Great discussion overall, y'all.
Dude health insurance is a damn joke. I pay almost $500 a month for a high deductible policy through my company for myself my wife and two kids. They wont cover anything until I hit my $6,000 deductible. They are supposed to cover preventative stuff like a mammogram for my wife who is at high risk but they don't...just got a $400 bill from that place. Her general practitioner doesn't even take insurance anymore because its too much of a hassle. $100 a month out of pocket but at least I have that setup to come out of my HSA. Most of the prescriptions we get come from Kroger pharmacy who doesn't even take our insurance. They run them through goodrx for a fraction of the price of it costs to submit it through insurance. It's a racket. Only reason to have it is in case of some terrible accident or hospital stay.
I dont disagree with that. They ARE for profit businesses. Some people lose sight of that.
I've only had health insurance for about 3-4 years of the last 23 years. I tried to operate a small business and wasn't really very good at it! Health insurance was not affordable. Then when the ACA/ObamaCare came (I was against it legislatively) it was suddenly affordable...for a couple of years, then all of the sudden they wanted over $3K a month in premiums and only one insurer in my county in Virginia. THAT was as catastrophic as having to make payments to the hospital after an emergency. We've never qualified for subsidy...always just above that line.
I started looking at paying out of pocket for a needed hernia repair a couple years ago and the medical system is so screwed up you cant get a clear straight answer on costs. I was looking at maybe 10-15K to get it patched...I think, they might have shocked me even worse after the fact since they dont like to hold to quotes. And THAT was after a self pay 50% discount which is how we had been going to the doctor...you go to the doctor, then pay them for their services...weird concept, eh? They dont take chickens and furniture anymore!
I looked in to health insurance through the exchange last year and was surprised to see prices fairly reasonable. I chose a plan that is about $685 a month with a $6,500 deductible. That's still a lot of money but my employer, who doesn't pay employee's health insurance fully, DOES pay a $300 a month stipend toward your insurance AND takes the rest out of my paycheck and pays the insurance company directly for me. They take it out pre-tax...apparently its legit, so my actual out of pocket for premiums is around $200 a month.
My surgery should max out the deductible at that approximately $6,500, about half what I was looking at as a self pay. Wellness stuff is covered. I dont pay anything for checkups and blood-work (except my premium of course). I have a colonoscopy scheduled later after the surgery, that except any subsequent procedures relating to that, is covered. I've never had one because its so expensive as a self pay. If there are any additional procedures as a result of that, as long as I have anything done by the end of 2024 or whenever my policy date is early 2025, my out of pocket will have already been reached from the surgery. Then it all resets next policy term of course.
So for me, this year, it's a net plus. Plus if I have a coronary or a major injury, that max, again is $6,500 rather than the hundreds of thousands for bypass/stents, etc.. Which is the only reason I really wanted insurance...catastrophic stuff. I've seen the bills from relatives who had heart attacks, you think insurance is high?! With the scenario I laid out above, my premiums cost me about $2,400 a year. Not too shabby, really.