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Do you go without health care coverage (US)?

Discussion in 'Off The Beaten Track' started by BaileyCatts, Mar 4, 2012.

  1. Debbie S

    Debbie S Well-Known Member

    Yikes, FiveRinger, that fall sounds scary. I hope you're doing OK. As I'm sure your lawyer told you, your expenses should be paid by the store's insurance. You should not be responsible for any of it.

    Yes, COBRA is expensive and you can probably do better with an individual plan as long as you are healthy with no pre-existing conditions. By better, I mean it will cost a lot less and coverage will generally be what you need. I believe that if you have had insurance for the past year with no lapse in coverage, you can get a pre-existing condition exclusion waived by a new insurance company - I think. Anyone looking into this should check on that.

    If you do have pre-existing conditions and can't get an exclusion waived, your only option might be your state's high-risk pool, but that will be just as much as individual insurance, maybe more, unless you qualify for assistance.

    After I got laid off 5 years ago, I got an individual plan with United Health Care, first under Optimum Choice, which then stopped offering individual policies in my state, and then under Golden Rule. I had to keep that plan until a month ago, when I finally got a job that provided health insurance (my most recent job was a contract position). I was very grateful I had it when I broke my leg ice skating - the hospital bill for surgery and a 1-night stay was $10K. And the surgeon and anesthesiology bills were extra. And then there were the follow-up doctor visits with x-rays, and 6 months of PT.

    I wouldn't recommend anyone go without health insurance for any length of time. I've been without insurance for a month here and there when I was much younger and was between jobs or between school and a job, but I was lucky.
  2. BaileyCatts

    BaileyCatts Well-Known Member


    Nope. Maybe age and weight have something to do with it then? That's something I forgot to add, I have been calling other places to get a short term, they deny me. I am 46, and while I am overweight, I do NOT have diabetes, I do NOT have high chloestoral (sp?), I have no heart or lung problems, I do NOT have any illness or disease that apparently all "fat people" are supposed to have simply because they are "fat". Other than being overweight, I'm probably healthier than half the people reading this. I rarely even get colds in winter. I had a blood test in 2009 and every single test came back smack dap right in the middle of NORMAL range. My BP is always normal, everything is always NORMAL. But apparently since I am overweight, that means I am laden with diseases. :rolleyes:

    So that is why I am thinking of going without until I can get on an employer plan, because I am running out of places to try who won't deny me based on one single question (how much do you weigh). And I am always asking for High Deductible plan options only because I know those are probably the best options for me. But if no one will sell it to me based on that one single question, what else am I supposed to do?
  3. topaz

    topaz Well-Known Member

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

    Also, young people aren't as "healthy" as they use to be or to what they think they are. A part of the US don't eat right nor exercise. I'm sure some would be surprised that they're obesity is putting them at risk for pre-diabetes and high blood pressure.
  4. PRlady

    PRlady foot in both camps

    If I needed private insurance I would be in the same situation; I read healthy on every single test, exercise, do all the exams you're supposed to do at my age....but I smoke. No insurance for me.

    However, although reading this thread breaks my heart and makes me so angry on behalf of everyone having to play russian roulette with the system, insurance is sort of a giant casino. They're betting by the actuarial tables that you or I will get really sick due to being overweight or smoking, and the tables are all they have to use. Some of this will change when the new healthcare system kicks in.

    I agree with everyone that you should get catastrophic coverage if at all possible. My daughter is 24 and still on my insurance (thank you Barack) because her job comes with none. She's got two years to find something that pays and/or ante up to pay for it herself, because I would pitch a total fit if she went without it. And she's healthy too.
  5. Cachoo

    Cachoo Well-Known Member

    Well I have not given up: BaileyCatts if I find anything at all I will post.
  6. Allskate

    Allskate Well-Known Member

    In some areas of the country it would be more, even for younger people. :(

    I think they make excuses for everyone. My friend was in her thirties and a marathon runner in great condition, but she was refused health insurance supposedly because she had once had a kidney infection. It's much more likely that she was refused because she was of child-bearing age. Fortunately, she now has employer-provided insurance and she had that when she was diagnosed with cancer. Otherwise, she would have been worrying about going bankrupt on top of worrying about losing her life.

    That kind of thing really bugs me, too. I think that people who genuinely can't afford health insurance should get care anyway at a cost that they personally can afford. And I don't think they should be waiting until their life is in danger because that's not good for them and it drives up costs. But, it drives me crazy that there are people who can afford insurance and would be able to get it, but cannot afford the cost of care when they get really sick or injured and those costs get passed on to everyone else through higher insurance rates and higher state taxes (because it is often state hospitals that provide the care). I think I read somewhere that the average person paying insurance is paying something along the lines of an extra $400 a year to cover people who didn't get insured.
  7. PRlady

    PRlady foot in both camps

    Yeah, but it's supposedly unconstitutional :rolleyes: 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.
    Kasey and (deleted member) like this.
  8. GarrAarghHrumph

    GarrAarghHrumph I can kill you with my brain

    My now-husband was without health insurance in his 20s, before he'd worked enough as an actor in Equity productions to 1) make it into the union and then 2) to accumulate enough weeks of work to qualify for their health insurance plans. During that time, he did have to go to the hospital for an injury to his hand, which cost him dearly.

    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.
  9. Kaffeine

    Kaffeine Well-Known Member

    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.

    It keeps me up late at night. :(

    My mom had no health insurance (she couldn't afford it ) when she was diagnosed with stage 3 colon cancer back in 2006. THankfully the hospital took her in, did the surgery, chemo, everything. I don't even want to think about the costs :scream::scream: She's now on some type of indigent program so she can get healthcare.
  10. Louis

    Louis Well-Known Member

    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.
  11. IceAlisa

    IceAlisa discriminating and persnickety ballet aficionado

    Illegal? Why?
  12. FiveRinger

    FiveRinger Well-Known Member

    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.

    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.

    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?
    flutzilla1 and (deleted member) like this.
  13. BittyBug

    BittyBug And the band played on

    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.
  14. mkats

    mkats Well-Known Member

    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. :mad:
    flutzilla1 and (deleted member) like this.
  15. IceAlisa

    IceAlisa discriminating and persnickety ballet aficionado

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

    MacMadame Cat Lady-in-Training

    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.
  17. Aceon6

    Aceon6 Hit ball, find ball, hit it again.

    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!!!
  18. sk9tingfan

    sk9tingfan Well-Known Member

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

    Cachoo Well-Known Member

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

    PRlady foot in both camps

    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.
  21. Louis

    Louis Well-Known Member

    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.
  22. BaileyCatts

    BaileyCatts Well-Known Member

    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?
  23. BittyBug

    BittyBug And the band played on

    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.

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

    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.
  24. Rob

    Rob Beach Bum

    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.
  25. aliceanne

    aliceanne Well-Known Member

    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?
  26. Debbie S

    Debbie S Well-Known Member

    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.
  27. Louis

    Louis Well-Known Member

    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.
  28. Debbie S

    Debbie S Well-Known Member

    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.
  29. Skittl1321

    Skittl1321 Well-Known Member

    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...
  30. PDilemma

    PDilemma Well-Known Member

    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.