Can't afford health insurance, is it worth having anything in life?

[kaywoody]

EMTALA requires hospitals to STABILIZE all patients regardless of insurance or ability to pay. There's a pretty big gap between stabilizing a patient and treating them.

A good example of this was when I was coaching High School volleyball with a student with an obviously broken arm. I took her to the emergency room and even with the notarized permission form from her parents, they wouldn't treat her until they made phone contact with her parents. We were 3 hours from home, and sat in the emergency room with her crying in pain because her mom was outside working in the garden and didn't hear the phone ringing.

When I pushed them to treat her because there was no doubt the arm was broken, they wouldn't because she was "stable", and not in danger of dying.

With no insurance, who knows what they might or might not do.... just splint it and send us on our way?

 

[indimom]

Like others have said, our insurance is already higher than a car payment. We pay $450/month for our plan.
I would never want to live without medical insurance. It's not just cancer and transplants and traumatic brain injuries that could ruin a family, it's chronic care for things like diabetes or high blood pressure.
Our daughter gets shots every six weeks to preserve her vision. The shots cost $500 each. If we ever run into problems getting this drug (a possibility, it's been taking a lot of heat lately), the only other option is another shot that costs $2,000 a pop every six weeks. That's A WHOLE LOT MORE than a car payment. That's more than double our mortgage!
I'll gladly pay for the insurance.

 

[SoonerSarah]

It is not uncommon for severe brain injuries to cost $1 million in the first year.

 

[fakereadhed]

A good example of this was when I was coaching High School volleyball with a student with an obviously broken arm. I took her to the emergency room and even with the notarized permission form from her parents, they wouldn't treat her until they made phone contact with her parents. We were 3 hours from home, and sat in the emergency room with her crying in pain because her mom was outside working in the garden and didn't hear the phone ringing.

When I pushed them to treat her because there was no doubt the arm was broken, they wouldn't because she was "stable", and not in danger of dying.

With no insurance, who knows what they might or might not do.... just splint it and send us on our way?

This is an example of needing consent for treatment, not lack of treatment due to insurance issues. There are options that need to be discussed with an injury, and treatment would be based on that. Often broken bones are just splinted and seen by a doctor for casting within a few days. There was no rush if she was stable.

 

[mrodgers]

Curious for those stating the premiums of $400 or more.. Is that fully paid self insurance or is that through work?

That's incredible because though mine might be lower at $326/month, supposedly I pay 20% and employer pays 80% of the premium. So that $326 that I pay is only 20% and the overall premium would be $1625 (if the word of the HR department can be trusted, which they've proven it certainly can not be trusted.) And I seem to pay out my rear every time one of us goes to the doctors too.

 

[MSLRAC]

Curious for those stating the premiums of $400 or more.. Is that fully paid self insurance or is that through work?

That's incredible because though mine might be lower at $326/month, supposedly I pay 20% and employer pays 80% of the premium. So that $326 that I pay is only 20% and the overall premium would be $1625 (if the word of the HR department can be trusted, which they've proven it certainly can not be trusted.) And I seem to pay out my rear every time one of us goes to the doctors too.

DH pays 50% which is roughly $850 a month for a family policy through work.

 

[bumbershoot]

I would rather spend my money on travel and such vs. trying to have the american dream that could be put up for sale by your local hospital.

I don't understand.

If you contact a hospital and set up a plan and then DO the plan, they will almost always (and I've never heard of the "almost", only the "always", but I'll put in "almost" just in case) work with you.

I had a plan in which we were to pay something like $25/month. They were awesome about it until we missed 2 payments, then they turned us over to collections. But if we'd continued to just pay the $25 it wouldn't have come to that; it was OUR fault.

If you need to use a doctor, a hospital, etc, just WORK with their billing people. In most, if not all, states there are ways for providers to work with those without insurance; while WA, for example, can't let you make a solid plan "this cost for those with insurance and that cost for those without", you can give a discount to whomever you wish. Hospitals often write off huge portions of bills. If you go to a Catholic hospital, there are Catholic charities that help pay bills. All you have to do is ASK.

So don't get all tweaky about not wanting to own anything so it can't be taken from you, when the likelihood of that happening, as long as you are in contact with the doctors/hospitals and making sure you follow whatever plan you've set up, is so so so so low.

This is an example of needing consent for treatment, not lack of treatment due to insurance issues. There are options that need to be discussed with an injury, and treatment would be based on that. Often broken bones are just splinted and seen by a doctor for casting within a few days. There was no rush if she was stable.

I agree. I've never had anything casted, but I've read countless times on the dis about the need to stabilize before you cast.

As a preteen, I took the end of my finger off in a door-slamming accident. My mom was off to work, and our neighbor heard me yelling as he left his house to come over and take us to the museum that day. He had absolutely no permissions to consent to treatment for me, so all we could do was wait for my mom to get to work, get the message to come home, and to get home (for everyone who wishes times were simpler and we weren't in the constant contact that cellphones allow for, there are moments like that where you desperately wish that a person could have been contacted while en route...). When she got home, I'd turned an orange towel an alarming shade of red, my face was very very pale, and I had no energy (while watching summer reruns of Love Boat). Only then could we head to the hospital.

I don't know if we had insurance or not, but I know the hospital wasn't going to treat me on neighbor Jim's say-so...

 

[Jey12]

I don't understand.



If you need to use a doctor, a hospital, etc, just WORK with their billing people. In most, if not all, states there are ways for providers to work with those without insurance; while WA, for example, can't let you make a solid plan "this cost for those with insurance and that cost for those without", you can give a discount to whomever you wish. Hospitals often write off huge portions of bills. If you go to a Catholic hospital, there are Catholic charities that help pay bills. All you have to do is ASK.



As a preteen, I took the end of my finger off in a door-slamming accident. My mom was off to work, and our neighbor heard me yelling as he left his house to come over and take us to the museum that day... When she got home, I'd turned an orange towel an alarming shade of red, my face was very very pale, and I had no energy (while watching summer reruns of Love Boat). Only then could we head to the hospital.

I don't know if we had insurance or not, but I know the hospital wasn't going to treat me on neighbor Jim's say-so...

It's been my experience that hospitals will only write off portions of bills for those without insurance. If you have insurance it's a sorry about your luck you owe us what's on the bill. I did ask when I had to have a fairly major surgery, followed by DH's needing emergency surgery a month later and yet another major surgery related to his first one 3 months after that. In the middle of all of this our daughter was born, so add that to the hospital bill. After insurance we owed over 30k in bills, mainly because half of the surgeries occurred near the end of the year so all deductibles started over. I asked about having a portion of the bill written off (a friend of mine had just had most of her bill at the same hospital written off the month before.) My answer? "No, sorry we can't do that because this is the insurance remainder, if this was an amount without insurance we could do it. I'm sorry, can we set you up with a payment plan?" Owing 30k with insurance or over 700k without insurance in the scheme of things really doesn't matter, it's going to take forever to pay off. BTW the friend of mine without insurance had her bill reduced from over 200k to just over 10k. She ended up owing less than I did and she didn't have a monthly premium to worry about paying on top of the bill.


As for your finger what an awful experience and I'm glad everything worked out. I don't understand why your neighbor didn't take you to the hospital though? Applying pressure and watching Love Boat isn't exactly a good course of treatment. Without a parent the hospital would have stabilized you at least and tried to stop the bleeding a bit better than using a towel. When I was young, think back in the late 70's early 80's, I was over at a neighbor's while my mom was at work. I flipped over the front of my bike and had cuts down to the bone and was bleeding everywhere. The neighbor left a message for my mom at work and plopped me in the car and we headed straight to the hospital. By the time my mom got there an hour later I was stitched up, enjoying some pain meds and eating a sucker. My mom just had to sign some forms once she arrived. I know times have changed, but a hospital would still need to stop profuse bleeding with or without parental consent. They couldn't transfuse but could apply treatments that reduced or eliminated the loss of blood.

 

[indimom]

Curious for those stating the premiums of $400 or more.. Is that fully paid self insurance or is that through work?

That's incredible because though mine might be lower at $326/month, supposedly I pay 20% and employer pays 80% of the premium. So that $326 that I pay is only 20% and the overall premium would be $1625 (if the word of the HR department can be trusted, which they've proven it certainly can not be trusted.) And I seem to pay out my rear every time one of us goes to the doctors too.

Oops, should have included that. Ours is through work. I don't remember reading that information this year, but in the past his employer paid over 60%. I'm guessing they still are. So the total premium is over $1,000.

 

[Kayka]

Curious for those stating the premiums of $400 or more.. Is that fully paid self insurance or is that through work?

That's incredible because though mine might be lower at $326/month, supposedly I pay 20% and employer pays 80% of the premium. So that $326 that I pay is only 20% and the overall premium would be $1625 (if the word of the HR department can be trusted, which they've proven it certainly can not be trusted.) And I seem to pay out my rear every time one of us goes to the doctors too.

Your premium is about what ours is for a family plan HMO, in addition there are copayments $20 for an office visit, $10-$50 for Rx, $100 for an ER visit. The plan does not cover dental or vision.

 

[mrsklamc]

My daughter has a private insurance policy that is $85 per month. I have insurance through my job that costs me $80 per month. My husband is completely uninsured. His work place does not offer insurance and because he smokes, even a high deductible policy is over $200 per month. We both drive vehicles that are ten years old. We live in a modest home. We have NEVER been on vacation- not even a honeymoon. (We are planning our first vacation for next year and I have been saving for a year already!). We simply can't afford more insurance.

The reason it's so expensive for a smoker is that they are highly likely to have very expensive medical needs. Any idea what you will do then? (I'm not judging, honestly curious if you have a plan.)

 

[ZephyrHawk]

This is an example of needing consent for treatment, not lack of treatment due to insurance issues.

Weellllll, it's both, really. They can't treat a minor without parental consent except in cases of emergency (which this was not) or very specific statutory exceptions (also, not what this was). However, the hospital does not want to treat you without insurance, anyways. So I doubt the hospital was particularly motivated to treat the girl in this instance. In general, the notarized permission slip should have been enough to ease the hospital's concerns about treatment of a minor.

 

[MSLRAC]

It's been my experience that hospitals will only write off portions of bills for those without insurance. If you have insurance it's a sorry about your luck you owe us what's on the bill. I did ask when I had to have a fairly major surgery, followed by DH's needing emergency surgery a month later and yet another major surgery related to his first one 3 months after that. In the middle of all of this our daughter was born, so add that to the hospital bill. After insurance we owed over 30k in bills, mainly because half of the surgeries occurred near the end of the year so all deductibles started over. I asked about having a portion of the bill written off (a friend of mine had just had most of her bill at the same hospital written off the month before.) My answer? "No, sorry we can't do that because this is the insurance remainder, if this was an amount without insurance we could do it. I'm sorry, can we set you up with a payment plan?" Owing 30k with insurance or over 700k without insurance in the scheme of things really doesn't matter, it's going to take forever to pay off. BTW the friend of mine without insurance had her bill reduced from over 200k to just over 10k. She ended up owing less than I did and she didn't have a monthly premium to worry about paying on top of the bill.

I think the statement in bold really depends on the hospital. Financial services has already been in touch with us about DD's accident and sent us out a financial packet that we had to fill out and send back with our tax return from last year and current pay stubs. They said based on our income, a certain amount up to all of it will be written off. That balance will be after 3 different insurances pay out.

 

[JAMIESMITH]

The reason it's so expensive for a smoker is that they are highly likely to have very expensive medical needs. Any idea what you will do then? (I'm not judging, honestly curious if you have a plan.)

It's scary, but I honestly have no clue what we'll do if something like that happens. I wish he would quit smoking (the savings alone would pay a good portion of the insurance premiums), but he won't. An accident or a major surgery isn't nearly as scary to me (because we could work out a plan with hospital billing) as cancer or diabetes would be. My vehicle is paid for, but my husband's is not. When I get it paid off next year, I do plan to use the money we've been using for that payment for insurance. I just have to hope and pray nothing horrible happens with his health in the meantime.

 

[Lucky4me]

I think I understand a bit of what the OP is saying. Not that I'd ever purposely sell off everything I owned to avoid paying medical bills. I just get it.

We had insurance and a catastrophic illness almost wiped us out. If we hadn't been savers to begin with, it would have been a lot worse. If we had to pay the orginal dollar amount of the bills, we would have had to go bankrupt.

I've learned it's all a shell game. After a year of stressing, I got to the point when the $20,000 a month bills were coming in, I'd just toss them in a drawer and not think about it. No way were we able to pay that and we ended up not paying anything close to that. They inflate those hospital bills so much. Like the government and their hammers.
Sometimes I do think it would be beneficial to scrap the entire system as it is now and start fresh. It all ended up being okay for us, but the stress and worry for all that time almost killed me!

Jey12, hang in there with the bill. Keep calling and telling them you can't afford it if you can't. They will lower the payments for you at least.

 

[Colleen27]

Curious for those stating the premiums of $400 or more.. Is that fully paid self insurance or is that through work?

That's incredible because though mine might be lower at $326/month, supposedly I pay 20% and employer pays 80% of the premium. So that $326 that I pay is only 20% and the overall premium would be $1625 (if the word of the HR department can be trusted, which they've proven it certainly can not be trusted.) And I seem to pay out my rear every time one of us goes to the doctors too.

We're fully self-paid and pay $600/mo for catastrophic-only coverage for our family. When I was working for the state (a job I never would have left if my crystal ball had been working re: the changes that would come with DH's insurance!), my share of premiums was just under $200/mo on an 20/80% split with my employer, but that was for insurance that actually *covered* things.

Now we just throw away $$$$ every year on a policy that has never paid our a dime (the total over 6 years has topped what we paid for our home ), in addition to paying our routine medical expenses OOP, and every year when the premium increase notice comes we discuss whether it is time to drop the insurance, bank the premiums, and basically roll the dice on self-insuring.

 

[elgerber]

My premium at work (which they pay none of) is now $800 a month with $6500 deductible, and 20% coverage after that. Previously it was almost $1400 a month with a $4000 deductible.

 

[Pea-n-Me]

Can anyone tell me just why it would be worth it to have any real assets such as a nice home, land, recreational items and such if your health insurance goes so high that you can't afford it. I can forsee this happening at some point not only to us but to many americans. So when it does get to the point that we do not have any health insurance because the premiums are more expensive than a car payment or grocery bill each month I really see no point in having anything that hospital and doctor bills could take from you. Its just a matter of time. I would rather spend my money on travel and such vs. trying to have the american dream that could be put up for sale by your local hospital.

I could definitely understand how someone would dream about this. Insurance costs have gotten ridiculous. BUT, for most people, it is one of the most important bills they pay. It's what reasonable people do when and if they can.

One of the reasons your plan is short sighted is because it's not just a hospitalization you have to worry about. It's after-care. And support.

A catastrophic accident or illness may not be just about a week's or a month's stay. It could be longer. And extremely intense. Life changing.

Let's say you shockingly find out you need an organ transplant, and are too sick to be discharged while you wait. You require medications and technology that will literally keep you alive. Your stay could be many months long. If you are fortunate enough to make it to the point of transplant, your care doesn't end there. It's life-long. What's more, the very basics of your eligibility for said transplant requires that you have a home to go to and have to have the support of others to help you. How will you pay your rent with no income and months in the hospital with bills piling up? Will others be there to support you with things like regular rides, perhaps many miles away, physical and emotional help, etc, when they know you've squandered your income and good sense on things like vacations and luxuries and made the deliberate choice not to carry insurance? Will you look to them to help you financially when you have nothing left? Hmm. Your health habits also have to be in line with taking care of such a generous donation from someone else, and proven to be so.

In other words, your survival will depend to some degree on a showing of personal responsibility in a variety of areas. Lack of health insurance wouldn't necessarily preclude someone from transplant eligiblity, but a lifetime of personal irresponsibility could. All factors considered during the selection process. There are far more people waiting for transplants than organs available.

Think this is far fetched? It's not. It's a reality many people find themselves faced with, often quite suddenly.

 

[Pea-n-Me]

My daughter has a private insurance policy that is $85 per month. I have insurance through my job that costs me $80 per month. My husband is completely uninsured. His work place does not offer insurance and because he smokes, even a high deductible policy is over $200 per month. We both drive vehicles that are ten years old. We live in a modest home. We have NEVER been on vacation- not even a honeymoon. (We are planning our first vacation for next year and I have been saving for a year already!). We simply can't afford more insurance.

You are taking a big gamble.

I wish he would quit smoking (the savings alone would pay a good portion of the insurance premiums), but he won't.

Wouldn't the premiums be less, also, if he stopped?

His doing this for his family would be a great gift to you all.

 

[denisenh]

I understand what the OP is saying and have sympathy. For many Americans being able to afford life is getting to be a strain. The cost of everything is high including health insurance which is not only more costly but often includes higher deductibles and co insurance.
It does seem like a losing battle for middle Americans. I have paid up to $300 a WEEK for employer sponsored plans (Harvard Pilgrim), but I wouldn't have the nerve to go without health insurance especially since I have children to provide for. Thankfully we have no chronic health issues but there are no guarantees that someday a costly medical issue won't arise.