Do you go without health care coverage (US)?

[IceAlisa]

Illegal? Why?

[FiveRinger]

Yeah, but it's supposedly unconstitutional to 'force' people into getting insurance. It's constitutional, apparently, to allow millions of free riders to crash the healthcare system when the worst happens.

My personal opinion is this: Everyone should be given the opportunity to get some kind of affordable health insurance, whether it's employer group, private, or something that the government will help to provide. Something should be available to everyone regardless of your income or employment status. However, if you turn down that option and you become ill, it is then your problem and you should be forced to work it out the best way you can. It's not fair to make someone else's irresponsibility my problem.

We are now both covered under his current union's health insurance plans, which are way better than what my (very very very large and stable major employer) company's health insurance plans are.

Your benefits department determines what services, procedures, and coverages you will have the same way they choose your provider. These corporations and insurance companies work together to deceive us and keep their costs down. Your boss is required to provide benefits and the insurance company provides the least amount possible. It's unfortunate that many people have group coverage and it doesn't pay for anything.

My boyfriend is currently covered under his parents insurance until May 31st (after being laid off in October). He has epilepsy..specfically absence seizures. And its very active--even with meds, he still gets them from time to time. So he really needs insurance. That and he has 5 herniated discs in his back. He's desperately trying to find a job that will have insurance while going through school.

Does his school offer insurance? While I was working on my undergrad, all registered students were required to have health insurance. You had to provide proof or you had to pay for it thru the school. I was employed at the time, so I had coverage, so I don't know about the specifics, but this might be an option?

[BittyBug]

Except it's illegal in many (highly Democratic) states, including NY and I believe NJ.

I would've had to buy a year policy costing about $12,000 to cover a one-month gap in insurance. Um, I'll take my chances.

I have a cousin in New York and I know that he had a catastrophic hospital coverage only policy when he was between jobs. A quick search shows that New York does in fact offer catastrophic coverage, and there is no minimum one-year coverage period - the policy can be canceled with 30 days advance notice, so it's basically a month to month. Maybe this is relatively new. My cousin had his policy about four or five years ago - don't know when you were looking.

[mkats]

My personal opinion is this: Everyone should be given the opportunity to get some kind of affordable health insurance, whether it's employer group, private, or something that the government will help to provide. Something should be available to everyone regardless of your income or employment status. However, if you turn down that option and you become ill, it is then your problem and you should be forced to work it out the best way you can. It's not fair to make someone else's irresponsibility my problem.

I agree with this.

We get a number of patients referred to our practice from various charities and other doctors calling, saying, will you please please please see this guy for free, he really needs it. One such guy showed up with a pleural effusion that had to be tapped, so our doc went ahead and did the (minor) surgery and drained it free of charge. However, he couldn't waive the fee for pathology tests, since he doesn't own the lab. He agreed to call some buddies at the NIH and see if he could pull some strings.

A few days later he found somebody willing to do it, and tried to contact the patient to tell him the good news. The guy emailed him back in response and said "F*ck that! I'm on vacation in Spain."

God people like that tick me off SO much when there are so many people out there who are trying to play by the rules and can't get healthcare coverage.

[IceAlisa]

^^^Hope your practice bills him for everything, full price.

[MacMadame]

My daughter is 24 and still on my insurance (thank you Barack) because her job comes with none.

Same with my 20 year old son. I give thanks to Obama every day that he has medical coverage while he deals with his depression and gets his life in order.

[Aceon6]

If you can afford insurance, the Federal Health Care Reform Act prevents insurers from denying coverage to anyone who has current coverage. BC, Humana told you the wrong thing. Call them back and ask about your rights under FHCR!!! Whoever told you they "can't" sell you a new policy is just plain wrong.

If you look into other insurance, get a "Certificate of Creditable Coverage" from Humana to prove that you had prior insurance.

I am so fortunate to live in Massachusetts where insurance is required. Those who can afford it have a wide choice, and those who cannot get a subsidy to help pay for it. It's almost unheard of to be unexpectedly dropped!!!

[sk9tingfan]

I have a cousin in New York and I know that he had a catastrophic hospital coverage only policy when he was between jobs. A quick search shows that New York does in fact offer catastrophic coverage, and there is no minimum one-year coverage period - the policy can be canceled with 30 days advance notice, so it's basically a month to month. Maybe this is relatively new. My cousin had his policy about four or five years ago - don't know when you were looking.

Some additional information about the availability of catastrophic insurance availbility can be found at: http://www.dfs.ny.gov/website2/hny/english/hnyhdhp.htm

[Cachoo]

If you can afford insurance, the Federal Health Care Reform Act prevents insurers from denying coverage to anyone who has current coverage. BC, Humana told you the wrong thing. Call them back and ask about your rights under FHCR!!! Whoever told you they "can't" sell you a new policy is just plain wrong.

If you look into other insurance, get a "Certificate of Creditable Coverage" from Humana to prove that you had prior insurance.

I am so fortunate to live in Massachusetts where insurance is required. Those who can afford it have a wide choice, and those who cannot get a subsidy to help pay for it. It's almost unheard of to be unexpectedly dropped!!!

Thank you for the info on this and btw I am jealous that you live in Mass. right now.

[PRlady]

God people like that tick me off SO much when there are so many people out there who are trying to play by the rules and can't get healthcare coverage.

My sister-in-law is a PhD in optometry specializing in multiply challenged children. She diagnoses and provides help for kids with autism, Down's, deafness and a range of other conditions. She takes no insurance at all since Massachusetts became so difficult to navigate for non-MDs; the law there is good for patients but for providers it can be so much paperwork that a single-person practice can't make it work.

People ask all the time for reduced rates and sometimes she says yes, she's a very socially aware person. Twice so far in 2012 she's discovered that patients' parents begging for reduced or no fees were in fact quite well-off. I don't blame her for being infuriated.

[Louis]

My experience with being unable to get temporary health coverage in NY was five years ago. My recollection is that the temporary health insurance companies would not cover maternity benefits, or something along those lines, and many "liberal" states like NY, NJ, and MA effectively banned them in response. I believe this was before HDHPs.

At my previous job in NJ, I had a prospective employee who would have had an insurance gap if she left her job to come work for our company, which had a mandatory 30-day waiting period for health insurance. Through our group insurance broker and our own independent research, we could not find any suitable solution for one month of coverage. This was in 2008.

The "Healthy NY" program linked has relatively low income restrictions. It won't work for your average job-changer who needs gap coverage. In my 2007 situation, I would've been denied.

BB, I checked out your link, but the New York State Insurance Department's web site is down at the moment. I'm curious about these three catastrophic plans that are recognized, as this is news to me.

[BaileyCatts]

Is it true that if you are ever denied coverage, or apply and then are denied during wait time based on application, you cannot ever get health insurance again due to being denied? I was reading an article and closed it by mistake and now can't find it again. Maybe I read it wrong but I was only on about page 2 of a 8 page article.


Can you be denied by an employer plan if you are in employee of that company? I thought if you were an employee of a company, you buy the company plan and can't be denied for any reason?

[BittyBug]

Is it true that if you are ever denied coverage, or apply and then are denied during wait time based on application, you cannot ever get health insurance again due to being denied?

No. What is true, however, is that just about every individual policy application asks whether you have ever been denied coverage, and if you have been, you need to disclose it.

Can you be denied by an employer plan if you are in employee of that company?

No. Group plans have to offer coverage to everyone in the group.

I thought if you were an employee of a company, you buy the company plan and can't be denied for any reason?

Correct. As long as you meet the company's eligibility criteria for the coverage (could be number of hours worked, classification of employee, work location, etc.) you cannot be denied coverage.

BC - one option you should look into is whether your state has a group plan through their small business association. If that's true, you might in the end be better off forming a company (make it skating-related!), paying the incorporation fee, which is usually minimal), and then joining the SBA. The states that offer that have group policies so you could not be denied. And they are not individually-rated, so premiums are averaged over the entire group.

[Rob]

I was not covered for a number of years in my late teens, and 2 asthma hospitalizations made me realize I never wanted to be uncovered again. My mother paid for them but I thought the bills were just huge (about $1,200 and $4,000 - very cheap by today's standards).

When my husband started his own business, my firm did not subsidize family coverage at all so it would have been $650 a month to add him. It was a very comprehensive policy, and we were a small firm with a lot of older people and not many younger people. He had no health issues at all. I went online (this was 2006) and found that I could buy the exact same policy for him with the same company as an individual for $225. I also found a number of catastrophics for around $100. He was 41 at the time. I said "hey, maybe I can do better for myself too" and got a quote for me - I was 46. $650. The asthma was part of it for me. But after putting in a variety of ages for him on the online quote system, I figured out that there was a big jump in price at 44.

[aliceanne]

My experience with being unable to get temporary health coverage in NY was five years ago. My recollection is that the temporary health insurance companies would not cover maternity benefits, or something along those lines, and many "liberal" states like NY, NJ, and MA effectively banned them in response. I believe this was before HDHPs.

At my previous job in NJ, I had a prospective employee who would have had an insurance gap if she left her job to come work for our company, which had a mandatory 30-day waiting period for health insurance. Through our group insurance broker and our own independent research, we could not find any suitable solution for one month of coverage. This was in 2008.

The "Healthy NY" program linked has relatively low income restrictions. It won't work for your average job-changer who needs gap coverage. In my 2007 situation, I would've been denied.

BB, I checked out your link, but the New York State Insurance Department's web site is down at the moment. I'm curious about these three catastrophic plans that are recognized, as this is news to me.

The part about the employee sounds strange to me. Everywhere I have worked employer provided health insurance takes 30 days after your start date to take effect, but it also covers you for 30 days after your termination date. Was there a gap of more than 30 days between jobs? If so, couldn't she use COBRA?

[Debbie S]

My experience with being unable to get temporary health coverage in NY was five years ago. My recollection is that the temporary health insurance companies would not cover maternity benefits, or something along those lines, and many "liberal" states like NY, NJ, and MA effectively banned them in response. I believe this was before HDHPs.

At my previous job in NJ, I had a prospective employee who would have had an insurance gap if she left her job to come work for our company, which had a mandatory 30-day waiting period for health insurance. Through our group insurance broker and our own independent research, we could not find any suitable solution for one month of coverage. This was in 2008..

Couldn't she have done COBRA for that month?

My individual plan didn't cover maternity care, either. And there were other exclusions. And when I shopped around for a new plan after my first one stopped offering policies in my state, I was told (by my state's Blue Cross plan, the supposed insurer of last resort) that anything involving my leg (that I'd broken over a year earlier) would be excluded. It was several weeks later, after I'd already signed up with another plan, that I got a letter telling me the exclusion could be waived if I provided a Certificate of Creditable Coverage.

[Louis]

In 2007, I quit a job on April 20 and had my insurance end on April 30. Whether it was legal or not, who knows. And maybe it was legal then but not legal now.

The situation I referenced above involved a relocation from overseas, so COBRA was not available. In the end, we had the person work from her home country for five weeks so that she'd have in-force health insurance by the time she came to the U.S.

And I have worked at two jobs, this one included, where insurance starts on day #1 of employment, so it is possible somehow.

[Debbie S]

At most places I've worked, health ins coverage ended at the end of the month in which you left. When I was laid off in 2006, I received 2 months of severance and my health ins was extended through that time.

That company and my current employer are the only places I've worked that provided coverage from Day 1. Both are large organizations. The smaller orgs where I worked previously had a month, sometimes a bit more, waiting period before health benefits kicked in.

[Skittl1321]

In my opinion, I think everyone at every age needs health insurance. Just regular maintenance per year with check ups, dental and vision.

Dental and vision is a whole new ballgame. I have excellent medical coverage (thank goodness, as I have a serious health issue), but dental/vision is totally separate.

However my dental coverage has a $1000 yearly maximum (we didn't know that until DH reached it, on normal stuff- nothing extraordinary like root canals or crowns) and covers like 50% of the insane charges the dentists come up with. My vision is a joke- 80% of an eye exam and $75 towards glasses or contacts. That's IT. Thankfully my corneal ulcer a few years back was covered by medical, not vision...

[PDilemma]

My vision is a joke- 80% of an eye exam and $75 towards glasses or contacts. That's IT. Thankfully my corneal ulcer a few years back was covered by medical, not vision...

Don't complain. Ours pays $35 toward an eye exam and $60 toward glasses or contacts.

And my retinal condition requires more complete scans each year but won't qualify for medical coverage until something besides thinning or floaters occurs. Lucky me--if one detaches, tears or hemorrhages, then I'll get it covered under medical. Until then, we have to pay out of pocket.