Comment by PaulDavisThe1st

Comment by PaulDavisThe1st 2 days ago

7 replies

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> I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums).

Self-employed here. My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible with typically a $20 co-pay. It covers 3 prescriptions, therapy sessions for each of us, various older age diagnostic checks, and almost all office visits. In addition, if either of us develops cancer or is hit by a truck, we will not be rendered bankrupt.

So I'd say ... nah.

wampwampwhat 2 days ago

i'm 36, self-employed. silver plans in my state are ~800/month next year, with 8k deductible, no out of network coverage at all, with no in-network providers out of my state, so god forbid I get injured while traveling to visit my in-laws. the marketplace is a joke and health insurance in this country is pointless.

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  • BeetleB 2 days ago

    > no out of network coverage at all

    I thought they'll all cover ER visits out of network. Is that not required by law?

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    • ceejayoz a day ago

      As usual, they find ways to limit that.

      https://www.emergencyphysicians.org/press-releases/2017/10-1...

      > In a controversial decision, health insurance giant Anthem Blue Cross Blue Shield is warning policy holders—in Georgia, Kentucky and Missouri—that they may have to pay for their trips to the ER. The company has developed a secret list of diagnoses that they will not pay for, such as "chest pain on breathing" and blood in the urine, even if the patient thought it was a medical emergency.

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  • PaulDavisThe1st 2 days ago

    Too expensive? check

    Deductibles too high? check

    Stupid coverage limitations? check

    Pointless? nope

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BeetleB 2 days ago

> My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible

That's really nice - are there state/government subsidies involved?

I work for a top tier company and my premiums are not that much lower than yours.

When I checked the public market's insurance options, getting a $3000 or so deductible was a lot more expensive than yours if one is not low income (i.e. not subsidized).

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  • PaulDavisThe1st 2 days ago

    Yes, those are numbers with

    (a) for 2025, federal premium subsidies in effect ($19k/year of subsidy) ! (b) for 2026, NM temporary subsidies

    A reminder that until the end of this year almost everyone gets subsidies. Nobody in the US, no matter their income level, should be paying more than 8.3% of their AGI for health insurance. That all changes come Jan 1st 2026, thanks to the current Congress. Our premiums would be $2531/month had NM not stepped in to use some of those sweet, sweet fossil fuel extraction taxes to help us out.

    Oh yeah, deductible in 2025 was actually $2800. At our age (early 60s) and general health (good), gold plans make much more sense (if you can afford them).

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