Where is Congress? Talk about collusion!!!
There are ways to fix this. It's just that Congress, the insurance companies and doctors don't want it fixed. It will mean money out of their pocket.
I would also propose tort reform...That doesn't mean limiting the law suits...But what it does mean is that IF you sue, and you lose, you pony up the cost of the suit for both sides. You better be right! There are plenty of stories out there that individuals who sue without just cause. Some lawyer "is going to hammer" the opposition. They take 33% (or more) of the proceeds and having nothing to lose if they lose the case. NOW, IF a lawsuit is valid, there should not be limits. Or should there be? What's right is right. For a death, there is a set fee. Why is one life more important than another? If a limb is lost, that one be one set award. If eye site is lost, that would be another award. If a disability occurred, that would be another award. why should it be different because YOUR family income may be different than mine? The award is the award...Would this put some doctors out of business? Possibly. But many might file bankruptcy and do it all over again. Besides...they have insurance for things like this.
There are just so many things to think about.
