I am ready to just opt out of health insurance. We are healthy, low consumers of health insurance. Our premium for next year will be $15,600 (up $3K from last year) and a $13K deductible. I’m considering moving to a short term, major medical plan for about $500/month. Our prescriptions run less than $100/month (DH has HBP and cholesterol and I’m on BCP (DH has a vasectemy - my BCP are strictly for hormone control in perimenopause. I added that info because I know pregnancy is not covered by short term med). If we are sick, we already go to a flat rate cash based clinic for treatment. We really only use health care in case of emergency and I don’t see the downside to moving to a short term plan. We are business owners covered by work comp in the event of a workplace injury. We don’t offer group health to our employees though. Is anyone well versed in this world that would care to offer input
I’m bracing myself to be furious (at the cost). I haven’t looked yet.
It’s awful for people who do not get health insurance through an employer and are of a certain age (and not yet eligible for Medicare).
I’m sorry. It’s very frustrating. I hope I see a good viable solution in my lifetime.
I’m sorry and saddened that so many have such unpalatable and overpriced options. One of the best things about H and S working for the govt is they always had affordable and excellent health insurance options. I wish everyone had the same options. It sure would remove a lot of angst!
I don’t know what to say. Personally…I would get the health insurance…because…you are healthy until you are not.
How much will you have to pay out of pocket if you have a major issue regarding medical care?
@thumper1 the out of pocket max for a short term plan is $10K/person on the plans I’m looking at. Currently we have $6500 to pay before our insurance kicks in. Difference in policy cost is about $800/month.
I’m like the OP. I pay $750 a month for individual coverage with a $6,000 deductible. I have no health issues and I am on no medications.
I just came from the dermatologist I usually use. But he is out of network for my current plan. He was in network for my prior plan. I just opted to pay cash and not hassle with insurance.
Are the short term plans guaranteed renewable? What if you have a medical issue at the end of the term — can they refuse to renew the plan and say, whoops, sorry! Then you are stuck with being uninsured?
Also does the OOP max reset each time you renew, eg $10k max 1st quarter, another $10k 2nd quarter with renewal, etc? That can add up fast, esp per person.
Is that your cost per person?
@thumper1 - premium of $500 is for the three of us, deductible per person is $10K
@HImom the shorter term plan is for up to a year (can decide length during application). If I had a medical issue at the end of the term it would fall during open enrollment and I could hop back onto the higher price plan. I know it’s a bit of a gamble either way - but if I do it for one year we could conceivable save almost $10K. DD will be in college next fall and I hope to get her onto the Universities health insurance plan if it’s available. She’s looking at all out of state colleges and our current insurnace is for our state only.
Ok, timing your term so it ends when the next open enrollment plan will begin sounds like something that could work. I’m sorry, I really don’t know all the ins and outs.
When do plans start, following open enrollment?
@HImom terms begin anytime but there is an application process and a person can get rejected.
I would never go without insurance. I’m not sure what the short term major medical you describe would cover, but let me tell you my story.
I am normally a very healthy person. 58 years old. Never sick, never miss work, run regularly. I am a few pounds heavier than I’d like to be but that’s it.
Last year I got the flu. It was the first time I’d been sick in years. I had tamiflu and it did nothing. Flu turned to Pneumonia seemingly overnight. Husband rushed me to the emergency room where I almost died. I ended up in the intensive care ward on a ventilator and in an induced coma for 10 days. 12 days total in the hospital. When I came out I could barely stand. Two weeks earlier I had run 5 miles. I had a daily visiting nurse. I had PT and OT because I had lost muscle tone. I’m not sure what the total cost was but I know it was substantially more than $28K.
Today if you looked at me you would never know anything happened. Back to running again too and actually doing better than before I was sick. But I would never not have insurance.
Hmm, non-auto renewal is scary, if you can get rejected after diagnosis of say asthma or another chronic condition. If there any policy that is guaranteed renewable, I’d probably lean towards that.
Pre-ACA, have read horror stories of folks who lost and couldn’t get coverage after diagnosis of medical conditions. Not sure whether insurers can still do those things—but lots of uncertainty in insurance marketplace.
Pre-ACA, I had a very hard time getting my S any medical coverage because he had mild, intermittent, well-controlled asthma. I was finally able to get short term policy I paid for monthly with significant deductible until he was again covered by our family policy.
Please read the fine print. Can you renew? What is not covered in the plan? Is there a cap on your coverage? Which providers are covered? What has to be authorized in advance? What does the prescription drug plan look like?
If the plan excludes conditions you’ve never heard of, watch out-- you probably won’t get them but if you do, they’ll probably be horrifically expensive.
Some of the short-term plans exclude certain diagnoses you get for a period after you sign up, e.g. you wouldn’t be covered for cancer diagnosed in the month after you sign up. Check, because obviously that is a non-starter for any plan.
If you post the info for the plan you’re considering, the hive mind can take a look.
While insurance prior to the ACA wasn’t ideal, I just can’t fathom how anyone could “like” the crap available under the ACA. Premiums are sky high. Deductibles are ridiculous. Even if you get a premium subsidy, the deductibles are unaffordable.
@threebeans I don’t know how many employees you have, but you may want to look into a level funded plan for your business. Aetna and United Healthcare are offering them in my state. It’s a self insured type plan that mimics a regular group plan. We actually saw a 14% reduction in premiums with a lower deductible. Good luck.
From early 40s I took statins for high cholesterol (genetics/not diet related). At age 47 I was working out regularly at gym (eg treadmill, stairmaster, rowing, swimming, lifting weights, etc). I was arguably in the best shape of my adult life and totally asymptomatic. What role genetics and/or lifestyle played in my parent’s heart disease (eg they smoked, lived sedentary lives, ate poorly, overweight, etc), I do not know. But, in part, because of this family history of heart disease, I had a treadmill stress test. At the end of the test, although asymptomatic, the EKG results told a much different story. I had 3 blocked coronary arteries with left anterior descending artery (aka widow maker) being estimated at 90-95% blocked. Within the month I had triple bypass surgery. When my chest was reopened a second time two weeks later for a staph infection, I can only say if I didn’t have health insurance, the stress of seeing the reams and reams of hospital bills from the two hospital stays would probably been enough to kill me. Although I think understand your situation and wish you/H the best, all I can say is I would never go without health insurance. Sh…t happens.
Our insurance for next year will top $20,000 and that’s for only 2 of us. Those short-term plans are tempting, but I’m concerned about what they won’t cover and the fact that they have lifetime maximums which could be met/exceeded with a major illness/accident. I just remember our former accountant’s wife had an aneurysm, had surgery, was in intensive care for weeks, and then in rehab. I doubt that these short-term plans would cover all that.
Our insurance will be about $20,000 for the two of us. On the other hand, the premium for a short term plan would be infinity, because we would be disallowed: husband has serious asthma, and we both have this and that.
So true, CF. Anything arising from a pre-existing condition is excluded. For me, who takes a statin and is treated for HBP, if I were to have a heart attack or stroke, it would be excluded.