Do You Need Health Insurance? I Pay $680 Premium for ACA Plan
Table of Contents
- If you're confused about buying your own health insurance or you're wondering if...
- Fact one employer I worked with had mostly high deductible HSA plans and...
- To healthcare.
- Prepared to pay out-of-pocket because that's what you're gonna have to do and...
- You're changing employers all the time and pretty frequently I think this is a...
- Example of $8.
00:00
if you're confused about buying your own
health insurance or you're wondering if
you really even need it this video is
for you hi I'm Jen and I want to talk
all about health care something that
affects your everyday life and something
you really should know about now for
context I spent about 15 years in the
working world so I have a lot of
experience with different types of
health insurance employer sponsored
health care also I have purchased my own
health insurance in two different eras
both in the pre Affordable Health Care
Act Obamacare era
and after and there have been some very
significant changes that I've noticed
for my own personal experience so
because this is an issue that really
affects everyone here in America I
wanted to make a video just relaying all
my experiences in the hopes that it can
help somebody out there who is trying to
navigate our really screwed up
healthcare system and I think no matter
where you fall politically and this is
certainly not a political video I think
many Americans feel that this health
01:01
care system is confusing a little bit
antiquated and also like ridiculously
expensive which I certainly feel it is
also a disclaimer I am by no means a
health insurance or medical expert
before you take my advice be sure to
talk to a representative in the health
care insurance industry talk to an agent
also I'm gonna link some resources down
below so you can do your own research no
matter who you listen to here on YouTube
you should always do your homework and
look into an issue yourself especially
because a lot of this health care
information in health care plans will
differ widely state to state now what
I'm gonna do here is go through my own
history with health insurance and also
try to explain what the differences are
from the ages of about 22 to about 35 I
was on an employer-sponsored healthcare
I have never had a period in my life
thank goodness where I was uninsured and
I've always been very diligent about
making sure I always had health
insurance now when you are working for a
company and they offer health insurance
usually what happens is the company has
02:03
some sort of deal with an insurance
company and they will cover all the
employees they usually get a group
discount but there are some limited
plans you have to choose from
and normally a company will cover and
subsidize part of the cost for your plan
and then you pick up the rest the
upsides to this is your premiums are
normally deducted out of your payroll so
if you're paid every two weeks and say
your premiums are like sixty-seven
dollars that sixty-seven dollars would
come out of your paycheck
normally I believe even pre-tax so you
saved a little bit of money there
because you paid with pre-tax dollars
versus after-tax dollars and you also
did don't have the hassle of like having
to write a check or pay online or do any
of that mess which is what I'm doing now
because currently we do buy our own
health insurance over the years I've had
varying quality and health insurance
plans from really great plans where my
premiums were pretty low and I had like
doctor's visit co-pays of like $25 and
then prescription co-pays of like $5 to
the lower quality plans where they're
usually more high deductible plans in
03:07
fact one employer I worked with had
mostly high deductible HSA plans and
what that meant is that your deductible
might be like six thousand dollars a
year so that means that if you get sick
or if you have hospital visits or you
need medication you have to pay
out-of-pocket six thousand dollars
before your insurance will even kick in
so it's really for catastrophic
emergencies like if you're a car in a
car accident or you need surgery but for
the average person who's fairly healthy
younger and doesn't have a lot of
medical issues you're gonna have to pay
out of pocket for most stuff the other
thing with that is which was sort of
good was that I had a health savings
account and the company kicked in a
pretty decent amount of money every year
so I would get like $750 or a thousand
dollars every year and actually I still
have a lot of that money in my HSA I
have about I think $4,600 in an HSA
which is mostly money that was kicked in
from my former employer and you can use
that money for any medical related
expense it is tax free if you're
04:10
anticipating medical expenses you can
kind of front-load your HSA and say you
know hey this year I want $5,000 to go
in my HSA and that money will come out
of your paycheck before it's tax so
contributing $5,000 of your gross income
is actually a better deal for you
thanking tributing
thousand dollars of your net income
after it's already been taxed compared
to some people I know it is just my
husband and I were younger we don't have
any health issues and we are child for
you so we do not have kids when I was at
that employer with the high deductible
HSA plan a lot of people with families
really hated it because they had to take
their kids to the doctor all the time
and people got sick more often so they
would have to shell out of pocket for
all of those expenses until their
deductible was met which kind of sucks
so that is the downside so a high
deductible plan is better for someone if
you're younger healthy you don't really
have any medical issues and you don't
really go to the doctor a whole lot and
you really just need health insurance is
more of a safety net for all of you out
there and more unconventional employment
05:12
situations like your employer doesn't
offer health insurance you work part
time or maybe you freelance full-time
I'm in the same boat as you and
currently we are purchasing our own
health insurance we did do this once
before in 2011 and this was before the
Affordable Health Care Act known as
Obamacare was put into place and I will
point out the differences and I know
this might be a little bit controversial
but believe me I'm really not trying to
be political there are good things and
bad things with the Affordable Health
Care Act but I really just wanted to be
real and I'm gonna lay it all out for
you in 2011 we purchased our own health
insurance and what you do is I went to
one of those websites like insurance and
you plug in some basic information and
then an agent gives you all your options
for your state at the time I think I
went with Aetna insurance it was decent
insurance it was actually better than
the insurance I had previously had at an
employer and it cost of myself and my
husband about a hundred and eighty
dollars per month it did have some
06:16
deductibles but also it had you know
co-pays for doctor's visits ER visits or
for prescriptions so for your normal
everyday stuff it was actually pretty
decent insurance and it was a lot
cheaper than I was expecting I was
expecting it to be more like four
hundred dollars a month or something
like that but I was pleasantly surprised
at the time that it was so inexpensive
we did have to have some
greetings I don't think there was an in
person physical or anything but I did
have to answer some questions over the
phone and just complete a questionnaire
about my medical history and whatnot but
it wasn't super invasive and it was a
pretty easy process
we had to this insurance for about six
to eight months and I thought it was
pretty good coverage now fast forward to
2018 when I had to do this all over
again I start out with the same thing I
went to a website for insurance and I
plugged in some information the only
option I would have in Florida was to go
through the healthcare marketplace
exchange Obamacare ACA thing so I went
07:17
to healthcare.gov now to their credit I
know they got a lot of flack for having
website issues
I actually didn't find the website to be
too daunting it is a pretty lengthy
process I think it took a couple hours
to navigate the website and then figure
out what plans were available to us
interestingly it is all private
insurance companies but they're all run
through healthcare.gov when it spits out
your options it gives you all of these
different plans I was kind of surprised
at the variety but here's the kicker the
plans for the most part are super crappy
unless you want to pay astronomical
premiums every month which I personally
do not now being in this situation I
felt okay with going with a more high
deductible catastrophic policy the
retail price on the one I picked for us
for 2018 was about 671 dollars but for
last year I will point this out we did
get a bit of a tax credit so how this
works is that if you make between 100
and 400 percent of poverty level income
you are eligible for an advanced tax
credit through the IRS now I'm gonna put
08:21
some links below cuz this gets a little
bit complicated and I'm not an IRS or a
health care gov an amine so on the
website you can check to see if you're
available for these advanced tax credits
you plug in some income information and
it tells you generally what kind of
credit you can expect so you have the
option you can take no credit at the
time beam and pay like the full price so
we would have paid $671 dollars or you
can choose to take some of the advanced
credit for 2018 I chose to take a two
and $50 a month advance tax credit just
based on our income levels they
fluctuated quite a bit and we were in a
lower tax income bracket than we had
been in years past so when I did our
taxes at the end of the year it worked
out okay but you kind of have to be
careful because if you take too much of
a tax credit and you have a higher
income than you originally calculated
you have to pay the tax credit back and
if you make more than 400% of the
poverty income level you don't get any
tax credit and you have to pay the full
price after doing all that and choosing
09:21
a plan at that point you can pay your
first premium and you have to then go to
the health insurance carrier website the
company I chose was ambetter yeah it was
it was pretty crappy insurance but it
was like the best of the crap and I was
okay with having a high deductible plan
only because we have enough money where
we could cover the deductible and we
don't get sick a lot but again we were
paying a lot more than we did in 2011
and certainly a lot more for a lot worse
insurance than I ever did working for a
company once you get that all set up
then you really just have to pay your
premiums every month to the insurance
company and I set up online payment with
ambetter you get insurance cards
it doesn't really cover a whole lot
until you meet that deductible and I'm
actually gonna throw up my coverage
right here just so you can see black and
white what kind of coverage we are
getting just so you know this plan does
not cover much until you meet that
deductible it does cover some super
basic stuff like a flu shot or like an
annual wellness exam at your primary
care physician but if you have anything
outside of that realm going on be
10:24
prepared to pay out-of-pocket because
that's what you're gonna have to do and
yes that includes prescriptions now
you're probably wondering hey Jen
doesn't your insurance provider usually
negotiate some sort of discounted rates
you know if you have to go to the doctor
or get insurance maybe to some degree
but I haven't really noticed any sort of
significant savings when I've had to go
to any of these places
I believe I did have to go to an urgent
care last year because I got bit by a
bug and my foot started swelling up and
I believe it was like $200 and I was
there for like 30 minutes so it didn't
really benefit me to have insurance in
that situation in fact they have lower
rates for people who are uninsured and
pay cash going into 2020 I had to do
this again and yes you do have to her
this process every year REE qualified do
your income levels again and then select
a plan in the plans do change from year
to year the premiums go up and I've
noticed the deductible levels definitely
change even with the same plan so there
were quite a few changes that I was not
prepared for this year now my income has
gone up in 2019 and so is my husband's
11:27
so we were definitely no longer eligible
for any sort of advanced IRS tax credit
so our plan for 2020 is going to cost
six hundred and eighty dollars per month
yeah you heard that right six hundred
and eighty dollars a month for really
crappy high deductible insurance for two
healthy people without children in their
30s now I know the Act was called the
Affordable Health Care Act speaking from
personal experience I have not found
that to be true and I in fact I find
that a little bit misleading I do feel
that the current system is intended to
help lower-income individuals certainly
if you make between 100 and 400% of the
poverty level which currently is
considered around sixty seven thousand
dollars you will get cheaper insurance
and in fact if you don't make a lot of
money your health insurance is probably
going to be pretty close to free under
this whole system so that is good for
people who cannot afford health
insurance later on in this video I am
going to go more in-depth on why you
really do need health insurance and why
you should not skip having it one thing
12:28
I did notice is that for 2020 we had
quite a few more options for plans which
I do consider a good thing and for 680
dollars even though we are gonna be
paying significantly more than last year
the plan is slightly better and I say
slightly it still is very high
deductible but the deductible is a
little bit lower than the plan we're
currently on and I did look and one
thing you need to look at when you're
looking at health insurance is after you
meet the deductible is there one a
lifetime max and I noticed on the plan I
chose for 2020 there is no lifetime max
or cap on how much you can get in
benefits that could be really
detrimental if you have a major medical
event and say you blow a million dollars
on hospital stay which is entirely
possible that could be it for you ever
so you definitely want to look for a
plan that does not have
Max or a cap on it and the other thing I
was looking at is coinsurance after the
deductible is met on the new plan I'm
getting for 2020 there is no coinsurance
required for a hospital stay or like an
13:31
ER visit and for some plans even if you
meet the deductible you still have to
pay 50% of the cost of your hospital
bill or like 50% of an ER visit so
that's a little bit misleading because
you'd think hey you know once I meet the
deductible it's all free from there but
under a lot of plans there is a lot of
fine print and a lot of restrictions
that you really need to be aware of
because it could make a huge difference
if you have something happen to you so
speaking as someone in their late 30s
who has been dealing with health
insurance for at least the last 15 years
overall I did find that the health
employer-sponsored plans did often have
the best coverage and they were the
least expensive although caveat to that
if you're adding just yourself the
employee it's usually a pretty good deal
but I noticed once you tack on like a
spouse or children that's where they can
get exponentially expensive something
that really frustrates me about the
current health care system and I know a
lot of other people is the whole fact
that often your health insurance
policies are tied to employers and in a
country where we change jobs a lot this
isn't like the 50s where someone had the
same job for 20 or 30 years
14:35
you're changing employers all the time
and pretty frequently I think this is a
pretty messed-up way to do health
insurance and I've been talking to some
other people and I think a lot of us
were in agreeance no matter what side of
the political aisle you are on that
health insurance should be tied to the
individual and not necessarily to an
employer because then you're in a
situation that's detrimental to you you
don't have consistency or continuity in
your coverage and often you're just kind
of sitting there praying that your next
employer has decent health care coverage
or even offers it at all and a lot of
employers don't moving on to the
question of whether you should have
health insurance or not yes my answer
would be hell yes recently one of my
husband's co-workers was unfortunately
the victim of a hit and run accident he
was walking to work and a driver hit
literally hit him and just took off this
guy did file a police report but they
have not been able to track down nor the
car or the driver and because he was not
in a vehicle himself he wouldn't be say
covered under his own auto insurance
policy
this guy does not have health insurance
so I know if you are young and you're
15:37
healthy you might be like you know why
do I really need this it's really
expensive and you know probably never
gonna use it anyways situations like
this are what health insurance is for
and let me tell you all the ways that it
can wreak havoc on your life if
something happens to you and you are
uninsured now this young man my husband
actually drove him to the hospital he
suffered some pretty serious injuries
from this hit-and-run and he was at the
hospital for two hours got a CT scan and
some x-rays basically and do you want to
know what his bill was it was eighty six
hundred dollars now can you imagine how
much more expensive this would be if he
had been say hospitalized for a week or
had more serious injuries needing
surgery that number could easily rise to
$50,000 $100,000 several hundred
thousand dollars and if you don't have
that out-of-pocket to cover
you're basically screwed hospital bills
are no joke people if you don't pay them
they go into collections and then your
credit is ruined for a very long time
and you may have to end up filing for
bankruptcy so even though health
insurance might seem like a bit of a
16:38
ripoff and believe me I feel that way a
lot too it's something you definitely
should have and it's not something you
should skip you're basically playing
Russian roulette with your medical
future and with your financial future
now this guy did go to a hospital and I
do want to put this out there for anyone
who does not have health insurance and
has something happened to them if you
look at a hospital's
policies they usually have a section for
paying your hospital bill and about
finances many hospitals especially
nonprofit hospitals have a significant
cash discount we're talking 50 percent
or more if you pay in cash
other things hospitals typically do have
our financial aid programs to help the
less fortunate which is a good thing and
they have payment plans but seriously
people do not skip the health insurance
think of it as just as important if not
more important than auto insurance which
is a legal requirement if you have a car
and you drive on roads well yes I did
just tell you about all these options
hospitals typically have to help people
pay their hospital bill do you really
want to be in that situation I used an
17:41
example of $8,600 but what if your bill
is two hundred thousand
dollars even if you can negotiate that
down get financial aid
you're still gonna end up being bankrupt
so why end up there in the first place
I'm just saying get the health insurance
and if you're all like but Jen I really
can't afford health insurance it's way
too expensive I would strongly encourage
you right now don't wait go to
healthcare.gov input all your
information see what plans are available
and also put in all the income
information because you're gonna see if
you don't make a lot of money you would
get a very large tax credit and that
might make it pretty affordable for you
again it is catastrophic health
insurance but the reason we get
insurance is in the hopes that we never
really do need it so if you never need
health insurance but you pay for it
anyways that's still a better deal that
if you end up in the hospital and if
you're one of those people watching this
video thinking whatever I'm not doing
this I'll be fine I'm here to tell you
you're a damn fool at some point in your
life there's a pretty good chance you're
gonna either end up in the hospital or
experience a significant medical issue
18:44
and these things are expensive so be
smart get the health insurance I'm
telling you get the health insurance
even if you don't think you can afford
it
check out the website healthcare.gov I'm
gonna link everything below you really
need to look at your options and see
what kind of plans are available and
just know if an emergency happens you'd
rather be prepared than not also don't
think to yourself hey if I rack up a
bunch of medical debt I'll just file for
bankruptcy it'll be fine right no it
will not be fine and here is why there
are a lot of negative ramifications that
come with filing for bankruptcy that
will affect your everyday life for a
very long time things like buying a
house getting a car even renting an
apartment and let's not forget many
employers now do credit checks on
potential job candidates especially if
you are getting into a position where
you would handle money if you can't show
that you manage your personal finances
well why would they think that you can
manage a company's finances well if
you've made it this far congratulations
I guess surprises becoming better
19:47
informed about health insurance I don't
know but thanks a lot seriously I know I
talked for a really long time and this
is a topic that can be a little bit dry
and also a little bit gloomy but it's
something that I feel is so important
and I
really wanted to get the message out
there because I think the more people
that understand why you need health
insurance and also understand the
options the better off we'll all be
right I was talking about this all to my
husband and he was shocked at how many
of his co-workers were just very
uninformed about health insurance in
general they were talking about the
co-worker that was in the accident and
some other people are like oh he's he's
he doesn't have to pay anything he's
covered right and he's like by what he
doesn't have insurance so I feel like a
lot of younger people might not know
enough about the topic but that's why I
wanted to make this video and if you're
interested in learning more I'm putting
a lot of resources down below in the
description box so you can kind of
research more on your own but please
guys don't skip this it's really
important also if you're looking for
something else to watch next I know
after you've just watched me talk for
like a half an hour you're welcome to
20:47
watch another video I made about money
mistakes I made in my 20s I'm Jen I'll
see you guys next time