12 years ago at age 64 husband and I had to pay $1600/mo as small biz owners. It was Aetna at that time. I couldn’t shop because I am diabetic and no insurance company wanted me. It is ugly out there.

than what I’m paying now because I’m not eligible for tax credits because I make just above that threshold. Obamacare did so many good things. Among them, of pre-existing conditions price gouging. Now they gouge on the basis of age. I’m 59, my husband is 62 and my kiddo is 18.

But under the ACA, can't insurance companies turn down coverage for those with pre-existing conditions if they are willing to pay a penalty for doing so? Which means if treatment of said condition is far costlier than the penalty, it makes no financial sense for them to cover that person.

'Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health. Medicaid and the Children's Health Insurance Program (CHIP) also can't refuse to cover you or charge you more because of your pre-existing condition.'

https://www.google.com/search?q=can+ACA+turn+down+folks+with+pre-existing+conditions&rlz=1C1CHBF_enUS1002US1002&oq=can+ACA+turn+down+folks+with+pre-existing+conditions&gs_lcrp=EgZjaHJvbWUyBggAEEUYOdIBCTE3MDc3ajBqN6gCALACAA&sourceid=chrome&ie=UTF-8

insurance corporations cannot discriminate against those with pre-existing conditions by charging them more for those conditions. Since they can’t charge more for those with pre-existing conditions, the only way that they can price gouge is by charging more premium based on age. That’s what’s happening here. My husband is 62, I am 59 and my kiddo is 18. They’re charging these rates based on our age not any pre-existing condition.. and, there’s no competition in Montana, so there’s that

That is what the 'market' price for coverage. If I had to pay that w my diabetes, i'd be paying $2K each month plus maxing my deductible, so and extra $625 a month. We spend so much here for so little health coverage. And no matter how wealthy someone is they are still at risk with all the overloaded emergency rooms.

know they only have a few years to soak you before you can apply for Medicare.

I tell my brother (who went straight from employer paid insurance to Medicare) and my mother (who retired 20 years ago) what I have to pay in premiums as someone who is self employed, and they think I'm exaggerating and making it up.

My plan's premiums are going up 17.5% next year. That's 13 points over the 2023 inflation rate.

I was finally able to go on Medicare..........for the previous two years, I had been paying 2400 A MONTH for medical insurance, being self employed.........It was pure extortion...............there was no other alternative.......The company was Humana and they knew there was nothing that I could do..........

People think once they get on medicare they are home free! Hardly...............Part B? is taken out of your social security, the medicare supplement, part C? is hundreds and hundreds a month, and the cost of the part D? Drug plan in atrocious............

The pharmaceutical corporations, The hospitals, the medical insurance companies, and even a lot of Doctors are focusing on stripping away what remaining money you have in the last years of your life.......

Record profits, stock buybacks, and Shareholder Value are all the corporations are entirely focused on these days.............

you have to pay an additional IRMAA premium. Health care costs before AND after age 65 are really high in the US, primarily because we allow certain members of the industry to knock down huge salaries and take obscene profits. We need to join other developed countries and manage our health care system humanely and fairly.

We’ve always paid exorbitantly high insurance rates even before the ACA because of the pre-existing condition baloney. I’m super pleased that they can no longer price gouge those of pre-existing conditions, but they figured out a way to price gouge another way. And it’s based on age.

It is some form of universal public health insurance. It makes healthcare available to everyone, affordable, both to users and to the system that funds it, and delivers results that are measurably superior in both health metrics and cost to our idiotic privatized mess.

But apparently that would be communism or something, so we can't do that.

It is so discouraging.

They'd rather be worse off than letting any but the richest minorities get decent health care. Racisism is at the root of our never nationalizing our health insurance.

we could cut back on the money we spend on Defense and finance universal health care like many other countries do..........Of course many of those countries don't pay much for their country's defense, because they rely on the U.S. to come to their aid...........

Sorry, but I think that is a valid comment

We've been fed this 'protector of the free world' bullshit for 80 years. Defensive pacts are fine, but our primary military mission has been protecting US military and economic hegemony for that entire time. We are the modern Imperium. We obscure our rule under an ideology of free market fundamentalism, now with a new '21st century fascism' feature.

We could certainly get by just fine, including supporting Ukraine and defending Taiwan (or at least leaving that ambiguous and credible enough to prevent China from invading,) on 500B a year. The other 500 would have to be yanked out of the claws of the bipartisan austerity shitheads and instead used to fund both social and physical infrastructure projects, with a focus on health education and sustainability.

But none of that is going to happen because we are a nation of delusional stupid fearful people. Oh, and the rest of the developed world appears to be competing to catch up to us in delusional stupidity.

The Uber Wealthy and Corporations have paid less in taxes for decades which support that Trillion Dollars.

The lower 99% is funding protection for the uber rich and corporations. How often do you hear of a corporation's cargo ship, bound for the U.S. being hijacked??????? No other country in their right mind would do it, because the instant it got hijacked, the entire Hell of the U.S. Military would rain down on their stupid asses......So the Corporation's assets and the stock holders of that Corporation are protected compliments of the U.S. Military/Defenses. And since Reagan the Corporations and Uber wealthy have watched their taxes go down continuously.............

triple, at the very least, income dipper counting all possible pots, present and future: SS private corp, PERS teacher, Military retired, benefit of Dad's contributions living w/her by whichever, divorced woman w/children.

It’s so true, it’s more like bankruptcy insurance than health insurance.

I have no idea about how health insurance is available, but doesn’t it largely depend on what’s available in your state?

“There’s nothing we can do” isn’t the answer you want to hear from your legislators, is it?

I can’t buy insurance out of my state. At least I got the courtesy of a response from Jon Tester.

Which is missed by too many is that, there is nothing one rep can do especially when too many are against it. The important part here is that WE can do something by voting, it is our role and first action to make change.

I'm so sorry. I just got on Medicare, thank god. Its not free, theres a small annual deduction, i pay 20%..but I'm grateful

But Medicare will be a godsend.

Yes, took 2 yrs since I'm disabled

They are not going to give up their stranglehold that gives them very handsome profits and bonuses. My budget is stretched to the limit with insurance premiums for my car, which I have to have by law, health, home and HOA insurance for common areas and my building. It’s nutz

Several years ago when I was self-employed and before Obamacare, I joined the Chamber of Commerce to take advantage of the group insurance they offered. It was quite a bit less than an individual policy.

And the whopper (one of them) is the deductible you still pay, if heaven forbid, one of you get sick!

One thing I've always wondered about, is that in very rural areas, such as some states in the western part of the US or within some states (the very rural parts), why they couldn't have some sort of COOP for health insurance that spans beyond state borders, thus doing away w/ these artificial boundaries, thus perhaps opening the market up a little more (maybe more doctors etc. would join such plans if this is an issue).

I'll have to chat w/ my sister some more, to find out her particular situation (medical-wise), since her contractor husband is self-employed too, I suspect that he too, is in this boat as you describe so well.

Thanks for reporting on this. It can't be easy having to worry about such an issue still in today's Obama Care environment, especially for the whole family. My best to you all.

Each state regulates the insurers doing business within the boundaries and will have a whole different set of restrictions and rules.

There is something called a "multi-state plan" but it appears to be just in name only.
https://www.healthcare.gov/glossary/multi-state-plan/

The whole system is rigged in the interest of extracting money from the poor and paying the rich. The state and federal governments are controlled by the lobbying interests or the insurance and other health-care industry participants.

Last edited Mon Dec 18, 2023, 04:13 PM - Edit history (1)

Plans on the open market vary state to state. More populous states have more choices than we do here in Montana. I hope she’s getting a better deal than we are. Lord knows self-employed people… And everybody else for that matter deserve it.

health insurance, I will pass it along to you! Take care!

I had a friend who did this for years.

Last edited Sun Dec 17, 2023, 06:52 PM - Edit history (1)

For-profit health insurance is pricy, no matter which state.

Those who make more pay more. There’s always room for improvement, however, and that’s one of the many reasons voting matters.

The reality is that my husband and I are both employed by our small businesses and we have to claim income whether or not we actually realize that income in our bank accounts. For example, my take-home pay was $24,500 last year. However, our businesses did quite well, thankfully, enabling us to pay our employees a living wage, and a wide range of benefits. That money that the business made is viewed as taxable, even though it didn’t ever end up in our bank account.

Are the rates similar?

An employee wants, they can be part of our small group plan and we pay their premiums. These premiums sometimes much more affordable because most of our employees are younger than we are. We have several employees who get health insurance through their spouses plan at little or no cost because those groups are large and thus they waive their opportunity to take part in our plan. We believe it is important for an employee to have some kind of health insurance whether it’s our plan or their spouse or partner’s plan. I have one employee who is on Medicare so he waives taking part in our plan. Each of our employees has different personal circumstances and we try to tailor benefits to their specific wants and needs, be they health insurance or other things but we don’t offer different plans.

rip folks off like this ?

The fact that blue states are much more populous, enables healthy competition with insurance corporations. Red states like mine are a fraction of the population in those other states. And, when I say “healthy competition” there is no healthy competition with insurance corporations. They aren’t about ensuring healthcare. They are about making money for the shareholders.

They can be thousands per month, per person. On the healthcare exchange, it’s worth taking a look at the plans with the lowest deductibles. The premiums are higher but it’s easier to get healthcare sooner before paying thousands out of pocket.

Medicare isn’t perfect, however it’s much more cost-effective healthcare.for those 65 and older, or on Social Security disability.

We paid $1300 A month for two. Zero subsidies.

Medicare costs about $140 per month and covers most of our health care costs. We do get supplemental coverage through my pension for the gaps in current Medicare, but it is free to us. Since starting Medicare at 65 we have never paid more than a very few dollars out of pocket, occasionally being billed like $15 or $20, only a handful of times. My partner spent two months in the hospital a couple years ago and then had home nursing care for most of a year. She's since had several surgeries and sees several doctor-ologists regularly. None of that has ever cost us anything. Not one dime. The only thing that has cost us real money has been dental care, because all dental insurance apparently sucks, making supplemental dental crappy for everyone. Adding dental to Medicare would straighten that out quickly, IMO.

We can do this for Medicare recipients. We could extend the same coverage to every American and improve life for all of us. Why do people tolerate the status quo? When I was working we had platinum health insurance through my (good union) job. We could provide equivalent health care for all Americans for a fraction of the cost many pay now for substandard coverage. When will people begin demanding it?

Because there are no other options for those who own small businesses and are self insured or those under the age of 65 who don’t get insurance through their employer or might work in the gig economy. I tolerate it because I have to.

Most all of us on Medicare had money taken out of our paychecks each and every week for decades. It wasn't a gift

Too many dems are unwilling to push for it.

I speak to my Democratic senator’s office on the regular and each person I speak to is shocked that this is happening. They shouldn’t be, of course, but there is an institutional belief that the ACA solved all these problems.

could probably care less about all of us. I can only imagine what they pay for medical is nothing or near nothing for top notch coverage........

Anyone know what they pay for medical coverage? Does it cover spouse and children???? Does that benefit continue for life after they retire???????

Wouldn't it be great, if everyone of them had to publish a report every year of the amount each Corporation and/or industry contributed to their campaign or PAC?????????? When walking in public, or when at the capitol, they should have to wear a jacket with all the Corporate Logo's of who supported them, just like race car drivers.

I know, I know.........dream on..........

The biggest campaign donor scam of all time happened right under our noses. Putin opened a branch of our NRA in Russia. (Hysterical, Putin allowing for any gun organization in his country LOLOLOL) Since it was a "chapter" of OUR NRA, they collected zillions from Putin and Russian Oligarchs. They sent that ton of money to the headquarters of the NRA here in the U.S. The NRA gave that TON of money to the campaigns of Trump, and all the heavy weight House members, and the entire list of Senate Republicans.......
as well as many RED state Governors who were up for election or re-election in 2016.........
The simple reason that every Republican Senator votes for anything and everything Trump/Putin wants is that if Trump's Campaign funds were exposed, and he was put on trial for accepting foreign money, the same would happen to them. Sorta black mail, in that if Trump goes down, they all go down......They knew it was corrupt funding, knowing it was illegal, so Trump and this "new" Republican Party have them all over a barrel.....

My daughter in mid 40's has high deductible plan so she tries to never go to doctor or get tests because its not covered. Few years ago she got so sick she ended up paying thousands for tests and appts because what she had got worse.

There are going to be people in later stages of cancer, etc because they don't want to spend for checkups and blood work.

And when you see a doctor its a chance whether they help or not.

She had vertigo this week and was dizzy, didn't go away after a few days so begged her to go in, got 5 min with doc who told her basically nothing more than advice nurse.

She was like, I paid for this! I can see why people don't go.

I can get a much lower deductible for around $4600 per month in premium.

on your behalf!

In this wealthiest of countries, the rich hoard their wealth, when they should be contributing proportionately to the health, housing, education, feeding of all - their fellow countrypersons.

But alas that kind of patriotism has gone the way of the dodo..

most civilized countries.

Very little political appetite to enact those here

for my disability. Don't laugh, but the $250 a month was rough on me with three years of out of pocket and deductibles because of my orthopedic problems. That was having my left hip replaced and being disabled from a job I really liked working for a blood center.

It was better than nothing though. Without "Obamacare", I may have been on crutches or in a wheelchair for two years. I've had a knee, the other hip and both shoulders replaced since Medicare kicked in. That was like an extra $800 bucks each time which I would rather not have had to pay, but a joke to what it cost before.

Any chance either of you have a skill that makes you eligible to join a union or an affiliated group like Chamber of Commerce of Montana that actually offer medical plans? The NM Chamber of commerce used to offer such plans. Also try Costco medical plans for businesses. They might cost less. As a final option, there might be a company or public agency that offers part timers full benefits right away and one of you could get hired part time and add the other on a group policy. A friend did this at age 62 and went to work for Citibank call center where he worked from home and got group health care coverage until he was 65 and Medicare eligible. There are, by the way, several companies that offer individual dental care plans...Spirit Dental, AARP, Metlife Take along plan, among others. Is the Montana Association of Counties a group anyone can join? I believe they offer health care policies to members. Good luck to you. I think it is a shame that our small businesses have to pay such exorbitant costs for health care. You are the engine of the economy.

I do pretty well on insurance through work. But my wife is on disability and they gouge the disabled for almost $500 for a medigap policy. It is sick what they are allowed to do. Without the gap policy we're on the hook for 20% of any unplanned medical expenses and WE HAD ONE earlier this year. all better now than goodness but even 20% of that hospital bill would have been crushing.........

Have you tried an insurance broker?

But have you spoken with your clinic or local hospital about a cash rate? The hospital I work in offers cash prices on many tests and procedures, sometimes thousands cheaper, if paid at a quoted cash rate the day of service. An example is when I had my colonoscopy. If I hadn't already met my deductible I would have paid it 100% out of pocket until the deductible was met. The local hospital will do one for under a grand if paid on day of service. Most of our labs are also cheaper if paid out of pocket.
Another one they offer is their well baby plan. They allow monthly payments until birth for pregnancy. It includes the appointments, ultrasound labor, delivery and overnight stay for $4500 for an uncomplicated pregnancy. It's thousands cheaper than a normal pregnancy.
You can't pay it and have it submitted to insurance but for smaller services you might want to look into it. We have lots of Amish and Mennonite patients who use us because we offer very cheap cash rates. You might want to ask if they have that service in your area.