Go away from the light!

September 30, 2004 12:30 PM

Catastrophic health insurance (in the US): I've just been laid off and am losing health care benefits. The COBRA premiums are insane--I'm looking for something cheap that will cover near-death experiences. (I will turn to the bottle for any minor ailments.) Anyone have any advice or plan suggestions?
posted by mookieproof to health & fitness (16 comments total)

well, for whatever its worth, when I was self-employed, and not relying on my wife's company insurance (4 years ago), I went for BlueCross/BlueShield CareFirst policy. It was bare bones, and was mostly for catastrophic and major med, but it also provided some benefits when I would go to a non-specialized care clinic. It obviously had no dental and no vision, and I think I paid about $120 a month, with a $2500 deductable. It was better than nothing.
posted by crunchland at 12:49 PM on September 30, 2004

A couple of years ago I got a short term policy from Fortis Health after I was laid off. It is only good for up to 180 days though, so if you think you may be unemployed longer, it might not be the best option. I don't remember the premium cost exactly, but I think it was less than $100 per month back then (2002.)

It looks like Fortis Health is now Assurant.
posted by pitchblende at 1:35 PM on September 30, 2004

Like crunchland, when I was between jobs I used Blue Cross / Blue Shield. I started out with a $5000 deductible, but over the 2-3 years I subscribed, they kept raising the premiums and lowering the deductible. They were obviously trying to squeeze me (and people like me) because we weren't coming anywhere near the $5K limit, so they could safely lower the deductible (and charge more for the favor) without serious risk of ever making any payouts.

If you can keep the deductible amount on hand just in case, and you don't tend to need fiddly, moderately-expensive (circa $100-$500) medical maintenance, I think it's a good way to go. The price is right (except for the aforementioned squeezing). I don't know whether the benefits are paid timely and without hassle because I never needed anything, but on the other hand, BC/BS never did anything to confirm my standard suspicion, which is that an insurer will do whatever it can to delay and avoid paying bills it owes.

Even now that I'm gainfully employed with various health plans available to me, my approach is to take the absolute cheapest (HMO) and just pay for checkups and diagnosis out of pocket. That way, the doctor works for me, and won't be reluctant to tell me what's really wrong. Plus, if I'm footing the bill for meds or treatment, I'll ask more questions and make better decisions about whether something is really necessary. And, if something really bad/expensive happens, I'll have useful backup when the HMO hack tries to get me to accept a cheaper, less-effective substitute treatment.
posted by spacewrench at 1:47 PM on September 30, 2004 [1 favorite]

Fortis Health was something I used two and a half years ago as stopgap coverage, and they fought tooth and nail to avoid paying when I *did* get sick. They also had long term policies available, but their behavior during that time period was such that I ended up going with someone else.

See also some previous discussions here, here, and here.
posted by weston at 5:22 PM on September 30, 2004

Just as a reminder, you might want to doublecheck your auto insurance, so you know what coverage it offers in the event you're hurt at the wheel. If you have homeowner's insurance or renter's insurance or anything else that might offer some kind of coverage, you might want to factor that in as well.
posted by scarabic at 5:36 PM on September 30, 2004

I am between benefits because of a job change, and like you my COBRA was prohibitively expensive. I found a basic plan from Oxford Health Care for about $130/month. It's actually a bit more coverage than catastrophic (meaning, I can go to the doctor for minor ailments too), and so far I have been satisfied with it. I'd recommend checking out this site, which is where I got a number of quotes when I was researching cheap alternatives.
posted by willpie at 7:20 PM on September 30, 2004

obligatory canadian comment: man, i'm glad my taxes pay for my health care. not only do i pay less, i get better coverage. y'all need to conceive of socialised healthcare as an insurance system everyone belongs to and that isn't out for profit. i suspect that'd make it saleable down there.
posted by five fresh fish at 7:24 PM on September 30, 2004

dude i spent a semster at mcgill and would gladly move to canadia if they'd have me
posted by mookieproof at 8:20 PM on September 30, 2004

Blue Cross /Blue Shield of NC pays out just fine. I wish I still had them.
posted by konolia at 8:29 PM on September 30, 2004

i suspect that'd make it saleable down there.

Republicans don't like your commie-pinko medical system, canuk!
posted by falconred at 11:04 PM on September 30, 2004

This is more an academic question than any possible suggestion - but what happens if you live without health care in the US? $120 a month sounds frightening, and impossible for many people.
posted by jb at 11:31 PM on September 30, 2004

a lot of people in the us know nothing and are scared of the doctor/hospital.
there are hospitals that must take in anyone, but it's pretty much like any overloaded socialist system--
i doubt there is that much different at four am in atlanta than it is in london, but i really couldn't say.
lots of people live years with something without knowing it
lots of people survive with help from family members in the health care field, with samples, info, vaccines--
it's a big place, can't really say--
one night it's a thirty minute wait in one place, seven hours in another--
in rural areas or special situations, people need to be transported large distances--
we have excellent medical care
we have no medical care
we don't work off bribes as much as costs and influence
i thought i heard canadian health was in trouble?
posted by ethylene at 1:00 AM on October 1, 2004

. . . what happens if you live without health care in the US?

Here's a data point. My wife and I have no insurance and cannot afford even catastrophic coverage. When we decided to have a young'un, we saved enough to pay the expected cost out-of-pocket, which came to $3500.

Unfortunately, complications arose during the last hour of labor, my wife had an urgent C-section, and our daughter spent her first four days in NICU. Everyone came out fine in the end, but with the final bill that arrived yesterday, we now owe $40,000 for that week's worth of services. Which is, coincidentally, exactly my annual pre-tax salary.

Had I quit my job before the birth, we'd have qualified for free care (but lost our house). But I didn't, so we don't qualify for income-based aid. It'll be a while before I figure out just what we'll be doing.

To get back to the question, though, I'd look into the new Health Savings Accounts. It had always been my intention to set one up this coming January, when money was going to be a bit less tight.
posted by ewagoner at 9:46 AM on October 1, 2004

FYI, I've just had a bad experience with a COBRA from Mega Life; lost paperwork, overbilling, general incompetence and indifference, etc.
posted by carter at 11:29 AM on October 1, 2004

i thought i heard canadian health was in trouble? only insofar as private interests want us to perceive it as being in trouble, so they can more easily convince us to give it up. reality is that the cost of delivery is lower in the canada than the usa, with better coverage. there are problems, but they are all fixable without privatization. see this and this
posted by five fresh fish at 12:09 PM on October 1, 2004

thanks, fresh: would you like chum or slurry as a tip?*
ewagoner: this is somewhere in my field of knowledge, though variable to state. there is health care to be had in the US if you know how to work it.
trying not to go on about the lack of easy information access for people in need of assistance when trapped amidst a republican state--
there are two great new yorker articles i finally got to read last night having to do with these issues-- must search for links if they exist, may try to post front page (despite reasons i don't)
posted by ethylene at 12:56 PM on October 1, 2004