Your retirement plans . . .

[Spekkio]

Yeah, the “or so” covered me for the college part, so mostly true.

Fair enough. It's mostly interesting that Tricare basically charges the healthcare.gov individual rates. Perhaps there's some better cost sharing perks but your Mk1 Mod0 20-something year old will spend $500 or less per year on medical expenses as a cash only customer (which barely exceeds the Tricare YA select deductible) yet would pay a $4000 a year premium on the off chance that they become hospitalized with a 6 figure bill doing something other than driving (because auto insurance covers this).

This makes me hate Obamacare even more, it basically creates a ponzi scheme for young people to subsidize unhealthy middle aged men and women, and the "you can stay on your parents plan until 26" is like when the cable bill goes up after the first discount year and they are banking on no one bothering to pay attention or cancel.

 

[exNavyOffRec]

This is not true.

Your dependents can be under your TRICARE plan until age 21 (23 if enrolled full-time in college). After this time, but before age 26, they can obtain Tricare Young Adult.

The premiums for TYA-select are $337 per month and skyrocket to $727 per month for prime. The fees / co-pays are the same as the parents' status - AD / reserve / retired.

That's an insanely expensive health insurance premium for most people that age, and it's interesting that the ACA rules allowing children to remain on their parents' insurance plans up to their age 26 birthday don't apply to Tricare in the strict sense.

Unless you want to pay the premiums for them.... your children should be planning on getting a full-time job and going on an employer sponsored health insurance plan that would slash that monthly cost by 50-67% or YOLOing it like our generation did.

I learned about this with my oldest when she hit 23 as I thought as long as she was in college she was good to go, but nope! I found out how much TYA was and just about died. It was cheaper to get her and myself on my companies health insurance, I could have added all the kids and it would have been the same since it said yourself + children and everyone could have been dual covered. I have my middle daughter on my companies plan since she is over the age limit and done with college, she pays half the cost of the insurance right now, then when she gets a full time job I will drop the civilian insurance.

 

[MIDNJAC]

We opted for select for many years when I was on active duty. And then in the reserves I use TRS, which is I guess select as well. But fun fact is that when you go on >30 day orders, you get auto enrolled in free tricare, and that tricare is prime. When I went off my most recent set of orders, they had autonomously enrolled my kid with some provider at the clinic and we kept getting messages about it. This was about 3 days before I reverted back to select and I don't even know what it was about, he has no condition or anything requiring medical referrals. Tricare is primarily dumber than a bag of rocks, though it is cheap. My wife was a provider for many years, and it is embarrassing what our country has contracted with them. They audited her 4 years ago, she hasn't been a provider for the last 2 of those years, and they still haven't closed out their audit. But they have also been systemically trying to remove (stop paying for) services to autistic kids for years now. Which is her area of expertise. It's a love/hate relationship I have with them. But you won't get a better deal pretty much anywhere, unless you go full Leeroy and join a health care coop or HSA as a young healthy person

 

[Gatordev]

But they have also been systemically trying to remove (stop paying for) services to autistic kids for years now.

Not just autistic kids, but claims in general. I've had several PT claims that were paid out, only to have additional billing come to me a year later. Fortunately the provider is pretty helpful and would tell me not to pay it, but it would take months to finally stop receiving the bills.

 

[MIDNJAC]

Not just autistic kids, but claims in general. I've had several PT claims that were paid out, only to have additional billing come to me a year later. Fortunately the provider is pretty helpful and would tell me not to pay it, but it would take months to finally stop receiving the bills.

Yeah I can only imagine the patient end of that nonsense is endlessly maddening and stressful.

 

[Flash]

This makes me hate Obamacare even more, it basically creates a ponzi scheme for young people to subsidize unhealthy middle aged men and women, and the "you can stay on your parents plan until 26" is like when the cable bill goes up after the first discount year and they are banking on no one bothering to pay attention or cancel.

I mean, that is health insurance in general.

 

[number9]

I mean, that is health insurance in general.

The only way insurance of virtually any kind works is if the non-risky members subsidize the risky ones.

That's it. That's how insurance works.

 

[Spekkio]

The only way insurance of virtually any kind works is if the non-risky members subsidize the risky ones.

That's it. That's how insurance works.

Yes but those non-risky ones generally pay a very small amount on an individual scale.

My auto insurance is $500 / year. If I get into an accident, it will cost my insurance company at least $30k.

If we apply this model to a healthy 20-something year old whose only risk is acute injury, insurance premiums shouldn't be $4,000 with high deductibles. It's only that way because the ACA created rules that insurance companies are limited on what they can charge a 50 year old smoker / alcoholic with a BMI of 42 that needs to pop a cocktail of cholesterol and blood pressure medicine so he doesn't die of a dyspnea induced heart attack, and anytime anyone wants to change this bullshit it turns into "waaa, they want to take away your health care!"

 

[Flash]

Yes but those non-risky ones generally pay a very small amount on an individual scale.

My auto insurance is $500 / year. If I get into an accident, it will cost my insurance company at least $30k.

If we apply this model to a healthy 20-something year old whose only risk is acute injury, insurance premiums shouldn't be $4,000 with high deductibles. It's only that way because the ACA created rules that insurance companies are limited on what they can charge a 50 year old smoker / alcoholic with a BMI of 42 that needs to pop a cocktail of cholesterol and blood pressure medicine so he doesn't die of a dyspnea induced heart attack, and anytime anyone wants to change this bullshit it turns into "waaa, they want to take away your health care!"

Put your car insurance on a scale of what some health care costs and you will likely get comparable costs for many things.

The ACA put limits on what health insurance can charge for many reasons, to include ensuring folks who have health issues that are not because of their behaviors or actions are not denied insurance. Plenty of folks get cancer with few or any risk factors, suffer injury that is not their fault or have conditions they were born with, and health insurance could legally deny many of them coverage before the ACA. With the good comes some bad. Welcome to the wonderful, fucked up world of the American health care system.

Car and home insurance rates have also risen considerably the last few years too, often because a lot of folks want to live in high risk areas like the states of Florida and California. While the residents of those states shoulder a significant portion of those costs we can't pretend that insurance companies are spreading the pain around nationwide...(not always on your side!).

 

[number9]

Yes but those non-risky ones generally pay a very small amount on an individual scale.

My auto insurance is $500 / year. If I get into an accident, it will cost my insurance company at least $30k.

If we apply this model to a healthy 20-something year old whose only risk is acute injury, insurance premiums shouldn't be $4,000 with high deductibles. It's only that way because the ACA created rules that insurance companies are limited on what they can charge a 50 year old smoker / alcoholic with a BMI of 42 that needs to pop a cocktail of cholesterol and blood pressure medicine so he doesn't die of a dyspnea induced heart attack, and anytime anyone wants to change this bullshit it turns into "waaa, they want to take away your health care!"

The whole model is fucked from top to bottom, don't get me wrong. But there are so many sharp edges in the way our "insurance" "industry" "works" that weird cases like this are the end result; healthcare is among the least suitable industries for a true free-market model and we manage to have found the worst of pretty much all worlds.

 

[Spekkio]

Put your car insurance on a scale of what some health care costs and you will likely get comparable costs for many things.

The ACA put limits on what health insurance can charge for many reasons, to include ensuring folks who have health issues that are not because of their behaviors or actions are not denied insurance. Plenty of folks get cancer with few or any risk factors, suffer injury that is not their fault or have conditions they were born with, and health insurance could legally deny many of them coverage before the ACA. With the good comes some bad. Welcome to the wonderful, fucked up world of the American health care system.

Sure...

The average cancer treatment costs $150,000. There is an estimated incidence of 2 million more cancer patients in 2025 estimated to cost roughly $200 billion, and 58% of those cases will be patients over 65 (covered by medicare, taxed separately with separate premiums).

There are 163 million employed Americans.

Which means treating every cancer patient in America costs an insured working American $500 per year.

If I had an entire family on Tricare YA, I'd be paying $20,000 per year in premiums. The average actual premium through employers is roughly $6000-7000 per year and companies pay half, so that's $12,000-14k a year, of which Uncle Sam pays the employer ~$3k.

If we multiply that $3k by $163M workers, you get about $500 billion in outlays per year in corporate welfare.

(sidenote: the tax credits and subsidies don't count toward profit margin reports)

I honestly don't think I've even used one year's worth of premiums on healthcare since my children were born and certainly not two. The idea behind insurance is that you pay a little over time so that you're protected from catastrophic bills, not so that you pay way more into a system that you'll ever use.

Where's the rest of the money going? Covering things that should, quite frankly, not be covered by insurance (akin to the fact that my auto insurance doesn't cover a new set of brakes). This discussion is predictable; you're going to rattle off a laundry-list of conditions that should make me feel empathy, and I'm going to prove to you that they account for significantly less than 50% of insurance premiums.

I will anecdotally say this: anytime I've gone to the ER, it's filled with 50 people waiting to see a doctor and ~40-45 of them probably shouldn't even be there because home therapy they could read on WebMD would be sufficient. I got a kick out of my interaction with a triage nurse ...

Me: "hi, my son's arm has a compound fracture"
Nurse: "Oh? How do you know your son has a compound fracture?"
Me: "[name], show her your arm"... son removes ice and nurse's face turns white
(sidenote: I went to UC first. Doc saw the kid in < 5 minutes and said he needed surgery that they can't perform there, gave some pain meds and I went to the ER, whereupon I waited 8 hours for him to get his arm set).

Like no, I'm not bringing my kid to the hospital for an owie.

Tricare paid something like $7-8k for the whole kit and caboodle. I could have afforded the procedure cash, if it were necessary and charged at that rate... but it wouldn't be because of our shitty billing policies.

It's impossible to have a healthy public discourse on the issue because people can't get past the fear mongering, and the reason we're here is because we had a partisan bill jammed through Congress (and I don't have a favorite team, the GOP is equally guilty with the 'big beautiful bill' and that's the real reason why Democrats have enough of a red-ass to filibuster the CR and shutdown the government until their demands are met).