Do you have health insurance?

[Mizzou B-ball fan]

I'm just curious what everyone's health insurance standing is on the board. If you don't have health insurance, please post your reason/predicament if you don't mind disclosing it.

[Cringer]

Yes, and it's a private policy so I pay out the ass for it. Don't want it, but the wife won't let me get rid of it. That money could really be used for so much more, or even saved which would be nice as well.

[larrymcg421]

I'm lucky to work for a company that has a really good health plan, although costs go up and deductibles continue to get higher.

If I didn't have insurance, I'd be $10,000 in debt right now or would be walking with a limp.

[gstelmack]

The "No" choice should be 2: I don't want it vs I can't get it.

[Danny]

I have emergency insurance basically. Very high deductible, only have in case of something really expensive happening. Hopefully I can go the next two years without needing to go the doctor

[PackerFanatic]

Not nearly as good as my last job, but happy I have it.

[lighthousekeeper]

The "No" choice should be 2: I don't want it vs I can't get it.

other than for certain religious reasons, what is the difference?

[Farrah Whitworth-Rahn]

My employer provides health insurance - the head of the family I work for is a former Chair of the Mayo Clinic Board of Trustees. Providing quality health care for his employees is very important to him. My premiums are $800 a year with the Mayo Clinic as an in network primary care provider.

[RomaGoth]

I have health insurance for a family of 6 and it was effective my first day of work. Also includes vision and dental, which take effect after 90 days. Very low deductible of $250 ($500 out of network) and cheap co-pay of $15 ($20 out of network).

I went without any coverage for the previous 9 months after I quit my last job and stayed home with the kids. My wife had coverage just for herself that was $120/month.

I am lucky to have good coverage, and I know what it is like on both ends of the health insurance scale.

[clemsonfan]

We have insurance and it's insanely expensive.

[gstelmack]

other than for certain religious reasons, what is the difference?

There are people who feel they are healthy and do not want to spend the money on insurance and don't want to be forced to. Those folks get lumped in with the "OMG so many people do not have access to health insurance!" statistics.

[DanGarion]

There are people who feel they are healthy and do not want to spend the money on insurance and don't want to be forced to. Those folks get lumped in with the "OMG so many people do not have access to health insurance!" statistics.

What would those people do if they actually end up not being healthy?

[molson]

What would those people do if they actually end up not being healthy?

What an individual person saves in health insurance over a year or two can cover pretty much any minor issue that comes up. I went without insurance for three years in school, and had to see a doctor a few times - I definitely came out ahead.

For major issues - you try to make payment arrangements or declare bankrupcy. It's a gamble. It's like someone giving you $10,000 and with it, a 0.25% risk you'll be ruined financially forever. A lot of people will take that deal.

You also might figure that if you're injured, odds are it will be in a car accident, and you can get that kind of coverage on your car insurance. That definitely narrows the risk.

I also knew a couple of law students that managed to get their hospital debt forgiven for things like broken arms. Just by communicating with the hospital. I'm not sure exactly how that works, but a quick internet search tells me that this is possible.

[RainMaker]

I was on a private plan when I started my own business with someone but I had heard they could drop you at the renewal rate. Scared me that I'd come down with cancer or something and get dropped. Moved to a group health insurance for our company which is a bit pricey but worth it for the peace of mind.

[JPhillips]

I need a sort of option. My new job left a short gap of coverage where I currently don't have insurance. However, the window is small enough that if something happened I could backpay COBRA and have coverage. Basically I'm not spending 1500 unless I have to.

[DanGarion]

What an individual person saves in health insurance over a year or two can cover pretty much any minor issue that comes up. I went without insurance for three years in school, and had to see a doctor a few times - I definitely came out ahead.

For major issues - you try to make payment arrangements or declare bankrupcy. It's a gamble. It's like someone giving you $10,000 and with it, a 0.25% risk you'll be ruined financially forever. A lot of people will take that deal.

You also might figure that if you're injured, odds are it will be in a car accident, and you can get that kind of coverage on your car insurance. That definitely narrows the risk.

I also knew a couple of law students that managed to get their hospital debt forgiven for things like broken arms. Just by communicating with the hospital. I'm not sure exactly how that works, but a quick internet search tells me that this is possible.
I'm all with the saving money part, but this is the USA where when people say they are going to save what they aren't spending, they usually end up not actually doing it.

As for the second part about the payment plans or bankruptcy. If someone plans with bankruptcy as an option they are doing things wrong. It's a cop out that then everyone else has to pay for... Not saying bankruptcy is wrong per say, just saying that people shouldn't be looking as it being an option from the start. It's this type of mentality that helped bring the economy to the point it is now.

[RainMaker]

I need a sort of option. My new job left a short gap of coverage where I currently don't have insurance. However, the window is small enough that if something happened I could backpay COBRA and have coverage. Basically I'm not spending 1500 unless I have to.
Health Insurance, Medical Insurance, Individual Health Insurance Quotes (http://www.ehealthinsurance.com/)

Look for the short term health insurance option. The coverage isn't great and you'll have to pay a little bit for anything minor that happens. But it covers the major stuff which is important and is a cheap stop-gap between policies. I used one for 2 months when I quit my job.

[Tigercat]

I am currently working part time while searching for a more appropriate permanent job. (Or ideally an opening in my chosen profession, but that may not happen for a year or two.)

Can't afford to pay off bills and student loans AND have have insurance on such low income. Luckily I am perhaps the healthiest person I know.

[RainMaker]

I'd still try and get something Tigercat. A slip in the tub or down the stairs can leave you stuck with bills for the next 10+ years.

Have you tried getting a forbearance on your student loan? Usually they give you two 6-month periods over the course of the loan.

[JPhillips]

Health Insurance, Medical Insurance, Individual Health Insurance Quotes (http://www.ehealthinsurance.com/)

Look for the short term health insurance option. The coverage isn't great and you'll have to pay a little bit for anything minor that happens. But it covers the major stuff which is important and is a cheap stop-gap between policies. I used one for 2 months when I quit my job.

I have all my prescriptions and I'd rather pay for a single doctor visit than any insurance. I have 60 days where I'm allowed to pay back premiums and retain COBRA as if I had been paying from the start. Well before that 60 days runs out I'll be covered at my new school.

[Mizzou B-ball fan]

I'd still try and get something Tigercat. A slip in the tub or down the stairs can leave you stuck with bills for the next 10+ years.

Or a frying pan over the head if he's married.

[TCY Junkie]

Insurance is for wussies who don't like to gamble, insurance companies thrive were there is fear. No wonder we our in the situation we are today, no gamblers. When this country was created there weren't talks about health care for all. What a bunch of pansies this country is coming to. I do have insurance but it is because of the sissified way I was raised being in this country. I can't support any full coverage plan for cowards, what would that say about our nation.

[Mizzou B-ball fan]

Insurance is for wussies who don't like to gamble, insurance companies thrive were there is fear. No wonder we our in the situation we are today, no gamblers.

That's because they're all dead.

[Honolulu Blue]

I do have health insurance now, but there have been times where I did not.

I suppose the current debate about insurance is good if we can finally get satisfactory answers to three questions:

1) Should everyone have health insurance?
2) If so, then how much?
3) Who should pay for it?

[Telle]

I work for the state of New York and have excellent health insurance. No deductibles and $10 copays. RendeR gripes about the cost of the premiums ($127 per two-week paycheck for family coverage), but for what we're getting for it I really can't complain.

[Tigercat]

I'd still try and get something Tigercat. A slip in the tub or down the stairs can leave you stuck with bills for the next 10+ years.

Have you tried getting a forbearance on your student loan? Usually they give you two 6-month periods over the course of the loan.

Yea I realize it's risky, even given my level of health. I should have permanent new employment any day now though, so hopefully it's a situation that will soon be rectified.

I seem to be able to set any conditions on the putting off or payment of my loan that I want, I think because my permanent residence was hit by Katrina while in school. (Which in my case seems fair, I was not able to finish my Master's because of the storm.) Even so, I want to at least do the minimum paying each month whenever possible.

[Mizzou B-ball fan]

I do have health insurance now, but there have been times where I did not.

I suppose the current debate about insurance is good if we can finally get satisfactory answers to three questions:

1) Should everyone have health insurance?
2) If so, then how much?
3) Who should pay for it?

For the record, I wasn't looking for a debate as much as just wanting to get a cross-section of the board for info purposes.

[RainMaker]

Yea I realize it's risky, even given my level of health. I should have permanent new employment any day now though, so hopefully it's a situation that will soon be rectified.

I seem to be able to set any conditions on the putting off or payment of my loan that I want, I think because my permanent residence was hit by Katrina while in school. (Which in my case seems fair, I was not able to finish my Master's because of the storm.) Even so, I want to at least do the minimum paying each month whenever possible.
Well the short term plans aren't too bad. I think you can get one for like $60/month. You still have to pay a decent deductible but it at least covers you under something for the major stuff.

I only mention it because my roommate in college graduated and got a job shortly after. He had to wait 90 days for his insurance to begin and tore his ACL and MCL skiing before. Had to pay for the surgery and treatments after. Set him back a lot and fucked up some plans he had for a big wedding.

On your school loans, if they are subsidized like the Stafford loan, you can file for a forbearance and not have to pay interest on it. Also, interest is tax deductible so it's not as huge a hit as it could be.

[Honolulu Blue]

For the record, I wasn't looking for a debate as much as just wanting to get a cross-section of the board for info purposes.

I wasn't talking about this little thread or even the other, bigger thread. I was talking about the bigger discussion in Congress and beyond.

[SackAttack]

Health insurance? What's that?

[RomaGoth]

Insurance is for wussies who don't like to gamble, insurance companies thrive were there is fear. No wonder we our in the situation we are today, no gamblers. When this country was created there weren't talks about health care for all. What a bunch of pansies this country is coming to. I do have insurance but it is because of the sissified way I was raised being in this country. I can't support any full coverage plan for cowards, what would that say about our nation.

You could always leave....

[Arles]

other than for certain religious reasons, what is the difference?
I didn't have health insurance for 2 years. I paid out of pocket to a clinic my final year in college and didn't choose to pay the premium my first year in my job (to save cash - wasn't making much). It was just me, so I wasn't risking anyone else. In retrospect, it was pretty stupid, but I made that choice. I could have paid around $70 a month to get covered in college and $35 a paycheck to have it at my job.

[Lathum]

I have insurance through my wifes company and it is very good.

I read recently that the number one cause of people being in deep debt and declaring bankruptcy is medical bills. IMO health insurance should be a top priority, I can't imagine anything worse then stalling your life before it's begun because of an appendectomy.

I'm not trying to sound critical because I've also been there, but IMO it should be right up there with shelter, food etc... If that means getting rid of cable or your cell phone so be it, but to me it is a necessity no matter how healthy you think you are.

[TCY Junkie]

You could always leave....

You didn't think out what you quoted. I'm a sissy, being one would make me afraid of change.

I believe health is by far the most under appreciated thing by most people, but if you start with health care for all were will it end. I don't like the right to decide to be taken away. The more things government gets involved in the more things they screw up. KISS

[Marc Vaughan]

I've got it through SEGA but it seems to be largely worthless as far as I can tell as we end up paying 25%+ of any bills incurred anyway (and more for dental work) ... I can only presume that its useful for a large one-off expense, but probably not knowing my luck ;)

PS - Are most health care schemes in America like this or have I just got one which is particularly poor for my requirements? (I've a reasonably large family of 5).

[Apathetic Lurker]

I get mine through my wife who gets it for free from her employer. It came in handy during my heart operation and various post-op visits

[Autumn]

We are actually on state insurance, we have a home business and make little enough while taking care of the two kids on top of it that we qualify. If we didn't we'd have to somehow make something like $15,000 more a year to pay for the cheapest plan we have in the state, so the state coverage is a godsend.

[terpkristin]

I've got pretty good insurance through work. The medical coverage is good, anyway, I'm not so thrilled with the prescription coverage. Then again, I do take some fairly hardcore medications that don't have generics, so I pay through the nose for those.

Given how many issues I've had, mostly related to my joints and Ehlers-Danlos Syndrome, I'm very happy that I have it.

/tk

[digamma]

I've got it through SEGA but it seems to be largely worthless as far as I can tell as we end up paying 25%+ of any bills incurred anyway (and more for dental work) ... I can only presume that its useful for a large one-off expense, but probably not knowing my luck ;)

PS - Are most health care schemes in America like this or have I just got one which is particularly poor for my requirements? (I've a reasonably large family of 5).

Well, you are British.

[Lathum]

I've got pretty good insurance through work. The medical coverage is good, anyway, I'm not so thrilled with the prescription coverage. Then again, I do take some fairly hardcore medications that don't have generics, so I pay through the nose for those.

Given how many issues I've had, mostly related to my joints and Ehlers-Danlos Syndrome, I'm very happy that I have it.

/tk

I'm amazed anyone would insure you ;)

[duckman]

I have insurance, but that will be gone once my paychecks run out in August unless I catch onto another teaching job before the school year starts.

[Schmidty]

We have Aetna through Costco (my wife's place of employment), and I've never had a problem with it in 5 years. The only thing we ever have to pay even part of are things like lab stuff, and x-rays. $15 for a doctor visit. Probably pretty standard, but I'm happy we have it.

[lordscarlet]

I've got it through SEGA but it seems to be largely worthless as far as I can tell as we end up paying 25%+ of any bills incurred anyway (and more for dental work) ... I can only presume that its useful for a large one-off expense, but probably not knowing my luck ;)

PS - Are most health care schemes in America like this or have I just got one which is particularly poor for my requirements? (I've a reasonably large family of 5).

I just pay $20 for regular doctor visits. That's the best I can tell you.

[NewIdentity]

I read recently that the number one cause of people being in deep debt and declaring bankruptcy is medical bills. IMO health insurance should be a top priority, I can't imagine anything worse then stalling your life before it's begun because of an appendectomy.

I bet most of those people had insurance, just like everyone else too. Many people have no idea how quickly medical bills can add up for something serious. OR, how almost all insurance companies have a Maximum value they are willing to pay out each year on every policy. Sure your cruising along with an 80/20 insurance copay, but as soon as you hit your limit your screwed.


How many people here know what their maximum limit is?

[Radii]

I've got it through SEGA but it seems to be largely worthless as far as I can tell as we end up paying 25%+ of any bills incurred anyway (and more for dental work) ... I can only presume that its useful for a large one-off expense, but probably not knowing my luck ;)

PS - Are most health care schemes in America like this or have I just got one which is particularly poor for my requirements? (I've a reasonably large family of 5).


Where do you get the 25% number? Does that go for regular office visits as well, or do you have a separate copay for those? Often you'll have an office visit copay(which is what everyone else is referring to here with the $15 or $20 per visit thing), but if you need outside bloodwork, or anything done at a hospital, MRI/CT Scans, or any number of other things, the copay doesn't apply and you're looking at deductible/coinsurance. Normally this is going to be something like a deductible of $2000, followed by a coinsurance of 80% with an out of pocket maximum of $5000(pulling numbers out of the sky here). What that would mean is that you would pay the first $2000 of anything done at a hospital, and then 20% of everything else up to $5000 total spent. Once you've spent $5000 for the year, insurance covers everything from there on out. So if you end up with a $150,000 hospital bill due to an unexpected lengthy hospital stay you still only spend $5000. EDIT: That example is based on my understanding of your standard, average plan that isn't Medicare or Medicaid, they are different animals. There are a lot of other ways things can be done and there's no guarantee anyone's plan works in that fashion necessarily.

Its kinda annoying and complicated, PM me if you are concerned about your specific details though and I can probably help out more(I work for a company whose business is performing and interpreting healthcare eligibility checks, with a few pieces of info I could most likely lay everything out for your specific plan if you wanted the peace of mind).


Dental pretty much sucks universally for anything past routine cleanings every 6 months and I can offer no help there at all ;)

[Radii]

OR, how almost all insurance companies have a Maximum value they are willing to pay out each year on every policy. Sure your cruising along with an 80/20 insurance copay, but as soon as you hit your limit your screwed.

How many people here know what their maximum limit is?

I've never seen a plan with a maximum covered amount on a yearly basis. Are you sure you're not confusing the "out of pocket maximum" which is a yearly amount, but actually works for you, not against you?

Most plans have a "lifetime maximum" which is the maximum amount they'll cover for an individual ever. The smallest number I've ever seen here is $1 million, and I think $5 million is more standard.

I don't know a lot about this from an industry perspective, but I know that my dad had cancer, surgery, chemo/radiation, monthly MRIs/CT Scans, spinal taps, and multiple doctors visits weekly for 2 years while he got through all that. That was about 6 years ago now and he unfortunately has had a myriad of health issues as a result, ER visits occur every 6-8 weeks or so, physical therapy, regular checkups with countless specialists, etcetc. He's been on the same insurance plan through the postal service for 40 years as far as I know(unless they bounced around a few insurances before APWU was formed, I have no clue there), and there has never been any mention/discussion/fear of any coverage being dropped.

[Arles]

I bet most of those people had insurance, just like everyone else too. Many people have no idea how quickly medical bills can add up for something serious. OR, how almost all insurance companies have a Maximum value they are willing to pay out each year on every policy. Sure your cruising along with an 80/20 insurance copay, but as soon as you hit your limit your screwed.


How many people here know what their maximum limit is?
I've been involved with hiring for 4 different companies (ranging from 20 people to 30,000 people) and never seen a plan like that. Your standard PPO (what most companies offer now) has out of pocket limits. The current plan I'm involved with (hardly the best, but typical) has a $500 deductible for out-of-network costs. If you stay in network, the plan pays 90% for surgery and 100% of lab/xray costs. There's a $2,250 cap on out of pocket for network costs in a calender year. If you go out of network, the cost is capped at $4,500.

So, you could go to an out of network doctor for serious surgery, labwork and hospital stay and you won't owe more than $4,500. If you stay in network, the max cost is half that. What you described above is something I've never seen and I think a policy like that would even violate numerous state and federal regulations on coverage.

They only way that could happen is if you were involved in some kind of experimental treatment that isn't covered (which is fairly rare). And, in most cases, hospitals/doctors will give a discount to gain the patient for their own research on things like that (and also because of some of the risks).

[Mizzou B-ball fan]

So, you could go to an out of network doctor for serious surgery, labwork and hospital stay and you won't owe more than $4,500. If you stay in network, the max cost is half that. What you described above is something I've never seen and I think a policy like that would even violate numerous state and federal regulations on coverage.


Yeah, I've been through 4 companies as well and never had a cap higher than $4,000/year.

[JonInMiddleGA]

I've never seen a plan with a maximum covered amount on a yearly basis. Are you sure you're not confusing the "out of pocket maximum" which is a yearly amount, but actually works for you, not against you?

Most plans have a "lifetime maximum" which is the maximum amount they'll cover for an individual ever. The smallest number I've ever seen here is $1 million, and I think $5 million is more standard.

They definitely exist, my father-in-law's private policy was like that. My grandmother's supplemental policy also had a max. annual cap, in addition to a max lifetime cap.

[Marc Vaughan]

Well, you are British.

Hey I'm british I'm happy with my ugly smile - its my wife and kids who get the dental work :D

[Marc Vaughan]

Yeah, I've been through 4 companies as well and never had a cap higher than $4,000/year.

My wife's dental has already ht the 'lifetime' cap I believe and we've only been over here for 2 years (admittedly after having had 3 kids her teeth have needed a bit of work BUT ...).

[Izulde]

Have student insurance that's not great, but discounted in the cost at least, through the University. It's terrible for prescriptions from what I've noticed, but I was still damn glad to have it when my $4,000+ hospital bill when I had food poisoning got reduced to just under $1,000 thanks to the insurance.

[lynchjm24]

There are Middle-Med plans and Mini-Med plans now that are legal in some states. In reality they are pure crap - they have low premiums but the Middle-Med plans cap out at about 100k annual benefits and Mini-Med plans can be as low as 10k.

They are generally offered to groups that otherwise wouldn't have any options like part time employees. I'm not certain if any companies market them to individuals, but probably somewhere they will until state insurance regulators get around to outlawing them in the individual market.

[lynchjm24]

My wife's dental has already ht the 'lifetime' cap I believe and we've only been over here for 2 years (admittedly after having had 3 kids her teeth have needed a bit of work BUT ...).

I don't see many lifetime caps on dental, but almost all plans that aren't in the public sector or a union cap out at 2k or less per year if it's a PPO/Indemnity plan.

Dental plans are still valuable even past the cap because your in network discounted rate is usually about half what you'd pay coming off the street.

[lynchjm24]

In addition:

The laws are different by state. Some require group plans to have unlimited benefits in network but that can be limited out of network. Some can be limited on both. Some can be limited on neither.

I don't think I've seen a group plan that isn't Middle or Mini med have a lifetime max of less then 1 million.