Ok to go without health insurance?

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Lee_WSP
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Re: Ok to go without health insurance?

Post by Lee_WSP » Thu Oct 24, 2019 3:38 pm

junior wrote:
Tue Oct 22, 2019 8:12 pm
dual wrote:
Tue Oct 22, 2019 6:55 pm
He could clear his debts through bankruptcy
Not clear that a high earning doctor would be eligible for bankruptcy, you could certainly talk to a lawyer, but this is a massive assumption.
You are only bankrupt if your liabilities exceed your assets + ability to pay. Unsure of the exact formula, but you can't declare bankruptcy just because your net worth is negative.

chessknt
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Re: Ok to go without health insurance?

Post by chessknt » Thu Oct 24, 2019 3:49 pm

Even if you hame the system by only buying coverage in a true emergency what if the emergency is with you? Is your corporation configured to let someone else buy insurance on its behalf in the event you become incapacitated? And surely you know lots of expenses could happen before that insurance kicks in. If you fall down the stairs and break your neck or get a brain bleed you will be out mid six figures in less than 24 hours easily. If it takes a week to get coverage in place you could be at seven figures or more. That would be 50 years of premiums for your entire family.

rkhusky
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Re: Ok to go without health insurance?

Post by rkhusky » Thu Oct 24, 2019 3:58 pm

The other option is that, if you are hit with an unlikely accident or illness, you don’t get treated and die. There are many who are not frightened of death.

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dual
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Re: Ok to go without health insurance?

Post by dual » Thu Oct 24, 2019 5:03 pm

MichCPA wrote:
Thu Oct 24, 2019 3:21 pm

Odds that you will get through bankruptcy with the mid 7 figure NW intact are appox 0%. Odds that mid 7 figure NW will still be mid 7 figure after 16k insurance are 100%.
Odds that OP's NW will still be mid 7 figures after 16K*10 = 160K annual premium are also 100%. Should he pay the 10X premium?

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TomatoTomahto
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Re: Ok to go without health insurance?

Post by TomatoTomahto » Thu Oct 24, 2019 5:05 pm

rkhusky wrote:
Thu Oct 24, 2019 3:58 pm
The other option is that, if you are hit with an unlikely accident or illness, you don’t get treated and die. There are many who are not frightened of death.
Do you think it would suck for the 3 surviving family members? Frightened or not?
Okay, I get it; I won't be political or controversial. The Earth is flat.

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abuss368
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Re: Ok to go without health insurance?

Post by abuss368 » Thu Oct 24, 2019 5:18 pm

I unfortunate incident and one could be paying for the rest of their lives.
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rkhusky
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Re: Ok to go without health insurance?

Post by rkhusky » Thu Oct 24, 2019 6:21 pm

TomatoTomahto wrote:
Thu Oct 24, 2019 5:05 pm
rkhusky wrote:
Thu Oct 24, 2019 3:58 pm
The other option is that, if you are hit with an unlikely accident or illness, you don’t get treated and die. There are many who are not frightened of death.
Do you think it would suck for the 3 surviving family members? Frightened or not?
Yes, it would be difficult, but OP might be willing to take the risk.

It wasn't long ago that most people did not have health insurance. If OP has other priorities, it's a legitimate choice.

aristotelian
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Re: Ok to go without health insurance?

Post by aristotelian » Thu Oct 24, 2019 6:28 pm

One more thought. If you are serious about this, you probably have the money to have a really good medical tourism option as a backup plan. Heck, you could probably buy your own hospital somewhere in Southeast Asia.

MichCPA
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Re: Ok to go without health insurance?

Post by MichCPA » Thu Oct 24, 2019 7:59 pm

dual wrote:
Thu Oct 24, 2019 5:03 pm
MichCPA wrote:
Thu Oct 24, 2019 3:21 pm

Odds that you will get through bankruptcy with the mid 7 figure NW intact are appox 0%. Odds that mid 7 figure NW will still be mid 7 figure after 16k insurance are 100%.
Odds that OP's NW will still be mid 7 figures after 16K*10 = 160K annual premium are also 100%. Should he pay the 10X premium?
No, because he just told me it cost 16k.

Nice appeal to extremes there.

JackoC
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Re: Ok to go without health insurance?

Post by JackoC » Fri Oct 25, 2019 9:40 pm

delamer wrote:
Tue Oct 22, 2019 6:16 pm
fru-gal wrote:
Tue Oct 22, 2019 6:02 pm
Shallowpockets wrote:
Tue Oct 22, 2019 12:11 pm
Two, you are not going to be able to buy insurance when you need it. No insurance company is going to have a policy that covers you when you are already in the hospital or have an existing and immediate diagnosis before you had bought the insurance.
I think the OP's plan is crazy, but didn't Obamacare do away with insurance companies being able to refuse coverage because of preexisting conditions?
But there is a difference between that and “retroactive” coverage. If you have $250,000 in medical bills in June, obtaining health insurance beginning July 1 isn’t going to help with the June bills.
Not only that, but under ACA while an insurance company 'must issue' policies without regard to pre-existing conditions, they don't have to cover that condition as soon as they write the policy, let alone retroactively. My carrier does not cover pre-existing conditions for 12 months. 'Pre-existing' is defined as "conditions for which advice, diagnosis, care or treatment was recommended or received during the 6 months before enrollment", or which displayed symptoms that would have made a "prudent person" seek one of those things. So older illnesses which return are not 'pre-existing', and you could game the system for the treatment of a slow moving chronic illness. But signing up as soon as you get sick wouldn't work for fast moving serious illnesses or injury, which is generally what one would imagine as the big downside for a currently young and health family.

The specifics I gave are from a provider in NJ, but it's obviously allowed by ACA and I would guess similar nationally.
[edit to add if not obvious, you generally count as 'enrolled' if you had insurance with another company previously, but the ins co's are allowed, without any change in the original ACA, to protect themselves to a significant degree from people getting insurance only after finding out they are seriously ill]

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dual
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Re: Ok to go without health insurance?

Post by dual » Sat Oct 26, 2019 1:23 pm

MichCPA wrote:
Thu Oct 24, 2019 7:59 pm
dual wrote:
Thu Oct 24, 2019 5:03 pm
MichCPA wrote:
Thu Oct 24, 2019 3:21 pm

Odds that you will get through bankruptcy with the mid 7 figure NW intact are appox 0%. Odds that mid 7 figure NW will still be mid 7 figure after 16k insurance are 100%.
Odds that OP's NW will still be mid 7 figures after 16K*10 = 160K annual premium are also 100%. Should he pay the 10X premium?
No, because he just told me it cost 16k.

Nice appeal to extremes there.
Nice no justification for paying current rate there.

Luckywon
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Re: Ok to go without health insurance?

Post by Luckywon » Sat Oct 26, 2019 2:01 pm

JackoC wrote:
Fri Oct 25, 2019 9:40 pm

Not only that, but under ACA while an insurance company 'must issue' policies without regard to pre-existing conditions, they don't have to cover that condition as soon as they write the policy, let alone retroactively. My carrier does not cover pre-existing conditions for 12 months. 'Pre-existing' is defined as "conditions for which advice, diagnosis, care or treatment was recommended or received during the 6 months before enrollment", or which displayed symptoms that would have made a "prudent person" seek one of those things. So older illnesses which return are not 'pre-existing', and you could game the system for the treatment of a slow moving chronic illness. But signing up as soon as you get sick wouldn't work for fast moving serious illnesses or injury, which is generally what one would imagine as the big downside for a currently young and health family.

The specifics I gave are from a provider in NJ, but it's obviously allowed by ACA and I would guess similar nationally.
[edit to add if not obvious, you generally count as 'enrolled' if you had insurance with another company previously, but the ins co's are allowed, without any change in the original ACA, to protect themselves to a significant degree from people getting insurance only after finding out they are seriously ill]
Not that I'm endorsing OP's idea, but OP would be purchasing employer based insurance. Under ACA, all such plans must cover preexisting conditions.

olliema
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Re: Ok to go without health insurance?

Post by olliema » Sat Oct 26, 2019 2:10 pm

Ironically a doctor would know the medical risks best.

How certain are you that you, or your family will not get sick or injured?

Is the benefit worth the cost? Sounds like a gamble I would avoid.

This is a proposition that poor people have deal with - be glad you are not one of them.

Katietsu
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Re: Ok to go without health insurance?

Post by Katietsu » Sat Oct 26, 2019 3:11 pm

Luckywon wrote:
Sat Oct 26, 2019 2:01 pm
JackoC wrote:
Fri Oct 25, 2019 9:40 pm

Not only that, but under ACA while an insurance company 'must issue' policies without regard to pre-existing conditions, they don't have to cover that condition as soon as they write the policy, let alone retroactively. My carrier does not cover pre-existing conditions for 12 months. 'Pre-existing' is defined as "conditions for which advice, diagnosis, care or treatment was recommended or received during the 6 months before enrollment", or which displayed symptoms that would have made a "prudent person" seek one of those things. So older illnesses which return are not 'pre-existing', and you could game the system for the treatment of a slow moving chronic illness. But signing up as soon as you get sick wouldn't work for fast moving serious illnesses or injury, which is generally what one would imagine as the big downside for a currently young and health family.

The specifics I gave are from a provider in NJ, but it's obviously allowed by ACA and I would guess similar nationally.
[edit to add if not obvious, you generally count as 'enrolled' if you had insurance with another company previously, but the ins co's are allowed, without any change in the original ACA, to protect themselves to a significant degree from people getting insurance only after finding out they are seriously ill]
Not that I'm endorsing OP's idea, but OP would be purchasing employer based insurance. Under ACA, all such plans must cover preexisting conditions.
A full fledged ACA compliant plan must. But short term plans and maybe the association plans can exclude preexisting conditions. I do not know what the health care ministry sharing plans cover in this regard.

Lee_WSP
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Re: Ok to go without health insurance?

Post by Lee_WSP » Sat Oct 26, 2019 3:17 pm

Katietsu wrote:
Sat Oct 26, 2019 3:11 pm
Luckywon wrote:
Sat Oct 26, 2019 2:01 pm
JackoC wrote:
Fri Oct 25, 2019 9:40 pm

Not only that, but under ACA while an insurance company 'must issue' policies without regard to pre-existing conditions, they don't have to cover that condition as soon as they write the policy, let alone retroactively. My carrier does not cover pre-existing conditions for 12 months. 'Pre-existing' is defined as "conditions for which advice, diagnosis, care or treatment was recommended or received during the 6 months before enrollment", or which displayed symptoms that would have made a "prudent person" seek one of those things. So older illnesses which return are not 'pre-existing', and you could game the system for the treatment of a slow moving chronic illness. But signing up as soon as you get sick wouldn't work for fast moving serious illnesses or injury, which is generally what one would imagine as the big downside for a currently young and health family.

The specifics I gave are from a provider in NJ, but it's obviously allowed by ACA and I would guess similar nationally.
[edit to add if not obvious, you generally count as 'enrolled' if you had insurance with another company previously, but the ins co's are allowed, without any change in the original ACA, to protect themselves to a significant degree from people getting insurance only after finding out they are seriously ill]
Not that I'm endorsing OP's idea, but OP would be purchasing employer based insurance. Under ACA, all such plans must cover preexisting conditions.
A full fledged ACA compliant plan must. But short term plans and maybe the association plans can exclude preexisting conditions. I do not know what the health care ministry sharing plans cover in this regard.
Ministries don't cover anything. They chip in according to whatever agreement is in place.

BarbBrooklyn
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Re: Ok to go without health insurance?

Post by BarbBrooklyn » Sat Oct 26, 2019 3:43 pm

IMHO, we are all one day away from the dx of a minor child with a lifelong condition requiring infusions costing several hundred thousands of dollars per month. This is the situation that my best friend is in; her daughter is now 40 years old and thanks to the ACA has decent medical insurance. Her parents both still contribute to the cost of her insurance.

I would think, as a physician, you would know about this sort of stuff.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."

EnjoyIt
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Re: Ok to go without health insurance?

Post by EnjoyIt » Sat Oct 26, 2019 3:54 pm

grabiner wrote:
Tue Oct 22, 2019 9:27 pm
The other advantage of health insurance is that the expected value of buying insurance is positive. Even if you have a high-deductible plan so that the plan pays nothing for most of your medical coverage, the payment is at the in-network rate. (And HDHPs make this even better by giving you more tax-advantaged savings.) Thus you can pay $5000 for an insurance plan which expects to pay $4000 in medical bills, and still come out ahead because the expected medical bills would have been $8000 if you paid them out of pocket.
Unfortunately this is not the case anymore. many times the same procedure costs less without insurance as compared to with since paying without insurance does not add to your deductible limit.

I have come across this many many times. If I expect not reaching our high deductible by the end of the year, I often times pay out of pocket, forgoing the insurance.

Frankly, it makes sense that if you pay for something through an intermediary, that intermediary will want their cut.

EnjoyIt
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Re: Ok to go without health insurance?

Post by EnjoyIt » Sat Oct 26, 2019 3:56 pm

BarbBrooklyn wrote:
Sat Oct 26, 2019 3:43 pm
IMHO, we are all one day away from the dx of a minor child with a lifelong condition requiring infusions costing several hundred thousands of dollars per month. This is the situation that my best friend is in; her daughter is now 40 years old and thanks to the ACA has decent medical insurance. Her parents both still contribute to the cost of her insurance.

I would think, as a physician, you would know about this sort of stuff.
You are missing the point....As a physician, this physician realizes that this type of cost would only last a few months at worst before acquiring health insurance since pre-existing conditions are not excluded.
olliema wrote:
Sat Oct 26, 2019 2:10 pm
Ironically a doctor would know the medical risks best.

How certain are you that you, or your family will not get sick or injured?

Is the benefit worth the cost? Sounds like a gamble I would avoid.

This is a proposition that poor people have deal with - be glad you are not one of them.
The risk is small, would only last for a short time, and OP has the funds to cover such a short term expense. It just sounds scary because "no health insurance" sounds scary. The insurance industry sure wants you to believe that.

randomguy
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Re: Ok to go without health insurance?

Post by randomguy » Sat Oct 26, 2019 4:03 pm

BarbBrooklyn wrote:
Sat Oct 26, 2019 3:43 pm
IMHO, we are all one day away from the dx of a minor child with a lifelong condition requiring infusions costing several hundred thousands of dollars per month. This is the situation that my best friend is in; her daughter is now 40 years old and thanks to the ACA has decent medical insurance. Her parents both still contribute to the cost of her insurance.

I would think, as a physician, you would know about this sort of stuff.
And those conditions you can go out and buy insurance for after you develop the condition. If they were all you had to worry about, you shouldn't buy insurance. The part where the OP runs into risk is the stuff that shows up instantly and costs a ton short term. Things like trauma, heart attacks, strokes, and so on where you develop a problem that you wanted treated in hours not days/weeks.

Obviously that is a gamble that most people aren't willing to take but I imagine it is bet that has a pretty high expected return. What you need to do is find 100 people to form a pool and each chip in 5k/year to cover the 1% of the people that do get hit with the poor results over time.:) It would be interesting to see what health insurance plan with say a 50 or 100k deductible looked like if they were allowed.

And yes these are obviously are ways to try and become a free rider n the health care system by find loopholes.

Luckywon
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Re: Ok to go without health insurance?

Post by Luckywon » Sat Oct 26, 2019 4:10 pm

randomguy wrote:
Sat Oct 26, 2019 4:03 pm
What you need to do is find 100 people to form a pool and each chip in 5k/year to cover the 1% of the people that do get hit with the poor results over time.:) It would be interesting to see what health insurance plan with say a 50 or 100k deductible looked like if they were allowed.

And yes these are obviously are ways to try and become a free rider n the health care system by find loopholes.
Such a plan would not have the major advantage that health insurance companies have in getting heavily discounted rates from contracted providers. The strategy of assuming that an individual or group of indviduals can negotiate similar discounts from a diverse group of providers after receiving services will probably fall very short.

JackoC
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Re: Ok to go without health insurance?

Post by JackoC » Sat Oct 26, 2019 4:17 pm

Luckywon wrote:
Sat Oct 26, 2019 2:01 pm
JackoC wrote:
Fri Oct 25, 2019 9:40 pm

Not only that, but under ACA while an insurance company 'must issue' policies without regard to pre-existing conditions, they don't have to cover that condition as soon as they write the policy, let alone retroactively. My carrier does not cover pre-existing conditions for 12 months. 'Pre-existing' is defined as "conditions for which advice, diagnosis, care or treatment was recommended or received during the 6 months before enrollment", or which displayed symptoms that would have made a "prudent person" seek one of those things. So older illnesses which return are not 'pre-existing', and you could game the system for the treatment of a slow moving chronic illness. But signing up as soon as you get sick wouldn't work for fast moving serious illnesses or injury, which is generally what one would imagine as the big downside for a currently young and health family.

The specifics I gave are from a provider in NJ, but it's obviously allowed by ACA and I would guess similar nationally.
[edit to add if not obvious, you generally count as 'enrolled' if you had insurance with another company previously, but the ins co's are allowed, without any change in the original ACA, to protect themselves to a significant degree from people getting insurance only after finding out they are seriously ill]
Not that I'm endorsing OP's idea, but OP would be purchasing employer based insurance. Under ACA, all such plans must cover preexisting conditions.
You're sure they have to cover the pre-existing condition from day 1? Just curious, I buy private plan so not directly relevant to me. 'Full fledged' (not 'temporary') individual plans under ACA must be *written* for people with pre-existing conditions and they can't be priced according to the condition, but the company doesn't have to cover the condition on day one if the person was uninsured previously.

Luckywon
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Re: Ok to go without health insurance?

Post by Luckywon » Sat Oct 26, 2019 4:35 pm

JackoC wrote:
Sat Oct 26, 2019 4:17 pm

You're sure they have to cover the pre-existing condition from day 1? Just curious, I buy private plan so not directly relevant to me. 'Full fledged' (not 'temporary') individual plans under ACA must be *written* for people with pre-existing conditions and they can't be priced according to the condition, but the company doesn't have to cover the condition on day one if the person was uninsured previously.
Numerous websites, including those sponsored by the federal government, are very explicit that all marketplace plans must cover preexisting conditions from day 1.

Check the website HHS.gov which states:

https://www.hhs.gov/answers/affordable- ... conditions.

" Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.

The only exception to the pre-existing coverage rule is for grandfathered individual health insurance plans -- the kind you buy yourself, not through an employer. They don’t have to cover pre-existing conditions."

Googling "pre existing conditions ACA" yields a multitude of websites that state the same thing with only very narrow exceptions that do not seem applicable to employer based insurance or even individuals buying marketplace plans during open enrollment or with a qualifying event.

I believe the discrepancy here is that you are describing situations where the company is offering a policy to an individual outside of open enrollment and with no qualifying event.

BarbBrooklyn
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Re: Ok to go without health insurance?

Post by BarbBrooklyn » Sat Oct 26, 2019 4:42 pm

I guess I've just never been able to trust insurance companies not to deny coverage, especially going forward.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."

JackoC
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Re: Ok to go without health insurance?

Post by JackoC » Sat Oct 26, 2019 4:44 pm

EnjoyIt wrote:
Sat Oct 26, 2019 3:54 pm
grabiner wrote:
Tue Oct 22, 2019 9:27 pm
The other advantage of health insurance is that the expected value of buying insurance is positive. Even if you have a high-deductible plan so that the plan pays nothing for most of your medical coverage, the payment is at the in-network rate. (And HDHPs make this even better by giving you more tax-advantaged savings.) Thus you can pay $5000 for an insurance plan which expects to pay $4000 in medical bills, and still come out ahead because the expected medical bills would have been $8000 if you paid them out of pocket.
Unfortunately this is not the case anymore. many times the same procedure costs less without insurance as compared to with since paying without insurance does not add to your deductible limit.

I have come across this many many times. If I expect not reaching our high deductible by the end of the year, I often times pay out of pocket, forgoing the insurance.

Frankly, it makes sense that if you pay for something through an intermediary, that intermediary will want their cut.
I've never seen that. I see a nominal charge on the insurance company's Explanation of Benefits statements, and often that same charge on the bill from provider, an insurance adjustment, and a lower, usually at least 50% lower (in some past cases 90% lower) 'subscriber responsibility' on the EOB which is the same as the net due on the bill I get from the provider. I mean on charges when I'm below the deductible. I don't recall any exception, including recently.

I would definitely pay with no insurance, and leave the insurance in 'reserve' for big bills of a major illness if what you said applied to my providers and ins co here in NJ. But I've never seen it. Your experience is completely different from mine and seems different from most people's from what I gather.

Lee_WSP
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Re: Ok to go without health insurance?

Post by Lee_WSP » Sat Oct 26, 2019 4:46 pm

Employers can start new group plans at any time if none existed beforehand.

EnjoyIt
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Re: Ok to go without health insurance?

Post by EnjoyIt » Sat Oct 26, 2019 4:59 pm

JackoC wrote:
Sat Oct 26, 2019 4:44 pm
EnjoyIt wrote:
Sat Oct 26, 2019 3:54 pm
grabiner wrote:
Tue Oct 22, 2019 9:27 pm
The other advantage of health insurance is that the expected value of buying insurance is positive. Even if you have a high-deductible plan so that the plan pays nothing for most of your medical coverage, the payment is at the in-network rate. (And HDHPs make this even better by giving you more tax-advantaged savings.) Thus you can pay $5000 for an insurance plan which expects to pay $4000 in medical bills, and still come out ahead because the expected medical bills would have been $8000 if you paid them out of pocket.
Unfortunately this is not the case anymore. many times the same procedure costs less without insurance as compared to with since paying without insurance does not add to your deductible limit.

I have come across this many many times. If I expect not reaching our high deductible by the end of the year, I often times pay out of pocket, forgoing the insurance.

Frankly, it makes sense that if you pay for something through an intermediary, that intermediary will want their cut.
I've never seen that. I see a nominal charge on the insurance company's Explanation of Benefits statements, and often that same charge on the bill from provider, an insurance adjustment, and a lower, usually at least 50% lower (in some past cases 90% lower) 'subscriber responsibility' on the EOB which is the same as the net due on the bill I get from the provider. I mean on charges when I'm below the deductible. I don't recall any exception, including recently.

I would definitely pay with no insurance, and leave the insurance in 'reserve' for big bills of a major illness if what you said applied to my providers and ins co here in NJ. But I've never seen it. Your experience is completely different from mine and seems different from most people's from what I gather.
It all depends on the product being bought.

I have found imaging such an MRI, CT, US less expensive paying out of pocket. Medications when using a coupon from GoodRx.com are sometime less expensive if you forgo insurance. Many doctors offices will take a lower self pay cash price if they don’t need to go through insurance but one has to ask for it.

All of the above holds true if one has yet to reach their deductible. Once the deductible is reached obviously using insurance is less expensive.

toofache32
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Re: Ok to go without health insurance?

Post by toofache32 » Sat Oct 26, 2019 5:26 pm

cmublitz wrote:
Tue Oct 22, 2019 11:45 am
I think I get it. Between whatever medical situations you can handle between you, your spouse, and colleagues (via professional courtesy?) that probably covers a ton of cases.
This rarely exists anymore. Most physicians are employees just like the front desk lady and have no say in the business side of things. Also, physician fees are less than 10% of all healthcare dollars. The (non-physician) facility fees are where your largest bills will be.

randomguy
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Re: Ok to go without health insurance?

Post by randomguy » Sat Oct 26, 2019 6:14 pm

Luckywon wrote:
Sat Oct 26, 2019 4:10 pm
randomguy wrote:
Sat Oct 26, 2019 4:03 pm
What you need to do is find 100 people to form a pool and each chip in 5k/year to cover the 1% of the people that do get hit with the poor results over time.:) It would be interesting to see what health insurance plan with say a 50 or 100k deductible looked like if they were allowed.

And yes these are obviously are ways to try and become a free rider n the health care system by find loopholes.
Such a plan would not have the major advantage that health insurance companies have in getting heavily discounted rates from contracted providers. The strategy of assuming that an individual or group of indviduals can negotiate similar discounts from a diverse group of providers after receiving services will probably fall very short.
Well then your group gets together to form a network and neogiate prices.:)

But lets assume you can't do that. What is better:
a) Giving up the insurance discount
b) having to pay to subsidize the people with 100k/year of health care expenses

I am guessing A wins out. See the health sharing ministries for examples of this where by eliminating expensive people, you can lower costs.

Again this only works out because for a large class of outcomes, you are able to buy insurance afterwards. If you develop a conditions that costs 100k/year to treat, you sign up for that 16k/year health insurance ASAP.

TDAlmighty
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Re: Ok to go without health insurance?

Post by TDAlmighty » Sun Oct 27, 2019 12:18 pm

On a similar note: How is the risk the OP is considering different than being on Medicare and traveling abroad? Medicare does not cover your medical costs outside the US. Sure you can buy travel medical insurance, but how do you know that the facility/doctor is contracted with your travel insurance? What happens if you exceed the cap on the travel medical insurance?

MichCPA
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Re: Ok to go without health insurance?

Post by MichCPA » Mon Oct 28, 2019 2:28 pm

dual wrote:
Sat Oct 26, 2019 1:23 pm
MichCPA wrote:
Thu Oct 24, 2019 7:59 pm
dual wrote:
Thu Oct 24, 2019 5:03 pm
MichCPA wrote:
Thu Oct 24, 2019 3:21 pm

Odds that you will get through bankruptcy with the mid 7 figure NW intact are appox 0%. Odds that mid 7 figure NW will still be mid 7 figure after 16k insurance are 100%.
Odds that OP's NW will still be mid 7 figures after 16K*10 = 160K annual premium are also 100%. Should he pay the 10X premium?
No, because he just told me it cost 16k.

Nice appeal to extremes there.
Nice no justification for paying current rate there.
My justification is that the cost is small in the grand scheme of things. 16k is probably (much) less than 10% of two doctors income. 160k could be 30-50% depending on the area and specialty. Are you still convinced you original solution of declaring bankruptcy is an option?

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goodenyou
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Re: Ok to go without health insurance?

Post by goodenyou » Mon Oct 28, 2019 11:03 pm

Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
"Ignorance more frequently begets confidence than does knowledge" | Do you know how to make a rain dance work? Dance until it rains.

toofache32
Posts: 1863
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Re: Ok to go without health insurance?

Post by toofache32 » Mon Oct 28, 2019 11:28 pm

goodenyou wrote:
Mon Oct 28, 2019 11:03 pm
Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.

retired@50
Posts: 614
Joined: Tue Oct 01, 2019 2:36 pm

Re: Ok to go without health insurance?

Post by retired@50 » Mon Oct 28, 2019 11:32 pm

DonIce wrote:
Tue Oct 22, 2019 12:03 pm
DiehardDoc wrote:
Tue Oct 22, 2019 11:59 am
We started with premiums of $250 per month approximately 9 years ago. Each year insurance company states so and so among your group has reached certain age and therefore premium is 12-15 % higher. When is this going to stop?
Never. It will only ever keep going up.
My ACA premium went down for 2020 (by 1.2%) for the first time since I joined the ACA circus back in 2013. Regards,

Lee_WSP
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Re: Ok to go without health insurance?

Post by Lee_WSP » Mon Oct 28, 2019 11:37 pm

toofache32 wrote:
Mon Oct 28, 2019 11:28 pm
goodenyou wrote:
Mon Oct 28, 2019 11:03 pm
Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.
Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.

delamer
Posts: 9280
Joined: Tue Feb 08, 2011 6:13 pm

Re: Ok to go without health insurance?

Post by delamer » Tue Oct 29, 2019 12:46 pm

Lee_WSP wrote:
Mon Oct 28, 2019 11:37 pm
toofache32 wrote:
Mon Oct 28, 2019 11:28 pm
goodenyou wrote:
Mon Oct 28, 2019 11:03 pm
Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.
Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.
One of which needs to be the lost income due to a serious illness — not just for the patient but for the spouse.

Does short-term disability kick in if your spouse is ill and you need to take time off from work?

Lee_WSP
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Location: Arizona

Re: Ok to go without health insurance?

Post by Lee_WSP » Tue Oct 29, 2019 12:52 pm

delamer wrote:
Tue Oct 29, 2019 12:46 pm
Lee_WSP wrote:
Mon Oct 28, 2019 11:37 pm
toofache32 wrote:
Mon Oct 28, 2019 11:28 pm
goodenyou wrote:
Mon Oct 28, 2019 11:03 pm
Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.
Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.
One of which needs to be the lost income due to a serious illness — not just for the patient but for the spouse.

Does short-term disability kick in if your spouse is ill and you need to take time off from work?
I would be extremely surprised if there was a policy for that. Imagine the abuses...

delamer
Posts: 9280
Joined: Tue Feb 08, 2011 6:13 pm

Re: Ok to go without health insurance?

Post by delamer » Tue Oct 29, 2019 12:57 pm

Lee_WSP wrote:
Tue Oct 29, 2019 12:52 pm
delamer wrote:
Tue Oct 29, 2019 12:46 pm
Lee_WSP wrote:
Mon Oct 28, 2019 11:37 pm
toofache32 wrote:
Mon Oct 28, 2019 11:28 pm
goodenyou wrote:
Mon Oct 28, 2019 11:03 pm
Try showing up at a place like MD Anderson with cancer or even worse, one of your kids with a cancer, without insurance. There will be nothing left of your fortune in a flash.
I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.
Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.
One of which needs to be the lost income due to a serious illness — not just for the patient but for the spouse.

Does short-term disability kick in if your spouse is ill and you need to take time off from work?
I would be extremely surprised if there was a policy for that. Imagine the abuses...
Right. I was being a bit sarcastic.

My overriding point is that if one partner in a couple where both are self-employed becomes seriously ill, there is going to an income hit for both spouses not just the one who is ill. Of course, even if the spouse has a traditional job working for a company/government, there may be some income loss.

Lee_WSP
Posts: 1205
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Location: Arizona

Re: Ok to go without health insurance?

Post by Lee_WSP » Tue Oct 29, 2019 1:26 pm

delamer wrote:
Tue Oct 29, 2019 12:57 pm
Lee_WSP wrote:
Tue Oct 29, 2019 12:52 pm
delamer wrote:
Tue Oct 29, 2019 12:46 pm
Lee_WSP wrote:
Mon Oct 28, 2019 11:37 pm
toofache32 wrote:
Mon Oct 28, 2019 11:28 pm


I was thinking similar. About once every couple months I see a patient with no insurance and was healthy but now has a cancer diagnosis. They need a major 8 hour surgery with a microvascular flap in the hospital with 3 days in the ICU and 10 days total in the hospital. I don't own the hospital and cannot force the hospital to allow the surgery. I can't force the hospital staff and nurses to work for free. Sadly, I have seen several patients go on to die of their disease. While I am not a friend of insurance companies, merely having insurance allows you to at least proceed with treatment.
Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.
One of which needs to be the lost income due to a serious illness — not just for the patient but for the spouse.

Does short-term disability kick in if your spouse is ill and you need to take time off from work?
I would be extremely surprised if there was a policy for that. Imagine the abuses...
Right. I was being a bit sarcastic.

My overriding point is that if one partner in a couple where both are self-employed becomes seriously ill, there is going to an income hit for both spouses not just the one who is ill. Of course, even if the spouse has a traditional job working for a company/government, there may be some income loss.
So, you're saying that OP should also take this cost into consideration in his cost/benefit analysis?

deltaneutral83
Posts: 1336
Joined: Tue Mar 07, 2017 4:25 pm

Re: Ok to go without health insurance?

Post by deltaneutral83 » Tue Oct 29, 2019 1:32 pm

This is the most entertaining thread I've read in a while. I've heard of car accidents with injuries and bad burns that required well into the 7 figures over several years of healthcare. OP, you really trust other broke/"insurance-less" drivers with your 7 figure net worth? There are endless possibilities of healthcare requiring millions, simply endless. Good Luck.

delamer
Posts: 9280
Joined: Tue Feb 08, 2011 6:13 pm

Re: Ok to go without health insurance?

Post by delamer » Tue Oct 29, 2019 1:33 pm

Lee_WSP wrote:
Tue Oct 29, 2019 1:26 pm
delamer wrote:
Tue Oct 29, 2019 12:57 pm
Lee_WSP wrote:
Tue Oct 29, 2019 12:52 pm
delamer wrote:
Tue Oct 29, 2019 12:46 pm
Lee_WSP wrote:
Mon Oct 28, 2019 11:37 pm


Yes, except in this particular case, OP can get a group plan in a matter of months. And OP does technically have the means to pay for any emergency surgeries if need be. So, in this particular case, it really is all about the numbers.
One of which needs to be the lost income due to a serious illness — not just for the patient but for the spouse.

Does short-term disability kick in if your spouse is ill and you need to take time off from work?
I would be extremely surprised if there was a policy for that. Imagine the abuses...
Right. I was being a bit sarcastic.

My overriding point is that if one partner in a couple where both are self-employed becomes seriously ill, there is going to an income hit for both spouses not just the one who is ill. Of course, even if the spouse has a traditional job working for a company/government, there may be some income loss.
So, you're saying that OP should also take this cost into consideration in his cost/benefit analysis?
It’s a difficult cost to quantify. But yes. Maybe assume that they’ll be a loss of 2 months of household income?

SunDevil
Posts: 85
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Re: Ok to go without health insurance?

Post by SunDevil » Tue Oct 29, 2019 8:24 pm

If self-employed without the option of health insurance from an employer, then wouldn’t premiums be an above the line deduction? I am self-employed and choose higher premiums/lower deductibles for the huge tax deduction on premiums.

User avatar
MP123
Posts: 1080
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Re: Ok to go without health insurance?

Post by MP123 » Tue Oct 29, 2019 8:40 pm

SunDevil wrote:
Tue Oct 29, 2019 8:24 pm
If self-employed without the option of health insurance from an employer, then wouldn’t premiums be an above the line deduction? I am self-employed and choose higher premiums/lower deductibles for the huge tax deduction on premiums.
Yes.

And consider getting an insurance plan that's HSA compliant and make contributions to it, then you can deduct those as well.

gd
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Location: MA, USA

Re: Ok to go without health insurance?

Post by gd » Wed Oct 30, 2019 7:50 am

There have been a few replies claiming that non-insured medical billings can be lower than the pre-negotiated rates I see on my insurance company's explanation of benefits forms. I have never heard this before. No offense to the anonymous posters, I appreciate the tip, but can anyone point me to any more substantiation of this?

skp
Posts: 56
Joined: Tue May 01, 2018 8:12 am

Re: Ok to go without health insurance?

Post by skp » Wed Oct 30, 2019 8:25 am

I can substantiate costs being lower. My husband was being worked up for an elevated PSA. He needed a prostate MRI which could only be done in a facility 45 minutes from our home. Sounds like it is newer technology and not every hospital is capable of doing it. We were told it would be $200 without insurance and $1200 with. It sounded to me like the NP was encouraging us to say we didn't have insurance and since I have a HDHP with a HSA and a deductible of $4,500, I was reluctant to do it. I thought the money came from some "donation pool" or something, and didn't want to take money from people who needed it. I most especially felt uncomfortable lying about having insurance. So we went the insurance route. Interestingly we ended up paying $700 - up front and I don't know how much after. I think- zero. Why don't I know?. The bill I received doesn't have anything but a date and a charge. You have to guess what you are paying for. Do they do this on purpose so people can see if they are being overbilled, double charged?? When I called the business office and complained, I was told that that's their SOP- you have to call and request EVERY TIME you get a bill if you want a line item description of what you are paying for.
Funny thing, I opened up my E mails from the hospital recently and got an E mail stating that our hospital is now offering this very MRI, and that it is $200 walk in. It sounded like they were encouraging people to bypass the insurance company and just pay the $200.
We have been healthy, and never needed to use our insurance until recently. I really feel for people who get a bill and then don't even know what they are paying for, who have to deal with not upfront pricing. It's like dealing with a used car dealer, except you expect that experience to be that way.

flyingaway
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Re: Ok to go without health insurance?

Post by flyingaway » Wed Oct 30, 2019 8:30 am

Because you are doctors. Assume that you can fix any medical problems on yourself.
Yes. You don't need health insurance.

dknightd
Posts: 1860
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Re: Ok to go without health insurance?

Post by dknightd » Wed Oct 30, 2019 8:59 am

I guess it is OK to go without health insurance. That is not the decision I would make. I prefer to pay for health insurance even though it is expensive. But you are free to make your own decision.
By its very nature insurance is a money loosing proposition for most people. But if you are one of the unlucky ones having insurance could be a very good thing. Insurance spreads out the risk. And yes provides a profit for the insurance company.

You could instead use the money you would have paid to a health insurance company to buy lottery tickets. How lucky do you feel? I'd rather win the state lottery, than the health insurance lottery. Perhaps my decision to buy health insurance instead of lottery tickets is a bad one ... ?

If it ends up I'm one of the lucky ones that looses money on health insurance I'm OK with that. I think it is almost my social responsibility to contribute to the funds that might help my neighbor in a time of need. Perhaps instead of buying insurance, I could buy shares in an insurance company, but that would rub me the wrong way.

I'm curious what you decide to do. There is no right or wrong decision. Do what feels right to you.

EnjoyIt
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Re: Ok to go without health insurance?

Post by EnjoyIt » Wed Oct 30, 2019 9:41 am

dknightd wrote:
Wed Oct 30, 2019 8:59 am
.....

If it ends up I'm one of the lucky ones that looses money on health insurance I'm OK with that. I think it is almost my social responsibility to contribute to the funds that might help my neighbor in a time of need. Perhaps instead of buying insurance, I could buy shares in an insurance company, but that would rub me the wrong way.

I'm curious what you decide to do. There is no right or wrong decision. Do what feels right to you.
That's the problem, you buying insurance is mostly used to pay for the profits and salaries of the insurance industry. The whole thing is a bit of a scam. Most of the time insurance today is like a third party bookie taking their cut, and rarely they act as a catastrophic insurance plan.

I pay for it also, but many times have contemplated going the route of OP.

michaeljc70
Posts: 5782
Joined: Thu Oct 15, 2015 3:53 pm

Re: Ok to go without health insurance?

Post by michaeljc70 » Wed Oct 30, 2019 10:01 am

simplesimon wrote:
Tue Oct 22, 2019 11:29 am
gr7070 wrote:
Tue Oct 22, 2019 11:24 am
Do not most health insurance policies have a maximum lifetime payout? So aren't we all self-insuring for any amount over, say, the $1M max limit?
No, the Affordable Care Act did away with lifetime maximums. Does that change your answer?

OP, if you really can get health insurance on short notice mid-year, then it's not really a question of if you're going without health insurance. What do you perceive as the risk of your plan then?
How do you go out and get insurance when you get hit by a drunk driver and are in the back of an ambulance unconscious?

dknightd
Posts: 1860
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Re: Ok to go without health insurance?

Post by dknightd » Wed Oct 30, 2019 10:33 am

EnjoyIt wrote:
Wed Oct 30, 2019 9:41 am


That's the problem, you buying insurance is mostly used to pay for the profits and salaries of the insurance industry. The whole thing is a bit of a scam. Most of the time insurance today is like a third party bookie taking their cut, and rarely they act as a catastrophic insurance plan.

I pay for it also, but many times have contemplated going the route of OP.
But the insurance company, and employees, and stock holders, also pay taxes. I think. I could be wrong. Likely (hopefully) they have health insurance. It could be they are self insured, and use our premiums to pay for it. So not like a street corner bookie.

I've always had health insurance. For me it is part of the cost of being alive. Food, water, shelter, health care when needed.

The ironic thing for me is the OP is a medical professional. Likely most of their income comes from insurance companies, or premium payers. But they are considering not paying for health insurance. Maybe their practice is in optional medicine. That would make more sense to me. Why pay for insurance for something that is optional?

michaeljc70
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Re: Ok to go without health insurance?

Post by michaeljc70 » Wed Oct 30, 2019 10:45 am

EnjoyIt wrote:
Wed Oct 30, 2019 9:41 am
dknightd wrote:
Wed Oct 30, 2019 8:59 am
.....

If it ends up I'm one of the lucky ones that looses money on health insurance I'm OK with that. I think it is almost my social responsibility to contribute to the funds that might help my neighbor in a time of need. Perhaps instead of buying insurance, I could buy shares in an insurance company, but that would rub me the wrong way.

I'm curious what you decide to do. There is no right or wrong decision. Do what feels right to you.
That's the problem, you buying insurance is mostly used to pay for the profits and salaries of the insurance industry. The whole thing is a bit of a scam. Most of the time insurance today is like a third party bookie taking their cut, and rarely they act as a catastrophic insurance plan.

I pay for it also, but many times have contemplated going the route of OP.
That is not correct. The ACA requires most insurers to pay at least 80% of their premiums on health care claims and quality improvement, leaving 20% for administration, marketing, and profit. For the large group market it is a minimum 85% medical loss ratio. Are people in the insurance industry supposed to work for free? Are people investing in insurance companies supposed to do so without getting any return?

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