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Ask HN: Bootstrapped US founders, who do you use for health insurance?

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Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#81

Post by [deleted] »

Mz wrote: post #75
mgkimsal wrote: post #73

Earlier quoted context omitted.

How am I giving you only partial info? "High deductible" plans, on their own, are very unaffordable relative to only a few years ago. Your link illustrates this even more. HSA funds can't be used for DPC monthly fees - those are out of pocket costs. You can pay service fees (for services over and above what's provided by regular DPC services) with HSA. However, you can't get money IN TO an HSA without also having a h…

Okay, that's valid. Here is the thing: Catastrophic health events are not determined by some random number generator that says "Tag! You're it! We decided to fuck with you today!" Study after study after study shows that diet, lifestyle and preventive care (or lack thereof) correlate strongly with whether or not someone winds up with a catastrophic health event. This includes cancer. One of the ways DPC lowers costs…

[deleted]

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#82

Post by phonon »

HoyaSaxa wrote: post #26

This is something I've been looking into for the last few weeks for my 3 person NYC based startup. All of the options through the exchanges/brokers are laughable. If you are young and healthy, a catastrophic plan might be your best bet. I was paying ~$125 a month for Oscar last year. Coverage only kicked in after ~$6600, but I was just looking for something that covered me from an IRS/penalty perspective. The premium…

Trinet (also a PEO) accepts a one person company. (I signed up through a WeWork special though...don't know for sure about new enrollments.)

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#83

Post by [deleted] »

Mz wrote: post #75
mgkimsal wrote: post #73

Earlier quoted context omitted.

How am I giving you only partial info? "High deductible" plans, on their own, are very unaffordable relative to only a few years ago. Your link illustrates this even more. HSA funds can't be used for DPC monthly fees - those are out of pocket costs. You can pay service fees (for services over and above what's provided by regular DPC services) with HSA. However, you can't get money IN TO an HSA without also having a h…

Okay, that's valid. Here is the thing: Catastrophic health events are not determined by some random number generator that says "Tag! You're it! We decided to fuck with you today!" Study after study after study shows that diet, lifestyle and preventive care (or lack thereof) correlate strongly with whether or not someone winds up with a catastrophic health event. This includes cancer. One of the ways DPC lowers costs…

[deleted]

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#84

Post by samaritan1 »

vyrotek wrote: post #77
samaritan1 wrote: post #71

We use a direct medical expense sharing non-profit. Ours is called Samaritan but there are a few of them. Basically, every month we write a check for about $460 to another member, and the one time we had a hospital stay, we got a bunch of checks to cover the full amount. (It covers everything but $300, but if you negotiate the price down at all, the full amount is covered.) That's a family plan price and we were look…

This is definitely a starting to become a popular option. I had just commented over in another thread about it https://news.ycombinator.com/item?id=13356900 It's pretty affordable and the nicest part is most of these health shares are ACA exempt so you don't get hit by the fine of not having "normal" insurance. Do you use a Direct Primary Health provider to cover normal doctor visits and things? I'm a fan.

Right now we just pay cash for the same doctors we would visit under insurance. I like the idea of direct care but our area of the country is slow to adopt a lot of things. Telehealth (paying $35-$40 for routine diagnoses and prescriptions) has saved us some money.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#85

Post by gaelenh »

cylinder wrote: post #74
gaelenh wrote: post #47

I run a bootstrapped non-profit in NYC with two employees (myself and my wife). A bronze plan for my family on the NY marketplace is about $1,200+ month with an $8k-14k deductible. I was hoping to get something through JustWorks, but since it's really just one household in our company, we can't apply for that (requires at least 3 separate insurees). Our combined family income makes us ineligible for subsidies, so I g…

This is why I can't be self employed. The situation is out of control. That's the rate for the small local carriers too with poor provider networks. The major carriers such as United go for $2,000/mo. Don't forget the 30% coinsurance after you get past that deductible!

I don't understand the subsidies at all. In 2015, ACA gave people waivers (no penalty!) if the minimum insurance was more than 8.05% of household income. The minimum plan for a family in NYC on the NY Healthcare Exchange is $12,500/year. Self-employed families making less than $147,000 and more than $60,000 (I think that's where subsidies cut off) are overlooked and left without a safety net.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#86

Post by tsomctl »

Mz wrote: post #75
mgkimsal wrote: post #73

Earlier quoted context omitted.

How am I giving you only partial info? "High deductible" plans, on their own, are very unaffordable relative to only a few years ago. Your link illustrates this even more. HSA funds can't be used for DPC monthly fees - those are out of pocket costs. You can pay service fees (for services over and above what's provided by regular DPC services) with HSA. However, you can't get money IN TO an HSA without also having a h…

Okay, that's valid. Here is the thing: Catastrophic health events are not determined by some random number generator that says "Tag! You're it! We decided to fuck with you today!" Study after study after study shows that diet, lifestyle and preventive care (or lack thereof) correlate strongly with whether or not someone winds up with a catastrophic health event. This includes cancer. One of the ways DPC lowers costs…

There are different kinds of catastrophic health events. A heart attack or stroke is preventable. Dropping an engine on my arm or breaking an ankle while hiking is very much determined by a random number generator, unless if I spend my whole life sitting in front of a computer. In which case I'm going to die from a heart attack or stroke from lack of exercise.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#87

Post by Mz »

tsomctl wrote: post #86
Mz wrote: post #75

Earlier quoted context omitted.

Okay, that's valid. Here is the thing: Catastrophic health events are not determined by some random number generator that says "Tag! You're it! We decided to fuck with you today!" Study after study after study shows that diet, lifestyle and preventive care (or lack thereof) correlate strongly with whether or not someone winds up with a catastrophic health event. This includes cancer. One of the ways DPC lowers costs…

There are different kinds of catastrophic health events. A heart attack or stroke is preventable. Dropping an engine on my arm or breaking an ankle while hiking is very much determined by a random number generator, unless if I spend my whole life sitting in front of a computer. In which case I'm going to die from a heart attack or stroke from lack of exercise.

I paid accident claims for over five years. The absolutely "Fuck you, you were in the wrong place at the wrong time" totally random stuff was a shockingly tiny proportion of the claims I paid. The vast majority were either 1) accident waiting to happen because people are irresponsible asshats or 2) people who knew how to work the system and wanted to milk their insurance for all it was worth.

And the thing I found hardest to swallow about that job was that many of the totally random, shit happens claims from good people not milking their policy for money got damn little money out of us. It seemed incredibly, horribly unjust to me.

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#89

Post by FireBeyond »

jbarham wrote: post #36

Do what I did six years ago: Marry an Australian and leave the US. I now pay AU $350/month for private medical insurance for my family of five, in addition to being able to access Australia's world-class public Medicare medical system. It's only when you live outside of the US that you realize it has the worst healthcare system in the developed world (unless you're very rich, in which case it's the best, which says a…

"It's only when you live outside of the US that you realize it has the worst healthcare system in the developed world (unless you're very rich, in which case it's the best, which says a lot about the US political system)."

As an Australian who moved to the US, this * 1000.

Yes, no healthcare is free. But a 1-1.5% increase in income taxes to pay for healthcare is a whole world away from the US situation:

- hospital stay in Melbourne, 9 days. Out of pocket, $36 for in room TV rental (this was 15y ago), including take-home meds

- kidney stone in Seattle, $8,000+ out of pocket AFTER insurance (and this was good insurance, but admittedly more complex than average kidney stone - surgical removal attempted, infection found, stenting, lithotripsy a week later)

How does your average person come up with $8K to deal with a kidney stone? Something many people might have to deal with multiple times in their life, if not annually?

Re: Ask HN: Bootstrapped US founders, who do you use for health insurance?

#90

Post by FireBeyond »

csdreamer7 wrote: post #29

A little off topic but I decided to look this up. What would taxes be if we compared the US to Canada? Using the following two tools: https://simpletax.ca/calculator https://smartasset.com/taxes/california-tax-calculator For 50k a year in British Colombia for Canada and California for the US I get the following: BC: $8,372 CA: $11,112 At 100k with 18k contributed to 401k/RRSP the numbers are 17.5K and 25.8k for BC an…

Coupled with that is the propaganda pushed by various political parties and interested factions that we are among the highest taxed in the world, if not the highest taxed.

Many people believe that despite it being a statement which is entirely a fiction.

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