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  1. #1
    Pedaled too far. Artkansas's Avatar
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    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?
    "He who serves all, best serves himself" Jack London

    Quote Originally Posted by Bjforrestal View Post
    I don't care if you are on a unicycle, as long as you're not using a motor to get places you get props from me. We're here to support each other. Share ideas, and motivate one another to actually keep doing it.

  2. #2
    I need more cowbell. Digital Gee's Avatar
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    Quote Originally Posted by Artkansas View Post
    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.
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  3. #3
    rae
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    legs full of molasses rae's Avatar
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    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.

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    Health Insurance is rapidly becoming a Luxury Item!

  5. #5
    Senior Member BlazingPedals's Avatar
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    Quote Originally Posted by cranky old dude View Post
    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.

  6. #6
    Senior Member MNBikeguy's Avatar
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    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 thought of that while riding my bike."
    - Albert Einstein on the theory of relativity

  7. #7
    Senior Member deraltekluge's Avatar
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    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.

  8. #8
    feros ferio John E's Avatar
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    Quote Originally Posted by BlazingPedals View Post
    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."
    "Early to bed, early to rise. Work like hell, and advertise." -- George Stahlman
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  9. #9
    feros ferio John E's Avatar
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    Quote Originally Posted by MNBikeguy View Post
    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?
    "Early to bed, early to rise. Work like hell, and advertise." -- George Stahlman
    Capo [dschaw'-poe]: 1959 Modell Campagnolo, S/N 40324; 1960 Sieger, S/N 42624
    Peugeot: 1970 UO-8, S/N 0010468
    Bianchi: 1981 Campione d'Italia, S/N 1.M9914
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  10. #10
    Small Member maddmaxx's Avatar
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    Quote Originally Posted by John E View Post
    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.

  11. #11
    Senior Member oldride's Avatar
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    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.
    Last edited by oldride; 11-20-08 at 02:12 PM.

  12. #12
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    All you have to do is stay well until Jan 20, 2009 and then someone else will be paying for it.

  13. #13
    Senior Member
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    Move to Canada.

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

  14. #14
    Senior Member Retro Grouch's Avatar
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    Quote Originally Posted by rae View Post
    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.
    Last edited by Retro Grouch; 11-20-08 at 04:58 PM.

  15. #15
    Gone DnvrFox's Avatar
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    Interestingly, as I understand it, Medicare administrative costs are lower than private health insurers.

    Please see:

    http://www.cahi.org/cahi_contents/re...nicalPaper.pdf
    Last edited by DnvrFox; 11-20-08 at 04:59 PM.
    Gone >> Gone >> Gone >> Gone >> Gone >> Gone >> Gone

  16. #16
    Senior Member deraltekluge's Avatar
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    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!

  17. #17
    Senior Member NOS88's Avatar
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    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.
    A conclusion is the place where you got tired of thinking. - S. Wright

  18. #18
    Senior Member MNBikeguy's Avatar
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    Quote Originally Posted by NOS88 View Post
    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.
    "I thought of that while riding my bike."
    - Albert Einstein on the theory of relativity

  19. #19
    Senior Member Retro Grouch's Avatar
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    Quote Originally Posted by DnvrFox View Post
    Interestingly, as I understand it, Medicare administrative costs are lower than private health insurers.

    Please see:

    http://www.cahi.org/cahi_contents/re...nicalPaper.pdf
    Of course. The two biggest departments in any insurance company are underwriting and claims. Medicare takes everybody so there is no underwriting.

  20. #20
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    Quote Originally Posted by John E View Post
    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.

  21. #21
    Senior Member cyclezealot's Avatar
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    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.. ?.
    Pray for the Dead and Fight like Hell for the Living









    ^ Since June 16, 2011

  22. #22
    Surf Bum
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    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.

  23. #23
    Senior Member cyclezealot's Avatar
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    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.
    Pray for the Dead and Fight like Hell for the Living









    ^ Since June 16, 2011

  24. #24
    rrg
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    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.

  25. #25
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    Quote Originally Posted by pacificaslim View Post
    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.

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