Going without health insurance

[dparm]

I am a young guy in his mid-20s with no real medical problems. A lot of my friends are like me and decided they don't need the insurance. I still carry insurance for the "what if" scenario. If I were to have a serious accident tomorrow, be diagnosed with cancer, etc., I'd be screwed without insurance.

Is it money down the drain? Partially. Do I feel more secure because of it? Absolutely.

 

[CivicFan]

Wow, this is a tough situation but I cannot in good conscious recommend you go without health insurance. For example, this Monday I was hit by a semi. I was taken to the ER. Had I had major health status deterioration because of this accident, my bills would run in hundreds of thousands of dollars. Would I be able to pay them? Absolutely not. If I were in a hospital bed, would I want to think about how I would pay the bills? Absolutely not.

But if you cannot afford the insurance premiums then you might not have a choice but to stop your coverage, live safely and wait till 2014 when affordable health plans will become available to the public.

 

[Schmoe]

Pray no one gets cancer. My wife developed breast cancer last year and for the first time, I totally changed my mind regarding health insurance. I'll admit, I'm probably better off health insurance cost-wise as others on here because I work for Uncle Sam and their health insurance is second to none. But still, it ain't free. Paying roughly over 400 a month. Her breast cancer would have wiped me out financially. No other way about it, I'd have to have filed bankruptcy. Now during that ordeal, I had to shell out about 5K in cash, however, I learned something. No hospital or medical provider can go after you if you make payments. There is no minimum amount. They LEGALLY can not touch your credit rating or even post these charges to the credit bureaus. The key is, make minimum payments, but keep it up religiously. Also, there are two different "bills." One is for without insurance and one is with insurance. Always check to see what the "negotiated" price is with your insurer versus what the bill is. Your out of pocket expense is the percentage of the NEGOTIATED price, not the uninsured price. Been there, done that. My current policy has a annual catastrophic limit of 5K. I always keep that money aside for this. I believe every insurance has a maximum annual limit, plan ahead. If your really young and healthy and not married, I'd almost say go with no insurance up until you hit mid-30's. But it only takes one scenario. It is "insurance", akin to auto insurance that you probably, hopefully, never need, but it is there just in case.

 

[eljefino]

One good thing about a catastrophic policy is you're still "in network" and your cash price can be much less than strict self-pay.

The main fallacy of our health care situation is that there's someone who isn't paying *enough* and by manipulating this or that we'll fix it. At 18% of GDP, I rather think we're all paying too much.

For what my employer and I are together paying in insurance, I could literally rent/finance a piece of industrial property and start my own business.

 

[Burt]

My thoughts exactly. Take a small piece of the money and join weight watchers, buy a health club membership instead.

 

[kb01]

Originally Posted By: CivicFan
Wow, this is a tough situation but I cannot in good conscious recommend you go without health insurance. For example, this Monday I was hit by a semi. I was taken to the ER. Had I had major health status deterioration because of this accident, my bills would run in hundreds of thousands of dollars. Would I be able to pay them? Absolutely not. If I were in a hospital bed, would I want to think about how I would pay the bills? Absolutely not.

But if you cannot afford the insurance premiums then you might not have a choice but to stop your coverage, live safely and wait till 2014 when affordable health plans will become available to the public.


Wow, that's truly awful. I completely agree -- Nobody wants to go without coverage but there aren't a lot of choices sometimes. We had to take a second mortgage to pay for medical bills and to cover our premium increases for this year. We can't do that for two years in a row. When I started my job, they actually paid 100% of our premiums but year-after-year, they've gutted the benefits. It doesn't help that we're so dependent on coal and our largest non-coal client was for BP.

I don't think the 2014 reform is going to help us since we earn about 402% of the poverty level. We'll get hit with the mandate but not the tax credits.

Hopefully, I'll get a government job before then or HR will find a cheaper carrier.

 

[Letter_K]

Originally Posted By: kb01
I'm still looking for a new job but they're hard to come by in West Virginia (my job is highly dependent on coal mining). I'm hoping for a job with the Army Corps so I can get government benefits.

The situation sucks. If I go without, I guess we'd have to get a divorce as soon as one of us were diagnosed with something, so we can get some financial protection. I can always go to the VA or do some work under my car when it's up on the scissor jack (I do have good life insurance).

My wife's also looking for a new job (her employer dropped their health plan completely last year).

Our plan year runs through Dec 31, so we still have some time to decide what we're doing and send out more applications on our own. If we have another 19% increase like last year, I just don't think I can stomach the idea of paying close to $1,200/month for insurance with a high deductible.


It's a tough situation and depending on where you live in WV (rural) you probably don't have some of the part-time employers that offer insurance. Starbucks used to be one, not sure if there are anymore. Believe me, I'm sorry you are in that situation.

You may want to call a broker and see what family coverage costs to buy on your own. Check with a couple of the major insurers in your state and unfortunately, the only other insurance broker I can think of is Zander Insurance, which Dave Ramsey endorses.

I too was going through life fine without problems until I developed a health problem went through a year of trying to figure out what was going on. I had to go to the Mayo Clinic (luckily they are nearby and covered) until I found someone who knew what was going on. In that year, I racked up $35,000 in bills that insurance thankfully negotiated lower and covered. The most expensive test was $7,000.00 and insurance agreed to pay $1,900.00. I don't think a uninsured person is going to get anything like that break unless they just can't pay and don't have assets to take.

 

[Johnny]

I'm thankful I have a good insurance plan through the Shell retiree program. Cost me $550 per month for the family plan for major medical, drugs, dental, and vision. My major medical bills in 2010 were well over $250,000. I would have been screwed with the insurance.

 

[IndyIan]

Originally Posted By: kb01
Originally Posted By: gathermewool
I'd be tens of thousands of dollars in debt if I didn't have insurance. I was fit as a fiddle one day, in agonizing pain the next, with no build up. Intestinal adhesion that could have killed me if I was too stubborn to go to the ER when I did. I'm minus a few feet of intestine, but only paid two grand (high deductible) - $1500 of which was already in my HSA.


How much were the total bills? How much is your health insurance premium?

I'm not claiming that health insurance isn't a good thing, it clearly is. But It just seems like that once premiums start breaking $10,000 or $15,000 a year with deductibles that are over $5,000 the math becomes that much fuzzier.

5 years of $15K premiums is a $75k safety net... If you could force yourself to save like that? What would that buy? It would be interesting to see the insurance companies probability tables on estimated claims.

 

[expat]

Warren Buffet LOVES to invest in insurance companies, he says they are the only business that gets their money 'up front' then argues about a pay-out.

So sad this situation has come about in America. :-(

 

[tinmanSC]

I went without normal insurance for 5 years, I just got insurance last year through an employer. When I was without insurance I had a policy that only covered catastrophic illness. It was a very high deductible (15,000) but I got in-network prices for everything. My doctor was in their network so visits and labs and such were about half off.

 

[PandaBear]

My parents are uninsured, they do have the option of flying to a 3rd world country to perform procedure out of pocket in any non emergency situation though. I was uninsured for about 6 months between job during the 2001 bust.

To be honest the most important thing to remember is that it is not the regular checkup and doctors visit, or the lower cost pills that will get you if you don't have insurance. It is the catastrophic incidents that you can't shop around . If you don't have much they can take away and a bad credit won't hurt you anyways, or you are low enough in income that care provider would pro bono, then you might be able to pull it off.

Treatment provider might not let you visit for long term care, however, so that would be an issue if you don't want to take the chance. You can't go to ER every time if you need physical therapy or a refill.

$1500 a year might be cheaper than a $16000 insurance policy, but it doesn't protect against hospital trying to seize your property to pay for the surgery you need but didn't pay for. $1500 fine also doesn't pay for any chronic illness treatment that you may need, and they don't pro bono long term treatment usually.

 

[PandaBear]

Originally Posted By: kb01
At least life insurance is comparatively cheap.


Funny how they only pay us so little if we die than to keep us alive.

If health care cost cutoff point is purely driven by cost benefit ratio or return on investment like auto insurance, half of us would probably be "written off" and left to die even if we are perfectly treatable.

 

[PandaBear]

Originally Posted By: CivicFan
So before going uninsured, make sure that you can afford lower quality of care and in case of large expenses you are willing to file for bankruptcy.


Please define "lower quality of care". If it is good enough to pass the current standard without losing the doctor's license, I'd imagine every doctor without a heart is providing it to cut cost regardless of whether the insurance is good or not.

p.s. pushing you out on a wheel chair after surgery is NOT quality of care.

 

[Drew99GT]

Originally Posted By: gathermewool
I'd be tens of thousands of dollars in debt if I didn't have insurance. I was fit as a fiddle one day, in agonizing pain the next, with no build up.


Likewise. I had my appendix removed at a cost of about $20,000. My high deductible plan costs me about $140/month (used to be under $100/month - Thanks Big O).

Try and shop around for some private plans, not through your employer. I'm one who rarely goes to the Dr. My plan alots 4 doctors visits per year with a fairly high co-pay. If I'm that sick, I'll go to the ER or an emergency clinic, not to a family doctor. Saves a lot in premiums.

 

[Drew99GT]

Originally Posted By: dparm
I am a young guy in his mid-20s with no real medical problems. A lot of my friends are like me and decided they don't need the insurance. I still carry insurance for the "what if" scenario. If I were to have a serious accident tomorrow, be diagnosed with cancer, etc., I'd be screwed without insurance.

Is it money down the drain? Partially. Do I feel more secure because of it? Absolutely.


That is basically what I have. High deductible major medical, but it has 4 general practitioner visits a year with a high co-pay.

It's through Blue Cross Blue Shield, called Tonik.

 

[CivicFan]

Originally Posted By: PandaBear
Originally Posted By: CivicFan
So before going uninsured, make sure that you can afford lower quality of care and in case of large expenses you are willing to file for bankruptcy.


Please define "lower quality of care". If it is good enough to pass the current standard without losing the doctor's license, I'd imagine every doctor without a heart is providing it to cut cost regardless of whether the insurance is good or not.

p.s. pushing you out on a wheel chair after surgery is NOT quality of care.


Doctors do not have an obligation to treat a patient they think will not be able to pay the bill. Or they may not recommend tests thinking that the patient cannot pay for them. Health care in the US is de-facto rationed by the ability to pay.

This kind of things are taboo to discuss but in real life they happen quite often. Statistically, controlling for the income level, uninsured people have more and more severe health issues than the insured. That did not happen by accident.

 

[meep]

you need insurance, at least catastrophic coverage, which is much less expensive - does not cover flu, earaches, and maybe even broken bones, but does cover the stuff that you HAVE to get taken care of, like appendix, liver, etc..

Having insurance does get you the negotiated rate with a provider, which is far less cost than "retail."

M

 

[Jim_Beverlin]

At almost 67 and employed by a good compomany that does not push the retirement issue, I would be a fool to retire based on the excellent plan that we have. Many others in the company are doing the same thing. Health care and insurance costs are going to be a significant factor whether you retire or not. I consider myself to be very fortunate and I do feel for families/individuals who are doing without insurance.

 

[opus1]

Originally Posted By: meep
you need insurance, at least catastrophic coverage, which is much less expensive - does not cover flu, earaches, and maybe even broken bones, but does cover the stuff that you HAVE to get taken care of, like appendix, liver, etc..

Having insurance does get you the negotiated rate with a provider, which is far less cost than "retail."

M
I have pretty good insurance, but thanks to the changes in the laws this year, all of my doctor visits so far have been out-of-pocket and applied towards my now-higher deductible. The irritating thing is that I have a thyroid ultrasound done every year in February, same doctor, office, billing codes, even billed-amounts. Last year I was on the hook for the co-pay, this year it was the copay plus the negotiated lower rate since my doctor is in-network, which then got applied towards the deductible.

And I'll stop now, lest I touch the dreaded political third-rail.