[Ibon]

For the cost of my $6500 deductible, the wife and I could have flown to India, had her surgery done by a board certified surgeon, and spent three days in a luxury suite at the hospital.

The bill here in the states was $30,000 and this was outpatient melanoma surgery and sentinel lymph node biopsy. Three hours of waiting around and prep. One hour surgery. One hour post op and released.

Don't get me wrong. Her care was excellent and thorough but there is no way these sort of costs can possibly work out in the long run.

India, Thailand, Panama. geez, even Cuba are excellent destinations for medical tourism.. For whatever it's worth my recommendation is Thailand. I just had the best experiences there, most modern facilities, best prices for what you get.

My wife and I have a health insurance policy here in Panama with Worldwide Medical. It is complete coverage with minimal copay and if the procedures are not available in Panama they send you to a country that can treat you......with one exception. There is no coverage in the US except for emergency care. Price of this insurance for both my wife and I, ages 60 & 57 = $4,300 per year. Very affordable and complete coverage everywhere in the world except the USA.

They should change the name of the insurance company to WWMEUSA World Wide Medical Except The USA

We all know why this insurance does not offer coverage in the USA. For the same reason that this complete coverage costs us $ 4,300 per year.

[Newfie]

Ibon,

That's similar to what I've been hearing from cruisers.

In fact, even though we have Medicare, we may need to look into something similar because we are now spending so much time outside the USA.

My Wife's Bronze ACA plan was costing her $9,000/year. No subsidies.

[Newfie]

Because we are spending 10+ months a year out of the states we decided to look into an international medical plan. Medicare doesn't do us any good here in Canada. We just signed up for $500 deductiable, $5,000 max out of pocket, $2,000,000 limit. Good for 2 months/year in USA. 66 yo and 65 yo. No medical required, no questions asked.

Just over $3,000/ year.

[Plantagenet]

Obamacare rates going up by 45% next year in Florida.

obamacare-premiums-surge-45-key-swing-state-florida

If Congress is unable to repeal the "AFFORDABLE care act" can they at least vote to rename it the UNAFFORDABLE CARE ACT?.



Cheers!

[Cog]

Republicans are in a pickle on this issue. Do an outright repeal, which appeals to conservatives like Rand Paul, and 20 million people who do have coverage by Medicaid expansion and the individual subsidized marketplace lose coverage overnight. There are not enough votes for that option, due to moderate Republicans who fear the fall-out over that decision. Democrats of course, won't vote for anything less than keeping O-Care in place.

So here we are. Not enough votes for a repeal and not enough votes for repeal and replace with something else. The whole health insurance industry, health-care industry, and costs are out of control. This ends badly.

[Outcast_Searcher]

Because we are spending 10+ months a year out of the states we decided to look into an international medical plan. Medicare doesn't do us any good here in Canada. We just signed up for $500 deductiable, $5,000 max out of pocket, $2,000,000 limit. Good for 2 months/year in USA. 66 yo and 65 yo. No medical required, no questions asked.

Just over $3,000/ year.

Interesting.

So at the risk of asking a stupid question, does this include care in the US, if you happen to be there? How about emergency care?

I just wanted to ensure I understand what "Good for 2 months/year in USA means/covers, since in my experience medical insurance is all about most insurers covering as little as possible.

Thanks in advance for any insight.

[Newfie]

It's not entirely clear to me either at this point.

We are now both on Medicare (Oct 1 for Wife) and I assume it will be hit first, then the private policy would cover excess for the limited period. So there exposure is pretty low.

We may well be better off staying outside USA for care until we exhaust this private policy.

Won't really understand it until we try to use it.

[MD]

My answer has been to eat right, exercise, and skip medical care and insurance entirely. If I get sick or have an accident, I will pay cash, if I can, or I will die.

By the way, cash isn't such a bad way to go. I was out of pocket about $500 last year for a couple walk in clinic visits.

The system here is -so- very broken. The $500 worth of services I purchased last year, had I run them through a typical insurance plan, would have cost me the $500 in deductibles, $1000 per month insurance premiums, and the doctors would have billed the insurance company $5000. Yes the numbers are estimates, but not far off the mark. It's -stupid- beyond belief.

Obamacare isn't the problem. It's the insurance industry, the pharmaceutical industry, and the legal system that promotes lawsuits for every infected hangnail, drug side effect, or "misdiagnosis".

FUBAR

We've become a nation of cupcakes where every bit of misfortune -must- be someone's fault and they -must- pay for their mistake. (pay the lawyers, I mean)

[Ibon]

MD is spot on here. I have commented in the past the way families in developing countries deal with health crisis when there is no money. Age related deaths like strokes and cardiac arrest is easy. You die. There is no entitlement or resentment with family members. There are no heroic medical efforts with cancer. You die. There are tears at the funeral and within a brief period of mourning life goes on. There is no resentment, no blame, no entitlement.

In developing countries health care is a privilege and not a right. And interestingly enough the population accepts this with a certain humility.

Religious beliefs are also of a more humble nature. There is none of this evangelical god will bless you with material wealth if you are born again bullshit you see in the US No entitlement with religious beliefs. You deal with the death of a loved on by leaning into your religious beliefs in a more humble silent way.

In American culture everything is touched by entitlement; religion, health care, the political left, the political right. The country has become a population of super entitled pansies.

[jedrider]

In American culture everything is touched by entitlement; religion, health care, the political left, the political right. The country has become a population of super entitled pansies.

Good one. Another manifestation of American Exceptionalism.

Our medical system is quite ridiculous. It is extremely high tech. If you go to the emergency room with insurance, they will offer to scan you for every possible ailment. Without insurance, you could easily be bankrupted. I also notice that insurance gets a discounted rate and without insurance you could wind up paying double the amount they usually get.

Most ailments, they cannot do anything about, so it is a complete waste. But, nice high tech equipment.

[MD]

I also notice that insurance gets a discounted rate and without insurance you could wind up paying double the amount they usually get.

.

That is absolutely the opposite of reality, which I know from personal experience and anecdotal evidence from others.

[Cog]

I also notice that insurance gets a discounted rate and without insurance you could wind up paying double the amount they usually get.

.

That is absolutely the opposite of reality, which I know from personal experience and anecdotal evidence from others.

jedrider is not wrong and I KNOW this from personal experience. An insurance company can negotiate a rate with a hospital. If you pay cash, you pay for the full gold ticket ride.

[MD]

I also notice that insurance gets a discounted rate and without insurance you could wind up paying double the amount they usually get.

.

That is absolutely the opposite of reality, which I know from personal experience and anecdotal evidence from others.

jedrider is not wrong and I KNOW this from personal experience. An insurance company can negotiate a rate with a hospital. If you pay cash, you pay for the full gold ticket ride.

Well then, the varying personal experiences demonstrate once again how screwed up the system is. Another case in point: a friend occasionally requires an emergency injection for migranes. $800 per from one pharmacy. $12 per from another, both pharmacies in the insurance network.

I walked into my regular doctor a few years ago, when I had insurance coverage. Co-pay was $40. Year later I had no insurance. The appointment cost me $40 cash. go figure.

so you an jedrider aren't wrong, and neither am I. The system all fooked up. Period.

I guess my advice to those that are being bent over in their attempts to pay cash? Shop around for other providers.

[Plantagenet]

A new nationwide study finds that insurance under the Affordable Care Act is now unaffordable for the average family

obamacare-unaffordable-for-the-average-family

We've seen 20-50% increases in insurance premiums year after year now, and families who don't get subsides can't afford Obamacare anymore, so they are dropping out of the program and going uninsured.

And the more people who don't sign up and pay the full rate, the larger the premium increases have to be the next year on the remaining people in the program to keep the whole thing going. In Florida, for instance, ACA premiums are going up 45% this year!!!!!


the Obamacare death spiral is speeding up

Cheers!

[Cog]

I suppose most people are aware of this by now but subsidies, that approximately 7 million people use to purchase health care on the exchanges are going away. The money was never appropriated for them past three years, as a federal lawsuit filed by Republican Congressmen has shown.
So what does Trump do? He cancels paying them which has a lot of people to lose their collective mind and soon their ability to pay a subsidized premium. Trump is simply following the law, that money can not be expended by the executive branch that the legislative branch has not appropriated. I like this approach since it forces the Republican Congress to deal with health care, something they so far have been unable to accomplish.

One thing most people do not know is that the ACA has 1400 instances in the bill, whereby the executive branch through the HHS secretary, can modify the law at a whim. Trump is using that feature to dismantle the ACA and force Congress to come up with something better.

More at link:

https://www.washingtonpost.com/politics ... 34ac591367

[Newfie]

I wish Trump well. I hope he succeeds in pushing congress to do something better.

I think he could have explained it to the public better. It's a bold step. Here's hoping it doesn't backfield.