Maybe dropping healthcare

[HikeMama]

I am considering dropping my healthcare. I do not qualify for medical assistance, but our income is plenty low enough to qualify for 100% financial assistance at all the local nonprofit hospitals. I don't travel and am young and in good health. What I have now I buy privately and it is a high deductible health plan. It covers my preventive gyne, preventive pcp, and one dentist visit every 2 years, but after that is the deductible. I could pick it up for a month or two when I want to get those, I don't need to sign up for an entire year. We make it but we struggle and I would love to use the money I use for my healthcare towards a bill so I can eliminate it, maybe even save a dime, or just worry less about how much is in our bank account. I know it's a risk. It would be temporary, probably for a couple years at most, when my daughter's in school and I get a part-time job and can afford to buy some healthcare again. I would probably up my medical policy on my car insurance a little, I hear it's pretty cheap to do that.

I'm wondering if anyone reading this has done this? Or if you have any input or anything I haven't thought of?

Thanks.

[2lilsweetfoxes]

It is a risk.  What is your plan if something catastrophic happens--diagnosis of a serious illness or you are in a severe accident?  Or, something happens in the next couple years and when you go to buy insurance, you are now uninsurable?  Do you have a partner and does he/she have insurance where a family plan is available and would you be eligible to be on your partner's plan?

[HikeMama]

valid points, and why I haven't made the jump yet. It is true that pre-existing condition clauses will still exist until 2014 and that is a consideration.

As far as if I was in a serious accident, I think I mentioned that I would be upping my policy limit on my car insurance just in case. But see, even if I went over the limit, the hospital would have to write off all of my personal responsibility and would be legally obligated to care for me regardless of my inability to pay.

My husband has insurance and is covered at no cost by his work. We cannot afford to add me to his plan.

I'm surprised I haven't gotten more responses to this. This is a tough decision to make. Perhaps I could switch to an even cheaper plan instead, although there aren't many, just so I am covered in the case that I was diagnosed with a serious illness, and that way I would never fall under pre-existing loopholes...

[zebra15]

Well look at things this way, yes the hospital would care for you but what about after care? Who is going to cover rehab/op-pt and the like? Out patient dr's visits, very few private dr's offices do charity cases, nor do rehab centers.  What if you need care from an in-home health  service?  Medications can also be costly.  Honestly I wold not drop the coverage.  I've also not heard of a plan where you can sign up for a month or 2, get your annual exams, drop then sign up again in a year for the same thing.

[PenelopeJune]

I wouldn't do it. My family has no insurance right now (hasn't since May) and I feel naked. It sucks knowing that we CAN'T go to the doctor. Sure, we'd go in an emergency, but what about a less obvious emergency?

If you CAN afford your insurance and still eat, I'd keep it.

[HikeMama]

I'm definitely going to look into some cheaper options. My plan does not require an annual contract. I can just pick it up and then drop it. But, yeah, it just might not be worth the risk....

[HikeMama]

keeping it. Thanks for all the input!

[medmom7]

So glad you decided to keep your health insurance. I can't tell you how many people who have had unexpected health problems and the lack of insurance forced them over the edge to financial disaster. So sad, but it happens. In my opinion, just not work the risk.

[thriftyqueen]

Glad you are keeping it.  My SIL's sister recently dropped to a catastrophic coverage plan and just found out that she has a rare illness that is going to require a lot of treatments and a high cost.  They are going to be paying out the nose even with the catastrophic coverage.  Can't imagine the bills if they had no insurance at all.

[sunnysandiegan]

I've been uninsured and it worked out. However, I don't recommend it. It wasn't deliberate on our part, but it sure was difficult to get insurance again.

(I've had EXPENSIVE group insurance for a few years now, which was a fight to obtain.)

Fast-forward to early this month -- I was finally FINALLY accepted for an individual plan again. I have applied many times over the years and was denied every time. I even have a friend who was an agent and he went to bat on my behalf with a local healthcare company where he had personal connections. Nothing worked due to my pre-existing conditions: allergies, asthma, and a benign kidney tumor. I hadn't been treated for ANY of those conditions in several years, but it didn't matter.

NOW, however, the application AND phone interview didn't ask any questions about those conditions in the "ever" timeframe. I answered every single question honestly and I finally qualified! The cost is half what the group plan was costing us and the new policy is BETTER. I went through ehealthinsurance dot com, as I have done for DD for 7-8 years. A different friend works for Blue Cross and she told me the new laws started taking effect and that's why the application was so different and how I finally qualified. There wasn't an application fee, either.

So, I recommend at least taking a look at ehealthinsurance and seeing what is available now.

[carmel23]

We do not have health insurance (DH and I, our kids do) and honestly, I would never go back to paying for it again.  I find the companies to be unethical and they prey on people's fears... what if, what if, so what if? 

We pay cash for a ND, and qualify for 100 per cent coverage by the local hospital.  So I will have a physical there every 3 years, and otherwise go to the ND.  We spend the money we aren't paying for insurance on wellness: good food, exercise, mental health. And if our income increases (which it will this year yippie!)  I will be overjoyed to pay this hospital whatever I owe them, and even more, because of the care they've given me--and I would love to allow them to do this for others as well.

If I get hit by the bus and need a ton of care I will work out a cash payment plan with the hospital.  And I will still pay less then I did if I had insurance. 

[carmel23]

Originally Posted by thriftyqueen 

Glad you are keeping it.  My SIL's sister recently dropped to a catastrophic coverage plan and just found out that she has a rare illness that is going to require a lot of treatments and a high cost.  They are going to be paying out the nose even with the catastrophic coverage.  Can't imagine the bills if they had no insurance at all.

Please tell your sister in law sister about the new Health care blue book. http://healthcarebluebook.com/

If she has recurring treatments, she should shop around at hospitals/ clinics and tell them she is paying cash-- she should get a 10 to 15 per cent reduction in the price (and she can know if someone is ripping her off with the health care blue book). 

[cocoanib]

Originally Posted by carmel23 

Please tell your sister in law sister about the new Health care blue book. http://healthcarebluebook.com/

If she has recurring treatments, she should shop around at hospitals/ clinics and tell them she is paying cash-- she should get a 10 to 15 per cent reduction in the price (and she can know if someone is ripping her off with the health care blue book). 

Thanks for the blue book link!
 

[HikeMama]

To the pp who mentioned checking ehealthinsurance- that's where I get my coverage and I think I have a pretty decent plan really. I rechecked it and I couldn't find anything I'd rather buy. There were a couple cheaper plans but there was a gigantic difference in OOP max and deductible. So I'm actually pretty reaffirmed about it now.

Originally Posted by carmel23 

We do not have health insurance (DH and I, our kids do) and honestly, I would never go back to paying for it again.  I find the companies to be unethical and they prey on people's fears... what if, what if, so what if? 

We pay cash for a ND, and qualify for 100 per cent coverage by the local hospital.  So I will have a physical there every 3 years, and otherwise go to the ND.  We spend the money we aren't paying for insurance on wellness: good food, exercise, mental health. And if our income increases (which it will this year yippie!)  I will be overjoyed to pay this hospital whatever I owe them, and even more, because of the care they've given me--and I would love to allow them to do this for others as well.

If I get hit by the bus and need a ton of care I will work out a cash payment plan with the hospital.  And I will still pay less then I did if I had insurance. 

I know what you're saying. What made me decide to definitely keep it is what a pp said about specialist office visits and other private practitioners. They can and many do deny care for those who can't pay. (I used to work in health care billing, so I should have remembered this myself...) And while I agree that they are unethical and prey on people's fears, they are often very valid fears and concerns. It was a hard decision for me to wrestle with, but while I can afford it, I am happy with my decision to keep it.
 

[crazyms]

I see you already decided to keep your plan but wanted to toss out something else for you to consider. You mentioned that you qualify for 100% assistance from the hospital if you needed that (I think I understood that right). I'd check with the local health department. Our state has medicaid and another state insurance for kids that has higher income limits so maybe you can at least get your kids on it (if you haven't already). Also they have a family planning medicaid that has higher limits than the regular medicaid and covers gyn appts and birth control and such for women if they aren't fixed. If you qualified for that then maybe there would be a way to swap to a different insurance plan to at least save you a little money. Just a thought although I'm not sure if that would work just wanted to toss it out there in case.

[HikeMama]

My daughter is covered by the state program. It is amazing. I tell everyone to get on it. (There are no income limits, but if you make over a certain amount you pay a premium on a sliding scale) I do believe I would be covered by the state if I was pregnant or had an infant under 1. Something like that...

[carmel23]

Originally Posted by HikeMama 

To the pp who mentioned checking ehealthinsurance- that's where I get my coverage and I think I have a pretty decent plan really. I rechecked it and I couldn't find anything I'd rather buy. There were a couple cheaper plans but there was a gigantic difference in OOP max and deductible. So I'm actually pretty reaffirmed about it now.

I know what you're saying. What made me decide to definitely keep it is what a pp said about specialist office visits and other private practitioners. They can and many do deny care for those who can't pay. (I used to work in health care billing, so I should have remembered this myself...) And while I agree that they are unethical and prey on people's fears, they are often very valid fears and concerns. It was a hard decision for me to wrestle with, but while I can afford it, I am happy with my decision to keep it.
 

I guess I see this as an area of activism.... because if an office had that policy I would not want to support that drs. office. It perpetuates this status quo of everyone having to pay tons of money to these companies that then provide very little " service." Not every insurance co is like that, but the majority see to be that way.

Mama, I am in no way critical of you choice. I know you have to do what you feel is right.  And every region/state is so different.  I happen to live in Oregon, which has a pretty good system for people with little or no insurance. Here is another web resource provided by the state of Oregon, which may also be useful to folks in other states:

http://www.oregonhealthconnect.org/
 

[kristandthekids]

Since you're healthy, have you thought about an HSA?

My kiddos have health insurance through the ex but I don't have any. I loved my cash system when we lived in South Dakota. I was treated like a paying customer. Since moving to Texas I had almost every place treat me like I was some deadbeat despite the fact I was paying them right then and here. Not making payments, paying cash up front. But they still gave me the eye.
I love the doc I've switched to. They're back to treating me like a customer. And they give cash discounts. I was told my first prenatal visit would be about $1200. I was able to whittle it down to about $700.

[carmel23]

Originally Posted by kristandthekids 

Since you're healthy, have you thought about an HSA?

My kiddos have health insurance through the ex but I don't have any. I loved my cash system when we lived in South Dakota. I was treated like a paying customer. Since moving to Texas I had almost every place treat me like I was some deadbeat despite the fact I was paying them right then and here. Not making payments, paying cash up front. But they still gave me the eye.
I love the doc I've switched to. They're back to treating me like a customer. And they give cash discounts. I was told my first prenatal visit would be about $1200. I was able to whittle it down to about $700.

We had a horrible experience with an HSA.  I don't like the IRS telling me what is a health need and what isn't.  I think they are really good ideas, in principal, but I'd rather be taxed a little bit and then decide what I spend my money on.  Things like fish oil and vitamins are not considered health care costs... or anything that goes to " general wellness," at least that was our experience with Paychex HSA.  Wells fargo was waaay better....

I love cash discounts/payment plans.  It has worked well for our family, too. 
 

[sunnysandiegan]

Just for clarification purposes, the IRS dictates the HSA rules not the bank/trustee. The IRS has cracked down on the rules. This year, for example, all payments/withdrawals for "medicine" (of any kind, even OTC) has to have a written prescription. Two years ago, when we were last able to contribute to our HSA, this was not the case. I looked up the rules on the IRS website since our HSA trustee is the same now as then. Even when you can no longer contribute, you can still take distributions for qualified medical expenses.

Anyway, that sort of thing doesn't concern me or my husband. We use the HSA for dental visits and eyeglasses. We would also use it for co-pays, if we have any. (We don't actually go to the doctor very often.) Our main purpose of having the HSA, though, is to build it up for supplemental retirement funds. DH's company does not have a 401k. We each have Roth IRAs and we max them out each year, but it is not enough to retire on. An HSA can be used for health expenses at any point in your life whether you can contribute anymore or not, so we use it for the random qualified medical expenses now and we build it for any potential unplanned health expenses in the future. It is treated like an IRA in many ways, just with a defined use. So, we just plan to build it more slowly for that defined use for the long-term. We look at it as it diverts health expenses away from our regular retirement funds when that time comes. It is a savings account meantime.