Co-Pays, Deductibles, Out of Pocket Expenses, and Me

As a self employed person who had private insurance and dropped it a few years back, let me simply share this with you. As I kept getting older and my premiums kept increasing, I couldn't afford what it cost me to keep my health care insurance. Before I took the final step of dropping that insurance, I progressively watered down my own coverage; opting for ever higher deductibles, dropping prescription drug benefits etc. all in an effort to contain the rising costs that I just couldn't afford.

It reached the point where I realized that the odds favored me being better off using all of that money that I was giving my insurance company each month to pay for my out of pocket medical expenses as they came up, instead of not being able to pay for them at all after spending huge sums on my insurance. In short I could no longer afford to pay for ANY medical care because of the amount of money it was costing me to retain medical insurance. There was nothing left in my pockets to pay for out of pocket expenses. My health insurance had drained me of my ability to seek and obtain medical care.

In the business world the choice I made might be called opting to be self insured. Instead of paying out huge sums of money to a profit making institution each month so that they could in theory pay my medical bill later when I got them, I "saved" that money myself for that later "rainy day". Except of course I didn't get to save anything - I actually needed that money to live on. But Instead of spending $600 on insurance every month, now at least I was able to squeeze out enough cash to see a Doctor from time to time, get an occasional test taken, and eat healthier foods etc.

If disaster strikes I'm screwed, but I was pretty much screwed anyway since I couldn't come up with the thousands of dollars needed each year to keep a policy that leaves me having to spend thousands of dollars I don't have on top of that in the event of any serious problems. At least now I can afford to cover routine medical expenses while I pray I remain basically healthy until I qualify for Medicare.

In my case that might happen soon enough for me to avoid being hit with heavy federal tax penalties for my inability to afford buying health insurance. So it could be worse. I still have a home. Had I been forced to keep paying for private insurance I would have lost it by now through foreclosure. I think I remember reading somewhere that homelessness contributes to poor health.

Tags: Democratic Party, Health care, health care reform, health insurance, Medicare, obama, Public Option (all tags)



Re: Co-Pays, Deductibles, Out of Pocket Expenses..

These mandates as designed take away my ability to make the choices I need to make to avoid both losing my home and afford basic health care. That's "affordable health care", as in actual medical services received, as opposed to so-called "affordable monthly insurance premiums" that provide no care and still leave me facing unaffordable deductables and co-pays after shelling out thousands of dollars for a bottom end policy.

I need some expensive dental work that won't be covered by the thousands of dollars I will be forced to spend on insurance I can't afford to purchase. That goes out the window also.

by Tom Rinaldo 2009-12-21 09:07AM | 0 recs
Re: Co-Pays, Deductibles, Out of Pocket Expenses..

We sort of need to know how much you earn to know if the mandate applies to you, what subsidies you could avail of should you choose to seek insurance again, and what coverage you would get compared to what you got for what you were paying.

by vecky 2009-12-21 11:15PM | 0 recs
Re: Co-Pays, Deductibles, Out of Pocket Expenses,

This is actually one of the issues I planned to diary about. In the attempts to discuss this, people often seem to argue that the middle class is not already feeling a financial squeeze. They look at someone say making 88 k with a family a year, and think, well why can't they afford this? They ignore the cost of mortgage, transportation, student loans and a number of other fixed costs. It is like we are on auto pilot that says "pass the mandate" in the bill. I don't get it, but that's where we are. Meanwhile, you got people claiming to want the bill in other diaries because they ahve pre-existing conditions, but when you point out that those are likely not going to be enforced because they are not being enforced at the state level, and this bill contains no mechanisn of enforcement they just gloss over that. I don't understand how this bill helps the middle class.

by bruh3 2009-12-21 11:49AM | 0 recs
Same. Exact. Boat.
Amen. This is exactly my place. Now throw in that I've got a moral qualm about being forced to give my money to the same insurance companies who've pushed this give-away on us, and that's why I'm livid about this bill. I can't see how people could call this an "ok" bill. It's an ethical outrage.
by luckymortal 2009-12-21 12:10PM | 0 recs
Re: agreed

Which includes you, because it's not likely he would be happy with a PO either.

by vecky 2009-12-21 11:16PM | 0 recs
Psychic FAIL!

No, I'd probably be fine if there was a strong P.O. I'd like to see some of the anti-choice language changed too, but...

And by the way, IMO, YOU are hurting Obama, the party and the potential for reform with your roll-over-and-play dead tactics. Remember, Obama said "make me," and I'll take him at his word. Like he said, if he can't go out and say "this will cost me votes" he's got no chips to play with.

It's the roll-over squad who's leaving big O' at the table with no chips.

by luckymortal 2009-12-22 07:55AM | 0 recs
Re: Psychic FAIL!

A strong PO was always preferable, but even the house passed a watered down version that would act solely as a dumping ground for private companies to unload their sick and expensive clients.

I attended a PO rally over the summer. There were about 60 of us.... somehow I don't think the "roll over and dead" is going to stick.

by vecky 2009-12-22 08:30AM | 0 recs
Re: Psychic FAIL!

Even a watered down PO is preferable to nothing. If it got the concept on the books, there would have been something to strengthen later.

Or MAYBE I could get behind it with anti-monopoly language--something that would restore competition...

As it stands it's a huge tax increase and corporate giveaway with no guarantee that it will accomplish anything. The only way we'll fix it is throwing down the gauntlet and calling Lieberman's bluff. Not throwing our wallets at the Insurance Lobby and thanking them kindly for it.

by luckymortal 2009-12-22 10:05AM | 0 recs
I'm in the same boat

Cigna raised my individual policy (for just me) to $1,000 a month, which already wasn't covering another $500 a month in treatments I needed.

I'd paid Cigna the outrageous sum of $700 every month for years on end, and not used it much.

But after a year of so of heavy usage, they decided I was just too expensive to keep on, I guess.

Typical, and sounds like the new system,too. You'll pay for health insurance which will provide healthcare you can't afford.

by judybrowni 2009-12-23 11:41AM | 0 recs

why would you spend thousands of dollars to buy insurance you don't want? if i remember correctly the fine is $750.00. please correct me if i'm wrong. pay the fine or even better don't. make them find us. there is no debtors prison. just don't do anything. the irs doesn't put people in jail, if you declare all of their earnings, they do for lying or hiding the money. breid

by breid1903 2009-12-24 02:15AM | 0 recs
Re: tom

...and get a tatoo that clearly stses that you've opted out and would prefer that EMS not treat or transport you to a hospital. Always carry enough cash in your wallet to get you to a funeral parlor.

Fair's fair.

by QTG 2009-12-24 02:34AM | 0 recs


Advertise Blogads