Health Insurance

[Ash]

I was reading up on how health insurance works over at Howstuffworks.com and was wondering how many of you have it.



I'm 34 years old and haven't had health insurance since I was 18. (since 1992!)
Fortunately, I've never been seriously ill or in any kind of major accident that caused me serious bodily harm.

I dread the day some idiot broadsides me while I'm driving and I have to go to the hospital knowing I won't be able to afford the costs. 
The thought of me having to pay an exorbitant hospital bill for the greater part of the rest of my life because I didn't have health insurance is quite disconcerting.

How about you?
Do you have health insurance?
If so, what does it cover and do you think it's enough?

[Mr. DS]

Yes I have health insurance and without out I'd probably be living on the street due to medical bills.  Working for a hospital I see what the final bills are for different things and they are simply shocking.  Being a parent, health insurance is a necessity seeing for the first year or two you practically live in the pediatrician's office.   Both my wife and I have prescriptions too which thankfully are at least partially covered.  I think my asthma medication (without the coverage) would run into the hundreds monthly. 

Don't get me wrong, if you're a single person and in a good state of helath indeed you may be better off without it.  However, forbid anything like an accident may happen to you.  The true hurting will immediately start after you're realeased from the hospital.   

[Menard]

I dread the day some idiot broadsides me while I'm driving and I have to go to the hospital knowing I won't be able to afford the costs. 

The thought of me having to pay an exorbitant hospital bill for the greater part of the rest of my life because I didn't have health insurance is quite disconcerting.

Hospitals are required to stabilize anyone who is admitted, provided they have the facilities to do it, and cannot refuse admission to anyone who is in need of critical care.

Paying a hospital bill due to lack of insurance leaves one of two options:

1) As you mentioned, you can pay it as you can afford it. They will still harass the hell out of you, even if you are paying regularly, until you have paid it off.

2) Don't pay it. Take the hit on your credit rating. They will try to collect, but beyond that there is nothing they can really do to you to force you to pay. They will eventually write it off, and hospitals can write off amazing amounts.

If you do not have much work going for you at the moment and you are hospitalized, hospitals can write off a percentage, or the entire bill, if you provide proof of your income, or lack thereof.

Do keep in mind that taking a hit on your credit is a double edged sword today, if it involves a hospital bill. Many potential employers, unethically, will check your credit, regardless if you agreed to that or not as they don't need your permission. A hospitalization on your credit record will put a question in their mind, not of you skipping out on a bill, but of your health.


No, I do not have health insurance.

I was hospitalized once, for a perforated ulcer. Due to my being a caregiver for my mother at the time and hardly having any income for which to show, the hospital was able to write off their part of the bill. I paid the surgeon in payments. The rest got screwed.


Health insurance is expensive, and insurance companies are criminal.

For a single person, well frankly for about anybody, a PPO (preferred provider organization) is a cost effective way to get insurance.

A PPO has the benefits of an HMO while also offering insurance coverage. Unlike an HMO that only covers you if you go to a doctor on their program, a PPO will provide full cover for any doctors on their program, and reduced coverage for any doctors not  on their program; so you still have coverage with a PPO regardless of who you see.

Do keep in mind that with any form of health insurance there is no such thing as full coverage. Most health insurance plans have a deductible, and an 80/20 split up to a catastrophic level at which they pay 100% after that level (catastrophic is generally in the range of 5 to 10 times the deductible). Whether it is an 80/20 split or at 100%, the insurance will only pay by a schedule they set of customary and usual fees; meaning they decide the amount they will pay for any procedure, whether that is what the doctor charges or not, and the majority of the time it is less than what a doctor will charge.

Saving money on insurance is primarily a matter of getting the highest deductible you can. Despite the load of BS an agent will give you about not needing to put yourself at that kind of financial risk should something happen to you tomorrow (they are paid as a percentage of the premium), if you do the calculations in the difference between the premiums, in two years you will be ahead of any potential loss at that deductible level; just take the difference and put it in a savings account if you are that concerned.

[CheezeFlixz]

I dread the day some idiot broadsides me while I'm driving and I have to go to the hospital knowing I won't be able to afford the costs.  Bluesad

In KY you are required to have auto insurance which cover medical cost. If you are hit, the victim then the person that hit you insurance pay those bills. If they do not have insurance they are still liable. I don't know the law in Iowa, but most states follow this plan. That is why there are so many ambulance chasing lawyers. In KY you have uninsured motorist insurance as part of your comprehensive coverage to cover the cost, but you can still sue the person that hit. (Not that they'll have anything to get other than a judgment.) 

[Menard]

I dread the day some idiot broadsides me while I'm driving and I have to go to the hospital knowing I won't be able to afford the costs.  Bluesad

In KY you are required to have auto insurance which cover medical cost.

It might just be the way that you worded that. Let me expand on that.

In Kentucky, you are required to have a minimum amount of liability insurance. Though this is not medical insurance, and liability does not cover your vehicle or you, if someone should hit you and you are injured, their liability (their's, not your's) will kick in (depending on whether their insurance company tries to default on it) and supposedly cover your bills, as determined by an adjuster, up to the amount of liability coverage. If the amount is greater than the liability, it is up to you to take legal action to recover the rest.

Uninsured motorist coverage is available as part of liability, and many states do require it.

Some states do not require you to have auto insurance, but in those states they do have an insurance pool, or bonding, in which you either have your own insurance, or you contribute to the pool, which is effectively the same thing as insurance.

[CheezeFlixz]

Ok is what the state says ...

"If you're driving in Kentucky, you must have liability insurance, as well as basic no-fault personal injury insurance coverage; otherwise, you risk being fined and losing your driver's license and plates.

The minimum requirements for liability insurance are $10,000 for property damage and $25,000/$50,000 for bodily injuries. Drivers may opt for the "single limit" plan that covers liability of $60,000. The no-fault personal injury insurance will pay up to $10,000, regardless of who caused the accident."

Now you know that is some moron runs into you it will pay up to $25/$50K for bodily injuries. It will not cover the medical cost of the policy holder only you, if you are the victim. If you do not have liability insurance you are "technically" not allowed in states that require insurance. TN use to not require it and the boarder cops saw easy money when they saw TN tags. 

I carry comprehensive fleet and I don't keep up with the ins and out of it, as my agent lives next door that's his job. 

Ok were sort of off topic we return you to your regularly scheduled thread.

[Menard]

Ok is what the state says ...

"If you're driving in Kentucky, you must have liability insurance, as well as basic no-fault personal injury insurance coverage; otherwise, you risk being fined and losing your driver's license and plates.

The minimum requirements for liability insurance are $10,000 for property damage and $25,000/$50,000 for bodily injuries. Drivers may opt for the "single limit" plan that covers liability of $60,000. The no-fault personal injury insurance will pay up to $10,000, regardless of who caused the accident."

 

Same difference. Each state has its own minimum requirements of coverages that comprise the minimum liability coverage.

[Sister Grace]

Medical bills, health issues and insurance are horrible issues to deal with.

Being disabled, i get medicare which helps alot. The premium is like $130 a month and then $29 a month for the card that covers my prescriptions. That's a total of around $160 a month and i still have co-pays on dr visits and prescriptions, and trust me... social security doesn't pay that much and then there is still a child to feed, house payment, utitlites, ect. But if i didn't have health insurance my meds alone would come to around $800 a month.

James and I have talked about getting married someday and one of the issues is that how would this affect my insurance as i've had friends that get married and then lose some of their health benefits. I went back to work part-time for awhile and though i was picking up an extra seventy five dollars a week, it was costing me five hundred dollars a month in the long run as since i was working they cut back my check and upped the costs of my copays and premiums. I'm currently trying to finish up my degree; although i'm not able to really do any physically labor, my mind is still good and i'll go back to work when my degree is finished in two semesters. I only have to make sure where i work has good health insurance because at this point even if i were to land a job making really good pay, without health insurance i'd be even worse off financially than i am now.

[trekgeezer]

I've always had health insurance through my employers. It's pretty necessary if you have a family. Of course back in the late 70's and early 80's it was a lot easier to afford.

I was diagnosed with advanced thryroid cancer in 1988 and went through three years of treatments to get it into remission. In 1989 they found it had metastasized into my lungs so I had to have all kinds of test including a bronchoscopy, bones scans, and breathing tests.

By the time we had it whipped it had cost the insurance about $250,000. This doesn't count all the follow ups I've had since then.  I now only have to go for checkups every two years.

I just bring this up to let you know that you never know what's waiting around the corner for you.

My daughter is 23 and just graduated college last year, but has yet to find a job in her field (Art).  Since I couldn't carry her on my insurance anymore she got a temporary policy through Blue Cross that was good for six months and really only covered treatment for when you actually have something wrong with you (we found out it didn't cover any kind of routine exams like physicals).

It was pretty reasonably priced at about $250 for the six months and it is intended for recent graduates and people between jobs.

[AndyC]

Being in Canada, medical insurance is provided by the government, and for me, I'm pretty sure it's less of an expense on my tax bill than it would be as a separate expense. If I made more money, it probably wouldn't be. Medication, eyeglasses and dental care are insured through my job. Not much that isn't covered, and I've been glad of that on a few occasions.

The health system here has it's own problems, of course. Aside from doctors going where there's more money, and the availability of service being determined by bean counting bureaucrats, wait times are the biggest problem.

Try to get service in an emergency room, and you could be there all night, surrounded mostly by people who have nothing to gain by being there. They came just in case, because it's "free." I'm told if you show up on a beautiful, sunny Saturday afternoon, it's far less crowded. But really, in a Canadian city, any time outside of weekday business hours, it's virtually impossible to see a doctor in less than five or six hours unless you have something immediately life threatening.

For less urgent matters, it can take weeks to see your doctor, and the typical family doctor has such a caseload that he acts mainly as a referral service, treating only the really simple stuff and sending everything else to a specialist. Seeing any kind of specialist means a wait of several months for the first visit. Same goes for really expensive tests, such as MRIs, although I think that has improved.

And there is relatively little choice. You take whatever doctor is accepting new patients, and go to whatever specialists you get referred to. It's not that you don't have a choice so much as there just isn't any room for choice.

I do think it's better than the system in the US, but it seriously needs an examination.

[Killer Bees]

I don't have health insurance and I don't intend to get any.  It's a complete rip off in this country.  I'm a very healthy person and I work hard to stay that way.  But come tax time because I'm over 40 and have no health insurance, thebloody government slugs me the Medicare levy which is $500.  So I usually end up paying the tax office instead of them paying me.  Bastards.

I've heard from lots of people that no matter how much you pay into insurance, if you get sick and have an op and are in hospital for a while, they never pay 100% of the cost, which is what you'd expect insurance to do.  You have to pay an excess and they MAYBE will pick up everything else.  In the meantime, they will stuff you around and make your life hell as you try and claim and then when they finally do pay, it takes months.

I don't understand this.  What's the point of having insurance if they don't pay up when you need it?  To countermand this, I'm putting 10% of my net pay into a high interest internet savings account so that if anything bad does happen, I can pay all of the costs in cash and that's it.   Our ambulance levy is charged as part of our electricity bill each quarter so everyone is covered if you need to call an ambulance.

My son once asked me if we have health insurance and I said no.  He asked why not and I told him we practice wellness not illness.  I think if more people did this, especially the grossly overweight/diabetic people who voluntarily eat crap takeaway food, then our health system wouldn't be in such a shambles.

End rant.

[AndyC]

The ambulance ride is one thing our health care system doesn't cover. I've never understood that. If you have an accident or a seizure and need to be patched up and taken to the hospital, I'd say that's as necessary as any medical procedure you get when you arrive. Strange.

I do agree about insurance being a ripoff, whether it's health, home, auto or whatever. Insurance is one of those businesses that seems to be able to decide how much profit they want to make, and set things up accordingly. If they're frequently paying out on a particular kind of claim, they'll start reserving that for the higher-priced policies, raise the premiums, or just raise the deductible on the basic policies. People must, under no circumstances, receive value for their money.

And if you do need to make a large claim, which is the reason you bought the policy in the first place, they dub you a high risk (even if it was a one-in-a-million thing) and jack up your premiums.

And all of this serves to discourage people from making claims.

To me, paying off on claims is a cost of doing business. If you have a string of big claims, profits just won't be as spectacular. If just about any other business hit some extra expenses, they would most likely have to eat that cost. They don't have the luxury of raising their prices to keep profits at the level they've chosen.

I think insurance is a useful thing, but I also think the industry has forgotten what it's supposed to be. Then again, they seem to remember in their sales pitches, where it's all about being there for you in your time of need.

I have the same problem with banks, using my money to make their profits and charging me for their trouble. Not cricket.

[Menard]

I do agree about insurance being a ripoff, whether it's health, home, auto or whatever. Insurance is one of those businesses that seems to be able to decide how much profit they want to make, and set things up accordingly. If they're frequently paying out on a particular kind of claim, they'll start reserving that for the higher-priced policies, raise the premiums, or just raise the deductible on the basic policies. People must, under no circumstances, receive value for their money.

Insurance, at least is the U.S., is the only industry that is not regulated on a federal level, but on a state level. There are common regulations from state to state, but each state has its own rules and regulations for insurance and an insurance commissioner.

There are solvency requirements for insurance companies; they must have a certain percentage, of their policies, in liquidity (meaning that they have to be able to cover a minimum number of the policies they hold if so many were to make claims at any given time).

The insurance companies maintain studies on death averages and other averages to determine what they need to have incoming versus outgoing on policies in order for them to stay above board. That's where adjusters come in and their job is to maintain their quotients by finding ways to deny and settle claims.

One thing that lawyers have found out is that despite what people think about them in general, they think even less about insurance companies; that's why so many lawyers run these private label TV commercials that make the insurance companies the bad guys and the lawyers the good guys.

[BeyondTheGrave]

I was on my mothers insurance till about a year ago when I graduated college at 22. Now being 23 don't have any and currently work with no insurance. Everyone here is pretty much right about Insurance being rip-offs. No two ways about it.

[AndyC]

I do agree about insurance being a ripoff, whether it's health, home, auto or whatever. Insurance is one of those businesses that seems to be able to decide how much profit they want to make, and set things up accordingly. If they're frequently paying out on a particular kind of claim, they'll start reserving that for the higher-priced policies, raise the premiums, or just raise the deductible on the basic policies. People must, under no circumstances, receive value for their money.

Insurance, at least is the U.S., is the only industry that is not regulated on a federal level, but on a state level. There are common regulations from state to state, but each state has its own rules and regulations for insurance and an insurance commissioner.

There are solvency requirements for insurance companies; they must have a certain percentage, of their policies, in liquidity (meaning that they have to be able to cover a minimum number of the policies they hold if so many were to make claims at any given time).

The insurance companies maintain studies on death averages and other averages to determine what they need to have incoming versus outgoing on policies in order for them to stay above board. That's where adjusters come in and their job is to maintain their quotients by finding ways to deny and settle claims.

One thing that lawyers have found out is that despite what people think about them in general, they think even less about insurance companies; that's why so many lawyers run these private label TV commercials that make the insurance companies the bad guys and the lawyers the good guys.

I'm just speaking in general terms, since the regulations do vary. But insurance companies do all seem to have the common practice of punishing people for actually benefitting from the policies they pay for.