Cheap Health Insurance................

[Cut-Throat]

I have read posts on this forum that said folks were paying as much as $12,000 a year for health Insurance and other posts that said they were only paying $2400 a year for a basic catastrophic policy with a $5K Deductable up to $3 Million.

Can anyone explain to me why anyone would pay $12K per year if a policy of $2.4K were available?

 

[Martha]

Shows how goofy the market is and how difficult it is to compare apples and oranges. Maybe:

1. What they cover are different. Some of those low premium, high deductible policies don't have drug coverage. If you have expensive medication needs, this can account for the difference. Also, they might have exclusions for various preexisting conditions.

2. You might not qualify for any policy except under a risk pool which is always more expensive. Just having asthma and needing to take steriods to control it excludes me from getting most insurance policies.

3. You might not have done your shopping.

 

[Mr._johngalt]

Well, I have done my shopping. I once thought, "Okay,
I have a bunch of chronic stuff, but it's under control
and stable. If they want to exclude this from the coverage that's reasonable." Found out it was still
a problem. It's like a lot of things today. Once the human element is taken out of decision making............
well, you either fit the particular parameters or you are
excluded. Could be a job, could be obtaining credit, or
it could be obtaining insurance. I'm not complaining.
That's just the way things are and you must deal with it.

JG

 

[Mr._johngalt]

And another thing.................I spent hours and hours
shopping and studying this issue. The premiums and
coverage varied wildly. One thing I did learn is that
if you "do your homework" you can almost always find an acceptable answer. Like C-T, I
am amazed at what some folks are paying for health insurance. If you spend enough time and do enough
thinking, even those of us with a few problems can find something that works. No matter what problems
you face,
there are almost always a whole collection of doable
solutions.

JG

 

[GTM]

The premiums are based on the coverage you get, the state you reside in and your health.

12k per year is probably for 2 people and should include visits to any doctor with a small co pay (maybe $10 or $15). All prescriptions at $5 to $15 with an option to purchase mail away 90 day supplies. Usually allows for physcial therapy, chriopractors, accupunture and other stuff.

Most don't need all this but some do. If you are at a doctors office twice a month for one reason or another you have to have it.

If not the catastrophic insurance should be fine.

 

[Mr._johngalt]

Just briefly (I know I repeat). I really admire unclemick for going bare (talking insurance here). I have been
covered much pretty continuously since I retired for good in 1998. During that time, I did a lot of doctoring and
had a lot of tests, but I would be many thousands ahead if I had chosen to
roll the dice and skip health insurance completely.
Of course, anyone with any sort of insurance and no claims can say the same (with hindsight). Honestly though, I never seriously considered doing it, and of course since I remarried there are 2 of us to consider.

JG

 

[unclemick]

Also - to repeat - all the women are covered, AND if I were to go broke due to medical costs - their retirement would not be derailed.

My blockheadedness is NOT a recommendation for anyone else. Although if I had not taken the risk - I could not have ER'd.

 

[cute fuzzy bunny]

What Martha said.

When I tried to compare health plans a year and a half ago, it was like buying a cell phone plan.

None of the three cards ever stops moving.

There was no such thing as "plan x", "plan x plus meds", "plan x plus meds with a higher deductible". Every plan changed about 3-5 'dials' at the same time. I had to get a pad of paper and a pencil and create a matrix by hand of what the ins and outs of each different plan were.

I dont know if there is a benefit to it being confusing, the health plan folks are just incompetent, or if its for some other reason. I know under hippa in CA that you have to be offered something like 3 plans 'similar' to what you are transferring from, so maybe some of them are simply unpalatable options they can offer up if forced to that are close enough to 'similar'.

 

[MJ]

Because of the high cost of insurance in NY, I have been looking at selected states where I might want to live in the next 2 years and I have found comparable health insurance in NM for example, costing almost a 1/3 of what I would pay in NY. I also haven't found any high deductable offerings in NY to further reduce the cost while NM offers some real inexpensive high deductable that would cost less than a 1/4 what I would pay in NY.

MJ

 

[farmerEd]

>>Can anyone explain to me why anyone would pay $12K per year if a policy of $2.4K were available?

Same reason someone might pay $500K for a mediam house in CA and not choose to live in a $85K house of comparable size in the boonies somewhere....

Also some people (like me) are paying $12K per year for a familiy policy (4 kids, 2 adults), even in Mass, where insurance is either expensive or damn expensive, I might be able to get down to $3K if the kids were on their own....


As a side note, for those of you with either no insurance, or very high deductibles, there was a show on 60 minutes last night (or 20/20 I can't remeber) about how an increasing amount of people are travelling to India to have expensive procedures done, by top-notch American trained surgeons/doctors, that they could not afford to have done here....one example was a woman who needed a hip replacement but had no insurance...in the US it would have cost her $38,000, in India (in a very fancy, brand new, well staffed modern hospital), the cost was about $5,000.

Sure isn't going to help you if you have a heart attack and need immediate help, but I bet this trend continues and accererlates...we've already outsourced everything else...why not? (Of course I wouldn't want to try and sue in an Indian court if something went wrong)

 

[deserat]

farmerEd,

I saw the same show on 60 minutes - very interesting as I work for a large integrated healthcare company right now and live in CA. We hire foreign doctors as well - lots of 'em. The technology in India or Thailand is very similar to that I spec, buy and implement as well. Throw in the 'airline' costs and gimmees and the vacation at the beach at that price or a little more....wow. Very hard to compete with here. Only issue I could see would be any blood issues (bloodborne pathogens/etc) possibly, but that shouldn't be an issue at those boutique places.

I know that the PTs Billy and Akaisha and the Terhorsts have talked about their catastrophic plans and being treated overseas - I know of my experience in Poland where I took a trip to the ER - had 5 different MD consults and a CT scan - now the ER and the hospital didn't have 1/10th the extent of technology penetration that we have, but I still think I got good care... and at about $250 versus umteen thousands in the US. I'm sure Tricare laughed all the way to the bank on that one. Only thing that bothered me was the language barrier, but I was lucky as my husband speaks Polish fluently....in the case above, they all speak English (becoming the universal language by the way - Pax Americana or Pax Romana).

US healthcare does need to look at different ways of delivering care in an efficient cost-effective manner--I also believe that Americans can help that by lowering some of their expectations wrt the use of technology to solve all of their problems and focus more on the prevention side of the equation. It's just plain cheaper for all concerned and in general leads to a better quality of life overall.

Stepping off another soapbox - Bridget

 

[Sparky]

The thing about catastrophic coverage is that you DON'T have to go overseas for major problems. You basically self-insure for drugs and doc visits (like we do) and hope you don't get hit by a bus.

But if you do, you're covered. It seems to me like a fairly cheap insurance policy against being financially wiped out.

You really need to get that type of catastrophic insurance when you're fairly young and healthy. Any sort of health problems (my neighbor was turned down for being, well, grossly overweight) you're turned down. And basically, you're screwed once you're turned down by one insurance carrier. They all share info on you.

To me, the thing about this insurance is all in my mind. I had a hard time giving up the employer-sponsored health insurance and going on my own. But the price of COBRA ($1,000 per month) soon changed that tune. So, instead of $12,000 per year, I pay about $2300 and pay for doc visits myself.

 

[treypar]

One benefit of health insurance are the negotiated rates. I had my physical and the bill was $400 but my insurance company paid half that amount. Is there someway to get the benefit of those reduced charges without an insurance policy.

 

[REWahoo]

Is there someway to get the benefit of those reduced charges without an insurance policy.

Not sure about getting insurance discount without insurance, but many physicians will discount their "rack rate" for cash. Also, you can get the benefit of reduced charges on your deductible through a HSA (Health Savings Account) policy.

REW

 

[sgeeeee]

. . . (Of course I wouldn't want to try and sue in an Indian court if something went wrong)

I know that this kind of case can be stressful, unfair, expensive and frustrating. I don't know if Indian courts are that bad or not.

 

[TromboneAl]

Is there someway to get the benefit of those reduced charges without an insurance policy.

I saw something on the news about this recently.  The upshot was that if you called the provider and asked for a lower rate, explaining that you are uninsured, that sometimes they will give it to you.

I dont know if there is a benefit to it being confusing, the health plan folks are just incompetent,

I think it's mostly the latter.  Maybe it's the result of design by committee.   Blue Cross's statements show the same complexity. They are so poorly designed and written, that I wrote out a cheat sheet so that I could understand them.   Here's an excerpt from my cheat sheet:

Total Billed

This is not the total billed.  This value should be labelled "The amount you would have been billed if you did not belong to Blue Cross."  This value is totally irrelevant, and can be ignored.  The only reason to include it is to make you feel that Blue Cross is paying more.

The True "Total Billed"

The real "total billed" is not displayed anywhere on the statement.  To calculate it, add the "It is your responsibility to pay" amount to the "Paid Amount."  If you call Blue Cross, they will refer to this as the Negotiated Fee Rate.

 

[intercst]

The thing about catastrophic coverage is that you DON'T have to go overseas for major problems.  You basically self-insure for drugs and doc visits (like we do) and hope you don't get hit by a bus.

But if you do, you're covered.  It seems to me like a fairly cheap insurance policy against being financially wiped out.

You really need to get that type of catastrophic insurance when you're fairly young and healthy.  Any sort of health problems (my neighbor was turned down for being, well, grossly overweight) you're turned down.  And basically, you're screwed once you're turned down by one insurance carrier.  They all share info on you.

To me, the thing about this insurance is all in my mind.  I had a hard time giving up the employer-sponsored health insurance and going on my own.  But the price of COBRA ($1,000 per month) soon changed that tune.  So, instead of $12,000 per year, I pay about $2300 and pay for doc visits myself.

Unfortunately, the more common occurance isn't "getting hit by a bus", but coming down with some kind of chronic disease as you get older.

If you happen to get one that's treated with $2,000/month of outpatient prescription drugs, you could be in trouble. If your finances aren't robust enough to fill the holes in a cheap catastropic policy -- it's the poorhouse, or back to work you go, assuming you're able.

intercst

 

[Sparky]

Unfortunately, the more common occurance isn't "getting hit by a bus", but coming down with some kind of chronic disease as you get older.

If you happen to get one that's treated with $2,000/month of outpatient prescription drugs, you could be in trouble. If your finances aren't robust enough to fill the holes in a cheap catastropic policy -- it's the poorhouse, or back to work you go, assuming you're able.

intercst

I have a huge amount of respect for you ... I know you started the whole retire early home page - I know you retired at 38 ...

With my DW at 44 and me at 45, I've tried to take into account as many catastrophies as possible and it seemed the right thing to do to get a catastrophic policy for us - the drug companies now are offering free meds to people who don't have drug coverage, regardless of income (former drug rep here).

So, you are right when you say, it's not getting hit by a bus that is a big worry, but some other disease that will cost $2,000 per pill.

I am a belt and suspenders kind of person; I am trying to protect ourselves as much as I can ...

 

[Mr._johngalt]

Hey Sparky.............what is this "free drugs regardless of income"??

I was prescribed medication for cholesterol. When I found out what
it cost I decided to go without.

JG

 

[Sparky]

Hey Sparky.............what is this "free drugs regardless of income"??

I was prescribed medication for cholesterol.  When I found out what
it cost I decided to go without. 

JG

Hey, JG, not a great idea to go without high cholesterol meds.

Go to "Free Medicine Direct.com" All the drug companies are trying to stop of the flow of US citizens going to Canada for their drugs (really only about 1%), but the drug companies are freaking out ... Pfizer only made about $4 billion 4th quarter 2004, so they're offering free meds for people with no drug coverage ... no income verification.

I think they charge about $15 per year and will contact the drug companies for you.

The drug companies are relaxing their rules for giving free, or lower prices meds.