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Health Insurance Ideas?

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#1
J.Lord

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Anyone else had struggles (or currently struggling) with what health insurance to get?

 
I've always just maintained basic catastrophic health insurance in case of an emergency. I let that run out about a year ago (long story of errors on their part and a lack of diligence on mine). At any rate, now that there is inexpensive health care options with Obamacare, Affordable Care Act, ACA, (whatever you want to call it) I need to get some new insurance to at least protect me in case of an accident or something.
 
My goal is to stay healthy, stay out of the system, not take any health or nutrition advice from doctors etc etc.  
 
That said is there any Health Plan/s that anyone would recommend that might cover some blood work and/or other tests that could be considered "diagnostic" for a healthy person trying to stay healthy?  In general, is there any plan that would be helpful to have if you are healthy and want only general preventative type tests done?
 
Any recommended or "sympathetic" Physicians in the Bay Area, Los Angeles or San Diego that accept something like Heath Net, Anthem Blue Cross, Blue Shield?
 
I'm not super knowledgable about how the heath care system even works as I've not had to use it, but it seems like you need to get a good / understanding Primary Care Physician who can then recommend you to specialists if he can't preform what is needed? So it seems like finding a good PCP and then figuring out what insurance they take would be the smartest route, yes?
 
In the past I've used Integrative Manual Therapy, Acupuncture, and some Reiki for the physical problems I've encountered. Did a baseline Wellness FX test last year and all was in the green/normal/healthy range etc so not looking for much. But thought that there could be some way to utilize my heath care for once in my life.
 
any suggestions, websites, blog posts, ideas, etc very appreciated 
Jeffrey
 


#2
Geek Gone Strong

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http://paleophysiciansnetwork.com/ might help in finding someone "sympathetic" to your cause. At the very least they might be able to give you some good advice about health care or references to someone else.



#3
Skeletor

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Anyone else had struggles (or currently struggling) with what health insurance to get?

 
At any rate, now that there is inexpensive health care options with Obamacare, Affordable Care Act, ACA, (whatever you want to call it) I need to get some new insurance to at least protect me in case of an accident or something.

_________________________________________________________________

 

Not to be that guy, but unfortunately, depending on your situation, Obamacare ain't all that affordable. At least, that's what I've heard from many people I know. YMMV, and it's probably worth looking into depending on your financial situation and whatnot, but you may consider just going back to your catastrophic plan.

 

Also, as they say: "Prevention is the best medicine". Use stuff like WellnessFX for labwork and track down a decent naturopathic doctor if you're so inclined-- one with a good reputation. Shouldn't be too hard to find out near you.

 

Depending on how much money you have, you may also look into concierge medicine.


"I know how to despise mere cool intelligence. What I want is intelligence matched by pure, physical existence, like a statue." --Yukio Mishima


#4
J.Lord

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Thanks @Geek Gone Strong checking out now. 

 

@DemonofChouka I'm in my mid-30s and my catastrophic plan was increased from $40 to $170 a month over the 10 year course I had it (age 25-35). The deductible went from about 2k - 6.5k. I did quite a bit of research and found that it was a "good deal" and/or cheapest option for a male my age. There were more comprehensive plans for a little more money, but I didn't want/need check ups or medication etc. 

 

A short summary of the one time I needed my insurance: I tore two ligaments in a dirt bike accident, went to the ER, they gave me a X-ray, said I needed surgery, multiple MRIs, drugs for pain, and then months of physical therapy, etc etc would have cost my full deductible and I didn't even feel like they we're diagnosing me, it was just like using a check list > when we see X > we do Y > like robot type thinking, it didn't seem "right" to me so I bounced and found alternative methods that worked great and were empowering.

 

Regarding price, I'm self employed and in a job where most everything I do can be a write-off so I'm in a good place for much less expensive health coverage via Obamacare.



#5
zero33

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California has its own Marketplace for helping you select a plan...

 

https://www.coveredca.com

 

Depending on your age, you may be able to select catastrophic coverage similar to what you used to have, but you can also compare more comprehensive Bronze, Silver, Gold, etc. plans.

 

You may also qualify for tax credits to offset the cost of the plan, if your income is low enough.


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#6
ACH85

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@Geek Gone Strong: awesome resource, thanks. 

 

@Jeffreyp: the only thing I can add to this is noting that I too have a "catastrophic" type plan set up. After I bought it, I noticed it had a neat provision: basically the only thing that's free is one yearly checkup and associated testing. Associated testing is key. I explained this to my doc, and basically said "I want every test you think is even slightly relevant, because for this once yearly visit, it's free." She did a decent job, but this was before I'd even heard of bulletproof. Now, I plan to go in with a list of biomarkers I'd like tested (and my prior WellnessFX tests) and I think I'll be able to get her to add vitamin D, hs-CRP, and ApoB at the very least.

 

So maybe look specifically for plans that have open-ended yearly testing based on a doctor's discretion. Then prepare to manipulate your doctor's discretion. For example, if you pay for one WellnessFX baseline or even the much cheaper e-checkup, LDL is often quite high in BP dieters. We're more worried about ApoB and/or LDL particle count, and also hs-CRP. If you go into the doc's office informed, show the high LDL, and ask for more advanced testing, you should have a fairly convincing argument when you add in that insurance will pay for it if the doc recommends it. Claim family history of diabetes to get insulin and Hemoglobin A1C tests, etc.



#7
J.Lord

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@ACH85 Great ideas! thank you! I knew someone would have some hacks :)



#8
KilltheEgo

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Highest deductible possible and when you pay cash ask for cash discount which is up to 30% off. Insurance shouldn't be thought to cover routine test and office visit but for unexpected surgeries or hospitalizations. When you change your mindset you get creative and start asking Do I really need that because I am paying cash. Doctors that are honest will surprise you 99% of time

#9
Desp

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Skip it.

 

Don't go to the doctor/hospital.

 

Done.



#10
Noogis

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It blows me away that people will spend 6-10k a year on health insurance, yet complain about high deductible plans. I know several people who have paid 60k over tha last decade when out of pocket would have cost them about 1500.

I agree with RonPaulFan. Just go the cash route, barter, and have a catastrophic plan.

Functional medicine is usually cash anyway.

Insurance companies are like Vegas. The house usually wins.

#11
zero33

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my partner and I are both over 30 and were not able to renew the catastrophic coverage we had prior to ACA.

since our penalty would be the cost of a Bronze plan we're both going with a zero-deductible Platinum plan which will be cheaper than Bronze after just one hospital/ER visit... and will cover most of the testing that we currently pay for out of pocket.
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#12
Lkaz

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I've been in the health insurance business for over 20 years. the Affordable Care Act aka Obamacare can be confusing, but I'll make it as simple as possible to understand.  This is NOT a political statement just the law of the land.  I am speaking for health plans in the State of California which is the only state I'm licensed to practice.

 

1. OPTIONS to obtain health insurance

     a)  On-Exchange  - through Covered California (C.C.)- the only reason to use C.C. is if your income is below 400% of the federal poverty level so that you qualify for tax credits to help you pay for your monthly premiums.  If you don't qualify there is no reason to use "on-exchange" plans.

or

B) Off-Exchange - going direct to the insurance companies.

 

2.  Pre-Existing conditions no longer apply and all U.S. Citizens and those here legally are eligible for health insurance.

3.  Deadline:  Everyone who wants health insurance must apply no later than 3/31 to obtain a 5/1 effective date.  If you miss this deadline you will be subject to either a $95 or 1% of your household income tax penalty whichever is greater. 

 

4.  You will not be able to purchase health insurance after 3/31; unless you qualify for a "special enrollment" (e.g. losing group coverage, returning to the country, etc.)

 

5.  All plans sold on/off exchange, must fit into 1 of 4 categories: Bronze, Silver, Gold, or Platinum.

On average a bronze plan will cover 60% of your medical costs, Silver 70%, Gold 80%, Platinum 90% - the more coverage you want the more expensive the plan.  The primary difference between health insurance companies is now going to be A) Cost of coverage  and B) access to doctors/hospitals.

 

 

Hope this helps.  If you have additional questions, please let me know.







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