What are you trying to do? Debian is pretty solid but you also could go with Rocky Linux or tons of others. Heck, you could even buy a Red hat license if you felt like it for some reason.
Ubuntu and Mint condition that affects your digestive tract and the other day I trust that this was the one I sent her an hour and there was an instant hot to handle this is the best for me.
Host family media through Jellyfin, etc. This would include tv, music, and possibly books as well. Many of these will be managed through the Arr apps.
Degoogle my phone - I’m beginning by replacing Photos with Immich, but hope to also use Home Assistant, backup other phone data such as messages media, shopping lists, etc. I hope to replace Google storage/backup with Proton Drive.
Seems like a solid plan. I used Nextcloud as a Google Drive/Photos/Calander/Lists replacement, but depending on what you are running as your server it may be a bit too heavy.
I’ve heard that once you get into it, Linux distros like Ubuntu are not very user friendly for self-hosting as a beginner.
Not sure who is saying this. Granted, if your not used to *nix, our ways of doing things can be a bit obtuse from time to time but the Ubuntu based distros are some of the most heavily documented distros available with only Arch being better documented (Don’t use Arch unless you’ve got stock in Bayer. /joking, kinda).
Your current OS choice is maybe not what I would choose, but it is fine. Xubuntu just Ubuntu Server with the XFCE desktop installed. A bit heavy for a server install as a result. One thing I will say is that most server software is setup via the command line and setup via configuration files (These are just regular text files readable by any text editor. I like micro, but anything will work). The desktop environment is just extra weight you don’t really need in this application. Doesn’t hurt anything, just heavy and not really needed.
So is it better on the whole for a beginner to have a popular distro with lots if documentation and step by step guides, or to have a purpose-built OS like TrueNAS that might be more straightforward, but with less support?
Stick with what you have. Ubuntu is a very well supported server distro, and the XFCE desktop doesn’t change that. Things like TrueNAS, UnRAID, and whatever is the flavor of the week tend to cover things up to simplify things. This is fine when they work correctly, the problem comes when things inevitably break. You won’t know where to go looking to fix things. Also TrueNAS is a network storage OS, not really suited for what you are trying to do currently, which seems to be hosting services.
It seems to be working well, but I’ve had a few hiccups trying to update it,
What hiccups were you running into? And were you using the GUI tool or apt on the command line?
Call yourself whatever you want, at the end of the day we’re all utopianists who’re overly self-assured that our favorite pet-theory-system will eventually remove all suffering.
“If my vision for society were adopted, the world would be perfect!”
Long answer: They won’t cover anything until you’ve met your deductible. Once you’ve paid out $1,500 (your deductible), they will start covering 50% of the remaining cost.
Depending which version of the MacPro you have exactly, that machine from 2010 is around the speed, or slightly faster, than a Raspberry Pi 5 with 8 GBs of RAM these days. The problem is the energy consumption, not really a green machine to run.
your scenario is either worded incorrectly or very atypical (which is very possible, there are a lot of different insurance plans in the us
typically high deductible plans work in a way of “meet your deductible and then we cover x% after that”
eg I am a therapist, I bill your insurance $100 for an hour session. You have a $1000 deductible with 80% coinsurance.
Our first 10 sessions will cost you $100 out of pocket, which goes to me directly. I submit billing for these sessions but get no reimbursement from the insurer because you have already paid the full amount. However, my submission of billing indicates to the insurer that you paid $100 for a medical service on whatever date for whatever diagnosis.
After the $1000 deductible is met your insurance splits the bill with you 80/20. Now you pay me $20 per meeting and when I submit the billing the insurance (hopefully) pays the other $80 to give me the $100 per meeting I am owed.
This of course assumes no other medical spending goes on for the duration, otherwise you would hit your deductible faster. If you saw me 3x and then had a surgery that cost $5,000, you’d pay $700 for the surgery to settle your deductible plus an additional $860 (20% of the remaining $4300) and then sessions would be $20 under the 20% coinsurance.
You should also have an out of pocket max, this is kind of similar to a deductible but it is different. This is a tally of your total spending and once you hit it your coinsurance usually drops and you pay nothing.
Also important point is that deductibles reset every plan year. This should have been made abundantly clear to you but I still encounter many who do not know this
Additionally your insurance may have certain services covered that don’t cost you anything or where the deductible doesn’t apply (eg you’d only pay 20% even if it’s the first appointment of the year). Typically this is preventative care, things like physicals and vaccinations
That is the most typical. But like I said it there are many plans and variations. It’s possible you have a plan that prior to meeting the deductible you pay 50% of billing and then have a 0% coinsurance. This would be really great insurance.
It’s also possible that you have a benefits package from your employer that is basically paying 50% of your deductible in a roundabout way. this is far more commonly done by the employer funding an hsa/fsa account which would be a payment card that you use on medical spending and not the insurer. However, I have encountered plans where the hsa and insurance were rolled together and joint companies, where the hsa would pay all or part of billing prior to deductible on the patients behalf
Using the same examples above you’d pay me $50 until you met your deductible, then nothing once the deductible is met. If you had a $1000 deductible, saw me twice, then had the 5k surgery you’d pay me $100 and $900 for the surgery. If you have one of the situations where the employer is covering 50% of the deductible it would be the same but the surgery would be $400 because ultimately you’re only paying $500 of the $1000 deductible and your employer is covering the other half. This is not a situation I’ve ever encountered
Another important point is that deductible status is dependent on your providers doing timely billing and your insurance processing said billing in a timely manner as well. This does not always happen. As a result you may meet your deductible but my billing verification shows that is not the case. The examples I used above were clean and easy but it’s never that simple. Most people have a deductible around $2500 (and many 2-4x this) and see several different healthcare services.
I submit my billing at the end of each day but some places are sloppy and will take weeks to submit. This can lead to situations where you are charged money because I was under the impression you had a deductible but you should not have been. Eventually the insurer will pay me once things sort out. If I am good at record keeping (I am great at it for this reason) I will catch the double payment and send you a refund. This is why it is important for you to keep track of deductibles and medical spending. Not all offices are managed well. I’ve personally had money stolen from me (because this is literally fraud, to not refund the double payment) and I don’t believe it was ever intentional, just offices with shitty management. Let your providers know if you’ve met your deductible. I will always hold off on charging you if you tell me this, submit billing, and see what the insurance reimburses. If they reimburse me in full then you were right. If they don’t I send you a bill and if that is incorrect you need to call your insurance to complain
You should be able to track deductible and out of pocket spending on your insurances consumer portal (eg go to Aetna.com or whatever and click “for subscribers” and make an account, if you haven’t already). This should also give you an explanation of plan details.
Most importantly you should be able to call the office of the place (or billing dept if it’s a larger health network) doing the procedure to have their office manager check what you will be expected to pay for the procedure both at time of service and expected cost total. This takes only a minute but be forewarned it is essentially an estimate and not a guarantee. Billing can change last minute depending on how the procedure goes (eg added complexity allowing them to add another cpt code for something)
There’s a lot more to it than this unfortunately. Some plans have tiered deductibles, sometimes a staff member in a hospital isn’t personally enrolled and then are considered “out of network”, which is a whole other thing, sometimes you are still responsible for a certain services that the provider requires but the insurance refuses to pay. That last point especially: every time you establish with a medical office or get a procedure you sign something that says you are financially responsible for services not covered by insurance (I guarantee this, every time). So if you get bloodwork with like 30 tests and 2 aren’t covered even if you’ve met your out of pocket max and have the best insurance in the world you’re getting a bill (and potentially a hefty one, some blood tests are extremely expensive)
Sorry this is very long and complex but that is kind of how insurance is? To boil it down to a “eli5” 2-3 sentence explanation would either require your specific plan information in much more detail or to overgeneralize and potentially mislead you.
Before we can commence with therapy relating to your suspected anxiety, adhd and trauma relating to people consistently extracting large amounts of time and money from you whilst making complicated, conditional, arbitrarily changing promises (involving the complicated, conditional, arbitrarily changing views of multiple third parties you do not personally know) to repay you in some way, which they never do…
… please allow me to trigger all of your suspected conditions as thoroughly as possible in the name of ethical transparency and consent before we can proceed.
Don’t worry this will only take 15 minutes to explain adequately if you’re in a good headspace.
…
Subject appears irrationally angry and violent for no discernible reason, suspicion of psychosis.
one of the most frustrating aspects of being a therapist in america in the past 10 years is the hand waving of the ethics involved in the financial renumeration of our relationship with those we serve
I would say a significant stressor for the overwhelming majority of the clients I have is financial woes. And because the system is backwards, those with high paying jobs well into their career tend to have the fancy PPO plans with no deductible where seeing me (or anyone) is only $10 despite the fact that they could much more easily afford a 5-10k deductible. Meanwhile the people who are making 20-50k a year on the other end of the spectrum almost always have those high deductible plans with sometimes massive deductibles and rarely have employer funded hsa.
I’m not an idiot, I run my own practice and I do the books for it. I can do the math to figure out how much take home pay someone has with those salaries. I can also conceptualize the cost of housing, food, phone, transportation, etc because I am also paying these things. So when I meet someone here and their appointments are $140 per meeting I am in a tough spot. I am asking them to take on a burden of $560 per month (assuming weekly sessions). That’s immense. And if the deductible is 5k, 7.5k, 10k, it will take ages to meet especially if they’re younger and not really making contact with many other medical providers.
I am contractually obligated to charge what your insurance pays me in these instances. If your insurance pays me $140 for the hour I have to charge you that until you hit the deductible. I could be dropped from the network if I modify this for you and get caught.
I can ask you to skip using your insurance and charge a lower out of pocket rate but this is complex. For one, many therapists can’t adjust their rate much lower. I have flexibility here because my practice is entirely telehealth so my overheads are much lower. But if you see them in an office? They are paying about 40-50% of that just in rent most places.
Additionally even with telehealth I have to be careful with adjusting rates. Insurance only pays me for specific timed and coded sessions. If you and I have a phone call for 25 minutes? Not covered. If you ask me to collaborate with your psychiatrist and I talk to them for 40 minutes? Not covered. The time I spend dealing with billing and this system, which works out to an average of 20-30 minutes per session? Not covered. So the 25% of my week doing billing shit and the overtime hours doing phone check ins, case collabs, etc. has to be covered by that.
This is why many therapists give fee schedules and charge you for all of these things. If you want paperwork from them it’s $1 a page, phone calls are $75/hr, etc. I can make it work without this because I’m not paying for office space but if I was I would need to do this to keep myself afloat.
This is also part of why many, many therapists simply don’t take insurance anymore. Just pay me the $140 directly. I can collect it via square or whatever and your billing is done. I no longer spend 5-10 hours a week on billing nonsense like fighting retracted payments, finding out why claims were denied, etc. You can submit receipts for out of network reimbursement and you deal with them.
I understand why my peers do what they do. But ethically it’s a mess. I signed up to help people and what I have become is a gigantic cash sink that puts a tremendous amount of pressure on the people I serve and is counterproductive to our work.
At the same time I deserve a fair salary for my work and this is the only way to get it. And if I protest the system by leaving it because it’s so broken then the end result is that there’s 1 less mental health provider who takes insurance. If I stop taking insurance altogether I alienate a ton of people with high need who can’t afford to pay out of pocket forever and/or don’t know how to navigate out of network reimbursement.
I cannot tell you how many times I do a screening call with someone and they say “this sounds like what I need”, they tentatively schedule, and then once I run their insurance and give them the actual numbers of what treatment will cost they simply ghost. It is a system that actively deters people from seeking assistance because it is so cost prohibitive
And the insurance lobby has its fingers so deep into the framework of america that this will simply never be fixed. It will only be changed. Look at Kamala Harris’ proposed Medicare for all: it still allows private plans. That will be a movement in the right direction because it will end the idea of someone being “uninsured”, which is great, but it will also create a two lane system in which many practitioners will do whatever they can to avoid taking basic Medicare patients in favor of the commercial plans. Commercial plans, at least in my area, simply pay more. Significantly more. Like $80/hr vs $140/hr. And in the end I will have the same problems because the unnecessarily complex private insurance system will still exist and be very powerful. I will just have one more insurer to add to the web of complexity. But no politician will ever remove the private health insurance industry. To do so would alleviate so much spending waste, so many wasted administrative dollars and man hours, but it would also result in layoffs of hundreds of thousands, if not millions, of americans whose jobs rely on processing the complex bullshit of this system
My ex-girlfriend used to break oatmeal cookies over my bare chest and would vacuum it up with a Bissell handheld vacuum. She’d call me her oatmeal boy and make me empty the vacuum after we were done.
She got out of prison last year and tried to crash at my place. Haven’t heard from her since.
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