Medical Insurance in the US
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@dafyre said:
There are times when having insurance helps, for sure. My cochlear implant was $30k, and that was just the surgery and the implant device.
Like I keep demonstrating, that would have been way cheaper for me out of pocket than to have insurance when I had insurance just a few years ago.
And like most things like that, you can optionally leave the US and get it much cheaper too. Only emergency services would I use in the US anyway.
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I've had a CPAP for a decade. Even when I had insurance it was cheaper to pay out of pocket than to use the insurance!
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@scottalanmiller said:
@Dashrender said:
How can there be no coverage? because you aren't living in the US?
Correct, a US citizen residing outside of the US but being in the US for a few too many days means we carry the fully requirements for US insurance legally without having any (or only trivial) coverage provided by them. If you are 100% outside of the US and don't return, you are okay. But if you have family to visit like us, you get seriously screwed.
Sadly, no Obamacare qualifying plan provides coverage when you are outside of the US.
There is a reason why travellers plans come in two types: global traveller and global traveller with US. US coverage is the singular country not normally covered by all the international insurance companies.
That's really special case and I guess affects tiny fraction of US population. For huge majority, health insurance is much cheaper than not having it and end up paying out of pocket.
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@marcinozga said:
Pre-existing conditions shouldn't matter anymore. That's one part that obamacare got right.
https://www.healthcare.gov/coverage/pre-existing-conditions/In theory. I'm pro-OC in general, it screws me to high heaven, but the idea is good. But the system is so bad and so corrupt that I don't have confidence in the no pre-existing conditions thing. As someone who has been turned down for a burst appendix surgery, I am acutely (see what I did there) aware that the system has ways of not paying for things one way or another.
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@marcinozga said:
That's really special case and I guess affects tiny fraction of US population. For huge majority, health insurance is much cheaper than not having it and end up paying out of pocket.
Perhaps that is true. But for a decade of my life that has not been true and I know several people who have run the numbers, and live in the US full time, and still find it cheaper to be without insurance. People on this forum, too. Sure, it might be under 50% of people, but I don't think that it is a tiny sliver, either. It's way too common when normal people doing normal things can pay the penalties and still save money on long term health care. And I'm super healthy, I have one of the best medical track records possible, and I still am not affordable.
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@marcinozga said:
... and end up paying out of pocket.
I think that part of the trick of American health care is that they never have people test that theory. Those that do often realize that the insurance cost is higher than it should be.
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@scottalanmiller said:
@Dashrender said:
What makes you a special case - and let's assume you were not a world traveler, but a person only living in the US.
If I live only in the US, I might have reasonable options (not reasonable by any non-US standard but...) but as I don't, I don't. I've lived outside of the US since Obamacare came into effect and removed any option of coverage.
Well in that case you're fringe case - and while I agree that there should be provisions for that in the law - The situation is not screwing you into a 40K a year plan. You can probably get an insurance plan in crete for significantly less if you so desire while you are there, and the next place, etc.
it does suck that you have to pay the Obama tax, and frankly wrong - but that's another matter. If you wanted US only coverage, it would not cost you $40K/yr for your family.
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I pay 4k$/year for Cadillac insurance right now. Pretty much everything is covered and expenses out of pocket cap out at $1,000. Those expenses are few and far between as even most prescriptions are covered with a 5$ deductible.
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@scottalanmiller said:
@marcinozga said:
Pre-existing conditions shouldn't matter anymore. That's one part that obamacare got right.
https://www.healthcare.gov/coverage/pre-existing-conditions/In theory. I'm pro-OC in general, it screws me to high heaven, but the idea is good. But the system is so bad and so corrupt that I don't have confidence in the no pre-existing conditions thing. As someone who has been turned down for a burst appendix surgery, I am acutely (see what I did there) aware that the system has ways of not paying for things one way or another.
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
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@marcinozga said:
@scottalanmiller said:
@marcinozga said:
Pre-existing conditions shouldn't matter anymore. That's one part that obamacare got right.
https://www.healthcare.gov/coverage/pre-existing-conditions/In theory. I'm pro-OC in general, it screws me to high heaven, but the idea is good. But the system is so bad and so corrupt that I don't have confidence in the no pre-existing conditions thing. As someone who has been turned down for a burst appendix surgery, I am acutely (see what I did there) aware that the system has ways of not paying for things one way or another.
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
Doctors can and do turn you away for a burst appendixs.
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$30K is a crazy high insurance cost in this country for a plan. And that would be for the best of the best.
A typical family plan with a deductible (and no caps) would be sub 20K.
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@Dashrender said:
Well in that case you're fringe case - and while I agree that there should be provisions for that in the law - The situation is not screwing you into a 40K a year plan. You can probably get an insurance plan in crete for significantly less if you so desire while you are there, and the next place, etc.
Thankfully no. The situation is simply screwing me into paying out of pocket (which is essentially zero) and having to pay the tax penalty for being uninsurable.
If there wasn't a penalty to mock us for being uninsurable it wouldn't be so bad. But it is literally a form of mocking us for having not been given an option. It's downright mean.
No reason to have insurance on Crete. We CAN get it here, but that would be silly. Insurance outside of the US is SO low.
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@BRRABill said:
$30K is a crazy high insurance cost in this country for a plan. And that would be for the best of the best.
No, it was literally almost worthless. Super high deductible, low caps and lots of coverage problems.
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@coliver said:
Doctors can and do turn you away for a burst appendixs.
And I'm not the only one to have had this happen to them that I know personally. It's way too common.
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@scottalanmiller said:
@BRRABill said:
$30K is a crazy high insurance cost in this country for a plan. And that would be for the best of the best.
No, it was literally almost worthless. Super high deductible, low caps and lots of coverage problems.
For you, but I have never heard of that anywhere else.
Now, I have NO experience with people buying their own plans.
But I know from the local unions how much they are paying for top notch family coverage, and it's no where near 40K.
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@coliver said:
I pay 4k$/year for Cadillac insurance right now. Pretty much everything is covered and expenses out of pocket cap out at $1,000. Those expenses are few and far between as even most prescriptions are covered with a 5$ deductible.
Before I found out I'm a type-2 diabetic I had done a LOT of shopping around for health insurance in the US. The cheapest plan I found, with a $10,000 deductible, ran $450/month. For much less than $450/month I can pay for all my own expenses thank you very much. If I tell you what it would be now I'd punch the monitory it's gotten so stupid.
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@scottalanmiller said:
@BRRABill said:
$30K is a crazy high insurance cost in this country for a plan. And that would be for the best of the best.
No, it was literally almost worthless. Super high deductible, low caps and lots of coverage problems.
The Cobra plans are all like this. The cost for it would have been crazy high if I needed insurance during the two weeks of voluntary unemployment.... when I did the math it was going to be ~10K for a month, if I needed anything.
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As someone who works for a small company. Insurance for us (because we are small even going through a broker) Cheapest I can get: $1200/month (this is family). With a $9,000 deductible. Now even if I never use my insurance the cost per year: $14,400. If I used it my prescriptions that I take each month on the insurance: $128/month. Dr's visits until I hit my deductible are $165/visit at least 4 per year for med refills = $660 Blood work to go with each of those visits: $250 = $1000. Inhalers: $450 x2/year= $900. Scans= $1,500 each 4x's per year: $6,000 And I still haven't come close to hitting my deductible.
Insurance: $14,000
Medications: $512
Inhalers: $900
Dr;s Visits: $660
Scans: $6,000
Blood Work: $1000
Total: $23,072Without insurance: Stupid Tax on not having insurance as of this year: $1, 614
4 dr's visits: $100 each if paid in cash each time = $400
Medications: $30/month = $360
Inhaler: $900/year
Blood Work: $75 each = $300
Scans: $1,500
Total for a year no insurance = $5,000/year (that includes the OC tax)This is only me using the insurance. If husband or son ever need to use it well the costs go up from there.
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@scottalanmiller said:
@dafyre said:
There are times when having insurance helps, for sure. My cochlear implant was $30k, and that was just the surgery and the implant device.
Like I keep demonstrating, that would have been way cheaper for me out of pocket than to have insurance when I had insurance just a few years ago.
And like most things like that, you can optionally leave the US and get it much cheaper too. Only emergency services would I use in the US anyway.
I'll disagree with you here again. You could have US insurance, come back to the US, have that surgery, all for the cost of US only insurance - which for your entire family would be way less than $30K/yr. Would you have to fly back to the USA - yes.. but we aren't talking about life threatening thing.
So here's a question:
Let's say you get US coverage insurance by a US company only for use while in the US - Let's say it costs $15k/yr and you get insurance for world traveler, non-US. How much is that? I'm betting that adding those two together come to way less than $40K.
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@marcinozga said:
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
I don't know why it happens, do insurance companies refuse to pay so doctors refuse to do the service? Do doctors just not like doing it? No idea. But something makes US doctors commonly refuse this surgery (commonly enough that I know like four first hand examples). No matter what the reason is, the result is still a lack of coverage. The insurance companies have many routes to avoid paying for things even if the law says that they have to.
