Are health insurance premiums really sending people into bankruptcy?

Factual Questions
21

Massachusetts has a new law mandating health insurance for people. I have known people (anecdotal, I know) who fall into this hole between what is considered significant enough financial hardship to qualify for assistance and being able to truly afford health insurance along with the other things that adult life demands (rent, food, utilities, prescription copays, etc). These are not people out blowing their money on scratch tickets and air conditioners. These are people who are stuck in the middle ground between needy enough and self-sufficient. The people who will never be able to scrape first, last, and security together to move into a better place. The people who are making a decent enough wage at an unskilled or semi-skilled position so that they don’t qualify for any sort or retraining programs in order to gain the skills to get a better job. And yes, of the people that I am thinking about, many have declared bankruptcy.

IMO, it’s not as simple as health insurance premiums causing that, but it sure isn’t helping.

22

[QUOTE=fessie]
If you have a pre-existing condition (high blood pressure, asthma, diabetes) and have to COBRA for a while between jobs it’s pretty expensive BUT you don’t exactly have a choice. If you don’t maintain coverage then even when you DO have a job future insurers don’t have to insure you for those conditions. I think the exclusion period is 90 days in some cases, maybe it’s 6 months, I’m not sure.

We moved out of state when my husband was unemployed so we had to buy insurance on our own. IIRC the premium was $750/mo through BC/BS for our family of four.
[/QUOTE]

We’re on COBRA now. On investigating going private, my wife found that she was uninsurable because she takes three prescriptions. If she stopped taking her Lipitor and Atacand (for hypertension) for six months or so, she could get the insurance. Of course she’d be dead or debilitated. What’ll happen if I don’t find a job before COBRA runs out, I can’t think about right now.

It’s time to end this travesty and implement socialized medicine now.

23

If you’re ever between jobs and can’t afford COBRA go to an insurance salesperson and ask about temporary health insurance. It is usually for 6 months and you can usually renew for 6 more months with the same company. After the year you can go to a different company and get another 6 months then 6 more. We recently had it for 6 months and it was under $300/ month for a family of four. I have a friend who has been through two different companies for almost 2 years of temporary coverage.

24

[QUOTE=Spectre of Pithecanthropus]
We’re on COBRA now. On investigating going private, my wife found that she was uninsurable because she takes three prescriptions. If she stopped taking her Lipitor and Atacand (for hypertension) for six months or so, she could get the insurance. Of course she’d be dead or debilitated. What’ll happen if I don’t find a job before COBRA runs out, I can’t think about right now.

It’s time to end this travesty and implement socialized medicine now.
[/QUOTE]

But socialized medicine is just as much a travesty to people who can and do find other means of health insurance. Why hurt the majority for the convenience of a few? Despite the shock of seeing the raw numbers of unwillingly uninsured people in this county, it’s still a minority. There are alternatives to socialized medicine that don’t violate anyone’s civil rights. On the other hand, maybe you don’t really mean socialized medicine, and you’re just flubbing your lines.

Now that’s not to diminish your wife’s conditions. I’m sure you can find an alternative, such as hiding the fact that she’s taking medicine. If you have to pay out of pocket, then it’s a bullet you’ll just have to bite. There are safe and legal internet pharmacies. There are cash-clinics that can prescribe medicines (might be different if she were taking addictive meds, though). It’s still relatively easy to hide from the system. I am sorry about your situation, and I don’t mind kicking in a little bit in taxes to help people like you, but to take away my awesome insurance because the government thinks it knows better than I do is just preposterous.

25

[QUOTE=Balthisar]
…but to take away my awesome insurance because the government thinks it knows better than I do is just preposterous.
[/QUOTE]

Where is that awesome insurance coming from? Your employer?

Then it CAN be taken away from you, at a moment’s notice, for good reason or none at all.

26

[QUOTE=fessie]
Where is that awesome insurance coming from? Your employer?

Then it CAN be taken away from you, at a moment’s notice, for good reason or none at all.
[/QUOTE]

So… that’s a private affair between myself and my employer. For the hourly guys, it’s a private affair between my employer and them, bargained for by their union. In my case, it could be taken away, but just like salary and other benefits, it’s a compelling means of compensating employees, so it’s not very likely. In the case of the hourly guys, they have to collectively agree to let it get taken away. See how the free market works just perfectly fine without government interference? But this is a silly argument anyway. Socialized medicine will never, ever see the light of day in this country in any reasonable amount of time. Or… are you also failing to understand what socialized medicine is? There’s a huge distinction between all of the different universal coverage schemes, and if you can’t even be bothered enough to figure out which is which and why and how they’re different, then just don’t bother saying anything in the first place. ::rolleyes::

27

[QUOTE=Balthisar]
Now that’s not to diminish your wife’s conditions. I’m sure you can find an alternative, such as hiding the fact that she’s taking medicine. If you have to pay out of pocket, then it’s a bullet you’ll just have to bite. There are safe and legal internet pharmacies. There are cash-clinics that can prescribe medicines (might be different if she were taking addictive meds, though). It’s still relatively easy to hide from the system.
[/QUOTE]

The problem is that if you do that and the insurance company finds out about it not only will you be on the hook for any medical expenses you’ve run up (in other words, they cancel your policy and pay NOTHING) they keep your premiums AND you can be hauled into court for fraud.

28

[QUOTE=fessie]
Where is that awesome insurance coming from? Your employer?

Then it CAN be taken away from you, at a moment’s notice, for good reason or none at all.
[/QUOTE]

^ That’s exactly what happened to me in November. I was laid off - sorry, we don’t need your services anymore! You’re a fantastic worker and loyal employee but we no longer need you, buh-bye! - and no more “awesome insurance”.

29

[QUOTE=fessie]
Where is that awesome insurance coming from? Your employer?

Then it CAN be taken away from you, at a moment’s notice, for good reason or none at all.
[/QUOTE]

As it could if this person is simply buying his own insurance out of pocket. IIRC it would be illegal for the company to cancel the policy during the current contract period, but they could refuse to renew, jack up the price, or drastically reduce benefits and coverage at policy renewal time.

While it might be easier to resolve issues with a private corporation than with a government agency, being privately insured doesn’t guarantee anything at the end of the day.

30

On unemployment you can not afford health insurance.

31

Yes, I’ve noticed that.

One more person lectures me on how “you have to have health insurance” after I explain I have NO money left after rent, food, and gas for car I’m going to pop a gasket.

32

It looks like Spectre of Pithecanthropus went and made the mistake of using the “S” word.

I always thought that “socialized” was a fairly broad category, but no matter. How about we simply come up with a non-travesty method of ensuring that everyone gets the health care that they need–after all it’s not a consumer choice–without anyone suffering severe financial hardship in the process.

33

A few words of advice for people:

#1. Shop. SoP is lamenting that he can’t get insurance because of the medicine his wife takes, but the people I work with will gladly insure someone taking Lipatore and people who have HBP or both. OTOH I can’t get coverage for a diabetic no matter what I do and BCBS of Md. covers them without a problem. Different companies have different underwriting guidelines, what is anathema to one might be no big deal to another. For those with conditions that can’t find any private insurance, investigate whether your state has some type of high risk pool like MHIP. Most do. All should.

#2. Consider non-traditional options like a HDP that is HSA qualified. In many cases it’s a better deal. Case in point, using MHIP prices as a guide (since I just linked them and they are handy): a 45 YO man would pay about $350/mo for a traditional PPO with a $500 deductible, followed by 80/20 coverage with an out of pocket max of $3000. His maximum possible liability for the year would be $7700 ($4200 in premiums plus deductible plus OOPM). That same man could get a HDP for $150/month and his maximum possible liability for the year would be
$4400($2600 deductable plus premiums), with $2600 of that being deductible from his personal taxes. What’s the better deal? I dunno. It depends on your individual situation, but I know a lot of people who won’t even look at a HDP because “The deductible is too high”(Is it? For the premium?) or “I don’t want to mess with all that tax crap.”(It’s very simple but you don’t HAVE to find a HSA along with your HDP) or even “That’s what Bush pushed in his speech so it must be awful” (really had a woman tell me this).

#3

Not quite. Everything that you say is true if you lie on your application, except that if the company does do this they refund your premiums (less any medical costs that they paid) in full. Cold comfort I’m sure, the lesson here is “Don’t lie”.

#4

This can work, just remember that temporary insurance is just that-temporary, and they don’t HAVE to extend you for another 6 months. If you’ve had medical issues they most likely won’t, which could leave you in a real bind if you have a heart attack on day 178 of your 180 day policy. 2 days treatment would be covered and then it’s sorry Charlie.

34

About 11 years ago my father started feeling the symptoms of a heart attack on a Tuesday. And again on Wednesday and Thursday. He ignored the pains and kept working. He was trying to wait until Monday, when the 90-day waiting period would be up and his new insurance with his new employer would kick in.

Finally on Friday he collapsed at a meeting in some guy’s office and an ambulance took him in for an angioplasty. Which went very well.

By Monday he was back out of the hospital, and out of a job. His employer never acknowledged it, but we always figured they did the math and realized putting him on their plan would cost too much.

Balthisar it’s easy to assume that a meritocracy combined with a free market is the best way to run a railroad. In my experience, it’s not nearly that simple.

35

[QUOTE=fessie]
About 11 years ago my father started feeling the symptoms of a heart attack on a Tuesday. And again on Wednesday and Thursday. He ignored the pains and kept working. He was trying to wait until Monday, when the 90-day waiting period would be up and his new insurance with his new employer would kick in.
[/QUOTE]

I’m going through something like this right now. I started a new job 5 months ago, and my health insurance has a 6-month window during which they can deny coverage for pre-existing conditions. You see where this is going, right?

So, back in December, I got a bit of food poisoning from some bad chicken & went to the doctor; I hadn’t been to this doc before, as I’ve never been one to get regular checkups. I’ve always been very healthy so there was no need. Anyway, the doc discovered I had high blood pressure, for which she prescribed medication. So far, so good – the pills do the job and the insurance has no problem paying for them. However, she then wanted to give me a full exam, since I hadn’t had one in probably 20 years.

The full exam turned up a heart murmur; since my mom’s side of the family has lots of heart disease, the doc referred me to a cardiologist. Cardiologist ordered an ultrasound & stress test, which turned up some circulation issues, for which they want to do a catheterization & possible angioplasty. This was two weeks ago – the insurance company hasn’t seen these claims yet.

However, the insurance company is pushing back, denying the claims for my last doctor visit (in which she referred me to the cardiologist) and the initial cardiologist visit, saying the heart issues are pre-existing conditions which they don’t have to cover since the 6-month window isn’t up yet.

Given that they don’t want to pay for the stuff I’ve already had done, I’m not about to schedule the cath – it’s a rather expensive procedure, and I’ve already run up several thousand in costs on the other tests, and I can’t afford to be on the hook for any further bills.

I have a follow-up visit with the cardiologist next week to go over the results of the tests I’ve already had, and to figure out what to do next.