Thinking about dropping our health insurance - Mothering Forums
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#1 of 56 Old 06-24-2010, 12:42 AM - Thread Starter
 
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We've gone over the numbers again and again, and we just can't justify throwing away so much money every month when we don't see doctors. Ever.

We went without health insurance for nearly 5 years...and in that time I saw a doctor once and my children had 2 check ups, and for those appointments we simply paid out of pocket.

2 months ago we purchased a high-deductible plan, but we still are having a hard time justifying the monthly bill for it...we don't use it...and we WON'T use it...as far as the typical well-visits go anyway. We very strongly feel like we're throwing our money away.

We have some money saved, and feel that we'd like to once again be without health insurance, and take the risks which are associated with that.

Our plan doesn't cover holistic medicine, and should someone in our family develop a serious condition, we're not likely to seek conventional medicine anyway. If one of us gets sick and needs to see a doctor, we could pay for it. If someone has an injury, we could afford to pay for it. If I get pregnant and end up needing a c-section (not likely), we could afford it. My husband has a great job and makes good money...and we don't like handing it over "just in case" when we aren't the doctor-seeing types. We'd much rather save it.

Does anyone else choose this route?

And/or can anyone bring to attention something we're missing in our logic here?

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#2 of 56 Old 06-24-2010, 12:57 AM
 
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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.

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#3 of 56 Old 06-24-2010, 01:03 AM
 
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I don't disagree that for us non-doctor-goers, health insurance is SO annoying. One thing to think about is that God forbid something big happen, you can wind up totally buried in bills (although your husband may make so much that money is truly not an issue). Last summer my brother in law was hit by a truck while riding his bike. He was in the hospital for a month on his back, multiple surgeries (in including one two weeks ago). So far the bills are about $400,000, paid by insurance. Without insurance I don't know what he would have done... I don't know if you just end up filing for bakruptcy or what.
I had a healthy pregnancy and wonderful, natural childbirth and my baby ended up in the NICU from meconium inhalation. A month later he had surgery for pyloric stenosis. Both of these things were beyond our control and would have cost a fortune without insurance. So.... not to be doom and gloom, but there are things that you just can't account for no matter how healthy your lifestyle.
I'm with you, IF I go to a doctor it's either a chiro or a naturopath, neither of which are covered by my insurance, but I still have it just in case. Our medical system is really screwed up and I hate paying into it I just don't feel like i have much choice at this point.
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#4 of 56 Old 06-24-2010, 01:46 AM
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We dropped our insurance this year. My kids are insured through their dad, but DH and I have nothing. We make too much to get on state health care, we make too little to afford the premiums, and the "limited" health insurance offered through my job doesn't pay for squat. It's a no-win situation.
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#5 of 56 Old 06-24-2010, 02:06 AM
 
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We dont have any either. We can buy food or insurance. Without food we'll be dead in a week or 2. Easy choice. We are prepared to declare bankruptcy in the event of catastrophic injury.

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#6 of 56 Old 06-24-2010, 02:46 AM
 
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I would think that health insurance brings a little peace of mind, esp. when tragedy strikes. If I were to end up in a situation where immediate treatment was needed, I wouldn't want treatment costs to be a factor in an already stressful situation.
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#7 of 56 Old 06-24-2010, 03:36 AM
 
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I would strongly suggest you go to ehealthinsurance.com, and buy the cheapest insurance you can for you and your family. Going without is a very bad idea. I know you never see doctors, and would prefer alternate medicine, but the fact of the matter is that health care in our country is silly expensive.

I'm imagining a family outing, when a drunk driver runs a light and totals your car with your family in it. All family members go to the hospital with various injuries. You say you can afford it. For this type of situation, the bill could top a million or more. Can you really afford it? If so, then why are you stressing the cost of health insurance?

The other sad truth is there is a different standard of care in our country for those with health insurance and those without. For example, limb reattachment is standard for people with health insurance, but considered optional for those without. Is your arm worth $500,000 or more? Would you like to make that decision for your family?

Under the new health care act, there are more state run low cost options for you and your family. Consider buying into one of those. Or like I said, visit ehealthinsurance.com and choose a plan that doesn't cover well visits or medications. They are cheaper. Just FYI I recently priced health insurance for our family of 4, and could go as low as $129 a month (for everybody) with a high deductible.

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#8 of 56 Old 06-24-2010, 03:47 AM
 
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also bear in mind that lapses in coverage can make it hard to have things covered when/if you do have coverage again.

My kids have double coverage. We have a kid who ends up in the ER and or admitted usually at least once a year. We'd be sunk financially w/o coverage.
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#9 of 56 Old 06-24-2010, 07:03 AM
 
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I was really glad I had insurance when, at 30 y/o, I unexpectedly got cancer. Prior to that, I really only had it because you are supposed to. Now, I really understand the value of having insurance.
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#10 of 56 Old 06-24-2010, 08:40 AM
 
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Last year, I had to have my gallbladder out. I was trying to wait until my baby was 12 months old (he was 9 months old at the time), and so I kept putting off my symptoms. Honestly? I was also trying to hold out to have it done until a new calendar year/deductible year hit, because we have a large deductible/out of pocket. I ended up with pancreatitis because of that choice.

I hate being in the position that I have to choose which health care I will take advantage of because of cost. And, I can only imagine that it would be MUCH more pronounced if I had no insurance at all.

My stepfather had his appendix out at, like, age 45? He was and is completely healthy before and after. But, the appendix was unexpected.

The cost for these benign surgeries travel into the 10s of thousands of dollars. Steep to pay for many people. Insurance helps with that.
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#11 of 56 Old 06-24-2010, 09:07 AM
 
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I was really glad I had insurance when, at 30 y/o, I unexpectedly got cancer. Prior to that, I really only had it because you are supposed to. Now, I really understand the value of having insurance.
I've been in the same boat. Health insurance is an absolute top priority in our family. If you were to be struck with a catastrophic illness or a chronic illness and don't have it, you are completely screwed. My cancer treatment probably cost half a million dollars, when all is said and done.

And while you might think you would shun conventional medicine, I think that's a really hypothetical call if you or your children are hit with something serious.
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#12 of 56 Old 06-24-2010, 09:20 AM
 
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can you get the kids insured thru your state?
every year whether we have insurance or not (and we have even had really good insurance at times) we spend about $10,000 out of pocket and we are not sick people. last year ds#2 fell of his bike and split his chin open and needed stitches, i had two miscarriages, the kids needed dental work.... it adds up.
one plus is that hospitals take payments. i can't imagine facing a half a million dollar bill BUT they will take payments.

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#13 of 56 Old 06-24-2010, 09:50 AM
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As someone who has been through chronic illness (lupus, since I was eleven), a major "accident" (beaten so severely that I was in a coma for eight days, when I was nine), and surprise emergencies (swine flu that nearly killed me, last year; car accident, age twenty-five; a collapsed lung out of nowhere; two years ago; etc.) I would never be without health insurance. I haven't been since I was ten.

You can never know what is going to happen.

My perfectly healthy, clean-living, physical therapist sister-in-law battled breast cancer a few years ago. My best friend's mother died of lung cancer, despite never smoking a single cigarette in her life at age forty-three. Another good friend's very cautious three-year-old daughter just fell off of a jungle gym at the park and broke her arm.

I'll say it again - you can never know what is going to happen.

I wouldn't risk it.
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#14 of 56 Old 06-24-2010, 09:56 AM
 
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I know there are different school of thought and some folks would move heaven and earth to have health insurance and others will always find it a complete waste of money and time.

I think in the OP situation you need to think of it as bankruptcy protection insurance not healthcare. How important to your family is it to not loose your entire net worth (minus whatever is in retirement) to a medical calamity? What makes you feel more frustrated/sick to your stomach paying premiums or losing what you have worked for be spent on medical care in a matter of a couple days, weeks or months. Perhaps the answer is actually a higher deductible plan?

I'm frustrated with health insurance too. For a totally different reason (but sort of the same reason too). My employer offers very good insurance, but at the expense of ever giving anyone real raises. I would enjoy some more take home pay and gladly forgo some of the admittedly great coverage since only one of the four people in my house has met the $100 individual deductible so far 9 months into the benefit year.
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#15 of 56 Old 06-24-2010, 10:14 AM
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I think in the OP situation you need to think of it as bankruptcy protection insurance not healthcare. How important to your family is it to not loose your entire net worth (minus whatever is in retirement) to a medical calamity?
I don't know the OP's whole situation, but if she's anything like me, she doesn't have a "net worth." What are they going to take from me? I have nothing in savings, the bank still owns my vehicle, and we rent. We live week to week, and will continue to do so at least until I finish school.
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#16 of 56 Old 06-24-2010, 10:17 AM
 
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I think in the OP situation you need to think of it as bankruptcy protection insurance not healthcare.
Exactly.

Yes, you can afford to pay for check ups and holistic visits or whatever. That's the main premise of a HDHP. A HDHP is for worst case scenario. Your whole family is in a terrible car accident, someone gets run over by a bus, that sort of thing. Those bills can easily run into the hundreds of thousands or more. Who knows, maybe you can pay that too. But would you really want to? I'd rather keep my money in my bank account. I know for me I'd rather pay $299 a month (the cost of a $10,000 deductible health plan for my family of 5) and know that I will never have to worry about hundreds of thousands of dollars in medical bills. Lots and lots of people have lost their life savings, their homes and more over medical bills they couldn't pay.
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#17 of 56 Old 06-24-2010, 10:22 AM
 
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We don't go to the dr much either, but my DH was laid off and we had no insurance for that time period and it was stressful to think that something could happen and we would have to file bankruptcy and loose everything we have worked so hard for. Not worth it in my opinion. Our health care is outrageously priced and we are a "poor" family yet we give things up to pay for it.

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#18 of 56 Old 06-24-2010, 10:28 AM
 
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Well, if you spend $10,000 per year or less general "emergencies" included that is less than most insurance esp. if you pay a deductible/copays plus payments. I'd look into catastrophic coverage since that is only for major emergencies.

If you are comfortable with what you describe, I'd say go ahead and drop it. Feeling okay with how you would handle various scenarios is as much peace of mind as anyone can have. Insurance companies sometimes drop coverage on people when things get expensive, deny coverage for really important things, etc. I have heard of quite a few people who have insurance having to declare bankruptcy due to medical expenses too. They thought they would be covered but then something major happened and the insurance co. found a way not to pay or coverage ran out. I've realized that big scary life-altering things can happen healthwise and we don't know when, nor how exactly we'll get through it no matter what we attempt to protect ourselves and our family with. In some ways health insurance can give a false sense of security at a hefty price tag.

That said, I will point out that while we are very healthy and low-intervention when it comes to medical stuff my dh will be 45 soon and the past five years he has used insurance a LOT. He has had a lot of small things and worrisome things come up. We used to never use it. I don't deal with conventional docs unless I have a need. I paid out of pocket for a long time and we paid maybe $300 per year average at most with six people in the family. (We qualified for state coverage at the time, but I didn't even have it BECAUSE you can apply on the spot if you take a child in to the hospital for something. It will then cover retroactively.) We still have paid for some things out of pocket. Like thousands for a vasectomy reversal...

I think when standard insurance becomes only an emergency backup plan the expense is highly questionable. I think you do what feels safe enough for you. This is a world in which things often do not turn out as we expect with or without insurance. Health insurance feels like good thing but I confess it doesn't give me very much sense of protection. I have difficulty trusting it would work out as needed if it ever involved paying out more than we were paying in. People get dropped all the time after they start having real health problems.

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#19 of 56 Old 06-24-2010, 10:53 AM
 
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People get dropped all the time after they start having real health problems.
Supposedly the regulations against this are now stronger than they used to be, due to the new healthcare law, so you soon will have more recourse if it does happen to you. That provision takes effect on September 23 according to this news article: http://www.sbsun.com/news/ci_15287105
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#20 of 56 Old 06-24-2010, 11:05 AM
 
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I don't know the OP's whole situation, but if she's anything like me, she doesn't have a "net worth." What are they going to take from me? I have nothing in savings, the bank still owns my vehicle, and we rent. We live week to week, and will continue to do so at least until I finish school.
She stated in the OP that she had enough cash reserves to self-fund a c-section. To me that's not paycheck to paycheck. I do think you're plan of action would be different with a net worth of $50,000 versus several million. She shared enough that the advice would be different than someone without any assets like yourself.
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#21 of 56 Old 06-24-2010, 11:10 AM
 
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Well, the point of insurance is protection in the event of an unforseen health problem. For example, last year I went to the ER with abdominal pain, turns out I had an ectopic pregnancy that ruptured. I had to have emergency surgery and ended up with a hospital bill over 20K. Dd2 was supposed to be a hbac...she wound up a transfer with a 2 week NICU stay and serious health complications and a 350K bill. No matter how healthy you think you are, stuff can happen. What if you get hit by another driver? Fall off a ladder? There's so much that can happen.
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#22 of 56 Old 06-24-2010, 11:20 AM
 
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I think in the OP situation you need to think of it as bankruptcy protection insurance not healthcare.
I realize there are different takes on it, but this is how I look at it.

We lost our own health coverage on Jan 1st, due to DH's company being too broke to pay the premiums, and we chose to pay for a high-deductible plan during that time, just for the peace of mind.

As of this week, I am switching from PRN to PT at my workplace. I'll be working roughly the same amt of hrs, only I will have less take-home pay due to paying the health premiums out of each paycheck. It's mainly so that I can have the peace of mind of knowing that we have health coverage.

We are "rarely see the doctor" types as well, but I like knowing that it won't completely empty our savings if something unexpected happens.

I guess it's just a matter of weighing the risks vs benefits, for your own personal comfort level.

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#23 of 56 Old 06-24-2010, 11:26 AM
 
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I think you should also consider what would happen if you do have something happen that would be beyond your financial means, forcing you into bankruptcy. I believe that would mean the healthcare providers would not be paid for their service to you, are you willing to deal with that?

We currently have state funded catastrophic insurance for our family. (we're between cobra ending and my new plan provided by my job beginning for a month. it doesn't cover any preventative care basically, but it gives us peace of mind in case of a major accident. I believe our deductable is something like $2,600/person?)

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#24 of 56 Old 06-24-2010, 11:36 AM
 
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One other thing about health insurance is that even with a high-deductible plan, your out-of-pocket costs are lower, because the insurance companies cut deals with HCP's. My high-deductible plan didn't cover a penny when I broke my foot, but my bills from the ER/doc/xray etc. were about 75% lower because I had insurance. Don't get me started on how stupid that system is, where the person without insurance has to pay the absurd premium rates!

In my mind, if you have little to lose by declaring bankruptcy and applying for state-funded health care in the case of crisis, then dropping your health insurance is probably no big deal. Otherwise, consider it as paying for a) discounted care and b) bankruptcy protection. If you think of it as paying for health care, you'll just be exasperated, 'cause heaven knows there's not much caring going on in the health insurance industry...

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#25 of 56 Old 06-24-2010, 01:06 PM - Thread Starter
 
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Well, if you spend $10,000 per year or less general "emergencies" included that is less than most insurance esp. if you pay a deductible/copays plus payments. I'd look into catastrophic coverage since that is only for major emergencies.

If you are comfortable with what you describe, I'd say go ahead and drop it. Feeling okay with how you would handle various scenarios is as much peace of mind as anyone can have. Insurance companies sometimes drop coverage on people when things get expensive, deny coverage for really important things, etc. I have heard of quite a few people who have insurance having to declare bankruptcy due to medical expenses too. They thought they would be covered but then something major happened and the insurance co. found a way not to pay or coverage ran out. I've realized that big scary life-altering things can happen healthwise and we don't know when, nor how exactly we'll get through it no matter what we attempt to protect ourselves and our family with. In some ways health insurance can give a false sense of security at a hefty price tag.

That said, I will point out that while we are very healthy and low-intervention when it comes to medical stuff my dh will be 45 soon and the past five years he has used insurance a LOT. He has had a lot of small things and worrisome things come up. We used to never use it. I don't deal with conventional docs unless I have a need. I paid out of pocket for a long time and we paid maybe $300 per year average at most with six people in the family. (We qualified for state coverage at the time, but I didn't even have it BECAUSE you can apply on the spot if you take a child in to the hospital for something. It will then cover retroactively.) We still have paid for some things out of pocket. Like thousands for a vasectomy reversal...

I think when standard insurance becomes only an emergency backup plan the expense is highly questionable. I think you do what feels safe enough for you. This is a world in which things often do not turn out as we expect with or without insurance. Health insurance feels like good thing but I confess it doesn't give me very much sense of protection. I have difficulty trusting it would work out as needed if it ever involved paying out more than we were paying in. People get dropped all the time after they start having real health problems.
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.

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#26 of 56 Old 06-24-2010, 01:14 PM - Thread Starter
 
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She stated in the OP that she had enough cash reserves to self-fund a c-section. To me that's not paycheck to paycheck. I do think you're plan of action would be different with a net worth of $50,000 versus several million. She shared enough that the advice would be different than someone without any assets like yourself.
Just to be clear in what I was saying there, we wouldn't be forced into bankruptcy over the cost of a c-section...we'd probably pay some of it upfront and then pay the rest in payments. We're certainly not rich, but we're not poor either.

Our current policy would cover $5K of an emergency c-section. We'd be responsible for the rest. In a years time, saving the monthly payments rather than having insurance, we could save a large portion of what a c-section would cost, and then keep it in the event that I don't get pregnant and need a c-section.


I'm so confused on what we should do. I feel like, and my husband feels like, we are just wasting our money and giving it to a company which we don't trust at all.

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#27 of 56 Old 06-24-2010, 01:37 PM
 
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It isn't a good feeling to be with a company you don't trust. You don't need an agent to get health insurance! Just an internet connection. It is important to look at several things when shopping: 1) visit co-pay. Cheeper plans will not offer this, and you will pay ALL costs out of pocket until you hit your deductable. The only exception is some preventative health care items, like mammograms, that are required by law to be covered by at least co-insurance. 2) co-insurance. When you hit your dedutable, you are not done paying. You will continue to pay a portion of your cost (a set %) until you hit your annual out of pocket maximum. 3) Annual and lifetime out of pocket maximums. You need to know how much you would have to pay in the event of a really $$ event. These range from $10,000 up to $50,000 or more. Pay attention to the difference between individual and family out of pocket maximums. Individual is the max amount you would pay if only one person was very sick, family is the max amount you will pay no matter how many family members are sick. 4) Maximum coverage. This is the amount that the insurance company will pay out before your insurance will stop. Usually in the millions, but good to know! 5) Network/out of network issues. I prefer an open PPO, like blue cross/blue shield. But you do need to know that if something happens, what will be the difference if you are in or out of network. Most high deductable plans arn't that picky about networks.

Once agian I suggest you DON'T use an agent! Health insurance is a buyer's market. Just go to ehealthinsurance.com, or the website of a company you trust, and price things for yourself. There are no contracts, so you can drop them anytime if you find a better rate (but don't have a gap in coverage!). Most rates are locked for at least 12 months, so they can go up slightly after that. But you can always switch plans if that happens. There is usually no enrollment fee, but if there is they will tell you upfront. That extra $75 you paid was most likely the agent's fee.

Good luck!

CD'ing, homebirthing, milk making school teacher. Supporting my family on my income and trying to get out of debt in 2013!
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#28 of 56 Old 06-24-2010, 02:24 PM
 
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There is a lot to be said on this topic and I can relate to everything you wrote, especially about preferred care (holistic) and not rich/not poor.

I'll just suggest you look at different plans for different family members. For our family, when we've had healthcare we had to pay for (at least in part), it has always been more cost effective for us to NOT have family plans. We've done several different arrangements, including no insurance for me. Right now, DH and I are on his employer's group plan. His premium is 100% paid by his employer; my premium is 100% paid by us. DD is on an individual plan 100% paid by us (purchased via ehealthinsurance.com).

"Kind words can be short and easy to speak, but their echoes are truly endless." - Mother Teresa

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#29 of 56 Old 06-24-2010, 02:33 PM
 
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This was our thinking a few years ago to go without health insurance. I would have, but where I worked, I got absolutely free health insurance worth like $400 per month for myself, so it didn't make sense to refuse something free. But my husband went without insurance for himself for about a year. Our thinking was also that we don't go to the doctors, use drugs, etc. anyway. Ever since we had our daughter though I felt that it was necessary. We can afford it, so we have it now. We are all healthy with no symptoms of health problems. Even our daughter has been extremely healthy, hardly ever sick and if sick only a little bit of sniffles and would be gone quickly. She was born at home, not vaccinated, fed a traditional foods nutrient-dense diet, not given any drugs or antibiotics. But...shortly after she turned 2 years old, she ended up in the PICU with vomiting, acidosis and bleeding in the stomach. Every test possible was performed. No doctor could determine a cause. They treated her as if she had type I diabetes, and it worked very quickly, but she didn't have it. This was last December. But anyway, so our hospital bills for our daughter totalled to about $68,000, which we do not have, but insurance paid most of it and we had to pay about $3,000 out of our pockets. So as you can see, even though we're all healthy, freak health problems can happen as it did in our case and we were glad to have insurance.

Traditional & nutrient-dense foods/Weston A. Price Foundation advocate, Reiki II practitioner, EFT practitioner, past life & life between lives Hypnotherapist practitioner. Home birth with DD 2007 = never vaccinated, breastfed 3 years

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#30 of 56 Old 06-24-2010, 02:40 PM
 
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Emma, what that agent did to you was a crime - I am not being hyperbolic, it literally was a crime. If I were you, I would want to talk to the insurance company, to the state insurance commissioner and possibly some other legal types about the fact that your family has been the victim of fraud.

I wouldn't want to keep paying your insurance company if I was in your shoes either, although I am very uncomfortable about going without insurance.
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