I have two options for my employer's insurance. I can either pay $270/mo for a $2k deductible, $25 copay, 80% coinsurance after deductible, or pay half that for a $5k deductible, $30 copay, 70% coinsurance. That's bullshit why the fuck do I need a degree in actuarial science and a predictive model of my future disease potential in order to know what a good fucking deal is here, I don't fucking know if I'll just be wasting money on the better plan or what.

Also you can get ACA subsidies on employer based plans, right? Or is it only plans through the "mArkEtPlAcE"

  • zifnab25 [he/him, any]
    ·
    1 year ago

    Generally speaking, if you know you have a nasty condition, you're better off getting the insurance and seeing the doctor and then just not paying all the fucking bills (or negotiating them down after the fact - which is a nightmare but also not nearly as expensive as the alternative).

    A lot of doctors simply won't look at you without insurance. So having it gets you in the door. And then you can worry about paying for shit once you have a diagnosis.

    Also, OOP maximums are nice once you've hit them.

    But I definitely understand the situation where you aren't earning enough to pay the fucking premiums. The best you can do there is to simply get the cheapest plan on offer and let the insurance company/hospital argue over what that means between them.

      • zifnab25 [he/him, any]
        ·
        1 year ago

        I drink a lot and it’s probably as simple as that giving me some fucking stomach ulcer or reflux condition and that’s what’s been causing my nausea, since the PPI seems to have helped.

        I've had that and I know a few other people who have had it as well, so its definitely possible. But I agree, really hard to say whether this is something that will just go away with a little sobriety or whether there's something mean enough that you'll need real care. In theory, a consultation and a bit of diagnosis can answer that and it shouldn't cost you an arm or a leg to get it. In practice... YMMV.

        It’s extra fucked because I just looked at the ACA marketplace and I WOULD be eligible for almost $400/mo in subsidies… but my work offers insurance, so, I get fucking nothing.

        I believe firms that don't cover their employees are hit with some kind of tax, so they have an incentive to give you the shittiest option on the market to just kinda skirt under the line. :amerikkka:

        Other Stuff

        :yea: I don't know if I'd lose sleep over the risks of that. I get a little nervous every time I skirt bureaucracy, but 95% of the time nobody fucking cares. And the other 5% its mostly about hitting some kind of quota more than anything. I'd like to say "just be smart" but when life is a game of Russian Roulette, its all just selection bias to pretend you beat the system.

        Do what you gotta do, I guess. I would at least get in for an annual check-up and go from there, though. Physicals are cheap and even just a conversation with a professional physician can put a lot of your fears to rest.