Exploding health care premium

[Anonymous]

Anonymous wrote:For the GLP haters. I was at a public event tonight and saw two morbidly obese people. Like sooooooo seriously obese they are one step away from being gilbert grape's mom stuck at home. One had a cane. Then below that some super obese people. Of course all these people should get GLPs. I think it would be miraculous.

Just like there are people that don't want the whole world to be fed because it's not profitable (thus we have hunger even though we can feed everyone on earth) there are people who don't want to help the sick and obese because it's not profitable. It's disgusting.

They should, but I'd be more concerned about the long term with those drugs being so new.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We have tricare and it no better. Our premiums, co-pays and deductibles go up, no doctor choice, and they will not pay for expensive medical equiptment I need.

Retired? Join MOAA

Why? And, they are for Officers, not Enlisted?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Well someone has to pay for everyone who got glp1s off label.

Only 19% of insurance companies cover GLP-1s for weight loss. Of those who do, 96% require prior authorization for GLP-1s (whether for weight loss, diabetes, or sleep apnea). So off-label GLP-1 use covered by insurance is not a thing.

https://www.healthsystemtracker.org/brief/perspectives-from-employers-on-the-costs-and-issues-associated-with-covering-glp-1-agonists-for-weight-loss/

https://ldi.upenn.edu/our-work/research-updates/patients-face-new-barriers-for-glp-1-drugs-like-wegovy-and-ozempic/

Even garbage insurers prove that covering GLP-1s only modestly increases premiums. BCBS stated that eliminating coverage of GLP-1s for weight loss reduced premiums by only 3%.

https://www.healthsystemtracker.org/brief/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026/

This. I wish I could get a GLP-1 covered by my insurance for weight loss but BCBS will not.

[Anonymous]

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Wow. What percentage of your income is it as a retiree?

Now I understand why people are saying $1 million retirement is nothing.

How do people will less than a million in retirement live? Wow

[Anonymous]

I have ulcerative colitis. Not only our premium went up significantly 80%, but they also made changes to speciality drugs in our plan. My Dr wanted to increase the frequency of my drug because my inflammation is out of control and despite 3 appeals it was denied. The reason was there is a quantity limit in our group plan.

I think I'm this country we have been convinced that our high salaries are enough and to hell with benefits. Corporations will gladly pay you more while cutting your healthcare benefits because they know it's their biggest cost driver along with lawsuits.

I am still fortunate to have a job. But I'm terrified what would happen to me when I retire. This is why as much as I am aggressive with saving for retirement I am also fulfilling many of my bucket list.

I have the feeling in 20 years less than 25% of Americans will be able to afford healthcare at this rate...

[Anonymous]

Someone has to pay for the millions of elderly, demented people to be hospitalized repeatedly to cure them from pneumonia and other illnesses despite the patients having no quality of life. Someone has to pay for the 31% of the nation on government subsidized healthcare (Medicaid, Tricare, Medicare, VA care).

[Anonymous]

Anonymous wrote:

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Wow. What percentage of your income is it as a retiree?

Now I understand why people are saying $1 million retirement is nothing.

How do people will less than a million in retirement live? Wow

Our income is significant as are our assets. Who would retire young and then not have the health insurance they want (ppo v hmo)?

[Anonymous]

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Where is this insurance from? Even an unsubsidized ACA plan at a high tier shouldn’t be that much.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We have tricare and it no better. Our premiums, co-pays and deductibles go up, no doctor choice, and they will not pay for expensive medical equiptment I need.

I have Tricare and have no idea what you're talking about. Tricare Select is fantastic and dirt cheap.

+1, in this area you can always find providers who accept it

[Anonymous]

We left the PPO a few years ago for Kaiser HMO. It's cheaper and no worse quality, if anything, I'm impressed by the efficiency.

We also have a high deductible plan and a HSA that we max out. We cash flow our health expenses as we will never hit the deductible, although if something does happen we can easily pay the deductible, which with Kaiser, isn't that high, about 4k per family member. This allows us to treat our HSA as a secret investment account and it's done very well. When we retire it will be worth quite a bit and we don't have to use it for health expenses. It becomes basically another Roth.

Just learn to be smart with your healthcare planning. Use it as a tool to work for you.

[Anonymous]

Anonymous wrote:Someone has to pay for the millions of elderly, demented people to be hospitalized repeatedly to cure them from pneumonia and other illnesses despite the patients having no quality of life. Someone has to pay for the 31% of the nation on government subsidized healthcare (Medicaid, Tricare, Medicare, VA care).

Congress has great socialized healthcare but MAGA will not let the rest of us have it.

[Anonymous]

Have any of you tools looked up the profitability of the health insurance industry in this country before spouting off with your inane “but SOMEONE has to PAY for it” nonsense?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Seriously? Well I think it’s completely crazy not to have health care… but there is an inflection point, and you are certainly at it.

Yeah, that's about 65K a year in premiums. Do you think your family will rack up medical bills worth of 65K every year? Even if you go out of pocket for specialists and scans/tests it would be a few grand if you start having issues. After the years you paid into it, like 10 years of being relatively healthy you are out of 650k. The only thing that can justify it is some catastrophic situation where your medical bills are in 7 figures. Otherwise, it's not even deserving to be called "insurance".

If you do not have e insurance, you get charged the full rate which can be 5-10 what is charged to insurance companies.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Seriously? Well I think it’s completely crazy not to have health care… but there is an inflection point, and you are certainly at it.

Yeah, that's about 65K a year in premiums. Do you think your family will rack up medical bills worth of 65K every year? Even if you go out of pocket for specialists and scans/tests it would be a few grand if you start having issues. After the years you paid into it, like 10 years of being relatively healthy you are out of 650k. The only thing that can justify it is some catastrophic situation where your medical bills are in 7 figures. Otherwise, it's not even deserving to be called "insurance".

If you do not have e insurance, you get charged the full rate which can be 5-10 what is charged to insurance companies.

I imagine it depends on what you elect to do. We're a high deductible with HSA so I've shopped around and so far the difference between cash and insurance hasn't been much.

You definitely want insurance for the major crises but for a lot of everyday visits and consultations I don't think it is as much of a difference as you might think.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We are retired and pay about $5350/mo for the 4. Up from $4900 last year but down from a few years ago when it was $5500. PPO and it sucks

Seriously? Well I think it’s completely crazy not to have health care… but there is an inflection point, and you are certainly at it.

Yeah, that's about 65K a year in premiums. Do you think your family will rack up medical bills worth of 65K every year? Even if you go out of pocket for specialists and scans/tests it would be a few grand if you start having issues. After the years you paid into it, like 10 years of being relatively healthy you are out of 650k. The only thing that can justify it is some catastrophic situation where your medical bills are in 7 figures. Otherwise, it's not even deserving to be called "insurance".

If you do not have e insurance, you get charged the full rate which can be 5-10 what is charged to insurance companies.

I imagine it depends on what you elect to do. We're a high deductible with HSA so I've shopped around and so far the difference between cash and insurance hasn't been much.

You definitely want insurance for the major crises but for a lot of everyday visits and consultations I don't think it is as much of a difference as you might think.

Have you ever looked at what the doctors charge, before the insurance company’s reduced fees?