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Wow. California actually has something CHEAPER than the rest of the country? I'm shocked by those numbers, they're amazing. I can't imagine it. :-) I've never seen a private family policy under $500 a month.

So at 1 physical a year for a couple of kids plus yourselves at say $150/visit plus say $500 total in routine labs (cholesterol, thyroid, blood sugar, school drug tests for sports, pap smears, etc.) has amazingly cheap prices for labs for people paying out of pocket, use discount code 12345
that's around $3400 out of pocket for routine stuff plus insurance premiums.

Vaccines at the health department are usually free or a token fee for kids, if you vaccinate.

Dental cleanings and checkups 2x a year for 4 plus one set of xrays each for $100/cleaning and $35/xray is around $940.

So minimum routine out of pocket for medical care is under $4500 for a family of 4. That's still a good chunk of budget, but much better than $12K in just premiums!

Your mileage may vary on individual office visit costs, I'm using Austin, TX and Charlottesville, VA numbers, but even in those two places you can negotiate cash prices and comparison shop.
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