Thinking about dropping our health insurance - Page 3

[kittywitty]

Originally Posted by Bokonon

I consider health insurance to be an absolute necessity, personally. Especially when you have kids. I know too many women whose kids get sick and get worse and worse because they aren't insured and the parents can't afford/don't want to pay out of pocket.

Even the healthiest people get sick and injured. I was a healthy 29-year old when I developed preeclampsia and had to have a c-section at 32 weeks. My son spent 6 weeks in the NICU. My insurance was billed $250,000 for both of us, and that was 5 years ago. My portion? $1200.

You don't know that you won't use your insurance. Medical bills bankrupt uninsured and underinsured families.

I agree completely. Luckily here in IL, we make under $100k+ so we qualify for Allkids even as adults. We don't have to use it, but it's there when we need it. Can you look into some sort of public assistance program if you can't afford it? Or can you save how much you put into insurance now and put it in a high yield account to access for medical bills?

[Turquesa]

As another consideration, the health care "reform" bill that just passed has a forced-insurance mandate attached to it, meaning that you will incur fines as punishment for not having health insurance. This rule doesn't kick in until 2014, I believe, but it's something to think about.

[Emmeline II]

Originally Posted by shayinme

So no not all states will cover kids. That said to answer the OP you never know when anything will go wrong. At 37 my father years ago was diagnosed w/throat cancer and given 6 mos to live. Thankfully he had insurance and received excellent treatmend is approaching 60 now. Just this year I had hernia repair surgery that was far more extensive and thankfully it happened when I still had coverage. Right now I am looking at high deductible policies which still offer some protective coverage.

A couple of years ago dh came home from a business trip not feeling well. He woke up at 3am in severe pain and bleeding. It turned out that he acquired some bacteria that produced a polyp in his colon-- the total bill for hospitalization and procedures was $30,000; we paid $800 and insurance covered the rest.

[kittywitty]

Originally Posted by Turquesa

As another consideration, the health care "reform" bill that just passed has a forced-insurance mandate attached to it, meaning that you will incur fines as punishment for not having health insurance. This rule doesn't kick in until 2014, I believe, but it's something to think about.

It also will help subsidize affordable care if you can not afford it. OP-sounds like you've been ripped off by a scam company. I would shop around for other insurance policies. Is this through an employer?

[Emmeline II]

Originally Posted by kittywitty

It also will help subsidize affordable care if you can not afford it. OP-sounds like you've been ripped off by a scam company.

If this is the case I'd contact the state AG or state insurance commission.

[Turquesa]

Originally Posted by kittywitty

It also will help subsidize affordable care if you can not afford it.

Not really, but I suppose that's fodder for another discussion.

[cristina47454]

About the fine...MA has already done that, but the fine is piddly compared to what it costs to pay for insurance. If we hadn't qualified for state health care we would have had to tke the penalty. We just couldn't continue to pay almost $700/mo for insurance that didn't cover anything! I'm not saying that dropping insurance is the right decision...but in our situation (obviously, since we DID qualify for state insurance) it was not doable. Don't know why it took us so long to apply.

[emma1325]

An update on our situation.

We're considering dropping our current policy (and seeing about getting some of our money back since we were lied to) and purchasing hospital only coverage through Blue Cross as an alternative to having no coverage.

Thanks again for the advice, everyone. And please comment further, if you'd like, on our new plan.

[EFmom]

Originally Posted by emma1325

An update on our situation.

We're considering dropping our current policy (and seeing about getting some of our money back since we were lied to) and purchasing hospital only coverage through Blue Cross as an alternative to having no coverage.

Thanks again for the advice, everyone. And please comment further, if you'd like, on our new plan.

I don't know the specifics of what your proposed plan covers, but for my breast cancer treatment, well over $300,000 of it was non-surgical and not delivered in a hospital setting.

[ThisCat]

I would never drop health insurance unless paying the premiums meant not eating or something equally as necessary. Not only would I not want to risk denial of care and bankruptcy, but I also I wouldn't want to risk having to leave a huge bill for a healthcare provider to absorb thus increasing the cost of healthcare for everyone else.

If I felt a traditional plan was a waste of money, I'd do a price comparison of high deductible plans from reputable companies, read all the fine print, and go with the best fit. I'd also stash the savings and put it in an high yield account to cover the deductible.

[lmk1]

Originally Posted by emma1325

Thank you.

These are the EXACT things we've discussed. Our plan is so-so...and we're not convinced it's the most reliable in the event that we'd need coverage for something serious/expensive. There are many, many exclusions and specifications involved in the coverage.

AND, the agent who sold us the plan lied to us about several things regarding the coverage. She assured me that pregnancy would be covered (it's not), that we had a $50 co-pay for ANY doctor visits, and the remainder would be covered (not true) and she also said the first payment would be X amount and it ended up being X amount + $75 dollars...an amount which was very important to our monthly budget.

This agent sat face-to-face with us in Starbucks, and we very carefully listened before agreeing to buy the plan. I was shocked that pregnancy would be covered, since it was a high deductible-high co-pay plan.

Now we're wondering what else we were lied to about. Would we really be ok if one of us were injured and had to seek expensive emergency room care? Or would we be inadvertently taken to a hospital which is out-of-network and be on our own anyway?


Bottom line is, we're not confident in this insurance company AT ALL, and think we'd rather go without than continue giving them monthly payments.

But we're going to check into some other companies before making our decision.

Thank you everyone for your advice.

Do you have Golden Rule, by any chance? I am self insured with them...and they are the worst insurance I have ever had. I specifically wanted something with maternity coverage, and that's what the agent told me I was getting. Turns out it caps at 2,000. That's NOTHING. I am actually going in as a self-pay at the hospital because if they even try to use the insurance, it will end up costing me more (they use different rates). I've also had to pay the OB pretty much out of pocket. Furthermore, NOTHING for the newborn is covered. So, if he ends up in the NICU, I can't even imagine what it will cost - I assume we would go bankrupt. And this is not cheap insurance, either.

[cristina47454]

lmk1,

Double check your policy. MegaHealth is THE WORST insurance ever (got it specifically bcs of maternity coverage and then it turns out there wasn't any - so similar complaint) but the newborn care they won't cover is "standard" newborn care, which means that anything like NICU would be covered. I contested a $2000 bill for putting a tube down my baby's throat...not "standard" care as far as I know (!), and they actually paid it (!). I'm still in shock that they didn't make it more painful to resolve! Sometimes it's just a question of staying on top of them, which is a royal PIA.

[lmk1]

Originally Posted by cristina47454

lmk1,

Double check your policy. MegaHealth is THE WORST insurance ever (got it specifically bcs of maternity coverage and then it turns out there wasn't any - so similar complaint) but the newborn care they won't cover is "standard" newborn care, which means that anything like NICU would be covered. I contested a $2000 bill for putting a tube down my baby's throat...not "standard" care as far as I know (!), and they actually paid it (!). I'm still in shock that they didn't make it more painful to resolve! Sometimes it's just a question of staying on top of them, which is a royal PIA.

Thanks! I didn't even think of that. I'm planning on adding the new baby to my coverage as soon as he's born, but I was somewhat terrified by the possibility of something being wrong immediately before he's added. Ds #1 needed an xray when he was born and the regular (not contracted) rate would probably be about $500 just for that. Back then I had awesome insurance, and I didn't have to split hairs about what was covered or not.

[mama1803]

Originally Posted by Bokonon

I consider health insurance to be an absolute necessity, personally. Especially when you have kids. You don't know that you won't use your insurance. Medical bills bankrupt uninsured and underinsured families.

[CariOfOz]

I haven't read all the posts yet... but I'll tell you my story. Almost 2yrs ago my very healthy 20yr old son was hit side impact by a fuel tanker and spent 5 weeks in a coma in an SICU. The total bill if there was no insurance? 390k

And that isn't even including the amazing rehab he had (the insurance insisted he go to Shepard Centre in Atlanta, one of the top brain & spinal injury rehabs in the US), and he was there for 6wks as well.

Absolutely no way would I have wanted to have him without insurance even if I paid thousands of dollars a year for it. That insurance made his remarkable recovery possible, and I do not think he'd have come back like he has if he was in a local, less progressive, centre.

disclaimer: These days this is not a concern for me, I live in Australia and we have medicare. Any serious health need we have will be taken care of.. it's not perfect but it IS great. We do however, buy 'extras' cover for dental, optical and other assorted care though.

ETA: Finished reading through the thread! OP I'm glad you found an alternative solution to going without insurance, the financial trauma and emotional heartache of dealing with catastrophic medical bills is something NOBODY should have to deal with. I mean, it just should not happen.

[sparklett]

Originally Posted by Bokonon

Even the healthiest people get sick and injured. I was a healthy 29-year old when I developed preeclampsia and had to have a c-section at 32 weeks. My son spent 6 weeks in the NICU. My insurance was billed $250,000 for both of us, and that was 5 years ago. My portion? $1200.

Yes, that. I could have written that. No matter how bad our financial situation is, DH and I have always maintained our insurance. Some months it really seems like a huge waste, but you never, ever know when you might need it. I had a ruptured ovarian cyst recently and BOY was I glad I was insured!