What to do if You Absolutely Can?t Afford Health Insurance

159 Responses to What to do if You Absolutely Can?t Afford Health Insurance

1. I’m an emergency physician. By federal law, if you present to an emergency room with an EMERGENCY CONDITION (Note – that does not include a rash you’d had for a year!) the emergency department and the entire hospital must stabilize you up to their maximum capability, regardless of your ability to pay – that may include such things as a heart bypass or brain surgery. Of course, the hospital will send you a (huge) bill. But – if you have no assets (or no locatable assets), the hospital can’t get water out of a stone, and will write off the bill.

2. Good points. I have 2 brothers without health insurance. They do need at least catastrophic coverage. They’re minimal wage earners and don’t manage money well.

3. Ishabaka – That’s an excellent point about true emergency cases. But it won’t help the person who needs something critical that falls short of an emergency.

   But even if you’re accepted to the ER with a true emergency, you could come out with a catastrophic financial situation absent any insurance coverage at all.

   Ken – If they’re minimum wage and don’t manage money well, they may be banking on the fact that they’re too poor to ever be forced to pay. But that still would leave them with very limited options in the event of a health problem, particularly one that’s progressive.

4. For me it’s not about being unable to afford health insurance, it’s about being unable to qualify for private insurance if I were no longer employed. Supposedly HIPPA is supposed to help with that, but I’ve heard horror stories.

5. So true Jackie. The health insurance companies are able to turn you down for just about anything. Some will turn you down if you’re on too many prescription therapies–like three or more.

   It was said however that under President Obama’s healthcare bill that companies will no longer be able to decline applicants for pre-existing conditions. That’s one of the changes that needed to happen, but we’ll have to see what the insurance companies will charge. Approving coverage at 2-3 times the going rate will have the same net affect as a declination for most people.

6. Kevin, there is also an alternative out there called Short Term Medical – there are some reputable companies selling this and basically the way it works is you pay month by month and you have the choice of several different plans including lower or higher deductibles – coverage is really good, but it only lasts for 6 months. But, at least it’s something!

   My brother-in-law signed up for this b/c he had no insurance and shortly after developed some pretty serious conditions – the insurance company paid their portion no problem – his premiums were right around or just under $100/mo!

7. Thanks Jason, that sounds like something worth looking into, especially if the uninsured period is expected to be temporary.

8. Several general comments: most health insurance plans are health care “financing,” NOT health care “insurance.” Insurance is, by definition, the pooling of risk for an unexpected financial loss (like your house catching fire or a tree falling on your car during a tornado, or, health-wise, having heart surgery for $87,000). Question: does your auto insurance pay for oil changes, new tires, or that brake job? Of course not; those are routine maintenance items that you pay for on your own. What if your auto insurance offered to cover them – think your premium would go up? Same thing with health insurance: the “better” the coverage, the more expensive it is. When looking into this:
   1. How “much” health care to you generally use? Don’t buy a Lexus if all you need is a used car.
   2. What’s your real risk? Big, expensive stuff (like hospital stays & surgery)? Most folks could find a way to finance $5-10k if they had to, but how about $50,000+? That’s what health insurance is for.
   3. While it’s okay to shop online “on your own,” most folks are better off dealing w/ a broker who specializes in health insurance. Find a broker near you by visiting http://www.nahu.org, the probessional association for brokers (full disclosure: like me) who specialize in health insurance. He’ll be able to present you with a wide range of plans and options designed to give you the best, most cost-effective coverage.
   4. If you find it hard to get coverage, especially due to health reasons, remember: there are a LOT of different plans & companies around and, to be frank, there are very few people who find themselves completely out of luck. Again, deal w/ an NAHU broker who has a “vested interest” in helping you (remember: if you’re not happy, he doesn’t get paid!).
   5. Finally, stick with the “brand name” companies. This stuff is too important to “play around” with and, sadly, there are a bunch of plans around that, frankly, are not all that great.

   While there are certainly a lot of things that could/should be changed about our current health care & health insurance system, getting mad at your insurance company because of high prices is rather like being mad at the waiter because the food at the restaurant is too expensive. Your premium cost reflects (1) the cost of health care (MD, hospital, drugs, & lots of gov’t regulations), (2) how much health care “financing” you want or expect (i.e., routine care benefits like MD & drug copays, etc.), and (3) your specific “situation” (age, sex, dependents, location, &, especially, health because, just like auto insurance, if you have a bunch of tickets or accidents, you’re gonna’ pay more for your car insurance).

   We don’t really have a health “insurance” crisis in this country. It’s the health “care” that’s expensive, and that’s reflected by the premium cost. Control the cost by:

   1. Finding a good broker (see above).
   2. Buy a plan with a big deductible.
   3. Consider supplementing that big deductible plan with critical illness and accident coverage (73% of claims over $10,000 are due to either accident or the “big things” – heart, stroke, cancer, etc.).
   4. Take better care of yourself; eat right, exercise, be smart about it.

9. Art – Very well said, and I endorse all that you’ve said for anyone in a position to be able to afford a health insurance plan.

   What Art has pointed out is the critical difference between a true health insurance plan–a plan that pays for true catyclisms–and the better understood, but much more expensive health benefit plans that pay for all things medical. The former is what we all need, the latter is what we increasingly can no longer afford.

   Knowing the differnce is critical.

10. I’m afraid this does little to uncover the big myth about Health Care. Insurance works best when it spreads the risk of low-probability, major losses among a lot of people (the law of large numbers). It does NOT work to run all of your expenses through a middle-man.

    Catastrophic health insurance uses the insurance concept for it’s strengths. All those plans with small copay’s and coverage at the first dollar of expense are completely wrong and inefficient use of the concept of “insurance.”

    Find the lowest cost policy you can and then use your premium savings to fund a cash reserve account (or better yet, an HSA). Use that money to pay your medical costs. Don’t be afraid to negotiate with the doctor on your fee. Many will be happy to be paid today at 50% of MSRP rather than wait 90-180 days for the insurance company to pay them nearly the same “negotiated” rate.

    Unfortunately, the government doesn’t want that competition and will eventually crowd you (the individual) out of the market. Oh wait, they’ve already done that. It is called ObamaCare.

11. So true John, they’re really benefit packages! Unfortunately, that’s what people have become accustomed to and how the prefer to consider “insurance”. That’s really caused the cost to explode.

12. I have been looking for insurance coverage for my wife and myself and wondered if it?s worth waiting to see how the presidents Health Reform Bill impacts me purchasing our health insurance. Does anyone have any idea on this.

    Many Thanks,
    Robert

13. I would also ask your church for help… welfare use to be the job of the church until the government took it over. It’s the church that is supposed to be helping those struggling and in need.

14. Good idea! Churches can be good places to get help in life’s emergencies. With huge medical bills, you might find someone at Church who can negotiate a lower and more tolerable payment arrangement, even if direct financial help isn’t available. The community aspect of Church is often forgotten, and if it doesn’t exist where you’re worshipping, it may be time to find another.

15. I also forgot to mention that it’s the church that should be helping out other Christians in trouble… and non-Christians. Many churches are struggling these days financially but it never hurts to ask. 🙂

    Just don’t expect the church to write you a check and not ask questions or require you to do some things yourself… a good church will ask questions, get you on a budget if you’re not already doing so, and may ask you to do some financial training or read a book as part of giving you money… .which you should cheerfully agree to if you really need and want help.

16. hi,
    my daughter is a food server until she finds a job in marketing. she pays about 100.00 for insurance but it hardly covers anything. she has had to have a colonoscopy and her tonsils removed (tonsils should have been done when she was on our insurance)and we have had to pay so would it be better for her to just drop her insurance for now and just go to emergency room….her boyfriend just had a seizure while driving my daughters car and spent 2 days in hospital with cat scan, etc and probably won’t have to pay a dime. by the way he’s allright…thank you, susie

17. Hi Susie – like the quote in the post reads, “any coverage is better than no coverage”, so my advice is to keep the coverage, but maybe do some digging to see exactly what it DOES cover. Hopefully, it at least covers catastrophic say anything above $5000 or $10,000.

    I don’t know why the colonoscopy and tonsils weren’t covered, unless they fell below the plan deductible. If the deductible is $5000, and she had one procedure done in 2009 and the other in 2010, she would have to satisfy the deductible in both years, but that’s just a guess. Colonoscopies may fall under well care, and while group plans generally pay for well care, individual plans often don’t.

    Did you contact the insurance company and ask why they didn’t cover anything?

18. Lost my job with excellent health insurance then COBRA ran out … now I have a job that only pays a fraction of what I used to make and with NO health insurance. To top it off I have an “indolent” cancer. Thank God I don’t need treatment. I looked into the new program for people like me offered by the government but it is still $500 per month for me … which I just can’t afford.

    Well, I lived in Japan with my Japanese wife for 15 years so I know what a good medical system is like, and isn’t … I’ll be returning to Japan one day.

19. Things have changed in the past year. A lot of commenters are talking about horror stories when they lost their job. For people with no group coverage and pre-existing condition, there are now PCIP plans that were not available before. You can see this information on my updated site.

20. There are also often state based health care plans and usually those that can’t afford health care can qualify for discount coverage.

21. Shey–That’s good information on your site. The President’s plan is supposed to require health insurers to accept clients regardless of pre-existing conditions, but I don’t think that will happen until January 2013, if memory serves. Either way we don’t know what the details will be or how much they’ll charge. Hitting someone with a pre-existing and charging them $2000 a month in premiums will be the same as declining them so it may not be the advantage that it sounds at first glance.

22. Hi Shaun–That’s true, but there are also income thresholds that are set pretty low. In many cases you’d have to be a certified poverty case to qualify. They’re always worth checking into, but don’t be surprised if your income is “too high” at $35,000 for a family of four. The healthcare problem really is greatest amoung the middle class.

23. I can’t afford insurance, and I do not qualify for state help…so when I get sick I just wait it out. I had an ear infection a couple of weeks ago. I had to just pop an Advil and wait it out. It sucks…In my family the men have a history of high blood pressure and heart disease, and colon cancer. I know I should get myself checked, but I can’t afford it. Even if I went, and they discovered something…I would have no financial means to get well…so I just bought a life insurance policy instead.

24. i make 26,000 a year and will not be able to afford the out of pocket 1,300 to 1,400 dollars a year for health insurance, will stay afloat until put in jail, good luck to everyone else, but my days if i stay in this country are numbered, goodbye!

25. asashii, you’re doing it wrong if you make 26,000 a year and cannot afford 1,300 to 1,400 dollars a year. It costs about 7,200 to 10,000 a year for a decent dwelling, 2,400 a year for food, your figure of 1,300 a year for health insurance, and 3,600 a year for amenities such as cable, phone, internet, and utilities. As long as you don’t buy expensive clothing, eat out regularly, finance a car, or buy stupid things like 50 inch televisions, the remaining 10,000+ should be enough for anything else that comes up, including household necessities and emergencies. Try living off a meager 10,000 a year.

26. Stevebo, In response to your last comment — I’m sure $26,000 a year is BEFORE taxes. And who can live on $200 a month for food? Some kind of fruit everyday is at least $1 a day. 1 apple is $1.00 – so that is $30 for fruit alone if you want to eat something healthy!!! How about a salad every 2 days– Lettuce 1, Peppers $1.50, Celery $1.69, Carrots $1.50 and you have a minimal salad! Not to mention DECENT ground sirloin and $4.99 a lb. If you eat 8 oz that would last 2 days; if you eat 4 oz. that would last 4 days. I mean $200 a month is NOTHING unless you eat Top Ramen. You certainly cannot eat healthy on $200 a month!!!Never mind that you don’t have a perfect car; one breakdown can be $500! What about dental work!!! 1 crown is $2,000–to have a tooth pulled is $200 – as long as you have no emergencies it is possible to live on $26,000 but its not easy

27. Hi Patricia–I have to agree with you. Stevebo’s analysis figures a single person who doesn’t have a car (at least $4,000/year if you DON’T have a loan on it!). It would be a tight squeeze with little room for savings or extra’s. Social Security taxes alone would eat up another $2,000 and a matching amount for federal and state withholding.

    And if asashii has a family, food alone would rocket to $600-$800/month (an extra $4,800 to $7,200 per year).

    I know people who earn the kind of income asashii does, and unless they have an employer plan, they don’t have health insurance. That’s the problem.

28. Thanks for sharing this very written article. There is no doubt that more people than ever are now facing the reality that they do not have health insurance. One thing the article mentions which I like is that one of the main things people in this circumstance can do which doesn’t cost any money is to get and stay in shape. Simple exercises like walking, jogging, swimming, whatever it may be, along with eating right could help eliminate some of the health issues many people face. That should be the first line of prevention. Another great point, especially for families is to do whatever you can to get your kids at least covered, whether from privatized insurance or a governmental program. In the meantime, when health issues need to be addressed, most of the urgent care centers are easier and more affordable to make appointments at that hospitals.

29. Thanks Jonah, you’ve hit on the very points I was going for with this article.

30. what oganizations can provide medical coverage for my sister. Harbor U.C.L.A. is just giving her the runaround. At last measurment the “ovarian cyst” she had measured 26cm. * 12cm. * 24cm. I think it is a tumor. Anyway sis can not afford to pay at all. Any suggestions would be so much appreciated. Thank you.

31. Hi Wolf Gang–Some hospitals will work with her, but she’ll at least have to agree to a payment plan. Check different hospitals and see what can be worked out. Also, look for government agencies (start with the local department of health) and see what programs are available. You may also be able to get help from charities. Does she belong to a church or temple that might provide some financial assistance?

32. These are all great ideas, but how do you suggest it be handled when the employee group plan costs 50.00 more a month than you make. Then you still have to meet a $5000.00 out of pocket expense. Oh and the 50.00 more per month is before taxes. And that is just coverage for employee and children, not spouse.

33. I would look into your state sponsored Medicaid program. It will generally only cover your children, not you and your spouse. For you and your spouse, you should qualify under PPACA/Obamacare come January 1, 2014. The rates are supposed to be heavily subsidized by tax credits, even if you have no tax liablity. We’ll have to see how that plays out in 2014, but it may offer hope for your situation.

34. We currently have medicaid, but due to my husband getting a job, my kids lose their coverage in September. My twin daughters won’t even be a year old, and have no coverage. We will no longer qualify to have them covered even though we qualify for nearly the maximum amount of food stamps.

35. Try getting private coverage for the girls, it’s usually not that expensive for children. However I’m hearing that some insurance companies are abandoning child-only policies with the onset of healthcare reform. But I imagine you’ll be able to get some sort of coverage come January 1st, 2014. The rates are expected to be favorable for lower income families under the new plans.

36. There are surgeons out there offering surgeries for the uninsured at amazing prices. My boyfriend just had gall bladder surgery for $120 initial doc visit, $60 pre-op blood work, and $3700 for the surgery in Bakersfield, California. No additional fees! Included in this is one night in the hospital, if needed. Look up Cirugia Sin Fronteras or Surgery for People Without Insurance. Dr Jorge Enriquez performes the surgeries at San Joaquin Community Hospital in Bakersfield. They also have podiatrists, OBGYN, urologists, gastrointestinal, etc. 1-661-333-5746 or 1-661-327-1655. I understand that another doctor offers similar services in Las Vegas. Google No Insurance Surgeries.

37. Hi Gracie–Thanks for the advice. I’m hearing that such practices will only become more common as the price of healthcare/health insurance continues to rise. Another big growth area are cross-border procedures. Its a lot less expensive to have surgeries in foreign countries than in the US. With Obamacare rolling out, I’m hearing that facilities are springing up in Mexico just accross the border. We’re truly living in interesting times.

38. Humorous to read these comments, most of which view the issue only from their personal point of view (like Art, the broker!). As a former broker, one thing to know – you cannot fully trust a person who works on commission. That being understood, our healthcare is one aspect of our lives that should NOT be insured. It should be funded by all of us in some form. Insure my car and house and life…not my ability to obtain medical treatment for myself. I only have the one life. I can get another car…..

    Unfortunately, the middle men (insurers, brokers, medical supply companies, pharma reps) are all taking precious money out of the system that should be going to CARE. They need to be slowly eliminated.

    We do NOT need groups and industries enriching themselves from what should be our healthcare system. We have this now.

    To minimize the risk, everyone must participate in paying, everyone must be covered. Thank you Mr. Obama for risking it enough to try to help us. Reform is not perfect, but it is a step in the right direction simply in eliminating insurers ability to DENY applications for coverage from citizens. It will be worked out over time. What we have now hasn’t been working since the 1970’s when I first sold it.

39. Spoken like a true, redistributionist Socialist, FormerBroker; the government knows best, how to handle my money better than I do, how to make decisions for me better than I do, how to take care of me better than I do … I should be glad that there are those “betters” who are willing to sacrifice themselves by going into government / public “service” so they can take care of us ignorant peons. Who was it that said “from each according to their ability; to each according to their needs?” (Hint: look it up)

    The government does few things well or efficiently … It’s hard for me to see how trusting them to handle my health care needs and decisions will be better for me. While there is certainly more than enough “blame” to go around in the lousy system that we’ve “jury-rigged,” there’s also a lot of things that could have been done to improve our health care system that wouldn’t have entailed a complete takeover of it by the government. Fact is, there’s very little in the “Affordable Care Act” that actually does anything to control or lower the cost of health care, but there is a lot that will raise costs and increase wait times for care significantly.

    As an evil, blood-sucking “middle man” who takes money out of the system (money better entrusted to the government, who will be far more efficient with it than I will), I simply find it hard to believe that a bureaucrat living and working in the DC “bubble” (I.e., not working in the real world, etc.) will do a better job at handling my money and making my decisions than I might. On the other hand, perhaps I’m simply to “dumb” to know the difference or how better off we’ll all be in the future.

    Thank you, FormerBroker, for opening my eyes!

40. Hi FormerBroker–I have to agree with Art here, I don’t see the government doing a better job. I’ve studied Obamacare a good bit. There’s a lot that I like – applicants cannot be turned down, rated up or dropped due to health conditions – we should have had that all along. But the bill does nothing on the cost containment side, which I believe to be the core problem with the US healthcare system. Some friends of mine who work in healthcare believe that reform has been set up to fail so that it ultimately can be replaced by a single payer system. That’s basically an expansion of Medicare, which is no longer even a standalone system in that people need to have generous private insurance supplemental policies to cover the increasing amounts Medicare won’t.

    I don’t believe any system – private, public or the disasterous hybrid system we’ve got now (and will continue under “reform”) will fix anything until cost containment is implemented. The grab bag system isn’t workking because it can’t. To simply turn the system over to the government under the “they always know best” mentality won’t fix the problem.

41. I am completely out of a job. What do I do?

42. Hi Debra–Does you employer offer health insurance coverage under the COBRA plan? It’s usually expensive but it could work for a month or two. Longer term, you can either consider a private plan with a very high deductible to keep the premiums low, or you could look for a part time job that has health coverage. You can start by checking out this post: http://outofyourrut.com/20-part-time-jobs-with-health-insurance/ . For what it’s worth, I talked to a girl who works at Starbucks last week and she raved about their health insurance coverage. You only have to work 20 hours per week to qualify. Good luck Debra, and please report back with what you work out.

43. Here is my problem, a year ago my husband got a compression fracture in is spine, we have no health insurance, we went to the same back dr he has seen over the years. He needed x-rays and an MRI. Since we put it all on a credit card (sucks) we got discounts for paying cash, if we had insurance we would have forked out much more. They gave us 60% off for the office visit 50% off for x-rays and 60% off the MRI. So we spent out of pocket $1500 total, with insurance we would have paid way more. This is the problem with insurance, you can get a “cheap” plan with a $10,000 deductible but the Dr’s charge twice as much as they normally do if you HAVE insurance, and people wonder why health care is so expensive. There is no such thing as “affordable” health care with these kind of practices. Imagine what they charge to those living off of welfare benefits, and I(we all) pay taxes for that crap.
    Very disappointing. Our health should not be a commodity, but it is.

44. Hi Christy–You make an excellent point. I’ve seen and heard this elsewhere too. It’s a bit of a vicious circle in that the insurance companies are constantly lowering payments to providers, so providers raise their prices to compensate. No matter how it plays out, we always seem to pay more. What’s becoming discouraging is how even with insurance, people are still paying out thousands of dollars, or going into debt. There’s a price spiral that’s making everything worse accross the board.

45. So, really, what does Obama care do for the ones that cant afford insurance? Say you make 10 grand a year and have no insurance because you just cant afford it, you don’t qualify for medicare because you are a single male that works a low paying or part time job. They are just lucky that they have never been sick, after you pay your bills, ie pay rent, utilities, food, child support, then there just is no money left. I don’t see Obama care doing anything for these people. I see them getting a penalty for not having any insurance. so now they have even less money to work with, doesn’t sound like much help there does it. They couldn’t get insurance before and will still be unable too. Sounds like all it really is, is just a big money grab! Seriously, I know people that fit this description, and it sounds like they are now #$%^@&!# more so under Obama care.

46. That part is fuzzy for me too Marcel. Supposedly, the working poor will get generous tax credits, but those don’t come until your taxes are filed and the refund comes in the following year. How do they pay for the coverage in the year prior to filing their income tax return??? You need coverage in order to get the tax credit, but if you can’t afford the premium until you get the credit, then the whole thing falls apart.

47. I’m sixty two years old. I live on $8520.00 per year. I owe nobody anything. I haven’t seen a doctor for thirty years, or more, Nobody seems to get it… I can’t afford to buy any health insurance. And now they are going to fine me for not having what I can not afford? I challenge anyone to try to live on my income. And look, if I get sick, just let me die. That’s easy enough and it won’t cost anyone anything. Otherwise, leave me alone. And yes, I subscribe to an Internet service, but have no other entertainment, or link to the outside world. In reality, I am already a dead man walking.

48. Frank, I understand what you’re saying (on several different levels). Fact is, and according to Obamacare, you shouldn’t have to pay any tax penalty because (a) your income puts you below the poverty level (so no tax penalty is assessed) and (b) you are, therefore, eligible for coverage under Medicaid (which, I gather, you either didn’t know about or or have chosen not to use). Now I recognize that this doesn’t address the underlying crux of things – should the government be allowed to “take over” a major portion of the economy and then tax us if we don’t wish to purchase a product? I think not, and personally don’t think it’s Constitutional (despite what Chief Justice John Roberts thought as he unilaterally rewrote a portion of the law), but that’s what the law allows (sad but true). While there was a lot wrong with the old system, there were also far easier – and less expensive and intrusive- things that could have been done to fix things. Sadly, (and in my opinion) this had less to do with improving health care or even access to health care and more to do with power and control.

    Sorry for the rant….. We, as a business (health insurance agency) have spent months – and a lot of money- preparing for the Obamacare tidal wave and how we might help individuals and small businesses find the best solution for their own needs. Much has changed; we’re trying to help people adapt and work through the new system.

49. Seriously would like a definitive answer to something.. have medicaid already because yes we are poverty level income and on food stamps.. as much as it is an embarrassment to admit.. IT has become a USA mainstay for probably more american families than the wealthy will ever consider or care to know about.. You have Medicaid, then you have a job that is part time (less than part time.. I mean less than 20 hours a week if that) who after 6 months offers you a health ‘discount’ program.. it is NOT insurance.. how the hell do you get Medicaid to accept that this is NOT insurance that Medicaid is primary ?

    Medicaid went and paid hospital bills from a broken foot injury.. the hospital discounted the state heavily as they typically do .. so I’ve learned. Then 6 to 7 months later medicaid retracts payment to the hospital ‘claiming’ you had ‘other insurance’ when in reality all you had was a discount program.. you get on the phone with the medicaid rep and try to explain this and he adamantly disagrees with you telling you // maam.. ! that IS insurance. ? what do YOU do ??? now the hospital is taking away the heavy discount. and now you are being sued in excess of $40K .. again, what do you do ? you do NOT have insurance, your employer has as much as written that you do NOT have insurance.. .. this is insane. I do not have money to pay this hospital bill and now being sent to collections.

50. That’s a very specific question that I don’t have anything close to an answer to. And I’m very sorry you’re in that position. The healthcare situation in the US is a MESS! Hopefully Obamacare will fix some of this going forward, though I’m not entirely confident of that outcome.

    I did a stint in health insurance, and it it was made clear that discount programs are discount programs, not health insurance. You may have to take your case higher.

    I’m not an expert in this area, but here’s what I would do…

    Start by contacting your congressman/woman. (I’m assuming you don’t have the money to hire an attorney to fight this.) I’d start with a phone call, then follow up with written correspondence. If that doesn’t get results, I’d write the White House. Seriously. My understanding is that someone will follow up with a letter to the agency, and because it’s on White House stationary, it will be acted upon.

    If not, you may need to consider talking to an attorney about filing for bankruptcy to discharge the debt. Then I’d change to a job that either has health insurance, or nothing at all. That will remove the issue going forward.

    Sorry that isn’t more definitive, but your situation is not typical.

51. This is still too much! I can only afford $100 for the whole year, if that much.

52. Reply to Privately Private: Sounds like you’re working with a government employee (CMS, I assume) who has no actual experience with health insurance in the “real world.” This is – or should be – a “no brainer,” as there’s no way this should be a problem.

    I would probably start with the discount program itself: contact them and ask for a written statement from them (referencing your specific program and contract number) specifying that the coverage is NOT insurance in any way, shape, or form. Most of the various discount programs I’ve dealt with in my role as a health insurance and employee benefits broker will state very clearly and unequivocally that they are most definitely NOT insurance. It should be relatively easy to get a statement, copy of a contract, marketing material, etc. ALL of which will say this. Send it off to the Medicaid office or person you’re dealing with; if that person still refuses to approve it, file an appeal with his supervisor. I would also “copy” all correspondence to the hospital person, an attorney, and possibly your US Congressman. Also, if one of your local TV stations has a “consumer advocate,” this would make for a great TV spot: “Medicaid recipient claim wrongly denied (or better, rescinded, as that’s something that’s been “played up” in Obamacare; something that insurance companies did that was going to fixed by Obamacare), person now being used by hospital,”etc., etc.

    Anyway, that’s how I’d likely start fighting back.

53. I lost my Hospital job of 20 years due to Hospital closing. My Husband died leaving very small ins. Policy. Both of my daughter’s are covered. One is 18 ,covered by M’caid. The other by College. As of today, I have not found work. I cannot afford any health insurance & wonder if by January 2014, will there be any options available?

54. Hi Susie – Have you tried the health insurance exchanges at Healthcare.gov? I know they’re mess right now, but with no income, you should qualify for a plan for practically no cost. At least that’s what the hype is telling us.

55. I did go to healthcare.gov and you are exactly right! It is a mess. I have tried again today & will continue to. Thank you for your reply & this site Kevin.

56. I have multiple pre-existing conditions. I have a minimal part-time job that barely keeps a roof over my head and barely keeps me on all of the medications I need to be on. Luckily, pharmacies have programs where I can get most of my meds for $4.00 for a month’s supply. I have no one that I can depend on for help (all of my family is gone). I have to keep working in order to survive. As I can barely afford to live, I cannot afford to pay for insurance coverage at all. What is a person supposed to do when they get too sick to work to keep themselves alive, but not sick enough to pass away or get on government aid?

57. Hi Cathy – That’s what Obamacare is supposed to remedy, but it looks like it’s a long way from happening. Can you get a job at Starbucks or one of the other companies that offer health insurance for part-timers? Please try this link to get started… http://outofyourrut.com/20-part-time-jobs-with-health-insurance/ Not a perfect solution but maybe it will work until Obamacare gets the bugs out…if not, we can always hold out for Medicare! Also, if you’re going to work in a part-time job it may as well be one with health insurance.

58. Cathy – Sounds like a really difficult situation you’re dealing with right now. Based on the bit of information you included, it seems highly probable that you should qualify for Medicaid, which will at least give you access to health care and pay for most of it. You need to contact your state’s Medicaid office directly or try to enroll via healthcare.gov, which will direct your data / info to the nearest Medicaid office. Your situation sounds like exactly the sort of situation these programs were originally designed for … Give it a try.

59. “Let?s get this point out of the way upfront: everyone should have health insurance.”

    I quit reading after this. Because you basically just told me I am wrong and stupid. So WHY should I even READ any further?

60. David – WHY should (you) even READ any further? So that, perhaps, you might learn something or at least show a willingness to hear other points of view or perspectives – that’s why.

    “Everyone should have health insurance” is, of course, a very generalized comment. Donald Trump or LeBron James don’t really need health insurance (though I suspect they both have it); they have the money to pay for whatever healthcare they might need. Sadly, the vast majority of us don’t live in that financial house. If you “choose” to not have health insurance and are NOT in a position to pay for a sizable claim (say a $25,000 knee replacement or $150,000 bypass surgery) then – whatcha’ gonna’ do? Either (a) go bankrupt and effectively “stiff” the doctors, nurses, hospitals, etc. that treated you, or (b) be dependent on someone else to pick up your tab for you (i.e., family members, taxpayers, etc.). I submit to you that, if that’s your “plan,” then that makes you, in essence, a gambler who’s willing to roll the dice and bet with somebody else’s money (which is sorta’ what the government does, because it’s a lot easier for them to spend someone else’s money on stuff).

    While I strongly disagree with Obamacare and its requirements that force everyone to purchase health insurance or pay a penalty/tax enforced by the I.R.S. (everyone’s favorite government organization), I do believe that – for most of us, as reasonable, responsible adults – the need/desire to have health insurance is a logical and prudent thing to do. (Now, if it were only more affordable…. )

61. I have a job I file for bankruptcy. I get paid every two week,sny way it pey all my bills except medical that my job offer. Bankruptcy take all my pay,dont leave my with nothing,my Husband recive SSA Disbility check trhat cover most of the thing and his bill but dont have enould to cover my health care at eork .Im 57 year old not able to draw Social Security, how can i afford health care.

62. Deloris – You’re in a tough spot. Based on what you’ve written I suspect that you might be eligible for help from the government for you health insurance, either in the form of a premium subsidy or (depending on the level of your taxable income) maybe even Medicaid. If you’ve not done so already you should visit a website like http://www.healthsherpa.com, which will give you a really good idea about what your options might be.

63. Many good comments about health insurance /health care plans on this site but both BEFORE and AFTER the Affordable Health Care Act (which I did support) – I still claim the following:

    1. Decent health care is NOT affordable for a large percentage of the population. (*Read below for definition of “decent”)

    2. The Affordable Care Act has worked. As of July 2014 statistics indicate that MOST states have a much lower percentage of people with no health insurance coverage than they did one year prior. The states with the highest increase in people with health insurance coverage are those (essentially, the Democratic states)that opted in to the federal exchange system.

    For example, Massachusetts now has only 11% of its population without any health insurance coverage, compared to 23% one year earlier in 2013. Texas, a state that strongly disagreed with Obamacare, has one of the highest levels of people without any health insurance at 22% currently – but even this number is better than in 2013, when the percentage was 34%. Likely the rate in Texas could be lower (17 – 18%) had the stated opted in to the federal exchange instead of choosing to go with their own state-run exchange.

    Again, per recent statistics, the groups who have benefited most are Latinos, and those earning a poverty level income or slightly above. Not only has the percentage of those covered with a health insurance plan increased significantly for these groups, but in surveys members of these groups say the plans work, and they ARE using them to obtain quality health care services.

    All of the above said, the Affordable Care Act has, of has expected, NOT made health insurance plans affordable for most at or slightly above or below what is defined as “middle-class” in this country. The insurance companies have increased plans cost even more.

    As noted above, now I can define “decent” in terms of health care coverage. Most of the world tends to define things in relative terms, so it is becomes very easy to maintain a point and make an argument for that line of thinking. I don’t. I define many items (especially critical need items such as health care) in ABSOLUTE terms.

    Here is an example. Only 5 years ago, I could obtain a solid health care plan (on my own OR through my employer) that would, for example, pay in full, or at least 80% for doctor’s visits, 80% for hospital, 80 to 90% of prescription cost, dental, vision, etc., and LOW deductible, usually about $500, but definitely no more than $1,000.

    The monthly cost of that type of plan was approx. $300 – $350 per month if purchased individually, or about $100 – $150 per paycheck (bi-weekly) if from an employer.

    That same level of plan today will cost me about $1,000 to $1,200 a month. If I am willing to “accept” a higher deductible (somewhere in the range of $3,000 to $6,000) then I might be able to get the plan for somewhere between $520 – $700 a month.

    Bottom line: The plans, to be “reasonable” for a vast majority (NOT everyone) of Americans – need to cost around $350 a month. Period. That is what I mean by absolute cost, not “relative to other costs”.

    3. Now we get to the reason why we can’t get health insurance at “decent” cost: Pure American greed. Of course, in our society today no major player will accept blame – its always “the other player”. Let’s spell it out: Insurance companies, brokers, hospitals, doctors, pharma companies, etc. – everyone “in the game” is to blame for the exorbitant cost. Good example: Don’t care what anyone says to this: A 5 star hotel can cost $1,000 per night. Why? I DON’T HAVE to stay there – its a choice. A hospital – I may NOT have a choice if I have to be there for an operation or procedure to save or at least change my life. NO WAY in the world a hospital stay should cost $1,000 per night.

    Answer to this: Well, the moderator of this forum said it best. Current laws (and, I should add, no past laws that I am aware of either) properly address and “go-after” cost containment. But I am not stating this in the terms normally considered. I am consider cost containment in ABSOLUTE terms.

    For example, (yes – you knew this was coming, did you not?). For at least a period of time (5 years ?) a hospital, or an insurer, or other medical player has a “profit max” restriction. In other words, their ceiling will 10 to 15 % profit (not the range of 20 to 30% or more that many organizations aim for). And they will simply have restrictions on what they can charge. No more than $2,000 can be charged for “xxxx” operation, no more than $400 per night for a hospital room stay, no more than $60 for a primary care physician visit.

    Of course, I made up these absolute figures, but we are all big boys and girls – sure that “acceptable” figures could be agreed upon. Not asking to have a gall bladder operation for $150, but not at $10 or $12,000 either – get the idea?

    Oh, if you think this smacks of the “S…” word – it does. But if stops some American greed, even for a while – I am all for it.

64. Hi Geoff – I wish you had emailed me before writing your comment – I would have set up a separate post, which is what your comment is.

    Anyway…

    If only hospitals did cost $1,000/night – we wouldn’t be in this mess!

    I’m going to take your comment about American greed as step farther…our problem is that we want gold plated healthcare, but we don’t want to pay for it at all. That’s the “reform” people want, even if they don’t express it in those terms. The $350 per month premium that you think is fair won’t sustain the level of healthcare that the public believes its entitled to. That’s the problem. No one talks about cutting costs, the “debate” always centers on funding. That kind of thinking has driven our healthcare crisis since long before Obamacare came in.

    We won’t fix healthcare until we agree that cuts in price and in service levels need to come about. There’s no way healthcare can ever be affordable if people want their healthcare to be a bottomless pit of service.

    If you think about it, it makes perfect sense.

65. Even this article is wrong right out of the gate.”and the cost of independent plans spiraling out of control,”. That “selling point” that every knuckle head uses including out leer-less feeder Barry is wrong. My “independent plan” was an 80/20 plan with $40 co-pay for $495 a mo. Now, thanks to obama care, it’s $632 a month for a 60/40 plan and $60 co-pay. Also, I have never paid so much for blood work or ultra sounds before in my life. What a rip off. They are just taking more money from the people who get up and go to work every day because we have it… like pick pockets… only under the guise of “making things better because we are too stupid to and they know best etc”. it’s like Socialist or something. (ha-ha) What will they do when they run out of MY money? This law has to get unwound some how. How about: you do you… and I’ll do me? My only charity is my wife and three children thank you very much.

66. Why Doug, you really are “disgruntled”! Unfortunately there’s a lot in Obamacare to be disgruntled about. My own thought is that Obamacare is just the latest version of the failed US healthcare system. It’s costing us twice as much per person in the US as it is for the rest of the industrialized world for “the best healthcare in the world”. Meanwhile we’re paying ever higher out of pocket costs, millions are going without “affordable healthcare”, and most of the population is being fed prescription drugs. And we’re only 26th in the industrialized world (which is near the bottom) in life expectancy.

    So what’s wrong with the US healthcare system? Where do we start???

67. This is so messed up. I lost my job when my Hospital closed due to finiancial woes. I worked 38 years in healthcare. Lose a good job by no fault of my own. Now no one is hiring me, and I cannot get health insurance! Oh, of course if i want to pay 456.00 per month out of pocket, then I can with a independent agent. What a joke. HHS (Obamacare) told me I did not have any options for healthcare since I was unemployed and since Ga. has opted out of M’caid, no help there . So I just forego any check ups and do the best I can with exercise and healthy eating. If any emergency comes up, guess I’m done for.

68. Hi Susann – Obamacare didn’t eliminate the problem of tens of millions of people not being able to afford health insurance. A recent report showed 4 million fewer people without coverage, but it was due mostly to the expansion of Medicaid. People who couldn’t afford health insurance before still can’t. And they’ve done away with the catastrophic plans that used to be the last best hope of the uninsured. No easy answers here, but take good care of yourself and make use of mini-clinics when necessary. Also if you’re a committed Christian, you should look into health sharing ministries, like MediShare. They offer a form of coverage at greatly reduced rates. Otherwise you may have to hang on until you qualify for Medicare. This is such a mess!

69. Last time I looked, I could get a top of the line BXBS or Aetna plan for something on the order of 900-1200 per month. Do the math. That’s between 10800 and 14400 per year I’d spend for plans that pay EVERYTHING, with no copays, and a very low copay of like $50. that was a couple of years ago while I had a ‘normal’ job.

    Under Obamma Care, whether it be a free (sic) plan, or the top of the line plan… the potential max out of pocket for a year is about the SAME. who do they think they’re kidding? (add up the copays, the deductibles, etc. plus what the ins does NOT pay)

70. I couldn’t have said it better.

71. My company was gonna charge me 700.00 a month for a family plan I make decent money single mom with House payment car payment, utilities no child support and even with this covered CA crap they want me to pay 600.00 so No insurance for us. I guess i have to chose to lose my home or pay health insurance.

72. Hi Heidi – That’s a choice no one should have to make, but it’s the reality of our time. Until the cost spiral of health insurance is addressed, all claims of “heathcare reform” are completely hollow.

73. What if you are offered coverage at a job? They do pay a portion of the Premiums. You have a family you wish to cover. You make too much to qualify for a government subsidy, but you still can’t afford it? Money doesn’t go as far as it used to. Is the government keeping up with inflation? What if I can’t afford it because the father of my child doesn’t pay child support? Why doesn’t the government account for the cost of healthcare when people apply for food stamps?
    How can this be a mandated and taxable thing when they don’t even have all their ducks in a row?

74. Hi Kelsie – The whole thing is a mess. Obamacare did much to enable those with health conditions to be guaranteed coverage, but NOTHING to address the affordability factor. Maybe this is just me jumping to conclusions, but it seems that on the cost side, all it did was to keep the healthcare cost juggernaut moving forward now as before. So while we have more access to health coverage, we can afford it less than at any other time.

    The whole idea of punishing people who can’t afford health insurance with tax penalties seems like a full frontal assault against the poor and working classes, and even millions who in the middle class. How can these politicians convince themselves that they’re “working for the people”. The words sound good, but the actions go in the opposite direction.

75. how can u tell what ur gone to make each week when his job is out side it rains for days .. what can u tell me about this .. What if he cannot afford it when he has to pay rent plus electric , water bills what can u do when u need this to live on .. I think Obama is wrong lot of people do not have a job they cannot pay for Insurance .. I need advice in what to do for my son .. Thank u

76. Hi Christopher – I don’t have an answer for that question right now. We’re going through this with our kids at this very moment so we’re working on it. I plan to write a new article on this in a week or two, talking about what happened and how we dealt with it. I’d love to try to answer your question right now, but I don’t know enough just now. I’ll share when we’ve got it figured out, so please check back.

77. I’m so glad I found this site. It’s actually comforting to know I’m not alone in this mess. The healthcare system had failed me and my husband as well. It’s unaffordable for us and we don’t qualify for medicaid. It’s a vicious cycle that I see no end in unless we move out of this country (which outside of being away from my extended family, would not be a bad thing). We have been lucky so far but it’s a gamble every day, and it’s not a good feeling.

78. Hi Brittany – We’ve had to deal with getting health insurance this year, so I understand what you’re going through. We’ve had to make a choice between paying for health insurance and LIVING! It’s so expensive, no matter which way you go. We’ve arrived at a hybrid solution, and it’s not perfect! It’s still unfolding right now, but I plan two write two or three new posts chronicaling (is that even a word???) our situation and outcome. So stay tuned, they should start appearing in a week or two.

79. I am interested in finding out more information for a friend he has a good paying job that is above the poverty limit but he also has about 60% of his income taken each week for child support so therefore he is now left with a small weekly check barely covering his necessities how does he get help getting medical insurance when he just doesnt have enough bring home pay to pay a medical insurance premium

80. Hi Nicole – He may want to look into Medicaid. I think – but I’m not sure – that they will adjust his income for the child support. The healthcare exchanges might do that too, but the deadline for enrollment has passed.

    The government seems to have opened up Medicaid under Obamacare, and a lot more people qualify for it than was the case before.

81. This ordeal with losing my job due to lay off, losing my health insurance. All a nightmare. I live in Georgia so no expansion on Medicaid even though I qualify. Just had a heart attack on the 19th, resulting in complete heart block. I now have a pace maker & wondering how in the World I am ever going to find insurance I can afford.

82. Hi Susann – With no job the exchanges may be the best place for you. You’ll get a big tax subsidy that will bring your premium down to nothing. And since health insurance companies can no longer decline your policy for health conditions, or increase your premium as a result, you’re in a good position.

    You can apply for the coverage since you’ve had a “life changing event” (the loss of your job, and presumably your health coverage. I’d apply for that right away.

83. Susann – Kevin is correct: if you’ve recently lost your job and, therefore, your health insurance, then you’re entitled to a “special enrollment period” (it’s important, though, that you don’t wait too long to check on this, because it’s a “limited time offer.”

    If you qualify for this, however, you’ll be covered in full, regardless of any pre-existing conditions (like the recent heart attack, etc.).

    Georgia (where I’m located) is one of those states that chose to not expand Medicaid. This may or not affect you, but this will depend on several factors (expected taxable income for 2015, your family size, etc.).

    Best advice? Go to NAHU.org and click on the “find a broker” link. You’ll find several brokers near you who specialize in health insurance and who will do so at no extra cost to you.

    Hope this helps a bit!

84. Art, thank you for your kind reply. I will go to the site you named and try to locate some coverage. I sure hope things start to get better. Again , thank you .

85. Thank you too Kevin, this site is a big help.

86. I am a concerned daughter. My father is 57, has been a mechanic for 40 years. He has worked hard and has always paid taxes for every job, has had health insurance most ofthe time. Three years ago he had to change jobs bc the 1st closed its doors, the changeover caused a short no insurance stint. In that time he had kidney stones so bad he would go to ER. They gave him pain meds and cconveniently each time their scan machine was incapacitated. Last year my moom lost her job and when she got a new one it forced a move 3 hours away. My dad cannot physically do the mechanics he did. He has severe neuropothy and falls down, cant lift hands above his head, etc. He is trying to get disability, and was denied bc he hadn’t seen enough drs. My mom makes 25K a year..before taxes, insurance on her and life insurance on her and my dad. Last month my father had to be admitted to hospital for chest pain…come to find out he is in kidney failure. He found a clinic that charges minimal, but he had to have emergency surgery yesterday. Guess what they found..kidney stones loged so long the ureters had grown obver them. My parents are just beginni g a long hard journey. He doesnt get medicaid bc they have 2 vehicles that are paid for and run well. Why should he have to sell them to buy ones that really will cost a lot more in maintaining than what they have now, just to be eligible for medicaid? And if those machines 3 years ago would have been utilized regardless of having insurance, my dad might very well not be toxic and unable to work. Its not right! I think this Obama health system is a euthanasia in disguise.

87. Hi Abbey – I’m very sorry to hear about your parents situation. That could truly be any one of us, given a wrong turn of events. This may be bad advice, but your father may need to get the necessary treatment, then try to work out a deal later on. Until his health improves, he can’t pay anyone anything. So maybe he asks for debt forgiveness as a charity case from some providers, and gets the bill reduced by others. Worse case scenario, if no one will work out a deal, your parents should file for bankruptcy and simply discharge the debts. That will give them a chance to wipe the slate clean and start getting ready for retirement. I know this is a shameless plug, but have them read the retirement articles on this site. I’ve tried to present retirement ideas from the point of view of people who have constrained options, and may do no better than semi-retirement. That may be the route they’ll need to take, and there’s nothing wrong with it if they do.

    Don’t blame Obama for this exclusively. Though Obamacare didn’t fix this kind of problem, it’s one that has existed for decades. Before Obamacare, your dad might have been considered uninsurable due to health condition. Our whole healthcare system is a mess, except for those who have subsidized insurance plans from employers or the government.

88. When you say you absolutely can’t afford ins. but you show little plans for a hundred or so. In my case I have no income I live in a motor home I bought years ago but a dear friend of mine pays my rent and elec.I am 69 and will collect next year and live on food stamps so that is absolutely can not afford anything.I had arthropathy in my foot and could not afford a doctor so now I will have my foot amputated.

89. Hi Guy – If you’re 69 you should have Medicare. That’s just a little bit over $100 per month. Also, with no income at all (where’s your Social Security???), you should also be eligible for Medicaid. Am I missing something?

90. What do you do in a country that allows health care providers charge you $900 for an HIV test?

    Cancel your health insurance. Which is exactly what I did.

    Why pay for insurance when it provides no coverage at all.

    Thank you Blue Cross Care First of Maryland. Scam/rip off/joke/lie

91. So many insurance companies have raised deductibles so high that they fall into what we used to call catastrophic plans. The deductibles are so high that unless you have a major medical event it will be as though you have no coverage at all. They might also exclude certain tests altogether, which makes the deductible virtually worthless.

92. I can not afford anything. I got none from my temp job. When I did have some from them, I had to wait six months to be eligible and then when I sued it for a dental cleaning and standard medical checkup (being years since no money), I spent $400 total out of pocket. No government help because they look at gross before taxes and other stuff, not after. I live off my 401k, and almost gone. I cannot find a second job or a REAL job, even with two degrees. All this from a 2011 layoff after being with one company for 15 years. I avoided that silly penalty last year, but the government has NO RIGHT to tell me to have it or else I will pay them even more money. If I had money, I would already have insurance. Now I have mot had any since Dec 2014 and I fear I will pay the government, who has my money (because not having a real, proper paying job causes you to owe a lot in taxes which I never had to in my life since I was 16 until 2012), even more money. I have no idea what to do because the people in the government are not helping me avoid their extra penalties for next year. How can I pay it if I have no money now? I already owe over 80k in school loans (defaulted) and owe federal and state over 2k total since 2013. I live off my 401k I spent 15 years building and it is almost gone. I have gone from temp job to temp job trying to make money. I have an AS in computers and BS in video game design. My credit was over 800 before 2011. Guess what it is now!!! Guess what I lost since then, and I did not even own much to begin with (lived very simple, but still, bills, food, taxes, gas, etc).
    What can I do? Government will not help me. I can barely buy food each week, to stretch my 401k as I only got 6 months of it left to live on unless God gives me that proper paying, real job before then.
    Dipp, in NC

93. Hi Dipp – I wonder how much of your situation owes to geography. Do you live in an area with chronic weak employment? If so, the only answer may be to move to a different area. The economic picture is very different from one area of the country to another. It seems that you have an impressive list of credentials that should land you a job doing something. The health insurances situation is more problematic when you have just enough income to NOT qualify for Medicaid. But it looks like your first order of business is to find a way to generate a credible cash flow.

94. 0b0mmacare. These too big to fail insurance companies were gonna go under so the gummint bails em out and in return everyone is now mandated to have health insurance. The problem is these corporations. In particular insurance companies who have destroyed health care. That’s why most skilled seasoned doctors are quitting because they have to get paid less than a day laborer. That’s why you see so many foreign doctors in the USA now because they are doing the job for less pay. Its the same as sending the jobs overseas. It is a very sad grim situation. Whats really sad is you will get the best benefits if you are unemployed. There is a big incentive not to work. We have a broken system that is powered by greed sweetheart deals with politicians and big pharma all in bed with each other. Be prepared to die in the woods. This is what we have now. A bunch of criminal psychopaths running things that need to be arrested.

95. Hi Franny – I wish I could disagree with your grim assessment, but I think you nailed what’s happening in the big picture. My thought is that whatever Obamacare was when it was on the drawing board, it became a bailout to protect the insurance companies and big healthcare providers. Some may think that to be an extreme assessment, but we have a precedent when after 2007 the government bailed out the big banks – while the big banks were throwing people out of their houses.

    I’m not absolving people who lost their homes – many of them never should have qualified for a mortgage in the first place. But that doesn’t change the fact that the government came down squarely on the side of the big banks and threw the citizenry under the bus. The same thing is now playing out with healthcare. The most conclusive evidence is that the cost of healthcare and health insurance premiums have continued to rise under Obamacare.

    My guess is that the government looks at healthcare, sees that it represents 18% of the total economy, and decides that like the banks in 07-08, it’s “too big to fail”. Isn’t it amazing how paranoid our government is that ANYTHING should fail in our system – except, of course, the citizenry.

96. i have been in severe sciatica pain for five weeks now. I have Medicare and Fallon senior premier health insurances..I have had to jump through fire hoops to get an MRI before I can see a back specialist. Medicare is arguing with my physician about the necessity of an MRI???? Are they serious or stupid??? Five weeks in extreme pain, with very little sleep and they don’t think I need an MRI??? Yet I can have all the pain melds I want (which don’t work). ??? BUT I MUST PAY MY MEDICARE TO THE TUNE OF $1200.00 per year, plus the cost of Fallon senior, or my insurance will be canceled. So what am I paying for if I can’t get service?

97. Hi Vicky – I’ve heard of such things. The husband of a co-worker of mine was initially denied Medicare coverage for knee surgery because at age 75, it was deemed unessential. They eventually relented and paid and he underwent a successful surgery. But we keep hearing stories about how Medicare is increasingly declining to cover procedures. My guess is that this will get even more frequent in the future. They’ve taken on more than they ever imagined they’d need to pay, and now they’re trying to retrace.

    Until we get some meaningful cost reduction in healthcare this will only get worse. We’re already seeing private health insurers reduce/deny coverage in situations where they used to pay the claims without questioning. My wife had shoulder surgery a couple of years ago and I’m not exaggerating that we had to fight with Blue Cross to get them to pay nearly all the claims. Their first reaction was always to decline the claim, then to pay on the second or third filing. I’m guessing this is an intentional strategy designed to scare away the timid. We can’t be timid! There’s no solution to this problem on the horizon, and the politicians aren’t even talking about it.

98. Hi,my situation is that I made $18,181 last year and cannot afford health insurance whatsoever..I applied for Medicaid and was told I made too much.then when I applied for the bronze I was told $171 a month was the best I can get.However I can’t afford that with rent,utilities,car insurance and food..my job offers health insurance but I keep getting denied yet I really can’t afford that neither..What can I do?

99. Hi James, I’m puzzled – your job offers health insurance but you keep getting denied? Employer sponsored plans are automatic, they can’t decline you. You’re accepted in the plan as a result of being part of the group, which is your employer.

    Am I missing something?

100. Okay, let me just put my situation out there and see if anyone can help remedy the massive health-coverage headache I’m suffering from.

     I’m barely 21, female, been married two years, have never used recreactional drugs, rarely drink, don’t use tobacco products, am overweight but very healthy minus a thyroid problem that caused the weight gain, and had a baby two months ago. My husband works and has insurance through it, my baby has medicaid, and I have nothing once my post-partum medicaid runs out. My baby was born two and half months early from preeclampsia so her drs suggest I stay home with her for a while, which is very frustrating since I have a four year college degree. If your thinking I shouldn’t have had a baby with tight finances, I’ll tell you she was a miracle baby, I’m not supposed to be able to have kids and I was on bc and made my husband use protection. Anyway, my insurance that I had before was 200$ a month, plus 20% of the cost which I definitely can’t afford now. I need health insurance but I rarely get sick and i really only want it to keep my thyroid prescription up to date. I can get insurance through my husbands work but then he takes about a 200$ a month pay cut. Which means bye bye car, and then bye bye house becuase he couldn’t get to work to pay rent.

     Anyone have any suggestions? The household income is right around 14500/month. I try to do side work but it doesn’t add up to even close to enough for insurance compared to diapers.

101. Hi Rose – Unless it’s a typo, there shouldn’t be a problem if your income is $14,500 per month! But assuming you meant per year, or $1450 per month, you might try to get the meds directly from the company that supplies it. They sometimes give deep discounts to people who have financial difficulties, and I think your baby would also be a factor. Failing that, check out some of the big boxes like WalMart and Target to see if the drug is included under any special pricing plans, such as the $4 per prescription plan.

102. In large part, this problem is America’s (that means the voting public) obsession with going it alone…I don’t want to pay for my insurance (because I am never sick) and I certainly do not want to pay for YOUR insurance. Socialist redistribution!!! What the heckeron is wrong with most of us? Redistribution is right…untold millions of profit are going to drug research/production companies, hospitals, doctors, and members of the board. Healthcare, transportation, utilities should all be non-profit, tax supported. But…citizens have to do some things too…like exercise, get verified help with alcoholism, depression, smoking etc. If you want bells and whistles, if you want perfect skin and nobody telling you what to do, then YES, go to your profit hosptial and pay the price. For most others, that is not an option. We live in a nation, in civilized groups of towns and cities. WE, the citizens have responsibility to all the other citizens. If not…we should truly in every way possible…quit complaining and go it alone, totally alone. Early death might be a condition of that…we can call it post-contraception. It does help make room for others, does’nt it. Otherwise, vote for people that believe in single-payer, support people/movements that want to expand Medicaid and healthcare for elders and children. There are frauds everywhere…in your own family, at the bank, at the company, at doctor’s office. If humans are involved, they need supervision because somebody will steal. That doesn’t make every effort to go forward a wrong effort. The police and regulation is needed until – well, probably forever. Changing things like healthcare on a large scale, will take a movement. Get moving please! We can at least fix this for our grandchildren.

103. Hi Debbi – I don’t think the method of the system matters as much as we think. The core problems are a) government policies that favor higher healthcare costs because it’s good for the economy, and 2) a national mindset that we all want to be able to get any medical treatment we deem appropriate, and we don’t want to pay for it.

     Until the powers that be come to us and say “here’s what we’re going to cut, and here’s what you’re REALLY going to pay for what’s left” they simply aren’t telling us the truth, and we shouldn’t believe that they’re offering any real solutions. I’m not at all optimistic about how the healthcare situation in America will turn out. Everyone – patients, providers, government/regulators, investors – wants their share of the swag and that’s hardly a recipe for improvement. Virtually all proposals center squarely on increasing funding (Obamacare is only the most recent example), not on cutting costs. That can’t possibly make anything better.

104. need something to help with my medications i am 63 yrs. old no insurance on zarelto can not afford this at 478.00 a mth. i only get 545.00 on my ssi.

105. Hi David – Try contacting the company makes the drug. Sometimes they’ll offer reduced or even free supplies in hardship situations. Failing that, contact your city, county or state administrative offices, and ask if they can direct you to a department that can help. Failing that, let your doctor know about your financial situation and see if he or she can recommend an alternative therapy. No guarantees, but they’re all worth a try.

106. What I don’t understand is how the government expects me to pay so much for healthcare when I am going to college full time and my wife is pregnant. I work full time usually about 42 hours a week. I live in a one bedroom apartment paying 700$ a month. My income is 1300$ a month and my wife is not employed (and not healthy enough to have a job). Yet the cheapest healthcare that is offered me is 150$ a month. That leaves me 450 to use for gas, food, school supplies, the electric and water bill, car insurance, and many other things. I don’t see how the government could think this is acceptable.

107. Hi Nathan – Actually, $150 per month is the lowest premium I’ve ever seen for a couple. I sympathize that you’re in a tight spot financially, but that really isn’t bad at all. My wife an I got a quote of $741/mo, and that was with a $6,000 deductible.

108. I left my career and VERY GOOD insurance to take care of my husband full-time after he had a ruptured brain aneurysm at 37 years old.
     My husband and children are covered under Medicaid since he is disabled and they are underage. But I am unable to find any coverage.
     I have $0 income so I do not qualify for the “catastrophic plans” in the affordable care act and I can not afford any of the monthly premiums.
     I am stuck. I feel like caregivers are just forgotten about as we save the government hundreds of thousands of dollars by keeping our loved ones healthy.

109. Hi Danielle – I’m very sorry to hear about your situation. Are you not able to qualify for Medicaid having zero income? If not, try writing your congress person, or even the White House. If “The System” can’t provide for a person in your situation then I don’t know why it even exists.

     I’d advise anyone who isn’t fully appreciating how delicate and precious life is to check out Danielle’s blog Small Revelations. We need to celebrate each day, despite any annoyances it may bring. We can never know how much time we have, or what the quality of that time will be. Her blog tells an ongoing story on how difficult it can really be.

110. Thank you, Kevin. I have wrote to every single politician I can think of. Not only about healthcare coverage, but also to ask why it is that Spouses are the only person in Michigan that is not allowed to be paid for at home care.
     We have been “stuck” in a system that is not working. Or as some like to say, we are in a catch 22. I made too much before my husbands disability to qualify for anything and make too little now to be able to pay for anything.
     If I ,as a spouse, could just be paid a minimal amount to care for him our whole outlook would change. And I would be able to pay into federal, state, medicare and SS.
     What a world we live in.

111. Have you tried to find some sort of work at home arrangement? Since you have a blog you might try freelance blog-writing. But there are other opportunities. Even if you only do it part-time, at least some money will be coming in. Maybe enough to get a cheap health insurance plan, with the tax subsidy. Maybe.

112. Thank you!

113. I’m a college student-22, recently kicked off my dads tricare because I’m too old. I make under 11,000 and I can’t afford insurance. Tried medicard/ CHIP , not eligible. I don’t know whether to curb up and die or go jump in front of a moving bus. I really need to see a doctor because of some unexpected problems.

114. Hi India – It’s hard to believe you’re not eligible for Medicaid with an annual income of less than $11k. Here in New Hampshire the cutoff is around $15,000 per year. In this post-Obamacare world, my only suggestion is that you look for a part-time job that provides health insurance.

     Please check out my post 20 Part-Time Jobs With Health Insurance 2015, as well as this site for other sources of health insurance/heathcare: The Self-Pay Patient.

115. If you don’t have insurance and must go to a hospital, sure, THEY will hound you for MONTHS for their money, calling you at all hours of the day or night, sending you repeat copies of the same bill every day in the mail, after about a year of that they will get their money paid to them from a collection company who will in turn harass your arse off for up to 1 year than that collection agency will sell your account over to another, than another and so on. meanwhile the hospital HAS insurance that PAYS them when a patient cant! SO the greedy hospitals (that really DON’T care about you, NO THEY DON’T! They only want a notch in their statistic belt and YOUR MONEY!) win twice!

116. No such thing as a “Part-Time” job that offers health plans in O’Bunga’s Socialist Scamerica anymore! Nope, NONE! Most FULL time jobs no longer offer any plans either, and NONE offer any affordable plans!

117. I guess the health insurance plan from my wife’s part-time job must be a figment of my imagination as well as to the hospital who’s $17k bill they recently paid.

     Try not to be so bitter that it blinds you to the fact that there ARE ways to deal with the health dilemma we’re facing. It IS a crisis, but we can never give up, and should try to find options where they exist.

118. I pay roughly $6400 a year for family health insurance – nothing to show for it. In Turkey, I pay $2100 per year for full coverage for me and my family, plus preventative care visits.

     I’m perplexed that health coverage, medical care and medical cost in the US yields nothing better than what I can get in a third world country. A CABG (quadruple bypass) in Turkey costs roughly $75K while the same procedure in the US is well over $280K.

     Coverage in Turkey is generally for a CABG – 100%. No hidden fees showing up in the mailbox for the next 6-years. In the US – 80%/20% for the patient at 5-times the typical out-of-pocket cost. And an endless stream of bills showing up when you least expect them for unknown and unseen services.

     I’m blown away by the fact US citizens will compare the price of a cell phone or cable service, but not compare medical costs at home and/or abroad, and then force the medical industry to standardize across the board.

     Now that I’m in the US, a DNR is the better option to save my family a lifetime of financial burden, and sending some shareholders dumb kid to medical school. Yeah! I’m bitter. I have a right to be. After 20+ years on the outside looking in, I see the greed as doctors and insurance companies prey on the misfortunate and concerns of the American Working Men and Women. Universal Healthcare? Not a bad option if the providers aren’t greedy ass-hats.

119. Hi Robert – I’m assuming that the DNR you’re referring to is the “Do Not Resuscitate” order? I have to thank you for commenting, since you bring a perspective from a different country. There are a lot of reasons why US healthcare has become so dysfunctional, but one of them is that we’ve all become myopic here in the US. There’s a general belief that the “American Way” is the best/only way, and we don’t look to other countries for answers. After all, we’re Number 1 and that’s the most important thing, right? (I’m being sarcastic, of course.) But as it says in the Bible, “pride goes before destruction” (Proverbs 16:18, but since fewer people believe in God these days, that kind of warning is mostly ignored). I wonder how many people don’t see that coming. The whole healthcare mess seems to be getting a little bit worse every year.

     But let’s get back to the reasons why it’s such a mess. Greed certainly plays a part. I’ve heard it described as the doctor/millionaire connection. But I also think it’s American optimism. We really believe that everything can be cured/fixed as long as we keep throwing more money at the problem. I’ve said many times that we pay the healthcare industry not for what it does, but for what we wish it could do, as in make us live forever. Fear of mortality is another issue – I suspect that other cultures are more OK with the idea of dying one day, but here in America we’re going to fight it every step of the way, even if it bankrupts the country.

     There’s also the fact that for those who have decent health insurance, they can have any medical procedure that they want, and someone else will pay for it. We want all we can get, as long as we don’t have to pay for it. That leads to another problem, which is political. No one in leadership wants to come before the American people and tell us what we’re going to have to give up in order to get truly affordable healthcare. And when the practice of government is to print or borrow as much money as it needs to keep from having to make tough trade-offs, bubbles can continue for a lot longer than anyone thinks possible.

     So as you can see, there are a lot of reasons why we’re in this mess. And I’m sure others could add to the list I’ve provided. What makes it so frustrating is that there’s no end in sight. The whole system is set up to continue traveling down the wrong path, and there’s no public groundswell indicating that the people are united around a workable solution.

120. Art Forrest –

     “Art Forrest – “WHY should (you) even READ any further? So that, perhaps, you might learn something or at least show a willingness to hear other points of view or perspectives ? that?s why.”

     Who’s to say I don’t already know more than you do? You? Typical.

121. Art Forrest –

     BTW, I am not reading the rest of your book. I’ve already made my determination through extensive research. I already concluded you are wrong. So why bother?

122. David – sorry that my earlier comments seem to have made you a bit “testy” – that wasn’t really my intent. It’s entirely possible that you do know more than I do (though I don’t know why you assumed I meant that in the first place – I didn’t) and I don’t know quite what to make of your offhandedly comment of “typical ” – typical of what? Or are you simply ascribing to me certain presumed character traits that may not, perhaps, apply?

     Finally, you’re not reading the rest of what book? And, to be honest, I’d be very interested in reading or viewing some of your extensive research you mentioned. A closed mind is a sad thing (“… Concluded you were wrong”). While I’ve worked in the health insurance field since 1980, I don’t believe I have a corner on all the good ideas – I’m curious to hear yours – and I won’t call you names, blow you off, or denigrate you or your views, even if I don’t agree.

123. David – I’m not sure what it is in Art’s position that you are challenging, but I cordially invite you to write your own article on the subject and submit it to me (see the About Page for contact information). If it’s a well researched, well written article, I’ll publish it. We welcome contrary opinions here. But I have to tell you that Art is a health insurance professional, and nothing he says or writes should be dismissed or criticized based primarily on emotional or philosophical disagreement. He has published articles on this site and his expertise is always welcome here. Rants and attacks on the other hand, won’t be entertained.

124. I am a 21 year old woman that just moved from Montana to Ohio to escape from overbearing familial issues and to what I had been told was an opportunity to further education in a way that would have have been affordable for me. In the years prior I was responsible with budgeting my income from a part-time job (due to company not wanting to even offer health insurance, grunts such as myself were not allowed to accrue more that 30 hours a week and even so optimistically I was only getting 12 despite asking for more.) and saved for years to pay for my car all up front in cash which I did just about a year ago. I take care of myself healthwise, and I’ve never had allergies, broken bones, medical surguries, medical problems or need for any persisting medication.

     But I have recently had a streak of misfortune in conjunction with my move that pushed any medical concerns that weren’t present to the bottom of my pile of concerns. My job, schooling and housing all fell through and I have been forced to use funds I made and set aside myself to even get by. Very recently I developed a strange rash on my legs and an intense pain in my left side that has persisted past the end of my last menstral cycle that may or may not be linked to one another. Up until I turned 21 while the insurance I had as a child was still valid I would have just gone to the hospital. As I considered my predicament, I remembered a year and a half ago when I slipped on ice on my way to work and ended up with a concussion that kept me out of work for another week (and it was on 12/26 only 2 days after I was cleared to return after recovering from influenza that had kept me out for 2 weeks additional weeks prior.) The bill even with insurance was far more than I had expected, and was something I paid for myself as my family had other financial worries. Back then it hurt a lot to pay nearly $800 but it was still doable even if it meant tightening my belt somewhat and eating cheap ramen for a while. Aside from housing, I was largly financially independant because I needed to be. Today as I look at this rash and pop ibuprofin for the unrelenting pain in my side like I have never done before, I realize with trepidation that even if this is serious, in my current financial situation, I cannot even afford to go to the hospital, let alone worry about insurance. I simply cannot afford the risk of getting another bill like that if it is optimistically nothing, or a far worse one if there IS something wrong.I’ll admit it, I’m a bit scared. If life is so precious and important why does it seem like an expensive luxury just to tske care of the basics.

125. Hi Larina – I have no special insight as to what to do in your situation, but an unrelenting pain is something that needs to be checked out. You’re going to have to get unconventional here. I’d check with the city or county health department to see if there are any resources that might be available. While you’re at it, check to see if you qualify for Medicaid. In the meantime, can you afford to go for a check up at a mini-clinic at a pharmacy? If you can you may be charged only about $50 or so. It could be that you just need an inexpensive antibiotic. If you suspect it might be something more serious, you might try calling some medical practices in the area to see if they take charity cases. They are bound by the hippocratic oath, and maybe you’ll find one who will take that oath seriously and agree to treat you.

     That said, if it’s life threatening, you need to just go to the hospital, get it treated, then deal with the financial consequences later. I know that isn’t comforting, but you’ve got to take care of your health first, otherwise there will be nothing to take care of later. Please resolve to do something even if it doesn’t seem like a perfect solution. In much of life, there are no perfect solutions, in spite of what school textbooks and some people who should know better might say.

126. Larina – I applaud your determination and efforts to be self-sufficient and not a “burden” to others like so many people seem to be. Kevin has given you some good insights and ideas. Let me review &/or add just a bit:

     1. Contact the closest Medicaid office in Ohio to see if you qualify.
     2. Visit the local city or county health clinic – try this link (http://www.needhelppayingbills.com/html/ohio_free_community_clinics.html) or this link (https://www.insurance.ohio.gov/Consumer/pages/LostJobToolkit.aspx).
     3. You can also visit this website – ohiofreeclinics.org
     4. If you’ve moved to Ohio within the last month or two you should qualify for an Obamacare “special enrollment period” (meaning you may enroll for a plan outside of the normal open enrollment period). Depending on your income, there’s a good chance you could qualify for an Obamacare plan at little to no cost. Surf over to healthcare.gov to check out plans available to you; if you want help from an “expert,” go to NAHU.org and click the “find an agent” link on the right side.

     Most importantly, though – and to echo what Kevin said above – you should get this checked out ASAP, regardless of cost because (as trite as it may sound), if you don’t have your health you don’t have anything.

     Hope this helps a bit…

127. Working for the health care industry will usually not get you better coverage but worse depending. I work for Optum which is one of the most reputable insurance groups yet their coverage is the worst I have EVER seen. I have never been in a situation like this.

128. Hi Nadine – I don’t doubt what you’re reporting, but I will add that not too many people are happy with their health insurance anymore. Ours is pretty good, but it comes with a $4,000 deductible, and a lot of people would consider that to be bad coverage. But in 2016 just having health insurance that’s reasonably affordable is a big plus. Having a high deductible and paying a high premium because you aren’t in an employer plan is fundamentally a worse position to be in. Your plan may be bad, but the options are few and far between, and usually cost a lot more. My biggest concern is that the whole situation will probably get worse as the price spiral continues.

129. There is a MAJOR PROBLEM with ObamaCare. First the subsidy is based on your income for the year, there is no calculation in that formula that accounts for rent, heat, electric, food, credit card bills, car, car taxes, car repair, fuel, insurance, pets, pet and pet food…it does not take into consideration Phone Service be it land or cell or both, it does not account for anything…the formula says you make $x.xx and you are eligible for y$x.xx

     for 2016 my total gross income is way to much to qualify for the States Medicaid program, and as a matter of fact the state, pushed by the exchange actually LOWERED the amount from about $17,000 per individual to somewhere around $16,200.. so some 20,000 residents of my state as of JULY 1 was kicked off the “FREE” healthcare onto the exchange.

     Being unemployed, recently married, trying to keep a roof over our heads, food on the table and warm in the winter there is no extra money to shell out for insurance. I have done everything I can to cut corners on the budget, buying generic foods, coupons, turning off all lights, shutting down a 90 gallon marine aquarium my one and only hobby…even after doing all of that, and a WEAK economy, with no job prospects in sight … there is NO EXTRA MONEY to afford another $200 a month for insurance for myself.

     Evening going on the private markets is way to expensive nearing $300…today, I had 4 reps hang up on me cause they asked one simple question…how much can you afford…I said for the next two months $60…click….really?

     I don’t know what I will do for 2017 as the premiums are going up somewhere on avg 28% with deductibles rising and copays rising…its a never ending cycle.

     My insurance ends on the 31 of August this year, I need just 2 months of coverage to avoid the penalty…and that may not even happen because now that I am married, the subsidy is based on the entire years household income…as a result I was NOT eligible for that amount, was over paid in subsidy by about $100 per month so I am now facing a TAX BILL of $800 just in subsidy payback.

     The ACA is just BAD LAW with BAD CONSEQUENCES….

130. Hi Nick – I agree with you on all counts. But there’s nothing we can do about this until the system is reformed once again. My guess is that it won’t happen if Hillary is elected, since she’s vowed to “protect” Obamacare. But on a practical level, check out the list of exemptions on the ACA penalty. I believe there’s also a catch-all that if the premium will exceed 8% of your income, you’re exempt from the penalty. As to covering two months, look into a short-term health insurance plan and see if that will cover you for two months.

     There are admittedly no good options here, which is exactly what Obamacare was designed to do – seal off the exits so that no other options exist so that we can all drown with the ship together. My own thought is that even if ACA isn’t actively reformed, it will crash on its own. Several major health insurance providers have already withdrawn from the program or announced their intention to do so. With no carriers, there’s no more Obamacare. I believe it’s coming.

131. ive had a different experience with obamacare. as a 27 year old, i ended up having chronic conditions that required heart ultrasounds, various tests and a colonoscopy. i could have known about these conditions and treated them 7 years ago if i had insurance. Obamacare changed that. i was able to get on Medicaid as i only make 16,000 a year. now i have heart medications and other medications. the colonoscopy even removed a small tumor which could have been a death sentence had i not done the procedure. i understand that i am the exception and most Americans are healthy and dont need insurance.. but the medicaid expansion literally saved my life.. if obamacare got repealed id be screwed. another thing is my family is from lebanon, a third world country that offers its citizens national healthcare. medicines cost a few dollars, surgeries cost a few thousand, the doctors are all educated in Europe and America.. yet healthcare is a fraction of the cost, and the government helps you out.. obamacare might of not been the right answer, but it helped 21 million people. we need to see what these other countries are doing right, and copy them.

132. Hi Sean – I’m glad you wrote in to share your own experience. I have no doubt that Obamacare did help a lot of people. But it has to be admitted that it was done through the Medicaid program, which has been in existence long before Obamacare. From what I’ve read, the great majority of people who got coverage under Obamacare did so through expanded Medicaid. The next largest group were people between ages 19 and 26 who were able to remain on their parents plans, even if they aren’t full time college students. The number of people who actually got health insurance from the exchanges was relatively small. To that degree, Obamacare has been a failure. It didn’t accomplish its primary stated mission of providing affordable healthcare for all. Rather, it got people coverage through side doors, rather than through the front as promised.

     All that said, I’m glad your own situation had a happy ending. In this day and time it’s necessary to get coverage and care in any way possible or available. Healthcare has really come down to a game of catch-as-catch-can. We can’t know how things will play out tomorrow, so get what you can while you can. That’s a sad state of affairs, but it’s the only one we have at the moment.

133. I got a part-time job to mainly get health insurance because my husband is self employed. Well the only thing about this situation is my checks all go to the health insurance so I feel I’m mainly working to pay the health insurance premium each month. Working my but off while taking care of two kids and only getting one bill paid-health insurance, with my paychecks.

134. Hi Syndia – We’re kind of in that situation as well. My wife has a part-time job that provides health insurance for our family. But it’s a high paying part-time gig, and only about half of her income from the job goes to pay for the coverage. It’s a tough spot because it feels as if you’re working for nothing. But it becomes a blessing when a major medical event hits, and you have the coverage. That’s especially important when you have a family because there’s greater potential for something to happen with more people in the family. It’s not easy but it’s the right thing to do. Give yourself a pat on the back! And hopefully a time will come in the future when you won’t have to be doing that.

135. I am near Seattle WA nd sometimes in CA
     I need a CT scan since 4 years, I think I have a DVT that could get bigger on my descendent aorta.
     Medicaid hasn’t agree to for it and when I call hospital/radiology they won’t accept me or give me a discount because I have Medicaid
     Would you help me?

136. sorry message got trunked
     Medicaid won’t pay for it so that is a problem, because most discount places won’t take me because I have insurance (Medicaid)

137. Hi Henri – I’d try contacting a Medicaid for advice, or a state agency that helps low income people with medical affairs. You can try the health department in your city or county, and see if they can point you in the right direction. Failing that, you might call the hospital and see if you can speak with a social worker who can help. There’s a solution out there for you, but you’re going to have to do some digging.

138. I cannot afford the high deductibles. Never mind the premium every month that doesn’t go towards the deductible. The cheapest premium has of course the highest deductible. The lowest deductible is still 1500.00? with a premium close to $200 a month. This is not about my life and me being able to afford high premiums to survive so I need to be able to make 6 figures a year to live its about those getting rich off of me because I can’t afford to live. Everyone has a hand in the pot and benefits from some level of where we are in life. Working to pay bills and insurance premiums and never afford to even eat. Is that living? No. Is it surviving? Absolutely not.

139. Hi Donnetta – I wish I could tell you there’s a silver lining but what you’ve written is completely true. The healthcare situation gets less affordable every year, and I know that for my family getting a policy on the exchanges would mean paying the equivalent of a large mortgage payment. They’re forcing everyone to choose between health insurance and LIFE. I suspect that we’re going to see the number of people without coverage to rise once more, probably even higher than what it was before Obamacare. And I agree, the people at the top of the chain are benefiting, while everyone else struggles just to survive. There are no easy answers here.

140. This is all hog wash. The bottom line is the government has destroyed our healthcare system. On a local- state level the community should be responsible for the continued operation of the local-state medical needs. Not some idiot in a suit 2000 miles away. We pay our government to destroy our lives. Every human being should be able to get medical care if needed. And not have to pay a arm and a leg. Ever since the advent of pharmaceuticals teaming with the local medical provider and grouped with the insurance company,healthcare has gone down hill. Corporate greed is killing people. Same story different time.

141. Hi Gary – I wish I could disagree with you. But since we’ve been conditioned as a culture to accept big government solutions as the only way forward, here we are. And here we’ll stay until the mindset changes. What I can’t believe is that the situation gets worse with each year that passes, and still there’s no plan and no consensus as to what needs to be done. We’re very much a lost society.

142. Why aren’t we suing the food giants like Nestle and Coke over their addictive sugary foods? Sugar is more addictive than cocaine and extremely detrimental to your health. Shouldn’t they be covering the majority of care especially for cancer patients. You’d be surprised at the link between fast food and cancer. That’s where we should be getting the funds to cover our health crisis.

143. I agree about the connection between addictive sugary foods and disease, but we’re looking for solutions closer to the ground. Putting Nestle, Coke and the Golden Arches out of business won’t make a dent in the healthcare crisis, nor will it enable us all to get affordable health insurance. But not a bad thought…

144. This is just simply unacceptable. I just returned from living in Europe, where I paid 50 a month for FULL health care (that means everything) and I am shocked to find that I must pay 450 dollars a month here in “the land of the free” for a 28 year old body, excuse me but those CEO’S, republicans, and politicians can go to hell. WE NEED HEALTH INSURANCE FOR EVERYONE, REGARDLESS OF THEIR FINANCIAL SITUATION. NO EXCEPTIONS. Tell your congressman

145. I wish I could argue with you, but I can’t.

146. I?m am 63 my husband 68 he has Medicare and Aetna
     I was on Medicaid for the last 4 years and it just came up for renewal and I was denied. I will loose my nj family heath the end of June. I only work part time I bring home before taxes 483 bi weekly my partial social security is 782.10 and ge gets 653 in his social security
     Neither of us have pensions and he does not work. They calculated my income and included his and they denied me now . We don?t have a pot to piss in or window to throw it out of after all bills rent electric etc
     What can I do now ? I went on to the health gov website and can?t afford any of these plans
     I?m literally sick to my stomach I have health issues and meds I need and now that will all be taken away .

147. Hi Linda – I’m calculating your gross monthly income at less than $2,500. The premium on healthcare.gov may be high, but you should get a very large tax subsidy on the premium. You can opt to have that used to lower the monthly payment. Have you calculated that?

148. Kaiser Permanente here in CA gave me antibiotics for ear infections from 2005-2008. Caused a colon Candida infection. It now turns out that my ear infection was fungal in the first place. So this is throughout my entire body. 100% skin has gone through horrible burning rashes, now dry and getting thicker. They tried to say Mixed Connective Tissue Disease/Scleroderma of unknown cause. But I am too smart.
     People this is what you are paying for in health insurance!!! It’s all a cover up and they just label you.
     The cause of all disease is acidosis, heavy metals, leaky gut and infections.

149. Hi BL – We don’t want to over-generalize here, but at the same time it’s true that the healthcare community doens’t know as much as we think – or more specifically, as much as we wish they did. They work like fixing a car – process of elimination. Go for the easy/obvious stuff first, then move on from there. The problem is false starts. Treatment for a misdiagnosis leads to the belief that the actual cause has been discovered, when it really hasn’t. The other issue is side effects. A treatment may be successful, but result in unintended negative consequences, ie, another health issue.

     In the end, I wish they’d stop calling it medical science, because there’s little about it that’s actually scientific. That’s not just semantics either. The current pricing structure assumes scientific capabilities that don’t exist. The medical field is one of the few where a practitioner can be completely wrong, and even fail, yet still get full compensation in the process. Something is very wrong with that, and it contributes mightily to this obscene price spiral we have in the industry. Not to mention the doctor-as-God fallacy.

150. Hi I’m a 56 year old male well starting last February 2017 I started out with igul hernias well a few months later I started going in to the e r I was told and on medical records that I have a bad liver with liver diease two bad kendneys with Stones a gallbladder with stones suppose to have a gallbladder surgery on the 25 of this month it’s only 150.00 dollars along with 100 dollor meds needless to say I can’t get it I have a right hand that burns itches numb tingles spreading to my other side left heptis C high ammonia levels 127 last count should be 47 anyway 10 times I get turn down for Medicaid and Medicare emergency Medicaid get approved once but the state of Florida doesn’t want to offer it to me at this time really recently last week got turn down because noone in the house is eligible ???? And that’s it.what a explanation that was omong other health issues I don’t meet the requirements but I can pay taxes for Medicaid and Medicare and social security for 36+ years and get told I don’t meet the requirements but thank u for all them years u payed in it’s weird how u can be told u have all theses things wrong with you but we can’t help u really.but I can go for months and months and months and months suffering with no help from the health system basically being told to wait and wait cause ur nutting but a number and we got all the time in the world to turn u down I don’t get it. I’m on my 2 round with ssi done had my five dollar exam and now I’m fighting that.i can’t get a job because nobody in there right mind would hire me I’m dirt poor I sure can’t get health insurance when Everytime u try u get the door shut in ur face or swept under the rug .but I can suffer and it’s no biggie one day my body will give out and why because I’m poor now and I’m treated like it’s my faught I get sent to free 20 dollor clinics so they can take blood work ask u what’s wrong and come back in two weeks so we can do it again really.ive payed in all them years just to be treated like shit.its sad when u can’t afford ur meds let alone surgerys which I will need but won’t get because I don’t meet the requirements.so I apply online and I’m eligible but wait next page ur ineligible because u put a life sometimes which I put no on it but I still got turn down ??? What do people not understand I’m homeless can’t get a job I Have No INCOME period and I sure can’t get health insurance but I keep getting if u can pay this mmmmmm I have NO INCOME Period how can I make my health issues better when I get swept under the rug every freaking time
     Can y’all help me ?????

151. Hi Paul – I can’t offer much. But you might talk to a charity to see if they can help you. Or look to get set up with a GoFundMe page to raise some money. You might even request a meeting with local hospital management and see if they’ll take you as a charity case. Unfortunately, there aren’t many options for someone in your situation. I wish I could be more help.

152. This is in response to Art, a while ago. You do get what you pay for, but what if you just can’t pay the outrageous costs? My son is RESPONSIBLE ,21, WORKS EVERYDAY AND at the same job for 3years. Makes a little more than allowed for Medicaid and can’t afford the premiums for the market place. He pays All the his own bills, no cable TV or extras AT ALL, But is stuck in the HOLE of the insurance Merry go round

153. Missy – this May be too late (depending on where you live), but a few things come to mind we could consider & look at their affordability:
     – assuming you have health insurance, your son might be eligible for coverage on your plan.
     – he could or should be eligible for an Obamacare premium subsidy & help with deductibles & copays, etc. (we have many people who are paying little to nothing for their insurance).
     – he could consider a ?short-term catastrophic-type? health plan and/or an accident/critical illness plan (at his age it may be his greatest single risk factor); these plans, while not as comprehensive as Obamacare would still provide him some basic coverage.
     – we could consider a Health Care Sharing plan like Medi-Share or Altrua; while not for everyone, these have a good track record of helping their members.

     Healthcare (& health insurance) is in a complete mess now and has been for quite a few years. I don?t know how it will end up (single payer run by the feds, probably, since I think that?s what they want), but ?if something can?t go on forever, it won?t.?

     Missy, let me know if you?d like some specific help – Kevin knows how to reach me.

154. I am 50 years old, I had an injury while I was out of work, either stress fracture to the hip or herniated disc. No insurance, no doctor. I can only tolerate working part time because I am in constant pain, I make too much to qualify for Medicaid, and based on my search for insurance on the marketplace, it would take 50% of my paycheck for the lowest premium. My out of pocket would 50% and max per year out of pocket would be 50% of my annual income. I’ve considered cutting my hours at work so I qualify for Medicaid. I work at a grocery store, it’s funny how people talk about their concern about socialism. The savings that are brought to customers come at the cost of employees that work part time so the company doesn’t have to pay for insurance, and of pushed quotas that injure people regularly as in the case of amazon. It is a sad world we live in, I am waiting for single payer, or I will finally give in and accept that I will have to incur whatever costs just to survive. Thanks for all the shares, sad to see so many people suffering, though knowing that I am not completely isolated is some comfort because if enough people write to their government, then maybe a change will happen.

155. Hi Eva – A lot of people are going through something similar. My 25 year old son went to the hospital last month for a lacerated toe. He got a bill for $1,108 which is his portion of the bill – and we have insurance! The whole thing is out of control. And as far as socialism saving us, Obamacare was as step in that direction, and now all we have to show for it nine years later is much higher premiums and MUCH higher out-of-pocket.

     I know this sounds pessimistic, but I don’t see any way out of this. Under the government’s watch – and they regulate everything these days – healthcare costs have spiraled out of control. Unfortunately, they’re better at breaking things than they are at fixing them. Now we have to worry about Medicare, which is universal care for the elderly. But it’s underfunded, mainly because of the cost issue, and they’re routinely cutting reimbursements to the providers. Until something substantial is done to lower costs, I don’t see this getting better. All we can do is muddle through and pray for a miracle.

156. I have no health insurance and am currently unemployed. My wife is a freelancer who has insurance through the ACA, but I can’t afford $470/month on no income, and I don’t qualify for any lower priced alternatives, due to her income and our married status. I have high cholesterol, but I eat healthy and run regularly. If something happens to me, like cancer or a heart attack, I hope that it takes me out fast. Should I die of an untimely death, I have enough money in an IRA to cash out and put me in the ground, so hopefully my death won’t be a financial burden on her.
     We live in a crooked, 3rd-world banana republic, where the laws have been written by insurance companies who are killing us. If you vote for corporate politician (ALL Republicans and most “moderate” Dems), this is your own fault. You are one medical emergency away from disaster, even if you have a job that offers coverage, because as soon as you are unable to work, you will be fired and booted from your insurance. Good luck, third-world America. We will need it!

157. Hi jd – I wish I could tell you that you’re wrong, that there is a silver lining, but I don’t see it. We’re on my wife’s plan at work right now, since I’m self-employed. But I worry what will happen and what we’ll do if that coverage ever disappears. As it is the carrier changes every year, and with it the terms of the coverage. We can hardly keep up. But we’re blessed compared to millions and I try never to forget that. But as you correctly point out, we’re all one health event away from disaster.

     I know you brought politics into it, and I realize a lot of people have political angles on healthcare. But I’ve watched over they years how healthcare has turned into this monster through different administrations and congresses, and I think it defies a political answer. The politicians on both sides of the aisle are completely unwilling to tackle the cost issue (healthcare is too big a chunk of the economy) so they argue over funding methods. All that does is feed the dragon. The Medicare for All idea has popular support, but the latest figures show it will cost at least $3.4 trillion per year, which is 100% of current federal tax revenues. That isn’t sustainable, especially on top of the existing trillion dollar deficit.

     My own thought is that we the people have no constructive representation in Washington from either party. Both sold out to the special interests long ago, and that’s how you get elected. So they say one thing on the campaign trail, then back off it once in power. Let’s not forget that the current iteration of healthcare is the ACA, and that was launched by the Obama Administration. It did a few good things, but lower costs certainly wasn’t one of them. If anything it preserved and extended the insurance monopoly. My doctor told me last week that the entire industry is now answerable to the insurance industry, and that’s why there are no longer any private practice doctors. Meanwhile the number of people without coverage is starting to grow again, probably due to cost.

     I’m afraid the current system will continue on its current path until it collapses, I suspect in the next recession. That may need to happen because the current setup is neither sustainable nor correctable. You can’t legislate away from high costs, especially when legislation contributed mightily to the cost structure in the first place.

     Not very encouraging, I realize. But I’ve learned that reality is what it is regardless of what we think, wish or hope it could be. Healthcare is like we’re trapped playing a game that isn’t winnable.

158. Communication and technology have become an essential part of our lives today, especially after the pandemic.

159. Couldn’t agree more Allen!