Where can I get cheap catastrophic health insurance?

June 11, 2009 4:08 PM

I'm an uninsured young healthy guy looking for affordable catastrophic medical insurance. Does it exist?

I'm 28, single, healthy, in California (US), just looking for a catastrophic health care insurance policy- something for if I need serious health care that will cost tens of thousands of dollars or more. Looking for a massive deductible, maybe 10k-15k.

No matter where I search I can't find anything cheaper than $48/month (with Anthem).

It doesn't seem to make sense, I'm looking for something that will cover me in the very unlikely event of something terrible happening, not just annual medical care. Any suggestions on where I could find cheaper catastrophic insurance? thanks.

posted by stewiethegreat to health & fitness (19 comments total)

$48/month isn't affordable, but you could swing a $10-15,000 deductible? I'm sincerely not trying to snark, but I don't understand how those two things square with each other.
posted by scody at 4:12 PM on June 11, 2009 [3 favorites]

$48/month is probably less than you pay for cable. If catastrophic health coverage isn't worth more to you than cable television, why bother with it at all?
posted by dersins at 4:23 PM on June 11, 2009

$48/month is pretty cheap given almost any sort of accident that puts you in the hospital or any sort of injuries that healthy young men are susceptible to (knees, shoulders, etc) that will need to be treated w/outpatient surgery will almost certainly end up exceeding your deductible.

A simple way to see if this is the case would be to price policies with different deductible levels and see what the curve of premiums looks like. I.e. how much cheaper is a 20k deductible vs 15k vs 10k vs 5k. I'm guessing the differences aren't massive.
posted by JPD at 4:27 PM on June 11, 2009

If you don't need coverage indefinitely then you might be able to get temporary insurance (usually limited to 6 or 12 months) slightly cheaper. Assurant Health gave me a quote of $45/month for a plan with a $2500 deductible, 50% coinsurance up to $10,000, and a maximum of $2M.

Hmm, when I change my zip code from Seattle to L.A., the cost goes from $45 to $96. Maybe other providers offer cheaper temporary rates in California. Or maybe you need to move...

$45/month is cheaper than I'd expected to find. Say the average "catastrophic" injury or illness costs the insurer $100,000, and 0.5% of customers have a catastrophe each year. Then the insurer has to charge $500/year ($42/month) just to break even. Those stats are totally made up, but I hope they illustrate how even unlikely events can affect your premiums.
posted by mbrubeck at 4:45 PM on June 11, 2009

A parking ticket in California costs at least $35. Paying $48 a month for worst case insurance is nothing. I was covered by Anthem for small periods of time (1-3 months) in the last 10 years. The last time I did it, I paid around 80 bucks a month for a $1500 deductible.

Even though I never used it, it was totally worth it.
posted by special-k at 4:49 PM on June 11, 2009

I just bought private health insurance. The highest deductible I found was $5,000 and it wasn't much cheaper than my deductible of $2,500, which doesn't trigger with preventative and routine care and my insurance pays 100% after. I got my insurance for exactly what you are talking about, and I think this is the best I'm going to get. I'm a healthy 34 year old male with no pre-existing conditions, and a BMI of 25. My premium is something like $85/month.
posted by mrmojoflying at 4:49 PM on June 11, 2009

48 dollars a month might be well worth it to avoid the situation my buddy Dusty is in.
posted by Hildegarde at 4:53 PM on June 11, 2009

I looked at Tonik through Blue Cross when I was shopping around for inexpensive insurance. It's a bit more than you are looking at, but the deductibles are lower and you have a few doctors visits a year. I have insurance for the first time in my life now, including when I was a kid, and it is really a relief to know I can go to the doctor without worrying it's going to cost me hundreds of dollars.
posted by apricot at 4:57 PM on June 11, 2009

Hildegarde: if he hasn't already, you might suggest to your friend that he should try to negotiate with the hospital/doctors/etc. and set up a long-term payment plan. I had a friend who broke his neck about 10 years ago, and his hospital bills went well into six figures, and he was able to negotiate down most of the fees and set up a payment plan. Yes, it's a payment plan that he'll be on for many years to come, but it allowed him to be able to get on with his (newly saved!) life without being bankrupted. /derail
posted by scody at 5:12 PM on June 11, 2009

$48 a month sounds about right for a low-risk adult only insuring themselves against extremely catastrophic medical events. The probability may be low (although I'm guessing it's not as low as you think; healthy 20- and 30-year-olds getting cancer isn't exactly a "stuck by lightening" type of unlikely occurrence), but the amount an insurer has to pay if that low-risk event happens is massive. Six or seven figures, easily, for a great many things.

In fact, it's so low that I'd urge you to make sure there's no hidden catch. Three things to look for:

(1) In looking through the explanation of benefits, is there anything conspicuously missing? Like, say, chemotherapy? (If it's not on there, then it's not covered. Even if you think "oh that must be covered.") Also, google around the plan name and carrier name to make sure they don't have a history of selling worthless policies that don't pay out for common unlikely events (cancer, heart attack, car accident, that sort of thing). Also look for any bad media about "rescission" of their members' policies--that's when something happens, and the insurance company goes back and searches for the smallest error on the person's application from years ago, and in order to use that as justification for canceling the policy without paying. This was a problem with several carriers in California recently, like within the last year or so.

(2) Is there a cap on benefits, either per-event or lifetime? I'd stay away from these like a plague, seriously, unless the caps are really really high. Anything less than $500,000 per event and $1-2 million per lifetime is too low. Insurers are never going to put something in a contract that doesn't have a point to it, so beware if you can't figure out what the point of the restriction is.

(3) Any sort of weird conditions that make you go "huh" should be scrutinized. For example: covering everything above the deductible, except the first day of the hospitalization. That's a huge problem; the first day of hospitalization is always the most expensive (that's when you get the surgery or other high-cost care), so that sort of condition can make the policy near-worthless.
posted by iminurmefi at 5:14 PM on June 11, 2009 [4 favorites]

uh, the last sentence on #2 should be in #3, obviously. my eyes must not be working tonight.
posted by iminurmefi at 5:18 PM on June 11, 2009

scodyHe's not saying $48/month isn't affordable, at most he's saying it seems unreasonably high, statistically speaking, if that.

I've been poking around on Google for statistics on cancer, car accidents, etc, but can't decide if $500 is fair for unlimited coverage. It strikes me as a bit too high.
posted by losvedir at 5:42 PM on June 11, 2009

On a not entirely serious note, you could always emigrate.
posted by onya at 6:04 PM on June 11, 2009

He's not saying $48/month isn't affordable, at most he's saying it seems unreasonably high, statistically speaking, if that.

What it seems and what it is aren't necessarily the same thing. It's not actually high, either in relation to more comprehensive individual coverage (which is not infrequently many hundreds of dollars a month) or in relation to how much a catastrophic injury or illness actually costs. I had a trip to the ER two weeks ago that resulted in a single overnight stay at the hospital at a cost of $25,000 (thank god I have full coverage).
posted by scody at 6:33 PM on June 11, 2009

No matter where I search I can't find anything cheaper than $48/month (with Anthem).

It doesn't seem to make sense

I think it does make sense and you're significantly underestimating the likelihood of a seemingly healthy young adult needing expensive medical care. Or not running the math on what the insurance company has to charge to break even if even 0.1% of people on the plan need treatment.

In other words, $48 is dirt cheap.
posted by Justinian at 7:52 PM on June 11, 2009

$48/month is probably less than you pay for cable. If catastrophic health coverage isn't worth more to you than cable television, why bother with it at all?

I don't have cable, sorry. I'm actually posting this for a friend, who doesn't have cable, either. He adds:

I've been unemployed for 8 months. I get part time gigs in my field, I'm signed up at a number of temp agencies, but right now I'm limping from month to month. I used to have decent insurance, but after I lost my job and Cobra ran out, I've been uninsured. I have been trying to find a decent way of ensuring that if something horrible happened to me like the fellow upthread, I would be covered.

Honestly, I don't have an extra $48/month lying around. I'm scraping by from month to month- thank god my landlord is letting me do some handyman jobs to supplement what I can pay for rent, or else I wouldn't have aplace to live. If I did have cable (canceled that a month after I lost my job) I would cancel it now and get the medical insurance.

But the bottom line appears to be: unless and until I have more money, I can't get insured in any way, that $48 is the bottom of the bucket. Right?
posted by stewiethegreat at 10:01 PM on June 11, 2009

Not necessarily. There are many services offered in California which are not offered in any other state. This stuff is not particularly well documented on the web, but it is worth seeing if your friend qualifies for any assistance or state programs. Find the health services office for your county or town and go talk to them, they may be able to help more than you think. Your friend may also want to look into unemployment-type benefits if he has not already done so. My own experience with the California social stability system was often that if you took the initiative to go and talk with people, navigate the red tape, wait in line, and fill out the right forms, there was frequently some help there for you. This may have changed in light of their recent budget situation.
posted by sophist at 1:11 AM on June 12, 2009

Stewie, is your friend re-eligible for COBRA under the stimulus provisions?
posted by WCityMike at 9:44 AM on June 12, 2009

But the bottom line appears to be: unless and until I have more money, I can't get insured in any way, that $48 is the bottom of the bucket. Right?

$48 is great. You will not be able to get below that, I bet.

My wife and I have catastrophic health insurance coverage, $10,000 deductible (for both of us, not for each of us) and our monthly premium is $120. We put $100 a month into a health savings plan which covers our doctors' visits and routine medical expenses.
posted by jayder at 4:31 PM on June 12, 2009