Currently I have a HDHP with a deductible of 10k. My wife and I run our own software consultancy and make ~60k-80k a year. We have two children and we are all healthy. We are paying 300/mo for the individual health insurance plan. We have a sizable emergency fund (30k). We feel like we are being extorted for 300/mo without any services whatsoever. Since the deductible is so high we are paying for everything anyway. Aside from living for a doomsday scenario of a car accident or a long hospital stay is there any reason we shouldn't cancel and pay cash for the few visits we have during the year.
Should I cancel my health insurance?
By sburke56 Follow Tue, 10 Apr 2012, 11:07am 10,618 views 60 comments
In Garland TX 75040
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I'm curious of anyone's advice would change if the parameters were like mine. Similar profession, but due to current economic conditions, much lower income, plus much higher premium (also for a HDHP), such that the premium is about half of our usual monthly income. In the case of a medical event, the deductible alone ($6k) would be more than we could currently pay out of pocket.
The premium cost itself prevents preventative care, and we have piled up a few "unfunded liabilities" in the form of postponed care because of that.
Every month I consider cancelling it. The only reason I don't is if a very-high-cost medical event were to occur and it racked up a half million in costs and our income were to return to what used to pass for "normal", I might be thankful that I had hung on to that protection. There is another reason, really, and that is the feeling, possibly unfounded, that the insurance card will get us past the gatekeepers in the event of an event.
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Concord, NH
I have a HDHP/HSA from Anthem that runs me around $4000/yr in premiums plus $4100 HSA contribution. That's with a $5000 deductible for a 56 year old female with no chronic conditions or medications. It really pisses me off that I end up paying for those who choose a.) not to have insurance and b.)"not pay". I don't love the thought of contributing to the profits of the insurance industry, but I was brought up to practice personal responsibility, not just talk about it.
For those interested in negotiated rates, I went to the doctor in September for simple wellness physical, a few basic blood tests (cholesterol, etc.), pap, mammogram and flu shot. Insurance was billed $1349.50 (I was 100% healthy before and after the visit, mind you). Insurance allowed $891.03. I paid nothing, as my insurance plan covers 100% of preventative services. The local hospital, with whom my doctor and lab are associated, provides a 15% discount for the uninsured. So without insurance I would have paid $1147.
No matter how much you exercise and how carefully you watch your diet, bad things happen. You don't need insurance...until you do.
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I don't know what to recommend but before deciding whether to keep or drop the policy, I wonder if you have actually read the whole thing? Most people don't even have a copy of the actual policy, they just rely on the advertising for "peace of mind" and then discover too late that they aren't really covered and they would have been better off keeping the money in the bank. Beware of "balance billing," "allowable fee schedules," pre-certification requirements for emergency services, etc.
Insurance suffers from lobbying by special interests that require coverage for things no rational person would buy, e.g. toxic and disproved pills advertised on TV. So, your policy probably includes coverage for a lot of stuff you'd be better off without, and yet it likely skimps on the things you might actually need.
Also, insurance companies conspire with hospitals to overcharge everyone outside of their "network." If you drop the policy, you would be out of all networks, so you would be more vulnerable to the overcharges. Emergency hospital overcharges can exceed $100k. An insurer might pay 30% as "full payment," then the insured might get hit with co-pays and/or balance billing. This practice should be illegal, but it's very profitable, so it continues.
Emergency department costs total less than 3% of total medical spending nationwide, so a true emergency policy should cost very little. Unfortunately, insurers are not allowed to sell such a policy, and the policies they sell are so full of loopholes that they don't provide much peace of mind once you've read them.
I wish that I had a good simple answer. I was really hoping we would get genuine healthcare reform, but instead we got ObamaCare, which in my opinion makes matters worse.
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Garland, TX
@Bluezette
I mentioned this earlier in the thread and it bears repeating. Since these charges for services were billed to an insurance company they are not anywhere close to reality or what would be charges to an individual. It's so hard to get actual costs for services if you are paying cash. Has anyone successfully done this (paid cash and got prices up front) on a regular basis?
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Garland, TX
@Bluezette
My parents teaching was similar but only consisted of you need insurance and make sure it's a PPO. That's it. I think the game has changed a lot now a days and insurance companies are preying on this "do the right thing" attitude. While I don't love the idea of having others pay for me I do think the insurance companies have used that very argument to milk people for gobs of money in pure profit and the argument that they have to pay for the uninsured doesn't seem to hold water. Granted I haven't done my research so someone please chime in with some data for or against this.
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Bluezette says
If it makes you feel any better, so called "cost shifting" amounts to only 2% of spending. It was one of the red herrings used to fool people into an emotional decision to support ObamaCare. (Anger, fear, "those people are stealing from you, make them buy insurance!" "Bad things can happen, we'll protect you, pay no attention to the profiteers behind the curtain with their exclusions and balance billing!")
Bluezette says
Personal responsibility means getting vaccinated, driving carefully, looking both ways before crossing the street, etc. Supporters of insurance call it "shared responsibility," but personal responsibility would be people paying their own bills rather than shifting costs through subsidized insurance (Obamacare).
Bluezette says
If you were healthy before the visit, then the only clear benefit you got from it was the flu shot, which should have cost under $20. The mammogram was a trade-off: it showed that you probably don't have breast cancer now, but you got irradiated, which increased your risk of cancer in the future. So, $900 payment for a $20 vaccine, the provider got a lot of benefit, you got very little value for $.
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Concord, NH
curious2 says
Bad things happen to people who do all those things, too. Get a virus through not fault of your own and need a heart transplant? Have a brain aneurysm and need surgery and rehab? For anyone who can pay those bills on their own, I agree that they do not need insurance. For anyone else who can afford insurance, that's the responsible choice.
curious2 says
If I was looking for a dollar back for every dollar I spent that may be true. I don't expect to get a dollar back each year for every dollar I spend on health insurance or car insurance or homeowners insurance. But some day I may get back those dollars many times over. This year my "extra" dollars go to someone else who's having a very bad year. Next year it may be me. I hope it's not. Believe me, I don't like supporting the middle-man insurance industry, but until this country has a single payer system it's the only way to protect myself.
And as far as I knew, I was healthy before the visit. However, there is a history of cancer in my family. Should I wait until I'm symptomatic? I did research the recommended tests and cancelled an appointment for one I considered unnecessary based on my risk factors. (I suspect there was a new, expensive diagnostic machine that required lots of appointments, needed or not, to pay for it.)
curious2 says
Agreed! Until we have the choice of a single-payer system, these profit-making tricks need to be eliminated!
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Bluezette says
I'm genuinely glad to know you did research and made your own informed decision. That may be part of why education remains the best predictor of longevity, better than health insurance or money. Given the age and family history you posted, some diagnostic testing may lead to a longer life, albeit at higher cost. Most people age 20-50 probably should wait until they are symptomatic, because the risks of unnecessary radiation and misdiagnosis outweigh the benefits of early detection.
Elizabeth Edwards was "saved" by early detection, meaning she lived more than five years with her diagnosis. She died at 61 instead of probably around 60 if she had not gone in for treatment. I don't know when she started getting routine diagnostic radiation, but the troubling question is, if she had never done that, would she still have got cancer? Some women start getting those scans at 30 even without a family history. There is no way to trace an individual case of cancer to diagnostic radiation, but the increased risk lands on some unlucky people. Women used to have a lower premature mortality rate than men, yet in recent years women in many states have been paying more than men for health insurance. These tended to be states that mandated coverage of "preventive care," which ends up wasting so much money that it overwhelms the fact that women used to be cheaper than men to insure. Now ObamaCare will obscure that cost by mandating it for everyone at the same premium. Equal premiums made a compelling campaign slogan, but concealed the deeper problems causing premiums to increase.
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orbitron says
Very bipartisan! You've managed to quote a myth from each of the two major parties. So-called "cost shifting" (the Democrats' myth) is 2% of total spending. Medical malpractice awards (the Republicans' myth) amount to another 2%, and that includes people who have been killed or terribly injured by malpractice; hospitals injure 20% of patients, and most of the small stuff never even goes to the legal system. But, you've overlooked the mandates that require insurance to cover all the toxic disproved pills on TV, and the unnecessary doctor visits those ads generate.
A third of insurance premiums go to administrative costs (CEO salaries, etc.) and profit. Most of the actual medical spending occurs in the last year of life, much of it in the last month of life, meaning stuff that didn't make much difference. The late Senator Ted Kennedy was diagnosed with a brain tumor at age 76, and Mass General said there was nothing worth doing; he got a second opinion at Duke, where a series of brain surgeries took away his speech and ability to walk but enabled him to keep breathing to age 77. I loved Senator Kennedy, but if it were me, I wouldn't have wanted to spend my life savings that way. And with current insurance premiums, that's what people are doing: the savings rate has fallen to around zero, as people are required to put their $ into insurance instead.
The British spend half as much as we do, and live longer. The Canadians spend a third less than we do, and live longer. The Mexicans spend a tenth as much, and live almost as long, maybe longer if you adjust for education (still the best predictor of longevity). Each of those countries has a different system, but they all allow lawsuits for malpractice, and they all prohibit DTC drug ads on TV.
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@curious2
Thanks for shooting down some myths that are constantly repeated as fact. Can you point me to some articles with the percentages that the insurance companies are paying out for certain things such as uninsured patients?
@rdm
Yeah I do already have my mind made up. I'm guessing you can guess which way I have chosen.
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sburke56 says
Insurance companies often don't even pay for their own customers, let alone the uninsured. But, the figure 2% is commonly cited, including by CBO and others:
http://www.aapsonline.org/newsoftheday/00385
On the whole, the uninsured often subsidize the insured, although that includes paying taxes that then pay for government employees' insurance:
http://liberty.pacificresearch.org/docLib/20070408_HPPv5n2_0207.pdf
http://www.cato.org/pub_display.php?pub_id=10576
More than 70% of 'medical bankruptcies' happen to people who had insurance, and RomneyCare led to increases in insurance premiums, hospitalizations, and 'medical bankruptcies'. (Medical bankruptcies are commonly defined as bankruptcies in which more than $5k of medical bills were discharged. The definition is intended to provide an approximation, there can be other factors also driving bankruptcy.)
Many articles report on administrative costs & profit vs "medical loss ratios," e.g.:
http://abcnews.go.com/GMA/YourMoney/health-insurance-premiums/story?id=8978954
Within the category of medical spending, around 50% goes to hospitals, another 30%-40% to doctors, and the remaining 10%-20% to pharmacies for prescription drugs.
Around here, we get direct mail ads from the local hospitals exhorting us to go there for every conceivable thing. Hospitals have practically monopolized childbirth, which used to be done at home; in Holland, most babies are born at home and they have lower infant mortality rates than America. Hospitals make extra $ by spreading infections:
http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/
I don't think they deliberately try to spread infection, it's just that infection control is a lower priority than bringing in more patients. The financial incentives tend to affect the priorities, i.e. the executives that get promoted are the ones that figure out how the institution can make more $.
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zzyzzx says
Being a shareholder only entitles you to be robbed both ways by the executives. They rob the customers by denying valid claims, but they also rob the shareholders with inflated pay packages and private jets.
rdm says
That is how insurance should work but often doesn't. If you can find a policy where you can feel confident, based on the evidence, that they will actually pay for what is actually needed, then the tax deduction (tax subsidy) can make it a good value. I've read too many loopholes and heard too many horror stories.
The calculation may differ for children though. If they get hit by a car while bicycling, would they get everything they need to recover fully without a lifelong limp? (BTW relying on the driver's insurance might not work: a friend was hit by a car and the driver's insurance company cancelled her policy, claiming not to have received the check that month.) Likewise if one of them gets leukemia, which has a high cure rate in children, would they get everything they need? Also vaccine coverage tends to be more comprehensive for children than adults. I am skeptical of insurance for adults, but a tax-subsidized family policy that covers the children might net out to be a good value depending on what coverage they get out of it.
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Concord, NH
sburke56 says
Good luck and good health. Hope it works out for you.
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orbitron says
The sellers of pointless healthcare blame the fear of litigation, but that myth was debunked years ago:
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
The author compared two cities in Texas that have similar populations but a 2:1 ratio of Medicare spending, and found the difference was due mainly to entrepreneurial doctors. You can read more about the tort reform myth if you want:
http://www.coloradolaw.net/blog/litigation-crisis-myth/tort-reform-myth-2-tort-reform-will-improve-health-care-866439/
Medicare has less than 4% overhead, much cheaper than private insurance. (On the other hand, they deal with a more expensive population, i.e. the elderly, so the % may be a bit misleading.) They may have a higher fraud rate, maybe 10%, but part of that is because they pay too fast; they could easily reduce it by waiting for patients to object to "explanation of benefit" statements. ("60 Minutes" did a great report on this issue.) Insurance overhead is much higher, especially if you consider the billing games that require every medical practice to hire a full time billing coordinator if they want to take insurance.
As for being fat and lazy, yes that makes a difference compared to some other countries, but the 2:1 ratio within Texas occurs between two cities with equally fat and lazy populations.
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San Jose, CA
Drop your insurance. Just provide fake info the the hospital if shit hits the fan.
Just make sure to remove all your ID before you go to the hospital.
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curious2 says
You can always vote against those pay packages. I always do.
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I agree. I wish all healthy people would stop paying. Let the insurance companies freak out and hopefully rethink their mafia scam. The entire system of being healthy in this country is utterly fucked.
Fucked fucked fucked.
Do they teach school children about the poisons used to grow food? Genetically fucked foods for all!!!!! Get cancer and die! Well actually, get cancer and suffer till they squeeze every penny out of you, then fucking die!
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My sister checked into a hospital for a routine non threatening procedure. She checked out and was sick for two years from a staff infection and still has recurring problems from just being in the hospital.
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KILLERJANE says
What kills me, hardly nobody had health insurance when we were growing up. And out of pocket pay as you go care was cheap enough and affordable by most standards, before Bill and Hillary Clinton "Fixed" it.
It was so cheap, free health care for the poor was a non issue, that's why Baptist and Shriner hospitals were possible.
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Further to the question of where does the money go, "By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States."
http://www.nytimes.com/2012/04/04/health/doctor-panels-urge-fewer-routine-tests.html?_r=1
NY Times tends to be conservative on this particular subject; I would have guessed more than half is wasted.
Insurance overhead (counting both sides) costs around a third, plus waste fraud and abuse cost around another third, really that leaves only around a third that is actually useful. In my opinion, unfunded mandates and cost concealment through insurance and government tend to increase the waste, fraud, and abuse in the system, tripling total spending compared to actual value. (And part of the problem is, Medicare pricing is controlled by an AMA cartel, based on credentials and cost not value delivered.) If a Mexican gets strep throat, he walks into a pharmacy and buys a box of antibiotic for $10. If an American gets strep throat, he isn't allowed to do that; the American is mandated to go to a doctor for a prescription, then bring that to a pharmacy where somebody with 10 years of post-secondary education counts out the precise number of pills on the scrip (and sometimes puts the wrong pills into the bottle, which causes many illnesses and injuries each year), and the whole thing costs so much that he wants insurance to pay for it, which costs even more. The same strep that costs $10 in Mexico can easily cost $200 or more here. And that's in addition to all the unnecessary tests (Throat hurts? Have an MRI. Throat doesn't hurt yet? Have a CT scan.) When medicine is about health, it can be cheap, but when it's about money and power (insurers and politicians), it gets very expensive and wasteful. From the perspective of people who gain money and power from it, the system "succeeds" by amassing more money and power. From the perspective of people and their health, well that perspective doesn't matter, people are merely pods in the Matrix.
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orbitron says
Huh? That all seems like a reason to have single payer and a mandate.
The OP doesn't realize that what you buy with insurance is not just goods and services, but "peace of mind", which you do receive. It is risk management as well as health care.
But, like so many, the answer to the risk we all face is that I'll take my chances, and if worse comes to worse, rely on the largesse of others to cover my mistake.
I doubt some stats mentioned here. The uninsured certainly drive up the costs, so getting them to pay for a policy of any kind would be welcome.
And if they had coverage, we might give them insulin instead of free amputations. Preventative care would save a fortune in this fat, lazy, addled and fried-food hillbilly nation.
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CL says
Again, no. Please see above. Not wanting to read facts isn't a reason to repeat myths.
CL says
And again, no. With the exception of vaccines, most services marketed as "preventive care" (including routine radiation etc.) do not save money. Many of them don't even have any benefit for anyone except the providers that sell them.
The most obvious refutation of these myths is RomneyCare, where mandatory insurance led to higher premiums, higher costs, more hospitalizations, and more people going bankrupt with medical bills they couldn't pay.
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Emeryville, CA
Who, then pays for the uninsured if they consume services? Is it economagic?
How many uninsured are there? Millions?
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CL says
Your questions are off topic and you should read about them elsewhere rather than sarcastically opining without data. In brief, there are around 50 million uninsured persons in the U.S. The uninsured use fewer services than the insured, and most pay out of pocket. Indigent persons who lack insurance can receive services funded by charity and/or taxes, as do people whose insurers don't pay; ObamaCare will increase the cost of that by subsidizing more insurance. Around 10 million of the uninsured are illegal aliens, who are exempted from ObamaCare, though they can still receive services under EMTALA. Most of the uninsured also pay taxes, which means subsidizing the insured who get tax subsidies to buy insurance.
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Emeryville, CA
{insert pithy indisputable "fact" here}
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CL says
We could make a wiki entry for you, if it would help with your selective comprehension problem.
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Savannah, GA
elliemae says
Actually, you may be screwed even if you have insurance, depending on the accident.
OK, sburke56, I am in your boat (healthy, self-employed, two kids, HDHP/HSA), except I pay about twice what you pay (and I'm 46 years old, probably older than you). We never receive claims reimbursements, and we are also considering changing policies, perhaps even playing "Russian Roulette" and dropping insurance altogether, like we did for most of the 10 years before we had kids. Our insurance has recently shot up, perhaps because we recently had a lot of health care expenses run past the eyes of the insurer: two births, a cystectomy, and PT for the little one (all of which were paid for with our money). The insurer claims to have dickered the price down from what the health care providers would have charged us uninsured. We have actually dickered down some expenses without the insurer being in the loop, and it is difficult to know how much more the insurer can dicker down, since both parties are somewhat secretive about that information.
sburke56 says
We did actually get a really good deal on our first birth by preregistering/prepaying with a hospital that was trying to court births away from another more popular birthing hospital: $2400 to the hospital (Ob/epidural not included).
Nevertheless, dicker power may still be an advantage for keeping a policy that doesn't pay outs. Another for us was peace of mind while fording through uncharted waters of labor/delivery health care. Of course, now I lose some peace of mind with each check we send to the insurer, knowing that part of that money is used to lobby against ever having a single payer...
Best wishes
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curious2 says
It's more like $300 for the doctor visit and $4 for antibiotics at WalMart.
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Garland, TX
@pianist
That is exactly what I suspect. We are younger, 30. And as for the insurance companies negotiating better rates with the hospitals I don't believe it for a second. It's a complete mind game with the "original" price being astronomical and then the negotiated price still being astronomical but thousands less. It inevitably makes people think they are getting a "deal" and thank god for my insurance.
Anyway, thanks all for the responses. We are canceling come the beginning of the next month. We'll see if I can get prices at all from docs before I see them.
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CaptainShuddup says
I comprehend, but if I don't believe this bullshit no matter how loudly you assert it, I'm the problem?
If the irresponsible here choose to be uninsured, and advocate such, it's not a personal problem for me. It is interesting, however, to see the rightwing flip on their own issue of personal responsibility. I hope their children don't suffer for this shortsightedness.
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CL says
Yes, but you're not alone. Here is an article from a paper that endorsed ObamaCare, so you might acknowledge its legitimacy instead of rejecting it as tainted by the "other side":
http://campaignstops.blogs.nytimes.com/2012/03/17/forget-the-money-follow-the-sacredness/
The basic problem is lemming behavior, following the herd rather than making the effort to consider facts and reason from them.
It was the same in the housing bubble. This forum draws people from many different backgrounds who recognize that housing was in a bubble, and that prices remain propped up now. But, your refusal to look at facts and your comment about "rightwing flip" suggests a preference for tribalism rather than evidence based decision-making.
An insurance policy is a contract. It is not a proxy for health or longevity. In fact, education is a better predictor of longevity. Saying everyone should be forced into a contract with a corporation is the sacred oath of a subset of the Democratic party (which used to oppose it). It is not an evidence based decision, nor is it rational economic policy.
I do not presume to know whether someone I've never met should enter into a contract that I've never read with an unidentified corporation that I've never done business with. Money spent on insurance could otherwise go into education, a safer car, checking the house for radon, or any number of other things. I have insufficient evidence upon which to decide whether the policy is worth the premium or not. You and some others skip past that whole inquiry, jumping to a conclusion while deliberately ignoring evidence, based solely on tribal sanctimony. Worse, you assume that your tribal decision is the only legitimate one, and everyone else is "irresponsible." ObamaCare, if upheld, will actually penalize people for the "mental activity" of deciding not to buy. That is precisely the problem.
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I gambled on not having insurance after losing my job last October (had 100% employer paid BCBS- Cadillac model ;o) )
My reasoning was - I mostly stay home so I'm reducing the risks of anything happening to me, and I have a good bit of savings to fall back on if something should happen 10-15,000.
Feb 06, slipped off a ladder and broke my leg/ankle... doc says pretty bad fracture, unusual fracture, etc, but I wasn't in critical condition from blood loss or at risk of embolism etc. 2 days in the hospital and 1 surgery for 2 screws to be inserted = $30,000!!!!
Needless to say, I nearly fell over when I received those bills. It NEVER crossed my mind the stay would cost that much!
Now I have a Hg Deductible policy that I pay $90/month, $10,000 deductible, 80/20 pay, $5,000 max out of pocket (total of $15,000 out of pocket).
THEN, I took out a separate Accident/Critical Care policy for $37 per month which will pay me $15,000 for accident or serious illness like heart attack / stroke / cancer etc. This will take care of my out of pocket expenses.
Is it ideal? No
I now put off going to the doctor where I would have gone before due to no cvg unless extreme emergencies.
Bankruptcy laws are more stringent. Don't plan on keeping your house if it's paid for. As the crunch tightens, more and more creditors will consider taking your home for unsecured bills like medical bills. It's unlikely (at this point) but the possibility DOES exist.
A simple accident like mine cost a bundle, now just imagine what it would have cost if I'd broken my pelvis, back, and both arms in that fall (and it was entirely possible IF I had gotten tangled in the ladder from which I fell *shudder*)
I know it sux to pay high insurance premiums, but doing it any other way is playing russian roulette and betting your home, and your future, on every turn.
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Garland, TX
@sweetlilreb
Thanks for sharing. Do you mind if I get some more info from you?
Who is this policy with? I wasn't able to find anything that affordable.
After your hospital stay can I ask how much you paid? Did you negotiate for less than the 30k?
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Sweetlilreb says
I suggest reading every page of your policies, looking for exclusions, pre-certification requirements, and maximum payments ("allowable fee schedule," in Aetna-speak). Many people read only the marketing documents, and ignore the fine print saying everything is subject to the policy. It sounds like you have put together a combination of policies that should theoretically cover you, but if either policy is longer than two pages, ask yourself: why does it take so many pages to explain something so simple? Did the corporation writing the policy have a reason to make it longer and more complicated? Why might that be? I've seen amazing exclusions buried in the last few pages of 100-page policies, and Aetna does not even publish their "allowable fee schedule" so it isn't even possible to know what they would actually pay. Check whether your state allows hospitals and other providers to "balance bill" you for amounts in excess of what your policy covers, even in emergencies. Also I'm not sure what "Hg Deductible" means, but mercury poisoning can be serious.
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When my brother and his wife were in their early 30s, they were hit by that "doomsday scenario." His wife was in a terrible car accident (someone else's fault) and they were financially wiped out. Insurance is a rip-off, but if you can afford it (I can't), get it. Otherwise you may very well lose everything you have in the blink of another driver's eye.
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SomeoneElse says
That can happen with or without insurance. Check the "allowable fee schedule" on an insurance policy and compare it to the local hospital's charge master, and you may see why more than 70% of "medical bankruptcies" happen to people who had insurance.
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Don't risk going without catastrophic insurance. Small medical bills don't really matter if you have money.
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FortWayne says
Can anyone find a genuine catastrophic insurance policy? Existing policies' defects have been rightly criticized from across the spectrum. From the left, Michael Moore's movie SiCKO illustrated why more than 70% of "medical bankruptcies" happen to people who had insurance: the policies are full of loopholes that the insurer can drive a truck through, and even then their payments are capped based on illegal collusion (see New York Attorney General's settlement with UnitedHealth Group). Meanwhile, other critics point to the ever-growing list of mandates, including for toxic disproved pills advertised on TV (see the Mental Health Parity Act). An insurance policy is a contract, but most people don't take the time to read it, until it's too late.
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curious2 says
Aren't most health insurance policies "catastrophic" these days. with their high deductibles and all.
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North Chicago, IL
I've been covered individually since my mom's coverage would no longer carry me though there was a period of time I had no coverage at all. It was during that time I acquired a UTI and had to go to the ER. My hospital bill was well over $2,000.
Normally, I have low deductibles, usually between $1,000 and $5,000. Had I been covered at the time, that one hospital visit would've met or even have exceeded my deductible.
Because I was uninsured at the time, a payment plan had to be worked out with the hospital so the bill could be paid.
I checked in with my doctor recently after a 2 year hiatus. That check in, along with some blood draws and lab work and a flu shot, would've costed me $1,145 out-of-pocket had I not had insurance. The office visit alone was $239.00 and blood work doesn't come cheap.
As someone who works in the healthcare field, I can tell you that it's quite expensive and one would rip through a 30K emergency fund rather quickly.
Right now I have a high deductible policy that I pay $98.91/month, $7,500 deductible, 50% co-insurance for participating providers, $5,000 max out of pocket (total of $12,500 out of pocket). The basic dental plan, which I can use with ANY dentist, costs me an additional $9.30. All total, I pay $108.11 a month. My insurance is through Assurant Healthcare and it's some of the BEST individual coverage I've had thus far. I'm shocked at what I've had to pay out to providers. It's the least amount of money I've ever had to pay my providers. (Paid $78 to the dentist and $43.48 to the medical group my doctor is affiliated with.)