Require health insurance assistance

[avidlearner]

Not sure what to do. Been without insurance for a while now, but i know I need to get it eventually. One potential problem is I have chronic pre-existing condition. One thats not immediately dangerous, but will definitely require medical attention at some point. I play poker for a living, and make enough money where getting a real job just for insurance doesn't make much sense. I also don't want a real job, I love what i do.

Anybody in the health insurance field, or been in this situation before? I feel totally lose and am pretty scared. Please help.

[Mitch Evans]

Not sure what your dilemma is. Just apply for insurance. You didn't state your age or what you pre-existing condition is, but I don't see what the problem is. You don't need a "job" to get insurance, you just need to pay the premiums. Depending on your health and whether the state you live in allows unrestricted medical underwriting will determine how high your premiums will be, if your existing condition will be covered, and how soon you can get covered. Shouldn’t take more than a few weeks…

[mikalina]

The sooner you apply, the better. It depends on the state that you live in, but in general, for cases of pre-existing conditions, if you have had coverage under the company for x years without an issue with the condition, they cannot deny your claim due to pre-existing condition.

Someone chime in and correct me if I am wrong, but I believe in my state it is 3 years. This applies if you do not disclose the condition at the time of application. If you do disclose, they have the right to completely remove claims that relate to your condition from your coverage.

I would do a bit more research on this than what I just said (although I should know this [censored], it's my field). I just can't remember if this is one of the things that is excluded from the statute of limitations.

[Nicholasp27]

EVERYONE should have health insurance in the US

even if you SELF-INSURE, you should get cheap insurance with a high deductible...it'll be cheap since insurance company will never pay out each year unless you have a major illness/surgery

so what's your benefit? you will pay what the insurance company allows

say u go to the hospital and have a few tests run on you...the hospital will try to charge say $2500 for this...if u don't have insurance, then you owe $2500

if u have insurance, even with a 10k deductible, then they send the bill to the insurance company...who comes back and says: this is only billable for $500...u then pay that $500 for your deductible and that's it

so u saved 2k because u pay those insurance prices

this has less of an effect on a standard doctor office visit, but will still save you $100 or so on those as well each time

[neuroman]

[ QUOTE ]
EVERYONE should have health insurance in the US

even if you SELF-INSURE, you should get cheap insurance with a high deductible...it'll be cheap since insurance company will never pay out each year unless you have a major illness/surgery

[/ QUOTE ]
This does not seem to be the case. I tried inquiring into high deductible, catastrophic type coverage and it would be over $1000 a year for a completely healthy mid-20s non-smoking male.

If I am wrong feel free to point me in the right direction but I don't consider that "cheap."

[hobbes9324]

Well, the problem is you young healthy male types are by far the most prone to being involved in traumatic injuries. To give you an idea, at our trauma center traumas come in three flavors -

T-5000 - pretty much nothing wrong, not much of a mechanism.

T-green - +/- hurt - say a rollover accident, or you fall off a ski lift from 15 feet.

T-blue - you're [censored] up - shot in the chest or stabbed in the belly, high speed car accident with open fractures, etc.

There is no minimum charge for a T-5000 - "just" the regular bill. For the ED fee, nursing charge, my fee, maybe an x-ray, radiologist fee - you MIGHT get out for a grand. Maybe. The meter spins pretty fast, though.
Now the bad news. If you come in as a green, with NO injury at all - automatic $8000 charge BEFORE I SAY HELLO.
For a blue $14000.

Last I looked, the average charge for a green came to about $20000 - for a blue, close to $100000 (yep, six figures)

note - before you bitch about expensive docs, I get a maximum of about $700 or so - for the sickest, most [censored] up patients. For the T-5000, I bill about $175. The rest goes to all the other place I mentioned.

So, anyway, that's why health insurance is so goddam expensive. Or at least a small part of the reason. And to the guy who thought we don't try to collect on the balance when the insurance company says "here's $500, take it or leave it" - we take it. Then we bill you for the rest, UNLESS we have a contract with your insurance company. (Medicare IS a take it or leave it deal, but you, by definition, don't qualify)

Best strategy - get a HIGH deductible policy from a WELL ESTABLISHED carrier. A lot of big hospitals have captive HMO's that offer these. BC/BS are a (poor) second choice - the coverage is fair, but they are god awful to deal with from both the patient and doc.) If you choose to go with Bob's great health care and pizza delivery, check with your state insurance board and make sure Bob is a real insurance company with the ability to pay if you bust your ass up. Believe it or not, a lot of people who think they are insured find out the hard way that they're not......

And yes, we should have a national health care system. With the special interest groups against it, though - no time soon.

MM MD

[Nicholasp27]

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

even if you SELF-INSURE, you should get cheap insurance with a high deductible...it'll be cheap since insurance company will never pay out each year unless you have a major illness/surgery

[/ QUOTE ]
This does not seem to be the case. I tried inquiring into high deductible, catastrophic type coverage and it would be over $1000 a year for a completely healthy mid-20s non-smoking male.

If I am wrong feel free to point me in the right direction but I don't consider that "cheap."

[/ QUOTE ]

<100/month is cheap...i don't know about prices, as i work for an employer, but u can shop around to see if can get cheaper with like a 5k deductible, co-insurance, and such...it only takes one trip to the hospital because u get sick/injured after 5pm and the difference u pay because u have SOME insurance is more than $1000 off

[NajdorfDefense]

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

even if you SELF-INSURE, you should get cheap insurance with a high deductible...it'll be cheap since insurance company will never pay out each year unless you have a major illness/surgery

[/ QUOTE ]
This does not seem to be the case. I tried inquiring into high deductible, catastrophic type coverage and it would be over $1000 a year for a completely healthy mid-20s non-smoking male.

If I am wrong feel free to point me in the right direction but I don't consider that "cheap."

[/ QUOTE ]

$600 see above. That *is* cheap, ftr.

[jogsxyz]

[ 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. There should be universal care for all. It should cover preventative care and emergency care.
Only those who want more coverage would need to buy health insurance.

[Nicholasp27]

obviously the US should have universal health care

but since it doesn't currently, everyone should have health insurance in the US