Is Health Insurance Worth Having?

This past year, I had many health related crisis's, from getting Covid pretty badly to being diagnosed with aplastic anemia, but luckily I have insurance...or so I thought.

I am just going to put the hard facts out there:

I pay for a Molina Bronze Plan through the Marketplace for my daughter and I. For the two of us, it's $297/mo -- but the individual deductible is $6k and family deductible is 13k.

For those of you who are less familiar with the workings of insurance, what that means is this: I pay $297/mo for a plan that doesn't really cover much of anything until I rack up $6k of medical expenses as an individual, or the combined total for Sofia and I hits $13k of medical expenses.

This means that the 3k that I spend on transfusions and blood work for my anemia was out of pocket, as well as all of my covid treatments--overall I spent 5k this fall on health related expenses, and this was during a time when I was out of work for a month due to covid.

The market place has a higher tier of coverage with a lower deductible (the silver plan) -- and those plans do seem to have a better value. The only problem is, you're looking at $600-$800 of premium per month, so you have to really have to feel pretty certain that you'll use more than $8,400 a month in medical expenses to make the premium worthwhile--not to mention that you need to be able to afford to spend $600-$800 a month for insurance in the first place.

At the same time--there is the complexity of exactly HOW insurance works. Insurance companies will tell you, "This service cost $100, but we negotiated it down to $50 and you pay $35" but when you call try and get the same service done at a cash rate, you get charged $50, so did the insurance really negotiate the price at all, or what the initial $100 cost artificially high to make the insurance look like it's doing something?

I also know from my time without health insurance that hospitals are able to forgive a certain amount of medical costs, and create reasonable payment plans for you to pay what you owe. The fact that their able to forgive so much so easily combined with the "negotiated" prices from insurance companies leaves me with one question: "how much do these medical services actually cost?"

More and more often, I find myself asking--if all affordable insurance is essentially catastrophe insurance, and many hospitals have the ability to forgive medical debt / create payment plans for you, is health insurance a worthwhile investment?

I'm going to be digging into this issue on my next podcast episode. If you have any significant experiences with health insurance as a consumer or just have knowledge about the workings of this industry that you think people should know, I would love to have you on the podcast to have you share your stories and your point of view on this issue.

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