Can a person get just ER insurance?

I have private insurance, but I am 73 now and never really needed a real MD till I was 63 for my eyes going bad with cataracts.

So from say 20 years old to 63 was 43 years … How much would a young person save today?

What if a young person today just had ER insurance? Wouldn’t that be like taking a chance that nothing else will happen to you?

Think about it. Most people must pay more into insurance than they take out; if fact the difference must be quite a lot. If that wasn’t the case, the insurance companies would go bust.

The big problem with all insurance is that you have no idea whether you will be a net contributor (to other peoples payouts) or a beneficiary.

I don’t know, part of the problem is that many ERs have out of network doctors which can add charges even if you have insurance.

I’d guess a very high deductible insurance policy is about the closest you will get to ER insurance.

I’ve read that in some jurisdictions you can buy ambulance insurance. It is basically a plan that’ll cover treatment from emergency medical technicians and wasn’t priced too high. However I doubt that covers anything once they get you to the hospital.

I’ve never had a health plan that didn’t cover ER 100%, even out-of-network. You can’t plan to have an emergency in your hometown only.

The problem with something like that is that an insurance company isn’t going to want you to use the ER as your primary care doctor. For example, if you only have ER Insurance, and you have a minor rash or your knee has been bugging you for a few weeks, no one wants you in the ER when you should be at a regular doctor. It ties up emergency resources and it’s very expensive.

Also, your insurance company would much rather you saw a doctor at least once a year to get a checkup (they’ll cover it either 100% or close to it) just so that you can avoid an ER visit.

Now, if what you want is ‘catastrophic insurance’. That is, something that will cover you in the event that you get into a car accident or your liver decides to shut down or you get cancer or pretty much anything else done that’ll cost more than a few thousand dollars in a calendar year. Well, that’s what pretty much what all health insurance is, especially now that most insurance is of the HDHC type.
Without comparing it to what things were like years ago since that doesn’t matter, it’s considerably cheaper than a ‘co-pay’ plan and really doesn’t do much until you hit your deductible. Once you hit that, and most people don’t, then co-pays kick in.
And a deductible of 2000-5000 for a healthy individual usually takes some type of hospital visit (inpatient/outpatient/ER) to hit.

Define “ER insurance”.

One big problem has been a lot of people with not-really-ER conditions showing up in ERs and requesting treatment. This is very wasteful and it also ends up with too many people waiting until their health care is bad enough that the ER doesn’t just send them packing.

So you think you have a real problem, go to the ER, get treated, the insurance company says “Nah, that wasn’t an emergency, you pay.” Of course the insurance companies will default to that in most cases.

It’s just not going to work for the customers.

If I had all of those years back along with today’s wisdom of health care cost. I would want the same discipline that Obamacare required, but instead of having to invest in a health care plan I would transfer that discipline to a good well managed stock investment plan … after 43 years I would be a millionaire, right? (or close to it)

I would have played the game to win not to lose and I would have 43 years to play it. Of course that doesn’t include my family which does complicate the matter.

I consider ER insurance would pay for broken bones, cat fights, dog bites, stepping on nails, back yard barbecue gone bad, robbery, bad husbands catching you, bad wives throwing things, sports injuries.

So is it go or no go for investing the healthcare money … with discipline of course without that all is lost anyway?

In principle yes, but it does get a little more complicated than that because there’s also the time dimension. In your model, an insurance is kind of a risk pool: Everybody pays in, people get payouts depending on the harm that happens to them, and some people are net contributors, cross-subsidising the payments to net beneficiaries. In some way, however, insurances (especially in the area of health insurances) also act as a kind of mutual investment vehicle: You pay in now, whern you’re young and healthy and therefore need little medical treatment; that money is set aside and invested, and used to pay your bills when you’re old and in need of more medical care.

Now of course you could argue that it’s possible to avoid insurance, invest the saved premiums yourself, and use the proceeds later on to pay for your healthcare yourself. But that works only if two requirements are fulfilled:

[li]You achieve the same return on your investment as the insurance company would, after all expenses (e.g. taxes).[/li][li]You actually do invest the saved insurance premiums, rather than frittering them away in the meantime.[/li][/ul]
It’s certainly possible to meet those two requirements, but it is by far not a given for all people.

What I’m reading, and you’re welcome to do it, is that you don’t want insurance. You want to take what you you’ve spend on your insurance premiums (or will spend going forward) and keep that money to do with as you wish. In your case invest it and use it in the case of a medical emergency.
There’s never been anything to stop you from doing that in the past and even now the only thing stopping you is an annual penalty for not having insurance.

I think, if you look around you might able to find something that be what you want, but I don’t know that any major carriers have it and there’s probably a reason for it.

Also part of what I’m getting from this is that you’ve never had the need for insurance. The concept of 'I’ve never needed it, there for it was a mistake to have had it all those years" is kind of a misconception. It’s like driving somewhere, arriving safely and proclaiming what a waste of time it was to put your seat belt on.
Had you, in the past 40 years needed that insurance, you’d have been kicking yourself if you didn’t have it.

I don’t know about the USA but in the UK that’s not true. Or wasn’t a decade or so ago. A mate used to work for one of the UK’s major health insurers and he said that they made their profit on investing - playing the stock market and the like - and encouraging people to pay their full premium up front.

US health insurance companies have strict limitations on how they are permitted to invest any money, or at least they did while I still worked for one (from the 1990’s through 2007). I’m not sure they can do what your buddy in the UK’s company did/does.

The problem with “ER insurance” is that generally while high the costs of an ER visit are finite. The costs of diagnostic tests can possibly run into the five figures, but once they figure out what’s wrong with you it’s no longer an ER visit. Either your admitted to the hospital as an inpatient, or referred for followup outpatient treatment. If you need to be admitted for heart surgery or cancer treatment you’re looking at non-ER costs of six figures.

Which, in the case of just about any regular insurance, would be just a bunch of (relatively) cheap co-pays or quickly maxing out your deductible, and than going from there to how your insurance handles what happens next, which is probably co-pays and co-insurance. But you’re not likely to spend 5 figures in a year (And if you set up and HSA you can get some tax advantages).

There is almost always a delay between the premium being paid to the insurance company, and the claim being paid out to the policyholder. The delay can be weeks, month or even years. In the interim, this money is called “float” and that’s what the insurance companies invest to make money, as mentioned by Quartz.

One of the medical helicopter companies in my areas sells “memberships” that cover their bills (which can be well over $20k). The most obvious problem* is that it only applies to their helicopters. Even if you happen to need transportation via air, there’s only a 50-50 chance that you’ll get the right company.

*Also, I strongly suspect that the [del]premium[/del] membership fee is pretty out of whack with the actual risk.

Many hospitals contract out their ER services, which makes things very complicated for patients.

Separate insurance can definitely be purchased for air ambulance services; it was free through my old employer, for employees and dependents, and $40 a year per person for others. It paid all deductibles, or the fee itself if that was charged, if a person needed the services of a helicopter.

There used to (and may still) be policies that would only cover things like accidents and cancer. Those have always been discouraged by honest insurance agents. This isn’t the same as AFLAC, which could best be described as disability income.

Many health insurance companies in the U.S. used to sell this kind of “catastrophic coverage” policy. It covered the big-ticket ER and hospital stays, and that was about it.

But, those policies became illegal with the Affordable Care Act. One feature of the ACA was that all health insurance policies had to cover preventative services, regular doctor visits, non-urgent care, etc. The intent was to make sure that everyone had insurance that covered a wide range of health needs (and a recognition that encouraging preventative care does help public health, in general), but it took away the ability of people to opt for that “catastrophic-only” type of policy.

Another nice thing with ACA is the no ‘per-existing condition’ thing. Previously each time my business would re-up our insurance, all the employee would have to fill out this huge form detailing their doctors, meds, anything that was wrong with this, anything that’s ever been wrong with them, if they do anything risky (like go skydiving etc) and then a few days later I’d get rates from a few companies and make a decision based on that. All that is gone. Now, the rates are based on, with few exceptions, age and sex.

While I have some issues with the government mandating private business (some issues, that’s a whole 'nother thread). I also think the insurance companies (and the medical community as a whole) sort of brought this on themselves as they slowly changed from ‘give us money and get coverage and a reasonable rate’ (remember paying $15 copays at the doctor and $5 at Walgreens) to ‘give us money and we’ll see how many things we can deny coverage for’.