The concern for me would be what the plan doesn’t cover and what happens if something catastrophic happens durin the year you are on the plan. Some have annual or lifetime maximums. My friend’s healthy 22 yo son was diagnosed with testicular cancer just before college graduation and treatment was very expensive, even during just that same year. Thanks to the ACA he was able to stay on his dad’s plan while delaying his start date at his post-college job and waiting for that insurance to kick in. Prior to that, in most states, he would have been out of his parent’s plan as of college graduation.
The small company I work for has insurance, but it is expensive. Yet I know that pre-ACA people with individual policies had very high premiums. My self-employed friends would change policies every year or so to get a better deal.
Have you considered having a group policy for your employees? How many do you have?
@MaineLonghorn I think the ACA requies a minimum income for subsidies. Your son is probably eligible for medicaid due to his very low income or would have to pay the full cost of the premium. That happened to one of mine when he was unemployed for a short while. Can he be covered under your policy as an under 26? Not sure if travel can be a qualifying event but check. You can add him for a month and then remove him. Or you might consider covering him (even if it costs you money) as if something happened, you may well want him to come to the US for treatment. Sounds like he would not be covered here under the current scenario.
I have my ACA-compliant health insurance as group coverage for a business composed entirely of family members. I’m actually the only person who has insurance under our group, and have been since the ACA started.
My stingy company only partially covers employees and no dependents, so I always get my D an ACA, plan as her college doesn’t offer health insurance. The premium nearly doubled for 2018, but is 12 percent lower for 2019. I feel like I should be feeling more grateful, but I’m realizing I spend far more on health insurance than food every month.
Actually $270 for a month of coverage is much less than I paid per month to cover S in 2020, after his university coverage ended and before he was again covered under our policy as under 26.
shellfell, it’s the same way in my state. My family members who are theoretically part of our group are all covered under Medicare, so are permitted to decline coverage.
Thanks for the info. I think I’m going to go with a Christian medical cost sharing company. I know it’s not for everybody, but I think it will work well for him. They will cover him overseas. His pre-existing condition would be covered for sure after three years. And they would ask members if they would be willing to pay for him if something happened before three years have passed.
@mom2and We have 10 employees and are looking into offering group health (I have a meeting next week with a broker). The downside is that we would have to pay for at least half of their premium in addition to ours, which may not be affordable either. We used to offer group health and didn’t take it for ourselves because a personal plan was less expensive. Then our group insurer said one person doesn’t make a group and kicked us off.
Here’s an article about Christian cost sharing (I have no personal experience). The article has several folks who have had challenges getting payments on their behalf as well as limitations on medications to 6 month supply/year.
https://www.bls.gov/news.release/cesan.nr0.htm says that the average household spent $7,729 on food and $4,928 on health care (including $3,414 on insurance) in 2017. However, that health care spending appears not to include any employer or government (Medicare, etc.) subsidy, since http://www.ncsl.org/research/health/health-insurance-premiums.aspx says that the total cost (including both employer and employee shares) of an employee family plan average $18,764 in 2017 (employee only is about a third of that). So if your employer or government subsidy is small or none, it is easy to see spending more on health insurance than on food (and even more so if you eat inexpensive home prepared foods).
Medical care in the US is extremely expensive, but the cost is hidden for most people who get much of it subsidized by their employers or the government.
Yes, the total cost of our policy premium is much more than we ever spend on groceries. We are very fortunate that H’s former employer pays 75% of the premiums and the policy coverage is excellent.
We looked into getting group insurance for the small business(es) I work for, and it was discouraging.
The broker said the SHOP program (Marketplace insurance for small businesses) was nonexistent in our state/county.
Then the broker explained that even if we could get enough people to join so we could pool rates, it would only be a good deal for the older people in the group. For the younger people, they’d get a better price buying an individual policy, especially if they qualified for subsidies.
I don’t think you can compare today’s insurance with pre-ACA. There have been a lot of changes in our nation’s healthcare system, particularly as healthcare has transitioned from non-profit to “make as much money as we can.” I’ve had the same insurance for 17 years and have seen the base costs of things - especially prescriptions - skyrocket. ACA has a lot of problems, but I believe that without it, the medical and pharmaceutical industries would be totally unregulated and costs would soar beyond our wildest imaginations.
Have you looked into HSAs that will allow you to have lower premiums with higher deductibles but save money for that fateful health crisis?
Wow, Some of you guys have pretty inexpensive options. When we owned the business ( and in the first Obamacare years) we paid $26K for our family plus we paid a 14K out of pocket. We also paid a 3% tax because the company made a lot that year and it was a lot of money. We also paid reduced prices but no where near free on medications ( of which we took nothing on a regular basis).
Although we are all healthy, over the years, a couple of hospitalizations and one big bump in the road created A LOT of bills. I mean a lot. We were able to access all the things we needed because we had the health care. So although we paid a lot, we also needed it at times and used it. We have never gone without healthcare, though my magic number was $50K, if it reached that annually I’d let it ride ( would have saved the money and kept it in an account called SHTF) . We were close at 38K as self employed folks.
The thing is, you really have to think long and hard before going without. Let me give you a few examples:
You suddenly get cancer and need specialized services and access to a premium hospital and special meds/treatments.
You have an illness which creeps up and you end up in the hospital for a couple of weeks.
Your kids ( if they aren’t grown) wind up with a rare disease and not all the options for treatment are covered.
You get sick and cannot work as you used to and have new medical expenses.
When my spouse sold the company, we joined an employee health care plan and now pay only about $600 a month and 6K out of pocket. It’s a lot less, but not insignificant to many people. I hate it when people think that health care is “free” It isn’t. The costs are spiraling for many families and employers as well. I have been an employer who pays a lot and many are surprised how much it costs to buy health insurance in some markets.
Before I’d go without it, I’d make sure to have a lot of money saved and also to think through some scenarios. Most medical things happen quick so you can’t wait to think through the best spending options. Also, maybe post on a forum of self employed people who opted out ( who will be able to tell you many horror stories). As long as you’ve done research and are comfortable, then you’ll know.
If you go without, just be prepared to file bankruptcy to get rid of the claims. My father’s wife was caught between short term policies and was diagnosed with cancer (pre ACA). The diagnosis was at the end of one policy and the beginning of another so neither policy wanted to cover it. She ended up with great treatment – Cleveland clinic and such, and a lot of bills. She paid what she could, got a lot waived under special circumstances, and filed bankruptcy to clear out the rest. She didn’t have a lot of assets to begin with, so the bankruptcy wasn’t a big deal to her.
And yes, healthcare is expensive. But there are all kinds of issues there. How can a provider “charge” $5,000 for an MRI, cut it down to $2,500 for someone insured by BCBS, when you can get it for $500 at a preferred provider? It’s nuts and unfortunately the one thing the ACA didn’t address – reduction of the costs of provision.
Where I live in the Chicago suburbs, the networks are very, very narrow.
I’m not going to argue that going without insurance is a great idea, but I find it quite disheartening that we are paying so, so much & should H or I get very ill, our choice of medical practitioners and choice of hospitals is…uh, not the best. Not even close.
Here you have to have a certain number of employees covered to be meet the “group” requirements, and every employee has to be offered coverage. However, we still have an employee-sponsored plan even though a number of employees are covered by their spouses. But yes, the company pays for about half the premium. The small company I work for stopped giving raises (and are still giving only very small ones), and removed the “gold” plans from the offerings (too costly), but still offers coverage.