goldberry Posted January 17, 2011 Share Posted January 17, 2011 Is anyone here doing this? Since DH and I have been self-employed (about 3 years now) we have struggled with health insurance. For about a year, we had a high deductible policy that cost us $300 per month. Basically we paid everything up until $7500, so we considered it just a catastrophic policy. The thing was, spending $300 per month, we couldn't put anything away to cover the deductible if we needed it. We ended up not needing it, thankfully, we are relatively healthy. After about a year, finances could no longer afford the $300 and we had to give up the policy. So basically, $3600 out the window. (yes, I know we had the peace of mind of being covered during that time.) We are now in a position to budget about $300 per month again. I am looking at policies (most about the same as we had before). But I am thinking seriously of just putting the $300 into a savings account allocated for healthcare instead. I figure at least if we don't use it, then it accumulates instead of us just giving it away. If we do have something catastrophic, we could still negotiate with the hospital for payments, whatever. If you had the choice in this situation, would you buy health insurance or put it in a saving account? ETA, it just makes me feel weird though, as someone who has always had insurance, I feel like I'm driving without a seatbelt! Quote Link to comment Share on other sites More sharing options...
Haiku Posted January 17, 2011 Share Posted January 17, 2011 If you had the choice in this situation, would you buy health insurance or put it in a saving account? I'd buy insurance. There really is no way you can save enough to cover a medical catastrophe, and "negotiating" with the hospital means that everyone else picks up the tab for your care. This, of course, drives everyone else's costs higher. Tara Quote Link to comment Share on other sites More sharing options...
elegantlion Posted January 17, 2011 Share Posted January 17, 2011 It depends, it's like roulette. We're one of the uninsured self-employed families. Fortunately we're fairly healthy and I don't worry too much, over think, yes, not worry. IMO I would try to find a large truly catastrophic policy that would cover expenses after a certain amount, like 25k just as a random number. We haven't looked in a while but you might be able to get that lower than 300/month. I would then put the difference into a savings. My decision would also depend on how well you like your doctor. We used to have one that would give us a nice self-pay discount and treated us an intelligent patients. He wouldn't order excessive tests or tx for a simple diagnosis. I know some people who would never go uninsured, but when it comes down to eating or paying a premium you never use...I dislike the insurance industry as a whole (pretty much). My only wish is that dh would find a dentist to barter services with. :D Quote Link to comment Share on other sites More sharing options...
Teresa in MO Posted January 17, 2011 Share Posted January 17, 2011 my dh had a 6 week battle with kidney stones this past summer. I'm not sure I would classify it as a medical catastrophe, it was not serious in nature, but did require 3 surgeries and 2 hospitalizations. His medical bills before being discounted by his insurance ran close to $75,000. This was for something that was not very serious. My dh is basically very healthy. I would get the insurance. Even a minor incident or surgery would make it worth it. Quote Link to comment Share on other sites More sharing options...
NoPlaceLikeHome Posted January 17, 2011 Share Posted January 17, 2011 I took care of plenty of formerly "healthy" people who racked up hundreds of thousands of dollars in health care bills:(. I think it is playing russian roulette to go without health insurance. Also, if one is able to afford health insurance and goes without it, then when they end up in the ER, everyone else has to pay for it. It goes against personal responsibility IMHO. OTOH I am strongly infavor of medicare for all since I believe it would be cost effective and help individuals, businesses, and governments on all levels. Quote Link to comment Share on other sites More sharing options...
Skadi Posted January 17, 2011 Share Posted January 17, 2011 It's insurance that drives up rates, not being uninsured -- and even in the case of something catastrophic, you can make payments of $20 a month without a problem. The idea that you'd just not pay or that you'd have your house taken from you is a farce. I guess I won't go into that debate here, as it'd be way too off topic for what the OP asked. We have a savings account instead of insurance. We deposit $400 every month (this isn't a "must have" figure we came up with, it's just what we can afford) into an ING account with high interest. With interest, that comes to around $5k per year. You see how quickly that can add up. We use our health savings account mostly for emergencies and for childbirth. We do live differently since we don't have insurance -- we don't go to superfluous check-ups, for instance, and we use a certified midwife instead of an ob/gyn (which comes to about $2k instead of paying $5k in that alone). We don't just hop on over to the ER for something the health clinic or a regular doctor could treat. We also use that savings account for dentistry and the like, fwiw. It's worked out great for us. Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 I'd buy insurance. There really is no way you can save enough to cover a medical catastrophe, and "negotiating" with the hospital means that everyone else picks up the tab for your care. This, of course, drives everyone else's costs higher. Tara The insurance companies negotiate with the hospital, so I don't feel like it is wrong for me to do so. For instance, in the example of the $75000 bill, I wonder how much of that the insurance company actually paid and how much was "disallowed" as part of the hospital-insurance company agreement. It is flat out evil that hospitals would charge more for a person who is paying cash, and I don't have an ethical problem at all negotiating for a more reasonable price. I do want to have personal responsibility, otherwise I wouldn't be putting the money away at all. But I know it could definitely go beyond what I put away. It's just really frustrating...and expensive... Quote Link to comment Share on other sites More sharing options...
MindyD Posted January 17, 2011 Share Posted January 17, 2011 That's a hard one. My initial reaction would be to put the money in savings. From my personal experience and a close friend's experience at our local hospitals anyway, is that the hospitals do have separate rates for insured and self-pay. The self-pay people paid a significantly smaller amount, and they work out a payment plan. My experience has been that we paid MORE for health costs with our insurance (except for dental). I know that the hospitals charge more for insured and we had to pay the difference between what insurance paid and what was still owed. Add that to the premium we paid every month and it was a farce. BUT I would feel like we'd be just asking for something major to happen if we didn't have insurance so I'd have a little more stress over it all. Plus, you'll have to have it anyway soon or you'll be fined. Maybe do like someone else suggested and find a real catastrophic plan and do an HSA. Then you're doing a little of both. Quote Link to comment Share on other sites More sharing options...
ChandlerMom Posted January 17, 2011 Share Posted January 17, 2011 The insurance companies negotiate with the hospital, so I don't feel like it is wrong for me to do so. For instance, in the example of the $75000 bill, I wonder how much of that the insurance company actually paid and how much was "disallowed" as part of the hospital-insurance company agreement. It is flat out evil that hospitals would charge more for a person who is paying cash, and I don't have an ethical problem at all negotiating for a more reasonable price. I do want to have personal responsibility, otherwise I wouldn't be putting the money away at all. But I know it could definitely go beyond what I put away. It's just really frustrating...and expensive... Depends if you have any assets worth protecting (like a car, house, savings, etc). If you do, you need insurance. IMO you've hit on one of two big problems with the medical insur system. Insurance "negotiate" rates a small fraction of what they bill. Some examples: prenatal blood work billed insurance over $600; they paid $30 (5%) I paid none. A hospitalization was paid at about 30%; an MRI they paid $700 for full payment on a $5,000 bill. It's a racket. The problem is that if you have any assets at all the hospital doesn't have to negotiate with you AT ALL. Even better, they can come back 18 mo later and rebill you for more if they decide they can. [i had that happen TWICE with each of my first two births; in the first case because my care cost less than insurance negotiated price, so I paid my 20% of the bill but 18mo later they wanted another $800 for the 20% of the amount they COULD have billed if I had required more care. WTH? If your risk was to have to pay what insurance pays, Id say go for it. After all, insurance is for-profit so they have to take in more premiums than they pay out. But as long as they can bill you 20 times MORE than they bill insurance and you have anything to lose, they've got you by the short hairs -- as they intend. The other big problem IMO is that it is currently impossible to buy private insurance that is equivalent to employer provided insurance. For example, private policies usually exclude any pre-existing conditions FOREVER. So, take a blood pressure med for migraines and you may be denied coverage for a heart attack. Nice. That's why the insurance companies hate the new medical bill and want it repealed. I just wish we could buy into medicare and get their negotiated prices even if we paid them. My 2 cents. Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 (edited) Does the money in an HSA have to be used in a certain time frame, or does it accumulate? Never mind, googled like I should have! Edited January 17, 2011 by coloradoperkins google first, then submit! Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 Wow, an HSA policy in Colorado with a $10000 deductible still costs about $250 per month. And last time they upped my rate by about $30 because I take meds for depression (despite the fact they won't be paying for the meds anyway..??) They don't do any higher deductibles here. Quote Link to comment Share on other sites More sharing options...
JudoMom Posted January 17, 2011 Share Posted January 17, 2011 I don't think I would do it. I don't drink, I don't smoke, and I work out daily for at least 30 minutes. I'm fairly healthy (except for a bum thyroid), or so I thought. 2 years ago, I was in for my regular thyroid check (I'd been tired and cranky) and the doctor found some abnormalities in my liver counts. A year later (because I forgot to go back), I had them rechecked and they were still high. Long story short, after lots of testing through a regular GI doc, I ended up at a liver specialist. The bill for my one visit with this doctor was over $1000. This was the appointment only, and included no tests whatsoever. I left with a handful of more tests to get done, and was recently called by his nurse to get more tests done. The bottom line is that I'm most likely looking at a chronic liver disease (I'm still waiting on an answer from the $1000 doctor) and possibly some other autoimmune issues (I see a rheumatologist in a few weeks because my GP suspects something like lupus). Sure, my case isn't the norm. But I know that we would be in a world of hurt without insurance. We are financially responsible, live at or below our means, and have no debt but our home, but if we didn't have insurance we would be facing more bills than our savings could handle. All this to say--if you can get insurance, I would not go without. Life can change in an instant, and I wouldn't want to be without the safety net. Quote Link to comment Share on other sites More sharing options...
Jen500 Posted January 17, 2011 Share Posted January 17, 2011 All this to say--if you can get insurance, I would not go without. Life can change in an instant, and I wouldn't want to be without the safety net. :iagree: Quote Link to comment Share on other sites More sharing options...
Ginevra Posted January 17, 2011 Share Posted January 17, 2011 No. I would never do this. I understand your situation; we are self-employed, too. We have a high deductible, which I hate, but otherwise, we would pay twice as much per month for coverage. Injuries, accidents, chronic illness or if you or a kid is presenting with symptoms that involve investigation, it racks up so fast. There's only so much you can negotiate with a hospital and personally, I would not want that gut-wrenching stress hanging over my head on top of one of us being in need of very expensive care. Health insurance is just about the last thing I would consider eliminating if finances were that dire and it would be long after cell phones, satellite tv and internet and other things I would not want to get rid of but would if necessary. Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 Thanks for the input. It would be playing Russian roulette.... It just kills me though. There has to be better way. I hope it's out there somewhere... Quote Link to comment Share on other sites More sharing options...
Ginevra Posted January 17, 2011 Share Posted January 17, 2011 Wow, an HSA policy in Colorado with a $10000 deductible still costs about $250 per month. And last time they upped my rate by about $30 because I take meds for depression (despite the fact they won't be paying for the meds anyway..??) They don't do any higher deductibles here. To me that would be an unbelievable bargain. Our family's portion is almost $1000 a month and our deductible is $5K. Quote Link to comment Share on other sites More sharing options...
happypamama Posted January 17, 2011 Share Posted January 17, 2011 That situation would make me uncomfortable. Yes, you'd have enough to cover some minor-major stuff but not major-major stuff. The possibility of hundreds of thousands of dollars for one illness/accident would make me uncomfortable. Or what if someone breaks an arm in the same year as someone else needs a tonsillectomy in the same year that someone gets cancer? I'd be looking for other types of insurance, personally, though I know the options vary between states. The other thing you might consider is, if you're Christian, one of the medi-share programs like Samaritan's Ministries. You could still end up owing quite a bit if there were too many needs to meet at the time you needed it, but at least your monthly payment, while not going toward you if you're healthy, would still go toward people who did need it. Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 To me that would be an unbelievable bargain. Our family's portion is almost $1000 a month and our deductible is $5K. Holy cow... Quote Link to comment Share on other sites More sharing options...
Haiku Posted January 17, 2011 Share Posted January 17, 2011 The insurance companies negotiate with the hospital, so I don't feel like it is wrong for me to do so. Yes, and hospitals set their fees knowing what they are going to get from the insurance company, and the insurance company pays what they say they will pay in full. If a child got cancer and you racked up several hundred thousand dollars in debt and negotiated a, say, $300,000 bill down to $150,000, and you had saved $10,000, and you paid that and agreed to pay $300 a month on the bill, it would take you 38 years to pay the bill. That's 38 years that the hospital is not being paid in full. So they go back to the insurance companies and renegotiate their rates, and the costs go up for everyone. I know that one family doing this doesn't cause rates to increase, but there are lots and lots of uninsured families who can't pay their bills in full, even at a negotiated rate, and it adds up. Our insurance costs $1600 a month. We can't shop for better/cheaper insurance because we have two kids with chronic illnesses who are considered "unisurable" in the individual market. We get what my dh's employer offers. I know how it feels to pay through the nose for insurance. I also know what it's like to have uninsurable family members, and if something happened that made someone in your family uninsurable and you didn't already have insurance, you'd be in a world of hurt. I am not, unfortunately, counting on the insurance reforms to really change this because too many people are hell-bent on repealing them. even in the case of something catastrophic, you can make payments of $20 a month without a problem But it's not responsible to intentionally go without health insurance under the assumption that if something happens, you can make miniscule payments just for the sake of saying you're making payments, knowing that those payments will never actually pay the bill. Tara Quote Link to comment Share on other sites More sharing options...
NoPlaceLikeHome Posted January 17, 2011 Share Posted January 17, 2011 I would not consider Samaritan Ministries IMHO since it is not insurance and there is no guarantee of coverage at all per their own web site. Quote Link to comment Share on other sites More sharing options...
NoPlaceLikeHome Posted January 17, 2011 Share Posted January 17, 2011 Yes, and hospitals set their fees knowing what they are going to get from the insurance company, and the insurance company pays what they say they will pay in full. If a child got cancer and you racked up several hundred thousand dollars in debt and negotiated a, say, $300,000 bill down to $150,000, and you had saved $10,000, and you paid that and agreed to pay $300 a month on the bill, it would take you 38 years to pay the bill. That's 38 years that the hospital is not being paid in full. So they go back to the insurance companies and renegotiate their rates, and the costs go up for everyone. I know that one family doing this doesn't cause rates to increase, but there are lots and lots of uninsured families who can't pay their bills in full, even at a negotiated rate, and it adds up. Our insurance costs $1600 a month. We can't shop for better/cheaper insurance because we have two kids with chronic illnesses who are considered "unisurable" in the individual market. We get what my dh's employer offers. I know how it feels to pay through the nose for insurance. I also know what it's like to have uninsurable family members, and if something happened that made someone in your family uninsurable and you didn't already have insurance, you'd be in a world of hurt. I am not, unfortunately, counting on the insurance reforms to really change this because too many people are hell-bent on repealing them. But it's not responsible to intentionally go without health insurance under the assumption that if something happens, you can make miniscule payments just for the sake of saying you're making payments, knowing that those payments will never actually pay the bill. Tara :iagree::iagree: From what I understand they will go after your house as well. They will not kick you or your spouse out of the home but after you pass away they will take it:(. Quote Link to comment Share on other sites More sharing options...
Ginevra Posted January 17, 2011 Share Posted January 17, 2011 Here's one more thought on the matter. Since I have this high-deductible insurance, I have experienced paying large bills in a short period of time, even though I'm not talking "large" remotely like an accident or serious illness would cost. Ds went to the ER for severe croup and I felt like I just bled and hemmoraged money for that visit. There was the ER "fee" ($98), the hospital cost ($161.39 for 4 hours), the pediatrician bill ($241.61), the cost of the nebulizer ($116.98), the pulmicort for the nebulizer (over $100) and an herbal tincture that was something like $30. It was $800 in costs for what is in reality a minor thing. If that was all that happened in the course of a year, well, that wouldn't seem so bad, but the month after that I paid $578 for dental work and two other children's doctor visits, which were around $100 each. If one relatively small incident with one child makes me feel like I'm the money tree, I cannot imagine the stress of having no coverage! At least I can reconcile in the back of my mind that if the costs go beyond $5,000, insurance will come into the picture. Not that I enjoy paying up towards the deductible, but I'd rather pay it knowing there is eventually a point where insurance will come in than know there is no limit to how much I could be on the hook paying! Quote Link to comment Share on other sites More sharing options...
goldberry Posted January 17, 2011 Author Share Posted January 17, 2011 Here is another thing that scares me. With private policies, you hear all the time of them denying claims once you have something serious. There have been reports of insurance companies hiring people specifically to go back to the initial app and see if anything was left out. One woman got denied coverage for her cancer because she left a yeast infection off her application, even though it had nothing to do with her cancer. I am afraid of paying "through the nose" and then having them bail on me when I need it. I know they deny things with group policies, but there are more loopholes with private policies. Quote Link to comment Share on other sites More sharing options...
Truscifi Posted January 17, 2011 Share Posted January 17, 2011 Well with the new health care laws some of that is going away and there is/will be plans available to people with preexisting conditions. Unless it gets repealed, as some people seem intent on. Quote Link to comment Share on other sites More sharing options...
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