Do you work at a club that offers it?
Did you purchace it on your own?
If no to the above answers, what is a reasonable monthly insurance payment?
If any of you have good, affordable coverage, please share.
Do you work at a club that offers it?
Did you purchace it on your own?
If no to the above answers, what is a reasonable monthly insurance payment?
If any of you have good, affordable coverage, please share.





Im looking for personal health insurance at the moment myself here
so Im interested in replies to this as well!
Don't blink. Don't even blink. Blink and you're dead. Don't turn your back. Don't look away. And don't blink!
I have great health ins. I am not sure if it is still available due to all the changes. It is a high deductible plan the works in conjunction with my HSA (Health Saving Account). They start at around 45 a month I think. The usually include well visits (doc checkup/gyno) x1 per year. Everything else is paid out of poct until u reach your deductible. I have Blue Cross Blue Shield (higher end), and my deductible is the lowest you can get (1750), so I pay about 170 per month.
The greatest thing about this plan is that even tho you pay out of pocket, they charge your ins. first. This means that I pay the BBBS negotiated rates for everything until my deductible is met. I just had a bone scan that was 2,200 dollars- but I paid 578. I also get the ins. prices on Rxs.
EVERYTHING is covered when i reach my deductible if I stay in BBBS. You are supposed to have a HSA as well, to draw that needed money from. HSAs are great- for so many reasons. But I don't think they exist anymore...
The do exist, I guess they just lowered the amount you can add per year.
Last edited by shasta; 11-08-2012 at 11:23 PM.
Shasta, any way you can send me the info? I'd like to check it out...





Go on their website, they list all the plans. I have humanna 1 I pay 330 a month and it isn't that great! I'm shopping around!





I wouldn't spend too much time evaluating this option. Under ObamaCare, the HSA maximum dollar amount is being significantly altered beginning in 2013, and high deductible 'catastrophic' coverage insurance plans which do not include coverage for such things as substance abuse will no longer be allowed as of 2014.I have great health ins. I am not sure if it is still available due to all the changes. It is a high deductible plan the works in conjunction with my HSA (Health Saving Account). They start at around 45 a month I think.


Before I got married, I paid $230 a month for Kaiser. I was happy with it. This was a while ago, like 9 yrs. My then fiance, talked me into getting on his plan. He was working in a profitable firm in Beverly Hills. One of his close HS friends owned the company and somehow he made it work as if I was a spouse to get his medical benefits. (I'm not sure how). Fast forward to the present: the firm went under. My husband already had early on-set arthritis before I met him. It got more intense, so our insurance went up. Get ready for this: We pay over $1K per month!
Luckily, he's making enough $$ to afford it. But I often wonder if I just should have stuck with my former insurance. My health has not changed in all that time. I know it would have went up, but not that high.
I know this isn't much help, sorry.
http://doriengrais.blogspot.com/-Senior Citizen Stripper
(Check out my blogs on stripperweb:-)




I have Premera, pay about $120. It includes dental benefits too. I like it a lot, low copay, cheap meds, but I'm also not someone who gets sick often.
Goodbye Seattle Lusty Lady, where every Miss is a Hit, and every Hit is Missed. 1985-2010.
I don't know how anyone affords health insurance.![]()



.....
Last edited by twistedprincess; 01-24-2013 at 08:09 AM.


The earlier you get health insurance, the less expensive it will be. In most cases, the older you get, the possibilities there are for accidents, sickness, bad teeth that will require assistance for the rest of your existence. The younger you are, the less pre-existing conditions. A lot of insurance companies won't take people with pre-existing conditions or they will charge through the roof, like they are for my husband's arthritis.
http://doriengrais.blogspot.com/-Senior Citizen Stripper
(Check out my blogs on stripperweb:-)





purely for future planning purposes, the following changes in US health care coverage are set to take effect beginning in January of 2014 ... from
(snip)"One of the main features of ObamaCare is the creation of a new federally-financed health care entitlement that will subsidize the insurance premiums for low and moderate income Americans, beginning in 2014. The amount of the subsidy is inversely related to family income and will be a administered by new state-based ”exchanges” that will replace today’s small group and individual markets for health insurance.
Exchanges
ObamaCare creates new entities in every state through which individuals buying insurance on their own must purchase their government-approved insurance. In addition, many small businesses employees will get their insurance through the exchanges as well because their employers will not offer coverage to their workers under ObamaCare’s rules for employer participation (see “Employer Mandate”).
Premium Subsidies
Households with incomes below 400 percent and above 133 percent of the federal poverty line (FPL) who are enrolled in insurance plans offered through the exchanges are eligible for premium assistance financed by the federal government (Medicaid will cover families with incomes below 133 percent of FPL). In 2010, the FPL is $22,050 for family of four. The new law establishes a sliding scale of assistance based on limitations on required family contributions to the cost of coverage. For instance, at 150 percent of FPL in 2014, ObamaCare limits the amount that such households must contribute toward their health insurance premium to 4 percent of their annual income. At 400 percent of the FPL, households must contribute 9.5 percent of their income toward insurance premiums. Whatever portion of the total health insurance premium for their coverage is not paid by these households is covered by the new federal premium assistance program.
Estimated Federal Costs and the “Firewall”
The Congressional Budget Office (CBO) has estimated that this new premium assistance program will cost $113 billion annually by 2019, with premium assistance going to an additional 19 million Americans (the Medicaid expansion will add 16 million new people to the program at a cost of $97 billion in 2017).
This CBO estimate of the cost of premium assistance assumes that tens of millions of otherwise eligible households will not be eligible for this new entitlement because their employers will continue to offer them qualified coverage at their place of work. Under ObamaCare, if a low income household is offered qualified coverage by their employer, they are automatically ineligible for additional federal premium assistance (this is the so-called “firewall” rule aimed at creating a barrier against mass migration out of employer-sponsored insurance).
Former CBO Director Doug Holtz-Eakin has estimated that employers will have strong incentives to move as many as 35 million workers who will be eligible for premium assistance out of employer plans and into subsidized coverage provided through the exchanges because both the employers and the workers will be better off if they are able to access the large new federal subsidies available to exchange enrollees. Holtz-Eakin estimates that adding this many additional subsidized workers in the exchanges would add about $1 trillion over the next ten years to the cost projections provided by CBO.
Marriage Penalties
The new premium assistance program penalizes married couples. For instance, if two people each earn $30,000 annually, on their own, they would be judged to have incomes at about 300 percent of the FPL. But if that couple were to marry, their combined income would total $60,000, or about 500 percent of the FPL for a household with two people.
Work Incentives
The new premium assistance program provides powerful disincentives to work by imposing high implicit marginal tax rates on additional earned income. This occurs because large amounts of federal premium assistance is withdrawn at various points on the income scale. For example, a family of four earning just below $88,000, or 400 percent of the poverty level, will receive about $5,000 in annual subsidies to purchase insurance in 2016. Once that threshold is crossed, the subsidy immediately drops to zero. So for a family of four in that income range, a raise in wages would actually result in a significant reduction in take-home pay. The same disincentive applies at other points in the income scale, as premium assistance drops abruptly with small amounts of additional earned income. In fact, combined with explicit federal taxes (income and payroll taxes), the implicit tax associated with the withdrawal of premium assistance can push the effective marginal tax rates on earned income for many low and middle income households to well above 60 percent"(snip)
Some of the key points discussed above , but with little detail, are ...
'Qualified' health insurance plans. (snip)"In order to be counted as a "qualified benefit plan," insurance coverage must cover routine health care -- such as checkups and contraceptives -- without co-payment. It must also cover maternity care, mental health and substance abuse. "(snip).
Certain existing health insurance plans which provide for high deductibles, which do not cover mental health or substance abuse treatments, etc. will not 'qualify' under federal regulations and will thus not be counted as insurance coverage for IRS purposes. This will mean that, if such high deductible limited scope insurance policies continue to be offered, the buyer may also be required to pay the new IRS tax penalty for failure to purchase 'qualified' health insurance coverage in addition to the premium for the high deductible limited scope health insurance.
'IRS penalty' - failure to purchase coverage under a 'qualified' health insurance policy or 'public exchange' policy will result in the imposition of a new tax item on your annual tax return. Early calculations show that the 'average' tax penalty will wind up being somewhere around $1200 per year.
'80% payout by Insurance Companies' - (snip)Under health care reform, insurance companies in the small group or individual market have to spend 80% of the premiums they collect on medical costs, with only 20% going to administrative and other costs. Another section of the law addresses plans that are eligible for exchanges, which many individuals and small businesses will rely on for coverage. As you might expect, the calculations get complicated in a hurry. But the big issue is that under regulations from HHS, the amount that patients spend out-of-pocket to pay their deductibles on HDHPs isn't included as a medical cost for purposes of determining the medical loss ratio. Rather, only expenses that the insurance company pays count as medical losses to meet the guidelines.(snip)
The basic nature of high deductible limited scope insurance coverage is to require the insured person to pay significant amounts out of their own pocket for routine health care costs, and to require the insured person to pay a high deductible before insurance payouts kick in for serious / catastrophic medical procedures ... in exchange for a low monthly health insurance premium cost. Since the out of pocket payments by the insured do not count towards the insurance company's 80% / 20% calculation, it is doubtful that insurance companies can actually cover the administrative costs for high deductible limited scope insurance coverage if their 'reimbursement' for administrative costs is limited to 20% of the insurance premiums paid.
'Firewall' - after 2014, if ANY 'qualified' insurance coverage is available through a straight job employer or a spouse's employer ... presumably regardless of the cost of that insurance coverage ... and the person / spouse does not buy that insurance coverage ... they will be rendered ineligible for financial subsidies to reduce the cost of 'public exchange' health insurance.
"Pre-existing Conditions - Age Related Risk" - (snip)‘‘(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
‘‘(1) Health status.
‘‘(2) Medical condition (including both physical and mental illnesses).
‘‘(3) Claims experience.
‘‘(4) Receipt of health care.
‘‘(5) Medical history.
‘‘(6) Genetic information.
‘‘(7) Evidence of insurability (including conditions arising out of acts of domestic violence).
‘‘(8 ) Disability.
‘‘(9) Any other health status-related factor determined appropriate by the Secretary."(snip)
Under Obamacare 'public exchange' coverage, there won't be any differentiation of health insurance premium costs for young and healthy persons versus persons with pre-existing conditions and/or age related elevated health risks. 'Net' cost of health insurance premiums will be strictly based on income level.
Obviously the entire US health insurance industry is in 'turmoil' right now. As such, the only immediately relevant thought might be to see how everything shakes out through 2013 in regard to the types and ( net of gov't subsidies ) costs of health insurance coverage that will ( still ) be available in 2014. Then will come the time to run all of the math to try and figure out 'net' costs of your various health insurance options based on actual monthly premium costs versus amount of gov't subsidies ( or lack thereof ) versus the amount of new IRS penalty which must be paid if the insurance coverage you purchase isn't 'qualified' ( or you don't purchase any health insurance coverage at all ).
Last edited by Melonie; 11-04-2012 at 04:28 AM.
Um...think about that statement about not affording health ins. IMO it is something that should come before internet and phone.





^^^ that was true in the past, where insurance companies could deny health insurance coverage altogether, or charge outrageous health insurance premiums, to persons seeking insurance coverage AFTER they had been diagnosed with a serious and expensive 'pre-existing' condition. However, the new ObamaCare laws force insurance companies to provide insurance coverage despite the existance of 'pre-existing' conditions, and 'public exchange' health insurers must charge the same premium to healthy Americans as they do to Americans with 'pre-existing' conditions ( assuming they both have similar income levels ). And unlike the phone company or an internet provider, all health care providers MUST provide medical treatment regardless of the patient's ability to pay.
This leads to a 2014 scenario onward where a healthy US dancer or camgirl can take the 'cheap route' of paying the $1,200 ( or whatever ) IRS penalty, plus paying a few hundred dollars out of pocket for routine health checkups, and going without health insurance. If the day comes when the doctor diagnoses a need for serious and expensive medical treatment, the dancer or camgirl can then stop by the 'public exchange' insurance agency on the way home from the doctor's office, sign up for 'public exchange' health insurance coverage at the same $5,000 ( or whatever ) annual premium cost as if she had signed up before the serious and expensive medical condition was diagnosed, and then head to the hospital to schedule her now fully insured medical treatment !!! In this scenario, a US dancer or camgirl spending the extra $3,000 ( or whatever ) per year for 'public exchange' medical insurance coverage while they are still young and healthy is arguably a total waste of money.
Obviously, the situation regarding ObamaCare actually being enacted, and/or enacted with all of the provisions of current law intact, is an unknown.
But if she took the cheap route and waited until a serious diagnosis, then stopped by the public exchange (which I am hearing most likely will not be offered in Texas) and picked up some insurance...... then how different is that from her just going into the ER, having surgery, and expecting Medicaid to pick up the tab?





Going today's medicaid based 'cheap route' depends on her earnings being low enough to qualify for medicaid. With the future 'public exchange' option, there isn't any income limit for eligibility. With the future 'public exchange' option, higher income levels will mean higher insurance premium costs ( net of subsidies ), but the insurance coverage will still be available and the unsubsidized insurance premiums will still be 'affordable'.if she took the cheap route and waited until a serious diagnosis, then stopped by the public exchange (which I am hearing most likely will not be offered in Texas) and picked up some insurance...... then how different is that from her just going into the ER, having surgery, and expecting Medicaid to pick up the tab?
And, with this week's 'developments', it is now extremely likely that ObamaCare will be enacted as already scheduled.
Does anyone know of a good health insurance company in canada? specifically ontario? I am not planning on looking for fulltime work at least not right away when I finish school this summer, and ohip does not cover a lot of things like vision, dental, physiotherapy, etc
But Melonie, I see people who never have health insurance (claiming it's their right to purchase or not to purchase insurance) then end up in the ER due to a heart attack, have a $120,000 bypass surgery, can't pay, and Medicaid swoops in to pick up the tab. I've seen this multiple times, these people call me up asking about health insurance, (mostly senior citizens) and I tell them too bad, they waited until the last minute, now they have to deal with it until the next annual election period, or wait two years if going on a supplement with Medicare.
I just applied AGAIN for health insurance and was AGAIN denied (by Aetna) due to a pre existing condition. I have sleeping/insomnia problems, and take Trazadone if I can't sleep. This is of course classified as "mental health", so here are my options (pre-Obamacare!):
1. wait 1 year for an individual policy to cover anything related to my sleeping/insomnia, including the prescription medications I currently take, or any doctor that prescribes them. So, even if I go to a totally new doctor, get prescribed the same medication but for a different diagnosis, my insurance will not cover either the doctor's visit or the medication at all. I have zero coverage for any medications and related doctors visits for anything I am CURRENTLY taking or being treated for, for one year.
2. Get a job, get on a group health plan, possibly wait six months instead of one year.
Now with Obamacare, I have the option of taking the Pre Existing Condition Plan in Texas, which blows away any private insurance carrier as far as deductibles, co pays, coinsurance, exclusions/limitations. Oh yeah, they also share the same network as United Healthcare, so I get to go to ANY of those doctors. They cover way more than any private insurance plan and also cost WAY less.
But Melonie, I see people who never have health insurance (claiming it's their right to purchase or not to purchase insurance) then end up in the ER due to a heart attack, have a $120,000 bypass surgery, can't pay, and Medicaid swoops in to pick up the tab. I've seen this multiple times, these people call me up asking about health insurance, (mostly senior citizens) and I tell them too bad, they waited until the last minute, now they have to deal with it until the next annual election period, or wait two years if going on a supplement with Medicare.
I just applied AGAIN for health insurance and was AGAIN denied (by Aetna) due to a pre existing condition. I have sleeping/insomnia problems, and take Trazadone if I can't sleep. This is of course classified as "mental health", so here are my options (pre-Obamacare!):
1. wait 1 year for an individual policy to cover anything related to my sleeping/insomnia, including the prescription medications I currently take, or any doctor that prescribes them. So, even if I go to a totally new doctor, get prescribed the same medication but for a different diagnosis, my insurance will not cover either the doctor's visit or the medication at all. I have zero coverage for any medications and related doctors visits for anything I am CURRENTLY taking or being treated for, for one year.
2. Get a job, get on a group health plan, possibly wait six months instead of one year.
Now with Obamacare, I have the option of taking the Pre Existing Condition Plan in Texas, which blows away any private insurance carrier as far as deductibles, co pays, coinsurance, exclusions/limitations. Oh yeah, they also share the same network as United Healthcare, so I get to go to ANY of those doctors. They cover way more than any private insurance plan and also cost WAY less.
Like I said, from what I am hearing, Texas is trying to opt out of this? I'm not sure, and I don't know a whole lot about the exchanges. I do know that okay, higher income = higher premium, but with that being said, higher premium = higher tax credit as well.... ?
As far as the 80% rule, I do agree that insurance companies have evolved into greedy third party corporations, denying cancer treatments, doctor recommended services, devices, etc. to save money. Basically you have a pencil pusher up in an office crunching numbers and deciding what healthcare treatment you are going to get. This is bullshit if you ask me! The doctor should be able to freely decide, taking insurance and money out of the picture, what the best treatment for your health may be. In the meantime, you have corporate executives getting their huge bonuses and taking company paid trips on private jets to the Bahamas, unacceptable! So now Obama is saying NO, the insurance companies HAVE to spend 80% of every dollar collected in premium back into actually paying for healthcare. I totally support this! Then again, I've seen way too many people have a catastrophic event, and end up on Medicaid to pay the tab, or just racking up hospital bills they never pay.
Like I said, from what I am hearing, Texas is trying to opt out of this? I'm not sure, and I don't know a whole lot about the exchanges. I do know that okay, higher income = higher premium, but with that being said, higher premium = higher tax credit as well.... ?
As far as the 80% rule, I do agree that insurance companies have evolved into greedy third party corporations, denying cancer treatments, doctor recommended services, devices, etc. to save money. Basically you have a pencil pusher up in an office crunching numbers and deciding what healthcare treatment you are going to get. This is bullshit if you ask me! The doctor should be able to freely decide, taking insurance and money out of the picture, what the best treatment for your health may be. In the meantime, you have corporate executives getting their huge bonuses and taking company paid trips on private jets to the Bahamas, unacceptable! So now Obama is saying NO, the insurance companies HAVE to spend 80% of every dollar collected in premium back into actually paying for healthcare. I totally support this! Then again, I've seen way too many people have a catastrophic event, and end up on Medicaid to pay the tab, or just racking up hospital bills they never pay.





I'm not sure of particulars pertaining to the Texas version of 'public exchange' insurance offerings, but I do know that ObamaCare mandates particular coverage standards in regard to WHAT is covered, how high the premium for that coverage can be, how high the co-pays etc. can be, as well as ObamaCare mandates that people with pre-existing conditions cannot be denied coverage and cannot be charged higher premiums because the pre-existing condition will result in higher insurance payouts. One of the areas of state to state variations will be so called 'expanded Medicaid' ... i.e. at what income level does 'free' health insurance coverage become available, versus higher income levels requiring payment of a 'public exchange' insurance premium ( that may in turn be offset by a tax credit below a certain earnings level ).Now with Obamacare, I have the option of taking the Pre Existing Condition Plan in Texas, which blows away any private insurance carrier as far as deductibles, co pays, coinsurance, exclusions/limitations. Oh yeah, they also share the same network as United Healthcare, so I get to go to ANY of those doctors. They cover way more than any private insurance plan and also cost WAY less.
In regard to the 80% mandate, the relevant point regarding previous posts discussing 'catastrophic only' health insurance coverage is that every health insurance policy involves a relatively fixed amount of administrative costs. On the other hand, the amount of total health care payout dollars varies widely between different health insurance policies, depending on what sort of things are or are NOT covered, depending on how high the deductible and co-pays are, etc. Thus the 80% mandate will essentially render 'catastrophic only' policies, policies with restricted coverage, policies with low premiums but high deductibles and high co-pays etc. impossible for insurance companies to offer in the future.
Not wanting to speculate prematurely, but if ObamaCare follows along the same cost control decision making processes as 'public' health insurance offered in other countries already, indeed future decisions in regard to 'acceptable' medical treatments, types of drugs, etc. will now place gov't health insurance bureaucrats in a position of having the 'final say' in regard to what medical treatments, types of drugs etc. that 'public' health insurance is willing to pay for - regardless of what a doctor actually recommends for a particular patient. Simple economics says that it's impossible to charge average insurance premiums of around $5,000 per year, while at the same time paying for $100,000 treatments for more than 4% of those insured ( assuming that 20% went to administrative costs ).
Last edited by Melonie; 11-14-2012 at 02:41 PM.
Whoa.... this is ALOT of speculation. Saying that the 80% mandate will render catastrophic plans impossible for insurance companies to offer in the future and taking into account all of the other factors is a bit one sided. What about the exchanges, and how that will change prices and plans that insurance companies offer? What about all of the hospital funding that our president is cutting off to hospitals that have too high of a re admission rate? That will also come into play, it's not just the insurance companies that will be treated this way. That entire economic model of the healthcare industry will change drastically, and to be honest there is no way to predict which direction it will take. I also don't think comparing to other countries' healthcare systems is even is minutely comparable.
Something had to be done, shit was getting ridiculous over here. Turned down from Aetna because of insomnia? Too high of income for Medicaid? WTF am I supposed to do???





again I don't want to get into a 'political' discussion regarding the future of US health insurance. However, at the same time, I don't want to leave dancers and camgirls reading this thread with the impression that paying expensive premiums for private health insurance coverage this year will somehow benefit them in future years.
i agree with you entirely that the entire US health care 'business model' will change drastically. However, I don't entirely agree that the probable changes are totally unpredictable. As to the speculations, I'm seeing these coming from financial media ... which is attempting to interpret the most likely 'cause and effect' results of the new 'rules'.
As to what the premiums will cost in 2014, as long as earnings remain below the 400% of federal 'poverty' levels, the maximum annual premiums will be as follows per the chart at the following link ...
for a single person earning less than the $ 44,680 annual income ( = 400% of federal poverty level ) the maximum public health insurance premium cost will be capped at $4,245 per year.
and of course this cost is a matter of interpretation, since failure to pay the $4,245 annual premium for individual 'qualified' health insurance coverage through a state / federal health care exchange will 'cost' the person a new ~$1,200 tax penalty ( meaning net cost of health insurance will only be ~$3,000 per year).
The mention of federal health insurance exchanges appears to be the available future option for persons living in states which choose not to set up their own state run health insurance exchanges.
There is also an open question in regard to what happens to health insurance premium costs if that single person earns $45,000+ ... and thus no longer qualifies for subsidized / premium capped public exchange health insurance coverage. Does the premium immediately shoot up to $8-10,000 per year ??? Time will tell. If so, this will in turn lead to some new analysis for dancers and camgirls i.e. are they actually 'money ahead' net of taxes and health insurance premiums by dancing or camming an extra night per week and pushing their incomes over the $44,680 income eligibility threshold ???
Last edited by Melonie; 11-20-2012 at 05:22 AM.
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