2022 Health insurance vent

[icarus_85]

I must say, I hate going through this health insurance crap every year about as much as doing taxes.

I'm self employed and have a family of 4. The cheapest plan on the site this year is $1344/month, from a 'Friday Health Plans', whoever that is. For that sum, you get an $8700 individual deductible and $8700 max out of pocket per individual. Family deductible and max is $17400. It pays basically nothing until the deductible is met. No primary care visits (except for immunizations apparently), no specialists, no x-rays, no labs, no outpatient, no prescriptions, no ER. Nothing until you've met the deductibles. So, it's basically a catastrophic plan for $16,188 per year in premium.

Want the Cadillac? Blue Cross has the Gold PPO for only $2785/month. It has a $1650 deductible and family out of pocket of $17400. But it steps up with a $950 copay for ER then 40% coinsurance after deductible, generic drugs are PAID, Primary care doc is $60 and specialist doc is 40% coinsurance after deductible. How awesome is that, and it only costs $33,420 per year in premiums.

Are they literally trying to stamp out self-employed? I find myself in no-mans land. I historically have made more than what would qualify for their subsidies, but not enough that $16k per year for CRAP coverage really works for me.

I seriously wonder if the family would be better off if I just folded up and got a job. Or try to scale business to a point where I could max out on the government subsidies, like they apparently want people to do. Whole thing is disgusting and frustrating.

Vent over. Can't say I feel much better.

I don’t know what your financial means are, but….. If I had $20-30K in the bank or an investment I could liquidate, I would think about cash flowing regular office visits, Urgent Care and shopping for a cheaper catastrophic umbrella policy. Say 2-3 million. You’d need to shop those policies to get best price. The umbrella would cover major surgeries, cancer treatments, etc.

I’ve a friend who does this and it’s been cheaper in the long run. Medical providers have an “insurance” price and a “cash payor” price. The cash pay is typically 30% less on average.

This assumes you and your family are all healthy and don’t have any chronic or long term health issues. If so, insurance is probably best.

 

[trekrok]

I don’t know what your financial means are, but….. If I had $20-30K in the bank or an investment I could liquidate, I would think about cash flowing regular office visits, Urgent Care and shopping for a cheaper catastrophic umbrella policy. Say 2-3 million. You’d need to shop those policies to get best price. The umbrella would cover major surgeries, cancer treatments, etc.

I’ve a friend who does this and it’s been cheaper in the long run. Medical providers have an “insurance” price and a “cash payor” price. The cash pay is typically 30% less on average.

This assumes you and your family are all healthy and don’t have any chronic or long term health issues. If so, insurance is probably best.

Problem is, I don't find those other cheaper options. I have subs I work with, not employees, so when I answer the question 'how many employees = 1 (me), I get dumped back into the obamacare quagmire of options. I pay for doctor stuff separate anyway, so it is 100% wasted in premiums for insurance. But, that appears to be a requirement under obamacare, whether you need or want it.

 

[Newbie]

Thanks. I'm studying HSAs and I'm thinking they probably make sense for us. Health Sherpa is basically showing the same plans that I'm seeing on Helathcare.gov. Obamacare basically killed the option out there. Interestingly, it recommends the plan that I mentioned at the start of the thread. Don't think it showed HSA qualified on the .gov site, but they had one that was slightly more expensive that was qualified.

I wonder why HSA qualified plans are higher premium than non? Is their administration the $80+ per month increase?

Where do you have your HSA set up?

Even if it doesn't say it's HSA qualified, as long as it has a deductible of over $2800, it's qualified.
Here's a nice table laying out the simple requirements for an HSA.
https://www.psfinc.com/articles/hsa-requirements-and-limits-for-2021/
I've used JCB and HSA bank, but I've heard Lively is good too and it has a nice interface. The thing is, if you don't like a place you can move it on a whim. Just make sure you choose "Self Directed Account" so you can invest it.

 

[JD8]

Problem is, I don't find those other cheaper options. I have subs I work with, not employees, so when I answer the question 'how many employees = 1 (me), I get dumped back into the obamacare quagmire of options. I pay for doctor stuff separate anyway, so it is 100% wasted in premiums for insurance. But, that appears to be a requirement under obamacare, whether you need or want it.

Honestly, I would recommend finding a broker. If you're doing a VIP MD service of some sort, you need to find a catastrophic plan. I did benefits for small businesses many moons ago and have lost touch with most of my contacts. However, there has to be some sort of product out there that fits what you're looking for.

 

[Newbie]

Problem is, I don't find those other cheaper options. I have subs I work with, not employees, so when I answer the question 'how many employees = 1 (me), I get dumped back into the obamacare quagmire of options. I pay for doctor stuff separate anyway, so it is 100% wasted in premiums for insurance. But, that appears to be a requirement under obamacare, whether you need or want it.

Is this on healthcare.gov? If so, just put 5 employees to bypass the dump, find out who's plan is best, and sign up for them directly. For instance, bcbs.com
If you're not a paperwork nerd (like me) you can call them up directly too and they'll walk you through it. They get paid millions of dollars for Obamacare stuff so they love helping you pick a plan and set things up. They have agents that do this all day.

I would advise against letting them suggest a place for your HSA account for you though, because they'll choose Bank of America or Chase or some other leftist one world loving communist backstabbing bastard of a bank to hold (and use) your money.

As an aside, I wish FNB Community bank offered HSAs. After they told Biden to suck a fat pickle over the IRS $600 spy job I moved all my checking and savings there. Consolidating my HSA there would be great.

 

[trekrok]

Honestly, I would recommend finding a broker. If you're doing a VIP MD service of some sort, you need to find a catastrophic plan. I did benefits for small businesses many moons ago and have lost touch with most of my contacts. However, there has to be some sort of product out there that fits what you're looking for.

I talked to a guy probably 3-4 years ago and he basically was pitching all the same options I was seeing on the .gov site. I'll cast around and see whaat/who I can find. This is a screenshot on what healthcare.gov says about catastrophic plans:

 

[tiasman]

This is right, but not right.

I'm going to get in the weeds here a just little, so skip this post if you don't have a business making active income. (landlords I don't think qualify because it's passive income).

First, your health insurance premiums should never, ever, ever be paid by yourself. They should be paid for by your business. If you pay for them yourself out of your pocket you cannot, by law, deduct the premiums. Let me say it plainly: THE GOVERNMENT SHOULD BE PAYING YOUR PREMIUMS. You made this money, don't lose it by giving it to the government.

Second, if you have a simple LLC and make more than 40k/year you're doing it wrong. You should convert to an S-Corp or just shoot yourself because you're losing a ton of money. That S Corp will pay your premiums.

Third, don't look on healthcare.gov for your HDHP (High deductible health plan, $2800 or more). Check out a site like Health Sherpa
Many plans offer FREE doctor visits etc, even with a high deductible for hospital work.
Once you find your high deductible health plan and get all the subsidies you qualify for, you can start your HSA. I think it's $7k you can put in per year for families. You cal also wait until something medical pops up, then put money in your HSA and immediately write a check to the doctor before the money gets cold. Poof! tax deduction.
Once it's funded, if you don't spend it right away, invest it. If you let it sit in an account that's dumb. You're losing money off of inflation. Invest every penny so you'll grow it while you sleep.
You can also pay out of pocket for HSA qualified expenses and just get reimbursed from your HSA account if you have the funds so you don't have to sell investments to pay for your doctor expenses.

HSAs are funded before tax, they grow tax free, you can invest them in anything (almost) that you want, and they pay out at any time for medical crap you don't want to pay for anyway.

Some stupid things you can buy with your HSA:
Tylenol and Advil
Heartburn pills
Allergy meds
Tampons and pads
Dental work and braces
Contact lenses
Over the counter meds
Heating pads
House smelly devices (like a diffuser)
Baby monitors (that you can use for security cameras.....)
First aid kits (we loves those here, don't we?)
and so much other stuff you wouldn't imagine.

Another thing about HSAs, if you turn 59 1/2 you get to pull all the money out if you want for any reason, you just have to pay tax on it. By that age you should have enough in your deduction bucket you're carrying over every year that the taxes should be near zero.

And if you die, it goes to your wife's HSA. If she dies? It turns into an IRA for your kids. This money never, ever disappears and it just follows your family around forever for them to use as they see fit.



Hope that helps. It's what we do and honestly we've got more in there than we'll use in the next 10 years unless something catastrophic happens, all growing tax free.

What an awesome, informative post. I’m a sole proprietorship making 6 figures. I probably need to see an accountant.

 

[tiasman]

I don’t know what your financial means are, but….. If I had $20-30K in the bank or an investment I could liquidate, I would think about cash flowing regular office visits, Urgent Care and shopping for a cheaper catastrophic umbrella policy. Say 2-3 million. You’d need to shop those policies to get best price. The umbrella would cover major surgeries, cancer treatments, etc.

I’ve a friend who does this and it’s been cheaper in the long run. Medical providers have an “insurance” price and a “cash payor” price. The cash pay is typically 30% less on average.

This assumes you and your family are all healthy and don’t have any chronic or long term health issues. If so, insurance is probably best.

This is what we have done for 6 years.

 

[Newbie]

What an awesome, informative post. I’m a sole proprietorship making 6 figures. I probably need to see an accountant.

Brother, you're killing it! You should not be stressed by healthcare costs. I bet my ex wife's left ear that your income taxes per year will cover every bit of your healthcare costs through deductions.

 

[Shadowrider]

I just got a quote and may buy a policy from Friday Health Plans.

Unlike you, I'm only covering myself now. With the subsidy I can get one for about $100 more than the healthshare plan I'm on now which I've never used but I get ZERO warm and fuzzy with this particular group. They've been cycling through a CEO every year or two, they had a disastrous website rollout, and when they did get it up and running it's quite lacking in features, and their reviews are utterly craptastic. So I'm switching to something else. It'll be Medishare or Friday Health I'm thinking.

The HSA arrangement works very well for me. I have a S Corp and I'm my only employee. It'll be nice to be able to start contributing to the HSA account again.