Require health insurance assistance

[NajdorfDefense]

[ QUOTE ]
[ QUOTE ]
EVERYONE should have health insurance in the US


[/ QUOTE ]

That's nonsense. The US should be like every other industrialize nation in the world.

[/ QUOTE ]

That's nonsense.

I don't want to wait 6 months for a /MRI/CT-scan or 12+ months for 'emergency' brain surgery.

If you're too cheap to buy insurance, it's your neck.

If you have no $, there's Medicaid/care. Medicaid in NYC, for example, offers far MORE comprehensive coverage than any private policy you could ever buy, even for $40-50k a year for 1 person.

'A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high, according to new research published Monday by independent research organization the Fraser Institute....
Saskatchewan (27.2 weeks), New Brunswick (25.2 weeks) and Nova Scotia (24.8 weeks) recorded the longest waits in Canada...Patients waited longest between a GP referral and orthopedic surgery (38.1 weeks), plastic surgery (34.8 weeks) and neurosurgery (27.2 weeks)....The median wait for an MRI... Newfoundland and Labrador residents waited longest (20.0 weeks). '

You fall in the US and injure your skull/brain, go to emergency room, you get your MRI or CT-scan that day, not 5 months later, insured or not, as it is a Federal crime to deny emergency care.

UK and Canada have well-documented literature, studies, and commissions that show the disgraceful nature of their health systems. Millions of people die off while waiting so that the gov't never has to pay for their care. In France, they just leave the old people in no-HVAC homes all summer and tens of thousands die during heat waves.

Some provinces in Canada report 18-MONTH waiting time for brain surgery for some patients:
http://www.sasksurgery.ca/specialty/...gery.htm#table

'Holmes began losing her vision in March 2005, she told a press conference at Queen's Park yesterday. An MRI in May 2005 revealed a tumour in her brain. Her family doctor couldn't expedite appointments booked with specialists for July 19 and Sept. 19, 2005. As the tumour pressed on her optic nerves, her vision deteriorated. Afraid to wait any longer, she went to the Mayo Clinic in Scottsdale, Ariz.

Within a week she met three specialists and was told she had a fluid-filled sac growing near her pituitary gland at the base of her brain. They urged her to have it taken out immediately. She went home with the hopes of quickly removing what is known as a Rathke's cleft cyst.

Unable to get surgery fast, she returned to Arizona and had the mass removed on Aug. 1, 2005. Her vision was restored in 10 days. The Holmes family is now in debt $95,000 because of medical costs.

...A computed tomography or CT scan showed a large wedge-shaped brain tumour. He was discharged from hospital four days later with a diagnosis of stroke and a prescription for anti-seizure medication.

Worried the tumour might be cancerous, McCreith and his family wanted an MRI. He was given an appointment date four months later. McCreith went to the U.S. and paid $494.67 (U.S.) for an MRI. Armed with the scan, he saw his Ontario family doctor, who referred McCreith to a neurologist. He was examined on Feb. 8, 2006. He was referred to a neurosurgeon but would have to wait three months.
Unhappy with this, he returned to Buffalo. In early March, during a biopsy, the tumour was found to be malignant and surgically removed.'

[MissT74]

Health Insurance companies can deny anyone for any reason UNLESS it's through an employer. So being self employed, and with pre-existing conditions you may have a hard time finding a company to cover you.

HOWEVER, if you're willing to accept a "rider" on your plan, then you can probably get coverage. It would basically state that any thing done related to your pre-existing condition would be denied, and you would be responsible for those charges.

Another idea that I would strongly suggest is Comprehensive Insurance only. It's much, much cheaper and would cover you in any emergency (broken arm, stepping on a nail, etc etc) and also cover you for anything major (cancer, AIDS, etc etc). For anything "normal" or routine (cough, cold, flu, etc) you simply pay cash at your doctors office.

For the most part people go to the doctor about 2-3 times a year at $120 a visit (average) vs. $200+ per month for health insurance. Unless you are on expensive medication, this is the way for most healthy to semi-healthy people.

(I own a medical billing service, feel free to ask any more questions that I may be able to help you with)

T

[MissT74]

Nicholas is correct, but also realize that there are a lot of doctors offices out there that offer "cash paying" discounts. Some don't, so you would have to call around.

I know my clients offices LOVE cash paying patients, no paperwork, revenue for the office instantly vs. waiting 2 months to get paid, etc etc.

T

[Ghazban]

The state you live in is key here. I just moved to Nevada and am also a professional poker player. Due to my pre-existing condition, nobody will underwrite an individual policy for me. In some states, there is a carrier of last resort that cannot turn you away for a preexisting condition (be careful, though, they may charge you through the nose for major medical).

This is not an easy question, particularly if you have a chronic preexisting condition so I'd recommend looking into your state's laws regarding individual policies. If you don't know where to start, just call around (BCBS, etc.) and get some quotes. If a given company will not underwrite a policy for you, they can probably tell you who in your state is the carrier of last resort (if such a thing exists).

[mikalina]

All good responses. I guess I am the only one who likes to find loopholes.

Another suggestion (especially if you are a poker player earning a high taxable income) is to look into (here come 2 different names for the same thing) a high deductible health plan or a consumer directed/driven health plan.

Downside: high deductible (~1200/year for individual coverage)

Upside: all preventive care visits are covered for free (checkups, lab work, etc), you have access to an HSA

HSA is a Health Savings Account... think 401(k) but you are allowed to make withdrawals without penalty for health-related purchases (anything down to Advil qualifies). This is just a really slick tax shelter with a $2,900 annual max for tax-free contributions.

And the plan should generally be one of the cheapest available.

Edit to add: deductible is not ~1200, its >=1200... the higher you go the cheaper it gets. Sorry for the confusion.

[z28dreams]

Mika's right - I'm in the process of changing jobs, and just applied for an HSA account w/ catastrophic coverage.

I'm 27, and it cost around $40 a month with a $5000 deductible. That's $480 a year... where are you guys seeing > $1000 a year ?!?!

HSA's are a GREAT idea if you are young and normally healthy. Even if you have a regular 9-5 job, you still still look into these and see if your boss will let you use it as an option. Think of it as being able to keep your premium at the end of the year if you don't actually use it.

Someone told me to use the Golden Rule plan, but I ended up going with Humana because for $10 less a month, it also allowed $300 of annual checkups and had a higher lifetime maximum.

For OP though, the preexisting condition will probably trump all other decisions - so check into your state laws.

[iron81]

You should look into what assistance the government can provide, either through your state's medicaid program or another program. Public hospitals are often avaialable as well in major cities that provide free care, although the quality of care usually sucks there.

[jogsxyz]

For individuals health insurance premiums are based solely on age. Even those who have never made a claim will have their premiums raised when they move into a higher age bracket.
How would you like your car insurance premiums based on the driving records of others?

[NajdorfDefense]

[ QUOTE ]
For individuals health insurance premiums are based solely on age. Even those who have never made a claim will have their premiums raised when they move into a higher age bracket.
... premiums based on the driving records of others?

[/ QUOTE ]

driving record <> age.

Old people get sick more. This is a fact of life, not some 'unfair ripoff' the insurance companies are scamming on us. 22-yr olds don't often get Parkinson's, Alzheimer's, clogged arteries, etc.

All of these things will continue to raise the National health bill:
more people
aging population in general
more senior citizens as a % of pool
new drugs and surgeries
more demand for treatment.

But no one thinks *they* should have to pay for it.

Look - the answer is there is NO magic bullet. With an aging population you can either:
1 - pay more
2 - deny care like in UK, Canada, elsewhere,
3 - not pay for new medical advances.

Offer people this deal - you can pay 1977 prices [+inflation] for your insurance and care, but you only get 1977-era treatment. Would anyone take that deal?

New treatments for HIV cost upwards of $20k a year just for the pills. That's with no insurer markup. Society cannot pay for everything for everyone's needs for all expensive treatments and experimental surgeries and etc that 300m people want offered to them 24/7 with no waiting.

Most estimates of countries that promise 'universal care' and deny patients treatment for months at a time, spend 17-22% of GDP, a system where millions die off in line and new drugs/procedures take years and decades to be covered, if ever.
Get enough voters to put in politicians who think the Gov't makes better HC decisions than individuals, and the system will change. Are you going to make it a crime to have private insurance and doctors like those countries also have in many places? Do you think smokers and drinkers and skydivers and fatties should pay more? No system will make everyone happy.