What does it mean to not have health insurance in the US?

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30 comments, last by VladR 10 years, 11 months ago

NOTE: I don't care about what your opinions about healthcare in US or around the world is, I care about what my options are. Your politics are meaningless to me. I don't care enough the left/right position on this issue. If you want to masturbate, start your own thread.

Hi. I recently lost my health insurance. I'm a healthy late-20s male. My wife is a healthy mid-20s female. What does it mean for both of us? Emergency rooms are still obligated -- by US law -- to take people in. Any other avenues that I can look into?

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It means almost nothing... unless you get sick or run over by a car. My family skated by for years without health insurance. We even had two babies while uninsured. We lucked out and came out ahead. We saved far more by not paying insurance premiums than we paid on checkups, vaccinations and even the delivery of two babies. If my wife had to have a c-section or there were other complications things would have been quite different.

Edit: Also, if you just lost your insurance and you want continued coverage, look into COBRA coverage.

About half of all medical businesses (doctor, dentist, vision-related, tests) will take patients without health insurance, you just have to call ahead to find out if they do then pay up front. The major difference is big-ticket stuff like surgeries, which may be refused if you can't pay, and if you develop or are diagnosed with a condition then when you do get insurance again it may count as an existing condition. Also a pregnancy while uninsured is a mess.

You can, of course, buy minimal insurance if you can afford it - was something like 4-5k per year last I heard.

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I have insurance and went bankrupt from medical bills. If you have any sort of retirement or investments, or possessions, you don't qualify for hospital charity or medicaid or any assistance, leaving you on the hook for huge bills.

My insurance has chipped away at the policy each year to the point I'm responsible for tons of co-pays that amount to thousands per year, as well as 20% of surgeries/procedures.

I'm 29 and was completely healthy until I got the worst pain in my face 1.5 years ago.

I had a craniectomy last week and it's been a nightmare financially, with health insurance: If I default on my mortgage and somehow cash in my Roth IRA I'd be on medicaid and pay nothing, so you may be better off depending on your assets. Liquidate anything you have of value and hide it if you develop a medical condition.

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Friend of mine (self-employed) has a high-deductible plan that costs about $200 a month. He'd only benefit from it if there were serious problems, but he has access to healthcare at a decent hospital if he needs it (that's the real reason he has the insurance). I've been uninsured for about 10 years and I've gotten by -- ignored a (probably) broken toe, taped up a couple of deep gashes, let my body fight off infections. I've saved a ton of money and so far I've healed ok. It's a gamble. Shop around though, there are a lot of ways to approach it. If you're healthy, you can do as my friend does, just try to have about 10k in the bank for emergencies.

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If you have any sort of retirement or investments, or possessions, you don't qualify for hospital charity or medicaid or any assistance, leaving you on the hook for huge bills.

This isn't true in my experience. For our first child we qualified for medicaid based on income alone. No investments are taken into account. Maybe you can't get medicaid since you already have insurance?

It's also very true that not all insurance is created equal. Pay attention to maximum benefits, copay, coinsurance, etc.

I work in insurance at a hospital. At its most basic, not having health insurance means that you are massively exposed to financial risk. It is true that emergency rooms are obligated to treat you, but only to the point of stabilization, meaning that once you're physically capable of surviving without immediate medical intervention the ER has no further legal responsibility to assist you in any way. Further, you are legally obligated to pay for any services you receive (both in the ER and as an inpatient if you are admitted). But you should avoid relying on the ER as much as is feasiible, as the ER is by far the most expensive way to access medical services.

You will lose access to any insurer's negotiated rates, meaning that you will be billed the full amount for any services you receive. All medical facilities have some form of uncompensated care funding whcih can defray some of the expense for you, but the procedures for accessing such funding varies from place to place and the degree of assistance is impossible to predict.

You will likely need to pay upfront for any non-emergency care you access. You should ask how much money you will be asked to pay when you schedule any appointment as you may be turned away if you don't pay when you present for an appointment.

You may be eligible to continue with your previous coverage through COBRA if your insurance ended because you left the employer who provided it. If that is the case, contact your former employer to start the COBRA process.

You can shop around for individual insuance policies from insurance companies, but they tend to be expensive and have a ton of variation in what sort of coverage you will get.

Many areas have sliding fee clinics where you can access routine care at variable prices based on your ability to pay. I strongly suggest trying such a clinic if you have any health concerns (other than in an emergency). If you need care urgently, many areas have urgent care clinics which tend to be far less expensive the ERs. In a true emergency, don't hesitate to go to an emergency room.

EDIT:

As for Medicaid, your options vary wildly depending on what state you live in. Adults without children rarely have access to Medicaid-- there are only a couple of states where it's available, and tends to be heavily restricted. And even then, eligibility criteria vary quite a bit in terms of what the state looks at. Count on income mattering a lot; assets tend to matter as well, though with lots of caveats.

What state are you in?

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Catastrophic coverage wouldn't have helped me as I had over 20 visits to specialists last year costing $40/copay each then $40/copay for prescriptions at the same time your income dries up, it just plain screws you.

For me they based medicaid and food stamps off income and previous years tax records. I also have a rental house that gives me income monthly but it's not cash in my pocket it goes to taxes, insurance and mortgage. I rent my house out and live with my gf, no kids, 29 years old.

The prescription companies have programs to give you meds ONLY IF YOU DON"T HAVE INSURANCE. It's stupid they'll give you the meds at $250/mo cost to them but not just help you pay $40 and the rest through insurance.

You can, of course, buy minimal insurance if you can afford it - was something like 4-5k per year last I heard.

Sorry to derail the thread, but there's always the option of emigrating tongue.png $5k+ on insurance is insane!
When I had insurance, basic coverage for ambulance/paramedic costs was $40/year ($80 for a whole family), or more complete insurance was about $50/month for a couple. I cancelled it though because it's not a necessary expense and I wasn't getting my moneys worth.

Sure there's a lot more factors to consider than just the differences in healthcare costs, but it's an option, especially if you or your wife have an interest in living in other countries before you get to the age where you want to put down permanent roots.

You should at least get a catastrophic plan. I'm currently self-employed and have a plan that costs around $130 per month. It has co-pays and a high deductible, but at least I'm protected should anything major happen. Just make sure you can handle paying the max annual out-of-pocket costs, should it come to that.

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