Dropping Health Insurance? Is This An Issue?

[eliot]

I seem to hold in mind that issues may possibly happen when you yourself have a gap in your wellbeing insurance. My fieance quit he work she's been at for year(that she'd healthcare overall health insurance from). She was employed at a new job, nevertheless, right after dealing with the new organization for merely a week, we unearthed that the new firm decived her on numerous essential issues, which includes Hours, Devote, and Journey Requirments. We'd no selection but to cease this fresh job.The Operate industry listed here is difficult. It can be a even though untill we discover complete-time function with her, it may possibly be a quantity of weeks. Her present insurance stops at the conclusion of the month. She'll have a cobra option, however it is certainly going to be extremely price high(something equivalent to $400 /mo for a healthier single-particular person).What difficulties could she encounter if there is a handful of month difference in insurance policy(apart from the most obvious problems with expense if she gets ill)? Can it make it tougher to get insurance with her subsequent company?Cheers!!!

[Bainhrydge]

Usually it will make no difference w/ her receiving insurance w/ a future employer.    If she has massive healthcare problams(which it sounds like she does not)....it could raise the premiums paid by the employer(depending on how many staff there are--i.e. the fewer the staff, the much more most likely this is to be a issue) who may ultimately pass this along to all personnel in the form of improved co-pays, improved deductibles and decreased rewards...Additionally there is normally a 90 day probationary period at most jobs.  If someone did have massive medical problems and this was found by the employer they might release the probationary employee for causes listed above.  Despite the fact that this is unethical and possibly illegal, I am sure it happens.....   Depending on the gap amongst jobs you may want to take into account private insurance coverage(not the Cobra from previous employer) with a really high(feel $2000) deductible.  This would lower the premiums but cover her in a catastrophic occasion.   An additional selection(in combo w/ above) may possibly be an HSA(wellness savings account).  This is essentially higher deductible insurance and a savings account to which she would pay into----and then make tax totally free withdrawals to pay healthcare bills as necessary.   You could also(naturally) go "bare".  Generally hold your breath and hope for the very best.  I did this and so do alot of people---it is risky and not suggested.  A catastrophic event(think automobile accident and substantial permanent disability) could leave her financially(as effectively as physically and emotionally) devasted.   Hard choices.  Hope for a new job with very good advantages--swift!

[Bardene]

Meditation is the answer.   drynofriry1989 23 months ago

[Jerrah]

If she's young and healthy, the big problem is going to be if you need medical care in the interim If she doesn't at least get a major medical plan, which will probably require a physical exam, then if she gets into an accident, or gets some really nasty infection, it could be extremely costly to get the care she needs.  Suddenly $400 a month won't seem like that much money.  It's a gamble if you don't take it, but some times it's a good gamble and some times it's a bad gamble.  There's just no way to know, and the best you can possibly do is get a major medical individual plan...the kind that maybe you have to come up with a couple grand out of pocket before you get any benefits, but which if you do end up in the hospital with a $200,000 bill, you don't have to come up with it.   The thing about insurance being as costly as it is, is because it's worth it in many ways.  For example, if you ever use your insurance, you'll probably get an "explanation of benefits", and if you look at that form, you'll see the amount that was billed, let's say that amount for an office visit to the doctor is $500, that would be pretty typical for just a sore throat for example.  Then you'll see allowed and disallowed amounts, like for example you may see $340 written off, then you'll see provider paid $140, and patient responsibility $20(if you have a $20 copay).  So your $500 bill costs your health insurance $140 and you $20.  You've paid $400 in monthly premiums so if that's your only visit, the health insurer has made $260.  Your doctor has made $160.  Everyone wins, because you've paid $420...$400 for your monthly premium and $20 for your office visit, but because you're not a health insurer with millions of subscribers, you can't negotiate with doctors and tell them, hey there are 3 million people who won't be able to go to your clinic unless you charge only $160 for what you would normally charge $500.  If you said that they'd laugh in your face, when the insurance company says that they go, well I guess $160 is better than not getting that business.  And that's just for something small like a sore throat.    For example, my son is 6, and when he was born, my wife had a C-section, spent 5 nights in the hopsital all told.  My son had low blood sugar and slight jaundice and they put him in the NICU for 7 nights.  Our insurancehad a family annual maximum out of pocket of $2,200, so we had to come up with that, the insurance cmpany paid just over $18,000 in addition to the $2,200 I paid, but the billings were $46,000.  If I didn't have insurance, I would have been $46,000 out of pocket, not $2,200, not $18,000, not $20,200.  So, this is why insurance is important, and why $400 a month, if you can afford it, is not a bad idea to do if you can come up with it.   But, if she rarely goes to the doctor, then it's just a matter of hoping nothing bad happens, and if possible, like I said, getting a major medical plan just in case.  But what will happen in terms of insurance at a new job is that a lack in coverage can cause problems from teh standpoint of what's called a pre-existing condition.  So, if your girlfriend has any pre-existing conditions, diabetes, high blood pressure...an old injury, ANYTHING, then she COULD run into a problem where the plan might exclude coverage for pre-existing conditions for 12, 18, even 24 months.  Like, she'll be covered whenever she becomes eligible under the new employer's plan, but let's say she had a bout of Tennis Elbow in college, went to teh doctor, got a few pain meds, gave it some rest, all was fine.  She gives up insurance now, and let's say she becomes covered at a new job, and 2 weeks later, something gives way in her elbow which can be in a way traced back to her original injury, and suddenly they're telling her she needs surgery, if they determine this to be a pre-existing problem, then suddenly they don't cover all the visits she's made and won't cover the surgery, and even though you have insurance, you're not covered.    Now if there's nothing in her history that could be a problem, and there's no worry about a serious illness or injury, or you've taken care of the problem via a major medical policy(which would also take care of the gap in coverage if she can get the major medical plan bound on the day of the ending of the old coverage), then no need to pay the COBRA.  All I can say is, we all think nothing will happen to us, and statistially speaking, we're right for the most part.  But on rare occasions, and I stress the word rare, very bad things can befall people.  We just a few months ago were told about a friend of a friend...her husband got sick on Friday with what he thought was a cold and died on Sunday, and he was in his mid 30s.  But these stories are the exception, not the rule.  So, like I said, it's a gamble.  The pre-existing condition is a consideration but not a dealbreaker if no such condition exists, then it's not that big of a deal.  Of course, if she gets sick or injured without insurance, in addition to having to pay for it out of pocket, she won't have coverage in the future if there are unresolved complications from whatever befalls her.   That's the best I can tell you...  dalepetrie_is_gone 74 months ago Please sign in to give a compliment. 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[Karina]

If she doesn't at least get a major medical plan, which will probably require a physical exam, then if she gets into an accident, or gets some really nasty infection, it could be extremely costly to get the care she needs.  Suddenly $400 a month won't seem like that much money.  It's a gamble if you don't take it, but some times it's a good gamble and some times it's a bad gamble.  There's just no way to know, and the best you can possibly do is get a major medical individual plan...the kind that maybe you have to come up with a couple grand out of pocket before you get any benefits, but which if you do end up in the hospital with a $200,000 bill, you don't have to come up with it.   The thing about insurance being as costly as it is, is because it's worth it in many ways.  For example, if you ever use your insurance, you'll probably get an "explanation of benefits", and if you look at that form, you'll see the amount that was billed, let's say that amount for an office visit to the doctor is $500, that would be pretty typical for just a sore throat for example.  Then you'll see allowed and disallowed amounts, like for example you may see $340 written off, then you'll see provider paid $140, and patient responsibility $20(if you have a $20 copay).  So your $500 bill costs your health insurance $140 and you $20.  You've paid $400 in monthly premiums so if that's your only visit, the health insurer has made $260.  Your doctor has made $160.  Everyone wins, because you've paid $420...$400 for your monthly premium and $20 for your office visit, but because you're not a health insurer with millions of subscribers, you can't negotiate with doctors and tell them, hey there are 3 million people who won't be able to go to your clinic unless you charge only $160 for what you would normally charge $500.  If you said that they'd laugh in your face, when the insurance company says that they go, well I guess $160 is better than not getting that business.  And that's just for something small like a sore throat.    For example, my son is 6, and when he was born, my wife had a C-section, spent 5 nights in the hopsital all told.  My son had low blood sugar and slight jaundice and they put him in the NICU for 7 nights.  Our insurancehad a family annual maximum out of pocket of $2,200, so we had to come up with that, the insurance cmpany paid just over $18,000 in addition to the $2,200 I paid, but the billings were $46,000.  If I didn't have insurance, I would have been $46,000 out of pocket, not $2,200, not $18,000, not $20,200.  So, this is why insurance is important, and why $400 a month, if you can afford it, is not a bad idea to do if you can come up with it.   But, if she rarely goes to the doctor, then it's just a matter of hoping nothing bad happens, and if possible, like I said, getting a major medical plan just in case.  But what will happen in terms of insurance at a new job is that a lack in coverage can cause problems from teh standpoint of what's called a pre-existing condition.  So, if your girlfriend has any pre-existing conditions, diabetes, high blood pressure...an old injury, ANYTHING, then she COULD run into a problem where the plan might exclude coverage for pre-existing conditions for 12, 18, even 24 months.  Like, she'll be covered whenever she becomes eligible under the new employer's plan, but let's say she had a bout of Tennis Elbow in college, went to teh doctor, got a few pain meds, gave it some rest, all was fine.  She gives up insurance now, and let's say she becomes covered at a new job, and 2 weeks later, something gives way in her elbow which can be in a way traced back to her original injury, and suddenly they're telling her she needs surgery, if they determine this to be a pre-existing problem, then suddenly they don't cover all the visits she's made and won't cover the surgery, and even though you have insurance, you're not covered.    Now if there's nothing in her history that could be a problem, and there's no worry about a serious illness or injury, or you've taken care of the problem via a major medical policy(which would also take care of the gap in coverage if she can get the major medical plan bound on the day of the ending of the old coverage), then no need to pay the COBRA.  All I can say is, we all think nothing will happen to us, and statistially speaking, we're right for the most part.  But on rare occasions, and I stress the word rare, very bad things can befall people.  We just a few months ago were told about a friend of a friend...her husband got sick on Friday with what he thought was a cold and died on Sunday, and he was in his mid 30s.  But these stories are the exception, not the rule.  So, like I said, it's a gamble.  The pre-existing condition is a consideration but not a dealbreaker if no such condition exists, then it's not that big of a deal.  Of course, if she gets sick or injured without insurance, in addition to having to pay for it out of pocket, she won't have coverage in the future if there are unresolved complications from whatever befalls her.   That's the best I can tell you... 

[Henrick]

That makes complete sense. Well, to everyone except for the uninsured patient. Someone I work with said they did successfully negotiate a Dr's bill down, but I'm somehow guessing that you need a fair amount of leverage to negotiate rates...the insurers have this, patients don't.

[Tyce]

Tulip_is_gone said: 1 Just a note on the person's postings RE fee schedules....Doctors fee schedules are set very high so that they can "capture" all of the money that they are eligible for by various insurance plans. It should be noted that a doctor can only have ONE fee schedule. Consider this example... Lets say Ins Co A would pay $50 for procedure X and Ins Co B would pay $100. If Dr Smith's fee schedule charges $75 for this procedure(and presuming he has contracts w/ both insurance companies---) Dr Smith would get paid $50 by Ins Co A and only $75 by Ins Co B(even though Ins Co B says it expects to pay $100 for this procedure---). SO, Drs will set their fee schedules HIGH expecting to write off big amounts to get all the $$ they can from each insurance company. The problem w/ this is the person who has no insurance or the person who has a plan not accepted by the Dr(likely insurance plan fee schedule ridiculously low) or who has an insurance plan who won't let them see a particular Dr(think HMO)---this person will be charged the Drs fee schedule. This is typically the very person who can least afford to do so----in this instance the patient in question should talk to the Drs office/clinic/hospital or whatever and see if they can negotiate the price down, set up a payment plan etc. 74 months ago

[Curtis]

Just a note on the person's postings RE fee schedules....Doctors fee schedules are set very high so that they can "capture" all of the money that they are eligible for by various insurance plans. It should be noted that a doctor can only have ONE fee schedule. Consider this example... Lets say Ins Co A would pay $50 for procedure X and Ins Co B would pay $100. If Dr Smith's fee schedule charges $75 for this procedure(and presuming he has contracts w/ both insurance companies---) Dr Smith would get paid $50 by Ins Co A and only $75 by Ins Co B(even though Ins Co B says it expects to pay $100 for this procedure---). SO, Drs will set their fee schedules HIGH expecting to write off big amounts to get all the $$ they can from each insurance company. The problem w/ this is the person who has no insurance or the person who has a plan not accepted by the Dr(likely insurance plan fee schedule ridiculously low) or who has an insurance plan who won't let them see a particular Dr(think HMO)---this person will be charged the Drs fee schedule. This is typically the very person who can least afford to do so----in this instance the patient in question should talk to the Drs office/clinic/hospital or whatever and see if they can negotiate the price down, set up a payment plan etc.

[giulio]

dalepetrie_is_gone said: 2 That makes complete sense. Well, to everyone except for the uninsured patient. Someone I work with said they did successfully negotiate a Dr's bill down, but I'm somehow guessing that you need a fair amount of leverage to negotiate rates...the insurers have this, patients don't. 74 months ago

[Patten]

Nothing? Typically it will make no difference w/ her getting insurance w/ a future employer.    If she has massive medical problams(which it sounds like she does not)....it could raise the premiums paid by the employer(depending on how many employees there are--i.e. the fewer the employees, the more likely this is to be a problem) who may ultimately pass this along to all employees in the form of increased co-pays, increased deductibles and decreased benefits...Additionally there is usually a 90 day probationary period at most jobs.  If someone did have massive medical problems and this was discovered by the employer they may release the probationary employee for reasons listed above.  Although this is unethical and probably illegal, I am sure it happens.....   Depending on the gap between jobs you may want to consider private insurance(not the Cobra from previous employer) with a very high(think $2000) deductible.  This would lower the premiums but cover her in a catastrophic event.   Another option(in combo w/ above) may be an HSA(health savings account).  This is basically high deductible insurance and a savings account to which she would pay into----and then make tax free withdrawals to pay medical bills as needed.   You could also(obviously) go "bare".  Basically hold your breath and hope for the best.  I did this and so do alot of people---it is risky and not recommended.  A catastrophic event(think car accident and significant permanent disability) could leave her financially(as well as physically and emotionally) devasted.   Tough choices.  Hope for a new job with good benefits--quick! Tulip_is_gone 74 months ago Please sign in to give a compliment. Please verify your account to give a compliment. Please sign in to send a message. Please verify your account to send a message.