The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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I moved to the US a few months ago when I married my American wife. Now that healthcare.gov plans for 2024 have been revealed, we have to choose one because she works for a temp agency that does not offer an ACA-compliant plan. Because our income is low enough, we'll apparently get about $500/mo in premium tax subsidies.
As a former Canadian whose experience with healthcare has always been to swipe a government health card and never see a bill (except indirectly as it came out of taxes), choosing an American healthcare plan is really daunting. My wife knows perhaps even less about it, since she's always been on her parents' plan until just recently.
The thing is, she's also pregnant (due in June), and her temp agency contract ends next August. After her contract ends, she'll likely get a normal job with proper employer-offered insurance. But until then, since pregnancy and its associated costs are very expensive, doesn't it make sense to get a plan with the lowest deductible possible, since it's almost guaranteed we're going to use $10k+ in healthcare in 2024 due to pregnancy and delivery?
It feels a little bit like cheating to know my healthcare costs will be high and then choose a low-deductible plan. How do they allow this? This is like getting home insurance knowing your home will suffer fire damage in the next year. It makes no sense for the insurer! But if those are the rules...
On the other end, high-deductible plans are confusing. I pay a premium and I have to pay the entire cost up until the out-of-pocket max of, say, $15,000? What am I even paying for then? Just hedging against the small possibility that I'll be charged $100k+ in some fluke accident? If so, then why are they even involved in quotidian care like doctor's visits and bloodwork? Why wouldn't they just keep premiums to a minimum and cover only catastrophic care?
I'm sure I'll get the hang of this, and I'm even inclined to prefer the American system over the Canadian one, but... gosh, I feel like I've been dropped into the middle of a game and have to figure out the rules and the "meta" in very quick order.
Yes, get the gold plan which costs more per month. If you KNOW you have expenses this is obvious right?
You are paying for the people (like yourself) who cherry pick a gold plan when they need health care. Sadly, Obamacare made cheap insurance illegal.
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The answer to all questions is probably "regulation".
The government broke the healthcare system many years ago by encouraging employers to offer healthcare plans. Since that time it has been trying to paper over and fix all the problems this has caused. It often causes new problems with the fixes, so they adjust it again.
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from my limited understanding of insane USA health system: an ambulance ride alone may cost outrageous amounts of money. Now imagine case where you are actually requiring surgery. It is not necessary to need face transplant to get 15 0000+ costs.
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My HR could probably identify which employees are trying for a baby based on who goes onto the low deductible plan every year. The elimination of pre-existing conditions is part of the reason why health insurance cost has gone up since the ACA. You aren't really exploiting anything, it's priced into the market already.
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Yes, if you know you are going to deliver you should get as premium a plan as you can pretty much. If you need help with the calculations shoot me a message, I work in health insurance.
And yes, it's antiselection, and yes, the ACA kinda allows it, something something risk adjustment makes people whole something something.
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