How would you handle this health insurance problem?

Miscellaneous and Personal Stuff I Must Share
1

My husband, after years of supporting my education, has decided that he wants to finish his college education. Awesome, except that quitting his full-time job puts his health insurance in a predicament.

See, he’s significantly overweight and has very mild asthma. The asthma is entirely related to his weight, and only rears its ugly head when he catches a cold. A couple of weeks of Advair, and he’s back to normal. He’s working on losing weight, and has had amazing success in the past, but it’s a constant battle.

The problem: Technically, he’s eligible for COBRA, the California program that guarantees the continuation of coverage for people who were covered when they we working for a previous employer. However, staying with COBRA will cost us $300 a month. Not exactly manageable for two students living on student loans. But, because he’s eligible, and because of his minor health issues, he’s being turned down from other programs left and right. He’s going to a small trade school that doesn’t offer any student health program.

In a year and a half, I’ll be done with school and should be able to move into a job that will provide for us. Until then, Sicko has the Husband justifiably terrified about being crippled by something curable for lack of funding.

Any one got any ideas?

2

Try looking into temporary health insurance. This is offered by many large insurance companies, but coverage only lasts for a short time period. That may be cheaper than COBRA.

Also, try looking into having your COBRA premiums paid for you by the state of CA. They do offer this to some qualified people, depending on their income and health status.

3

Having asthma will likely disqualify him from individual health insurance for at least 5 years after his last treatment. I would get the COBRA coverage if he goes through with leaving his job.

Truly though, my advice would be that he not leave his job until you graduate and that would resolve the insurance issue right there.

4

Do either of you belong to any trade associations? Often they will have group insurance available. The rates typically aren’t as good as you can get through an employer, but they might let you make it for the time you need. Or if you are still in school, check and see if you can get coverage for him under your school’s health plan.

5

Wait, COBRA will only cost you $300/mo for two people?

Have you looked at how much a non-group plan (a single plan for you and him) would cost?

I’ve been on COBRA (it’s a national thing btw) and it was about $500/mo for me. I’ve also been on a single non-group plan, and it was about $300/mo for me.

I’d totally take COBRA and run … I can’t believe that even if he wasn’t turned down that a non-group plan for a family of 2 would be much less than $300/mo.

Ever think about foregoing insurance and putting your money into a savings plan to cover emergencies and doctor visits while you’re in school?

6

This sounds like good advice. A year and a half, or even two years if you want to allow for a job search – that’s not so long to wait.

Can he take some on-line classes in the meantime? Or night classes?

And yeah, $300 a month for two people is a bargain.

7

Well, if he’s otherwise healthy, you could just forgo the insurance for a while. A month’s supply of Advair runs about $150.

8

I disagree. Any pre-existing conditions that are present when you resume coverage will not be covered. Typically six months to a year though I have seen longer periods.

9

I was also wondering if you can get health insurance thru your school, every university I’ve attended allows you to put your spouse and kids on a your student policy. Probably won’t be be cheaper than COBRA, but you never know. And so long as we’re brainstorming, is he tied to his current school, or could he transfer to someplace else that does offer student insurance?

10

BCBS, for one, doesn’t seem to have a problem accepting chronic conditions. At least, they’re paying for my asthma medicine with nary a twitch.

11

It depends. At the last place I worked, the agreement with the insurance company was that new employees and their dependents would be covered with no disqualification for pre-existing conditions, and regardless of any breaks in coverage.

Even before we had that agreement, pre-existing conditions were covered unless the new employee had been treated for the condition in the previous six months.

12

Do not ever, ever do this if you can help it. If you must go without insurance and set aside money because there is no other option then you do what you have to do, but that $300 a month won’t go very far if you fall down the stairs or break your leg or get injured in a hit and run accident. Insurance is there to cover catastrophic things that would force you into the poor house and just think about what would happen if your husband were diagnosed with type II diabetes while you were uninsured or if you got pregnant while you had no insurance. It isn’t worth the potential cost to forgo insurance in most instances, I promise.

13

This is very, very bad advice. The uninsured pay much more for services than the insured. KellyM went to the ER last fall and the insurance reduced what she was charged for the visit by over $5000. Just by having an insurance company review your bill and say, we are not paying these stupid charges may well make up for what you are paying out in premiums.

I was laid off some time ago and my COBRA cost me about $1000. I have asthma and my husband has a myriad of medical issues. The first month, my husband, who was fairly healthy at the time, despite his many issues, had serious symptoms that mandated an ER visit and may tests that cost well more than COBRA. Nearly 18 months later I found a job with good health insurance again and he was covered with no problems, because he had remained insured the entire time.

Accidents happen to even the most healthy and cautious. If you don’t keep your insurance up, you are gambling and you can lose big.

14

I second this. Hospital rates are extremely high these days. LUHS Maywood has a posted rate at their admissions desk of $1140 per day for an inpatient admission. ER visits are billed at $275 an hour, if I recall correctly. The rates at Westlake are similar. To whoever it was who suggested a private medical savings account instead of insurance: bad idea. Even one ER visit and it’ll be wiped out by the time you fill out the paperwork at the door. Note that neither you nor your insurance will pay these rates if you have insurance; insurance companies negotiate the street rates down to the so-called “usual and customary rates”, which are typically about 30% of the posted street rate. I was in the ER for about 6 hours followed by a half day in inpatient care back in September; my initial bill was for about $8700, which was subsequently reduced by my insurance company to around $3300. The hospital ate the other $5400.

That aside, if you are uninsured and not willing or able to let them put a $10,000 hold on your credit card, you will be “treated and streeted” at almost all hospitals. Typically only one hospital in a given geographic region will be obliged to treat all patients regardless of ability to pay (the so-called “charity hospital”), and that hospital is not the one you will want to be at because they have the worst budgetary situation, which means the lowest-paid, and therefore least-qualified, staff. (In Cook County, this is John Stroger Hospital; nobody goes to Stroger when they have a choice to go elsewhere.) If you find yourself at another hospital in that region, and do not have either insurance or large wads of cash, you’ll get only stabilizing care only followed by the choice of leaving or of being transferred to the local charity hospital. Not a pretty picture; it’s not worth the gamble, especially if you already have known medical issues.

15

I third this. I think it was 60 Minutes who had a thing on uninsured and the bills they get stuck with if something serious (and even not-so-serious) happens. These people got royally fucked because there was no negotiation. Do your best to remain insured.

16

Thanks for all the input, everyone. Couple of things to clarify:

That $300 COBRA quote will only cover him. I have insurance through my school. But, my insurance does not cover spouses, even though I’m a grad student. (thinking on it again, I don’t know why they exclude spouses. Will check). And having him attend my school would likely provide him with an inferior education. His interest area is not well done at my school, or at any of the other schools nearby aside from the one he is attending.

Waiting until I graduated was the original plan, oh those many years ago. But, long stints at crap jobs combined with an inability to get hired elsewhere at a reasonable rate was making him seriously depressed. So, he’s already started up school.

We would go with the COBRA coverage, except our entire food, gas, and incidentals allowance is about $600 a month. We’re both maxed out on student loans, but most of our money goes towards credit card payments. 7 years of living off of one salary earned by someone with just a high school diploma takes its toll. I’ll look into the possibility of getting the State of California to cover the COBRA fee

Neither of us belongs to a trade association. He might be able to join one, but I don’t think there are trade associations for Graphic Designers that are developed enough to offer health insurance. Will check.

Normally, we would just suck it up and try to coast without insurance. I did as much for the 9 months between undergrad and grad school. But a year and a half is a long time for bad stuff to happen. We’re scared. pbbth and lee gave great examples of exactly why we’re terrified.

The kicker is that he’s honestly quite healthy, despite his size. His asthma only needs treatment when he catches cold. His blood pressure is always great. His heart rate is low for someone his size. The majority of his size is muscle mass left over from fitter days.

All we’re looking for is an insurance plan that would make it feasible for him to get digits replaced should he be in a car accident. (the man interviewed in Sicko who had to pick between getting his thumb or his forefinger replaced is a flavor of horrible that makes my stomach turn). Or get a pacemaker if he has a heart attack. But we need that coverage to be more in the $100/month range. We don’t mind paying full price for the occasional Advair and head cold doctor’s visit.

17

Oh yes, fourthing. A broken leg will run about $20,000, heart attack about $40,000, the median cost of a hospital stay in 2005 for uninsured patients was $9,907.

18

okay, Kelly M and Kalhoun, quit it. :frowning:

19

I would suggest finding a temporary insurance plan that is designed to cover catastrophies only. I had one with Humana (I think that was who it was with anyway) when I graduated from college until I found a job with a health plan. It was like $123 a month for me and I am also extremely heavy. Honestly, my recommendation would be for him to get a part time job at Starbucks or another retail place with a health package and work part time while he goes to school full time. It is hard to do but many, many others have done it before him and it will not only provide health insurance but also a little extra money so you aren’t budgeting down to every last penny.

20

That is a great idea, I think – my husband is a Starbucks barista, and you get inexpensive medical, dental, and vision coverage as long as you average 20+ hours/week over a quarter. It’s pretty good coverage, too, and very affordable. My husband and our baby get their medical through SB, and my husband and I get dental coverage, and the whole thing costs us something like $70/month.

Plus, you get a pound of coffee free every week – what’s not to like? :wink: