For all those jealous of the poor—peaceful discussion please

Amarante ↓

Wed, Jan 11 2023, 8:43 am

amother Ivory wrote:

So weird. I have Medicaid and pay for bcbs out of pocket just to get the aba, ot etc. The providers definitely said bcbs pays more. Maybe it varies by plan? I’m paying for the omnia gold. I’d better research this more bec I assumed the bcbs plans were similar and was hoping to find a job that offered bcbs as a benefit Confused

Platinum is the highest level on the marketplace.

Even if you are purchasing private insurance through the marketplace, the networks or other elements of each plan (even through the same company) will differ depending on whether it is an PPO, HMO or EPO.

There is no such thing as one kind of plan when you get insurance from a corporation as corporations - especially the large ones - can design their own plans so a BCBS plan might be completely different. Also many large corporations self insure and use the health insurance companies only as administrators and again - their plan might be completely unique.

The only thing one can say is that as a general rule, health insurance through a large corporation will generally offer the best coverage for their employees. This is also because they have a large pool of workers and so the cost to injure each employee is averaged among all of their employees - young, old, healthy, female etc.

amother

Whitesmoke ↓

Wed, Jan 11 2023, 9:05 am

amother OP wrote:

ETA I started to list the "positives" of being poor on page 4

I am starting a spinoff because on the other thread people were saying how the poor are getting richer and middle class is suffering etc...

Now I decided to point out what things being poor makes us lose out on and you tell me if middles class is the same (or even worse) and it would be clear if its really worth it. I would appreciate if first the poor class would comment on this first so the list be more complete but obviously it's not necessary.

When being poor there is literally no way you can get a good therapist who deals with trauma and severe cases as they do not accept Medicaid. (I have seen many who accept the non Medicaid insurances) So if you went through something extreme in life you have to either take loans to pay for it or live with it (I don't know about middle class but let me know)

You can barely go on vacation , get a trip to eretz yisroel , cancan or most of those high class hotels that people post about or are in the magazines (unless you get a signup bonus credit card which anyone can get)

I haven't seen a poor family with medicaid (who deserves medicaid and isnt making money under the table) buy a house or get a mortgage

your status in communities are usually lower when you are poor. You get less shidduchim for your child (see the other thread) aren't really recognized and chances are you will never be honored for anything in your life (even for the yeshiva dinner parents of the year award which is not important)

If there is something you really need badly and cant afford it there is no I will work more or work harder this week month etc.. becuase if you do you will lose all yor benefits.. you will always have to go to gemachs if that item or service is available or chv live without it

there is almost no room or potential to get promoted to a higher job / position/ wealth ...

you always rent and never know if you will get kicked out , will need to move , or if rent will go up

its extremely hard to save money for emergencies chv..

you are always in worry about how you will make your next simcha and will need to call this gemacch and that one and get references etc.. and work much harder and it doesn't always feel good

certain dental speialists are not covered forget about those dental costs (this is a message to be carefull about your teeth) such as endodontists, periodontists, crowns caps , and harder procedures..
to get a provider that accepts you have to go to a hospital and usually its the med students that see you who may not be that professional. To pay for a crown sometimes is over a thousand dollars (and there have been numerous threads here where people couldnt afford it)

Now this is the perspective of being poor , maybe if I get a chance I ll post the benefits as well. Those who complain about middle class you can post the challenges of being middle class and it can be an open (peacefull) discussion as honestly I have never been in your shoes so I don't know what perspective you are coming from. If anyone wants to add onto the list please feel free..

Middle class here. I can honestly say unfortunately we are in the same pickle. The only difference is we bh have a mortgage on a tiny old dumpy house.
Dh was so careful about paying tuition on time every month that they figured we can forsure afford it and they upped it cuz you know we're middle class.

I need a new shitel for years no money. I need a dental implant cuz a bad dentist (insurance covered 50% helped much. Ha?) Messed up my tooth. The imbalance is messing up my other teeth but no $$$$ to do it.
We have debt from when my kid needed surgery. Money we need to pay up front. The other woman in my community who's kid needs the same surgery had medicaid and didn't have to pay a penny. She even got transportation to get there! While dh drove there in our old car and paid a fortune in parking.....

We don't have any fancy furniture. We bought used second hand furniture 8 years ago. Used from a company that does furniture rentals. Its old but functional. $80 book shelves ordered online.
My bedroom is a set we ordered on Amazon, we ordered every single pc separately even we could afford it. The most expensive pc was the big dresser. That was around $150. It's 3 years holding up ok. But it's starting to go.

Dh has potential for more pay, like everyone does. There is no such a thing as less potential because you have all these programs. Figure something out. I don't know. I can't stand this "omg I'm poor wawawa"

We're poor too. Yes we have an income of close to 200k. But that's HARD WORKED money of 3 different jobs and still living month to month.

We pay tons in taxes, tons for insurance. Tuition, bussing (so expensive). Kosher groceries. Specialty foods for 2 of our children.
Y kid needs ot and other help we need to pay cash....
Vacation on this year was one overnight stay w kids all in one room ($135) and some free attractions.
Even that was stretched thin. (The pictures were amazing insta worthy. Insta is SOOO deceiving. Don't believe what you see!) And this was the first time we went away in 5 years. Then befit that was 5 years prior too.

I sure there are other middle class ppl making it and taking it. But I am so turned off by the judgment.

amother

↑ NeonGreen

Wed, Jan 11 2023, 10:57 am

amother Whitesmoke wrote:

OK now I'm curious where you vacationed with free attractions and instaworthy pictures.

My pig of a house just demanded $450 of boiler repair. And I was just sick for a week trying to decide if it was worth paying $100 for a medication insurance refused to cover (normal common med, no idea why they're so obstinate.) Bh I'm feeling a little better now after figuring out an over the counter hack that still cost $30 (on old poor obamacare insurance I would have gotten the rx version free). But my last bloodwork came back borderline and now I'm afraid they're about to send me to redo it for another $30 copay. Sounds like small amounts but they add up so fast.

Dh pointed out that at least we get equity for the house that's eating up all our money. He's not wrong but it's hard to feel it's worth it with the constant stresses. And it's not like a billion dollar equity that will have us leaving a fortune to the kids. We were able to borrow a lot of money from ourselves by refinancing the mortgage to pay a huge bill we had, which may be nicer than scrounging for gemachs, but now our mortgage is significantly higher every month for the next 30 years and it's really hard to see the light there.

amother

↑ Ivory ↓

Wed, Jan 11 2023, 11:02 am

Amarante wrote:

Oh gosh I didn’t quite realize how complicated health insurance was. Thanks for explaining all of it.

amother

↑ Buttercup ↓

Wed, Jan 11 2023, 11:32 am

So, I'm at a stage in my life where I've basically given up control
Not given up altogether, but given up the idea that it's in my control how much money I can earn.
I don't chase opportunities to earn money. I will turn down a job if it doesn't work for me and my schedule. Gone are the days I'd happily stay up all night completing a project if it would bring in a few hundred dollars. My physical and emotional health are worth more than that.
I work 3 jobs as it is. I started a program to earn an additional certification that could possibly earn more than double what I'm making now, but I'm stuck for now because I don't see a way to live while working part time and finishing up the program. (I did 6 months online but now need to do 6 months in person training.)
I have an interview coming up for a new job that pays more and might be more flexible and allow me to work PT and finish this program. I have a lot of doubts though whether this job really is for me because it will be much more stressful than my current job.
It's all so complicated and confusing.
I've been running a treadmill for the past 15 years. I guess that's what life is until you're done... Praise Hashem I still have the kochos to keep running.

amother

Canary ↓

Wed, Jan 11 2023, 12:04 pm

amother Orange wrote:

I recently switched from medicaid to private insurance. No one wants my insurance. I have top insurance they all tell me medicaid pays so much more they don't want it. I had no issue finding top doctors on medicaid. This is a lie people like to spread to convince people to think getting off medicaid is good. It's a disaster, I can't find good doctors, I pay premiums, co insurance, deductibles, copays. I might as well just pay out of pocket it would come out cheaper. Really let's stop pretending medicaid is a disadvantage I lost so many amazing doctors when I lost it.

I have this problem. I have very good insurance and many of my specialists that I use won’t accept it and I pay out of pocket .
In Rockland County if you can be on Fidelis through Medicaid or the market place you are better off. I have constant medical bills and the doctor won’t see my kids if their balances are not fully paid off. So the next option is putting it on the credit card making me go deeper into cc debt.
I just got charged $480 after insurance paid their part , for my sons ear wax removal at an ENT. I had to call and make a payment plan to pay off that bill.
It’s nice to be able to earn more money than being eligible for Medicaid but in the long run the expenses are so high between premiums, deductibles and copays , I end up losing more money this way.

↑ Amarante ↓

Wed, Jan 11 2023, 1:21 pm

seeker wrote:

Obamacare helped somewhat with that. Made the cliff a bit less steep and the cutoff a bit higher. Came with other issues and the marketplace insurances are worse than both medicaid and private (in terms of which doctors accept) but if you're in that bracket it's way better than being cut off.

This is not completely accurate.

All insurance is private insurance whether you get it through your state's marketplace or whether you get it directly from the insurance company. Or if you get it through your corporate employer.

However, if you purchase your insurance through the marketplace you are eligible for a premium subsidy which can be a significant savings as it is based on income and size of family.

There might be some slight differences between a Blue Cross plan but in general the big difference in terms of co-payments and out of pockets costs would be the tier with Bronze being the least expensive and Platinum being the most expensive.

The way to determine which makes sense is to try to calculate how your family uses health insurance and see what the total annual cost would be including premiums less subsidies.

A good insurance broker has software that does the calculation for you and you can use an insurance broker for insurance you purchase through the marketplace or otherwise. Your broker gets the same commission from the insurance company because the insurance company makes the entire premium and any "subsidy" is paid to the insurance company by the Federal government.

Corporate insurance (I.e offered through a company) is also subsidized by the Federal government as well since the cost of health care benefits is deductible by the corporation and NOT taxable to the employee so it is a doubly valuable benefit.

amother

↑ Brunette

Wed, Jan 11 2023, 1:29 pm

Amarante wrote:

Except, as I said earlier, one is only eligible for premium rebates through the Marketplace if there is no insurance available through their workplace.

There are tax deductible benefits to workplaces who have insurance available, but they don't have to pay and they don't have to have anything affordable available.

My husband's job offers Platinum insurance level only. That means $1800-$2500 monthly premiums just for myself and my husband. Kids are still eligible for JerseyCare. And deductibles of $6000. They don't subsidize because they don't have to.
So we went to the Marketplace. But because technically he has insurance through his office available, we are not eligible for any subsidies so it was a choice of Bronze level at $500/month with a $12500 deductible or Silver level with an $900/month and a $8000 deductible.

That's not any affordable options for an average couple that makes 115k a year.

amother

↑ Whitesmoke

Wed, Jan 11 2023, 1:43 pm

amother NeonGreen wrote:

We stayed on an old farm so there was putting zoo, and other old fashioned stuff. And a playground. Kids were AMAZED. We took along a cooler with food and a disposable grill.
We also went to a free museum tour. But the sleeping accommodations were tiny but the most fun part. I you want you can post an email and I can share location.