Fifty Plus (50+) - Health Insurance

As a part of being laid off, they finally got me my COBRA forms.

But COBRA wants $700.00 a month! Just me alone. That would be the single biggest expense in my budget, almost 160% larger than rent. Should I go for it?

As a part of being laid off, they finally got me my COBRA forms.

But COBRA wants $700.00 a month! Just me alone. That would be the single biggest expense in my budget, almost 160% larger than rent. Should I go for it?

I had to do that once, and it's not fun. Find out whether keeping yourself insured will make it easier to get your own insurance, should you have to, once the COBRA runs out. If you let your coverage lapse, you might have a problem with any preexisting conditions (such as being alive, breathing, and possibly wanting to actually USE the insurance some day down the line) keeping you from being accepted by a new company.

When I was without employer-provided insurance for a few years, I found decent (not perfect) policies through insweb.com -- there are other sites too, I think. I just had catastropic coverage, and a fairly high deductable so my premium was not much more than I am paying now, admittedly for much less coverage. I could cover my routine costs okay on my own.

Health Insurance is rapidly becoming a Luxury Item! :(

Health Insurance is rapidly becoming a Luxury Item! :(

Correction: Full Health Care is rapidly becoming a luxury item. The cost of insurance merely reflects that unpleasant reality. If health care were cheaper, people wouldn't need insurance for it.

COBRA is priced to kick you out. They don't want you on the plan anymore, but the law says they've got to tag you along for a number of months.
I would recommend you check out this site:

http://www.arkbluecross.com

I'm no expert, but having recently dealt with this I found the Blue Cross / Blue Shield Individual plans made the most sense. Goodluck!

I was faced with a situation kinda like that. I chose to do without the insurance (call it being "self-insured"). All was well for quite a while. Then, I was not so well: Congestive heart failure, enlarged prostate requiring surgery, cataracts in both eyes requiring surgery, two hernias requiring surgery, gout, and other assorted problems. I ran up medical bills (uninsured and unreimbursed) of about $100,000 over five years time before I got old enough for Medicare. Sounds scary, but it wasn't as bad as it sounds. If I'd had insurance, the premiums would have cost me about as much as my medical bills amounted to...I figure I broke about even.

Correction: Full Health Care is rapidly becoming a luxury item. The cost of insurance merely reflects that unpleasant reality. If health care were cheaper, people wouldn't need insurance for it.

Partly true. The other part of the equation is that our health insurance system is less than 70% efficient, meaning that more than 30% of your premium expenditures go to administration expenses and other "leakage."

COBRA is priced to kick you out. They don't want you on the plan anymore, but the law says they've got to tag you along for a number of months.
I would recommend you check out this site:

http://www.arkbluecross.com

I'm no expert, but having recently dealt with this I found the Blue Cross / Blue Shield Individual plans made the most sense. Goodluck!

Your remarks about the COBRA system are spot-on. The issue is that employer health plans must take all comers, whereas private health plans can cherry pick their clients, minimizing risk by excluding some 15% of the populace because of "pre-existing conditions."

If I lose my employer-provided health insurance, I'll probably check out ehealth.com and similar companies, as well as going directly to Blue Cross/Shield/et al. for a quote.

By the way, does anyone know the exclusion period for cancer survivors, after which they can qualify for regular individual health insurance policies? For example, is 15 years after a thyroidectomy long enough?

Partly true. The other part of the equation is that our health insurance system is less than 70% efficient, meaning that more than 30% of your premium expenditures go to administration expenses and other "leakage."

Being as I live near Hartford, Ct.......at one time the insurance capital of the world, we occasionally see interesting bits in the newspaper. It appears tha some of "our insurance companies are returning only about $0.25 on the dollar. That might be more than inefficient............It might be theft.

John E asked:
"By the way, does anyone know the exclusion period for cancer survivors, after which they can qualify for regular individual health insurance policies? For example, is 15 years after a thyroidectomy long enough?"

I have Blue Cross/Blue Shield and when I applied they only asked about the last 8 years for any medical treatments.

edit: I am 55yo and my plan costs $260mo. with a $5k deductable.

All you have to do is stay well until Jan 20, 2009 and then someone else will be paying for it.

Move to Canada.

As long as you don't mind cycling in the snow for four months of the year.

When I was without employer-provided insurance for a few years, I found decent (not perfect) policies through insweb.com -- there are other sites too, I think. I just had catastropic coverage, and a fairly high deductable so my premium was not much more than I am paying now, admittedly for much less coverage. I could cover my routine costs okay on my own.

Buying insurance to cover your routine office visits strikes me like buying insurance to pay for your car's oil changes. It's just not worth it.

Insurance companies typically have around 40% administrative and expense loading. That's a lot extra to pay just for having somebody pay maybe 2/3 the cost of an office visit.

The best insurance program that I ever had was a Medical Savings Account. It had 3 parts:

The first was a high deductable major medical insurance policy.
The second was a PPO to take advantage of the insurance company's negotiating power with medical providers.
The third was the MSA. It was completely self-directed. I got a check book and could use it for anything medical related.

As I remember, it cost us about the same as the insurance program that we had previously, but it paid 100% of all our medical costs. Of course, we didn't have anything big while we had the MSA.

Interestingly, as I understand it, Medicare administrative costs are lower than private health insurers.

Please see:

http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf

I skimmed through some of that report, and it seems to be comparing Medicare to private insurance with things like commissions and profits excluded from the private insurance costs!

It's probably just the socialist streak that runs through me at times, but I don't think health care should be a profit making venture. And, yes I know the arguments about the incentives for new cures, treatments, etc. being driven by profit. But it irks me at the very core that someone will make money off of others being sick. Now keep in mind that the company I run just got our quote for health insurance this week. It is now 9.7% of our total operating budget; over $12,000 a year per employee.

It's probably just the socialist streak that runs through me at times, but I don't think health care should be a profit making venture. And, yes I know the arguments about the incentives for new cures, treatments, etc. being driven by profit. But it irks me at the very core that someone will make money off of others being sick. Now keep in mind that the company I run just got our quote for health insurance this week. It is now 9.7% of our total operating budget; over $12,000 a year per employee.

I agree. Except your logic is far from socialist. :)
IMHO the entire system is ass end backwards. They need to completely remove "insurance" from the equation and stop making this an employer carried cost.
"Insurance" is for unexpected, unintended losses. e.g. My house burns down, someone steals my bicycle. It makes no sense to me that health care is administrated through this type of system.

Interestingly, as I understand it, Medicare administrative costs are lower than private health insurers.

Please see:

http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf

Of course. The two biggest departments in any insurance company are underwriting and claims. Medicare takes everybody so there is no underwriting.

Partly true. The other part of the equation is that our health insurance system is less than 70% efficient, meaning that more than 30% of your premium expenditures go to administration expenses and other "leakage."

This is the real problem. I did a number of stories on this before I took a "voluntary" buyout after 30 years in the newspaper business, and one of the things I learned was that about one-third of our "health care" money goes for administration, basically just shuffling papers back and forth. Even in good times, our insurer routinely rejected all but the most basic claims, even things that were clearly covered. Sometimes they'd pay up after one phone inquiry, because there was no reason for the rejection. Meanwhile they'd draw interest on the money, and sometimes we'd give up and pay out of pocket to avoid being sent to collection. I'm hoping the November election helps change that--I don't give a damn if it's socialized medicine; I just want those insurance b******s broken.
FWIW, you're getting off pretty easy. Our COBRA policy is running us $1235 a month for me and my wife, for a year until I'm old enough for Medicare. Probably I wouldn't spend anywhere near that on health care, but a 64, with questionable heredity, you can't risk it.

Thing is about US health insurance.. FIrst the cost.. Often greater than rent.. But, unreliable deductibles and unreliable coverages, is it worth it.. You can pay out the 700 bucks and find out when needed , it won't be there for you... Is it worth it.. Is insurance without defined coverages really insurance.. ?.

If you are healthy, it may be worth it to just get a catastrophic policy that will kick in and cover everything after the first $5k or $2k or $10k or whatever (many different plans available). The premiums each month are very low. Think of it this way: you're going to pay $8500/yr in premiums for the full coverage plan, right? What if you could pay $1500/yr in premiums and be on the hook for the first $7k yourself? If you get really sick and run up a bunch of bills, your cost ends up being the same as you would have paid anyway. If you never need any care that year, you just saved yourself $7k.

Insurance companies.. Don't trust them as far as you can throw them.. All their exemptions and non coverages. .Just because you think you're covered, don't be so sure; when it come time to collect.

I am a case manager, use to work at an insurance company, and my 2 cents: COBRA is ridiculous, but individual policies are fraught with problems, and COBRA will keep you from being denied for a pre-existing condition if you get another group plan. Individual plans don't, as I understand them.

If you are healthy, it may be worth it to just get a catastrophic policy that will kick in and cover everything after the first $5k or $2k or $10k or whatever (many different plans available). The premiums each month are very low. Think of it this way: you're going to pay $8500/yr in premiums for the full coverage plan, right? What if you could pay $1500/yr in premiums and be on the hook for the first $7k yourself? If you get really sick and run up a bunch of bills, your cost ends up being the same as you would have paid anyway. If you never need any care that year, you just saved yourself $7k.


All great plans for healthy people. That's the problem, healthy people don't really
need the insurance. The people with life long illnesses are screwed. Pay out $1200
a month for family coverage and add to that another $200 a month co-pay for meds
that cost $1800 per month retail. The poor get health care provided but only after
they've been sick for so long that many who could have been successfully treated
when first getting sick or noticing a problem end up dying of a terminal disease due
to delayed care. The rich are all set, no worries. The rest of us will go belly-up if/when
we fall seriously ill. That has become the American way. If we don't go broke trying
to stay insured, we'll go broke paying medical bills.

2000 years ago, many of us believe a man walked the Earth who healed, fed and
provided salvation for all who would come to him. Now we have CEO's who feed
off the general populace and the sick, and create the hungry and homeless.

For the first time in my life, I feel like I'm getting my money's worth for my insurance premiums this year. I'm seeing some scary looking bills from all the doctors, hospitals, treatment centers, labs etc. that have been involved in treating my cancer. I'd hate to think about what it would be like without good insurance.

Just to add fuel to the fire I just copied the following from the home page of the British Columbia Medical plan.

" In B.C., premiums are payable for MSP coverage and are based on family size and income. The monthly rates are:

$54 for one person
$96 for a family of two
$108 for a family of three or more "

http://www.health.gov.bc.ca/msp/infoben/premium.html

The rates are reduced dependent on family income.
Sure we have wait lists for a lot of things but if you are sick and need treatment for serious illness you get it. I just had a non-urgent ultrasound today that my doctor said that I needed when I saw him on the fourth and recieved notice of my appointment time the next day.A friend just moved up here from Atlanta and had to get private coverage for six months until he met the residency requirement and paid between $650 and $700 for his six month plan that covered both him and his wife. He said that when the clerk told him that was the cost for six months he nearly fainted as it was less than he was paying per month in Georgia.

All great plans for healthy people. That's the problem, healthy people don't really
need the insurance. The people with life long illnesses are screwed.

BINGO! That's the key issue with paying for health care as we do it in the United States. Insurance companies only want to insure healthy people. Health care providers don't create wealth so any pro bono care they provide has to be paid for by somebody else. Unfortunately, the less healthy among us won't go away so ultimately we are all contributing toward their health care costs today anyway.

A single payer program that covers everybody would spread the cost (that we're already paying) more fairly. We would also eliminate the 30% to 40% administrative cost loading that we're paying now. That's a huge cost reduction. The only real losers would be the insurance companies. They're going to scream real loud to keep this from ever happening in the US.

The bottom line is that Europeans pay roughly half what we in the US pay for health care and, based upon objective facts like infant mortality, they get MUCH better results. We pay by far the most and get about the 25th or 30th best service.

Just to add fuel to the fire I just copied the following from the home page of the British Columbia Medical plan.

" In B.C., premiums are payable for MSP coverage and are based on family size and income. The monthly rates are:

$54 for one person
$96 for a family of two
$108 for a family of three or more "

.

^^^....Retro.. It's not half.. It's more like 25%. Health care procedures are so reasonable, you likely , hopefully, won't go broke; even if you are one of the non -nationals without insurance........ We live in France for now... Your rates are even cheaper than ours... By about 1/3... We never have to fear about services being denied. We get what Rx's the doctors orders and the deductibles on all non hospitable procedures are only 3 euros... Even house calls by the Samu ( emergency response. ) are still 3 euros... had to use them once when I got heat exhaustion from riding once.. Got a valium shot in the rear in my bed at home to get my breathing straightened out... 3 euros..

The last time I read, health care in the USA was one step BELOW Costa Rica, a third world nation, where we live. And our costs are usually around 10% or less of what they are up there. 3 to 4 times lower, I could understand based on salaries, but not 10 times!

And, having used the health care here to stitch up my hide, I can tell you they did a good job. But they obviously don't spend on frills. 6 stitches, 2 locations, lots of removal of grit, 45 dollars. (45 minutes of work). I have been told that would have been well over a thousand in the USA.

I will admit to being very distrustful of insurance companies. So far, anytime I have really needed them, they have managed to weasel out of it - so, instead of paying into their system with a hope that they will pay out, I have invested the money wisely and now we have what we need. I really like deciding for myself if I need a certain procedure, instead of having to have it approved by a bean counter.

I can hardly believe how expensive your health insurance and general health costs are in the US. I'm a GP in Australia and basically, your monthly health insurance costs are about equivalent to ANNUAL private health insurance in Australia. Moreover, private health insurance in Australia is additional cover. If you are willing to go with the public system (which is adequate for most things), then it doesn't cost anything at all (at point of care). Moreover, I don't believe our taxes are any higher than in the US.

Regards.

Moreover, I don't believe our [Australian] taxes are any higher than in the US.


Yes, but we have way more missiles than you. :twitchy:

Yes, but we have way more missiles than you. :twitchy:

And more wars!

In a few years there won't be any doctors left to go to when you're sick. Believe me, I know. My wife is one and everyday she wants out and there aren't many coming through the system to replace her. Her practice has shrunk from 11 docs to 4 in the past 3 years. There are no primary care docs to replace them. The system is so f****d up. Insurance companies are only part of the problem. Liability is a huge concern that drives up costs big time.

The health care costs are totally rediculous in the US. I work at a hospital and my insurance cost me 250 a month. In February I had an incident of chest pain while at work, went to the ED and was admitted over night with a stress test and an echo cardiogram done the next day. When all was done the total bill was 14234 dollars and I still had to come up with 586 dollars out of pocket after the insurance paid what they were going to pay.

The health care costs are totally rediculous in the US. I work at a hospital and my insurance cost me 250 a month. In February I had an incident of chest pain while at work, went to the ED and was admitted over night with a stress test and an echo cardiogram done the next day. When all was done the total bill was 14234 dollars and I still had to come up with 586 dollars out of pocket after the insurance paid what they were going to pay.

You got to be kidding me!!! :eek:

Totally out of control if you ask me.

The last time I read, health care in the USA was one step BELOW Costa Rica, a third world nation, where we live. And our costs are usually around 10% or less of what they are up there. 3 to 4 times lower, I could understand based on salaries, but not 10 times! ...

Defenders of universal single-payer health coverage like to say how bad the US life expectancy and general health are. Poor health in the US has nothing to do with the health care system, which is still world-class for those who can afford it, but everything to do with an overweight and underexercised populace.

The US probably has the best medical care in the world, for those who can get it, but the worst medical system in that 47,000,000 people are uninsured, 470,000 patients go bankrupt each year as a result of medical bills, employees lose coverage if they change jobs, and the paperwork involved is unbelievable. This is unheard of in any other developed country.

Medical care for everyone should be a right (Obama), like security (e.g. the military, fire service, police force etc), not a responsibility (McCain).

People here cringe at the mention of "socialized," but what are Medicare and Social Security if they are not socialized, i.e. individuals contributing to the good of the whole? The thing is that they work, as I know from my own experience!!

The Canadian and UK systems are often taken here of examples of poor healthcare systems. I have no experience of the Canadian system, but plenty with the UK and plenty with the US. Example of the US:
8 hours in a ER in Atlanta to correct Atrial Fib; bill $20,000. When I examined it I found an error of $8,000 and complained I was told "we can't check everything, sir."

Similar situation in the UK for the same problem: 5 hours in ER; no charge. Prescriptions for over-60s: no charge.
Yes, if you need a hip replacement in the UK under the national health system you will have to wait, but you have the option of supplemental private insurance if you want faster service. In any case, if it's an emergency, you don't wait and you don't pay a penny.

Recent experience in the US:
Referred by family doc for 5-yearly colonosopy in a part of the same medical system here in FL which prides itself on seamless transfer of patient info between depts:
-appointment made and package of questions and waivers received. Over 6 pages in all.
-had to drive 30 miles round trip to have pre-procedure consultation with surgeon at place where they already have all my info. Asked me all the questions I had filled out in the 6 pages. Asked for Medicare and supplemental insurance cards and wanted to take a copy of my drivers licence. Never allow a copy of your drivers licence, because then they have all the information (SS # DoB etc) which some employee can use to steal your identity.
-had call day before procedure to ask most of the same questions I had already answered
-day of procedure: sign more papers and answer same questions.
-procedure done and I'm clean, for a further 8 years - but tired!!

Over here we have a "National Health service" Treatment may be "Free" but we do pay for it with taxes. And the Free at point of delivery but it is not quick. Took 4 months before I had Prostate cancer confirmed and another 3 months before treatment.

Same with the bypass. From the time of diagnosing the treatment- it took 3 months of pain before I was treated.

And cost--Around 9% of your taxable income- which for me is around $300 a month. Out of $3500 a month.

Over here we have a "National Health service" Treatment may be "Free" but we do pay for it with taxes. And the Free at point of delivery but it is not quick. Took 4 months before I had Prostate cancer confirmed and another 3 months before treatment.

Same with the bypass. From the time of diagnosing the treatment- it took 3 months of pain before I was treated.

And cost--Around 9% of your taxable income- which for me is around $300 a month. Out of $3500 a month.


You make very succint points about the time it takes. Seven months from diagnosis till treatment could have been fatal with many forms of cancer.

From what I understand about Canada, having traveled and worked there for most of two years, if you are over 60, have anything less than near perfect health, and need a transplant........YOU'RE DEAD AND JUST DON'T KNOW IT.

Just to be blunt, the issue is that we are all dead, the question is, when? As a good friend of mine told me once regarding my healthy lifestyle. "It is going to be a real shame someday when you die of nothing..." :rolleyes: