Health Insurance Cost
June 24, 2011 11:32 AM
What to expect to pay for health insurance as a Canadian living in Florida?
I am a Canadian and have a fantasy of moving to Florida. To keep my fantasy realistic, I'd like to know what I would have to pay for health insurance. This would be for me and my partner. We're in our late 30s. My partner has an ongoing condition that requires a daily dose of a certain drug, bi-weekly blood tests to monitor the drug's effect, and monthly doctor's visits. I'm just looking for a ballpark sense of how much an insurance plan covering the two of us, including my partner's special needs, would cost; I really have no idea coming from Canada and it's socialized health care system. I know I might get coverage from an employer, but for now just want to get a sense of cost assuming I was paying privately.
I am a Canadian and have a fantasy of moving to Florida. To keep my fantasy realistic, I'd like to know what I would have to pay for health insurance. This would be for me and my partner. We're in our late 30s. My partner has an ongoing condition that requires a daily dose of a certain drug, bi-weekly blood tests to monitor the drug's effect, and monthly doctor's visits. I'm just looking for a ballpark sense of how much an insurance plan covering the two of us, including my partner's special needs, would cost; I really have no idea coming from Canada and it's socialized health care system. I know I might get coverage from an employer, but for now just want to get a sense of cost assuming I was paying privately.
No insurer will sell an individual policy to your partner, until forced to in 2014. And then at a ruinous cost and likely a high deductible.
You'll need to get a group policy through your insurer. Even then, if your partner's medical bills are too high, your employer will contrive to fire you (even though that's illegal).
I have a fantasy about moving to Canada.
posted by orthogonality at 11:40 AM on June 24, 2011
You'll need to get a group policy through your insurer. Even then, if your partner's medical bills are too high, your employer will contrive to fire you (even though that's illegal).
I have a fantasy about moving to Canada.
posted by orthogonality at 11:40 AM on June 24, 2011
"A lot."
Individually, a shitty health insurance with a $5k deductible is a few hundreds of dollars per month, which ends up being nothing more than catastrophic insurance.
Assuming you're both non-smokers, and you could actually find a company to cover you (unlikely), it would cost into the thousands per month to get real coverage.
Realistically, in Florida, you need to find a full time job that could offer you the insurance. Not even all of them do.
posted by Threeway Handshake at 11:43 AM on June 24, 2011
Individually, a shitty health insurance with a $5k deductible is a few hundreds of dollars per month, which ends up being nothing more than catastrophic insurance.
Assuming you're both non-smokers, and you could actually find a company to cover you (unlikely), it would cost into the thousands per month to get real coverage.
Realistically, in Florida, you need to find a full time job that could offer you the insurance. Not even all of them do.
posted by Threeway Handshake at 11:43 AM on June 24, 2011
I wouldn't budget less than $800 - $1000 a month for individual insurance for the two of us.
If you wouldn't be getting group insurance from an employer you should assume that any individual insurance you could buy would completely exclude coverage for your partner's condition. Depending on the drug and blood tests your partner requires, the cost of that could be quite substantial. Also, if your partner's condition is associated with other poor health outcomes, they might be uninsurable entirely through individual insurance, other than through the state high-risk pool (which if I had to guess is probably a joke in Florida).
Even if you could get group coverage through your employer, it would basically be totally up to your employer whether they offered coverage to unmarried domestic partners.
posted by strangely stunted trees at 11:45 AM on June 24, 2011
If you wouldn't be getting group insurance from an employer you should assume that any individual insurance you could buy would completely exclude coverage for your partner's condition. Depending on the drug and blood tests your partner requires, the cost of that could be quite substantial. Also, if your partner's condition is associated with other poor health outcomes, they might be uninsurable entirely through individual insurance, other than through the state high-risk pool (which if I had to guess is probably a joke in Florida).
Even if you could get group coverage through your employer, it would basically be totally up to your employer whether they offered coverage to unmarried domestic partners.
posted by strangely stunted trees at 11:45 AM on June 24, 2011
Dur, the two of you, obviously
posted by strangely stunted trees at 11:46 AM on June 24, 2011
posted by strangely stunted trees at 11:46 AM on June 24, 2011
Your best source of individualized information is simply to call an independent Florida health insurance broker, explain your circumstances, and get a quote. You'd go to a lawyer for a free consultation, if you had a legal question, wouldn't you?
posted by paulsc at 12:15 PM on June 24, 2011
posted by paulsc at 12:15 PM on June 24, 2011
I'd second the $800-$1000/mo--if you could find someone to cover the two of you as "healthy adults", which given your partner's health problems, seems unlikely. Even if you do find someone willing to cover your partner, the odds are good that their previously existing conditions (and complications from those conditions) wouldn't be covered.
A few months back, I got insurance quotes for two healthy adults to get private health insurance in Florida. For a high-deductible plan--$5K per person that needs to be paid out before the insurance company starts paying anything at all--it cost about $250 a month. Before insurance would pay anything, the person making the claim had to meet their deductible--so $250 + ($5Kx2)/12. Which comes out to $1083 a month for fair to middling insurance that doesn't cover most diagnostic tests or any maternity care (which may or may not be a consideration for you).
That plan, I remind you, does not include coverage for pre-existing conditions. For a plan that would cover your partner's needs, you're probably looking at significantly more money, and by "significantly" I mean "I'd count on paying at least twice that."
I don't wish to shatter your fantasy, but I will say that in my opinion, moving to the US if you're a person with chronic illness is an unwise move--doubly so if you're in a same-sex partnership, which means that in most of the US, including Florida, the healthier party will probably not be able to carry insurance for less-healthy partner. You will pay out your nose for any coverage at all, and many things will not be covered. Your saving grace will be that if push comes to shove and you find yourself with tens or hundreds of thousands of dollars in medical bills, you can move back to Canada.
As someone who has chronic health conditions and is in a queer relationship with someone else who has chronic health conditions, I can tell you that I would cut off a limb to be able to move to Canada.
posted by MeghanC at 12:18 PM on June 24, 2011
A few months back, I got insurance quotes for two healthy adults to get private health insurance in Florida. For a high-deductible plan--$5K per person that needs to be paid out before the insurance company starts paying anything at all--it cost about $250 a month. Before insurance would pay anything, the person making the claim had to meet their deductible--so $250 + ($5Kx2)/12. Which comes out to $1083 a month for fair to middling insurance that doesn't cover most diagnostic tests or any maternity care (which may or may not be a consideration for you).
That plan, I remind you, does not include coverage for pre-existing conditions. For a plan that would cover your partner's needs, you're probably looking at significantly more money, and by "significantly" I mean "I'd count on paying at least twice that."
I don't wish to shatter your fantasy, but I will say that in my opinion, moving to the US if you're a person with chronic illness is an unwise move--doubly so if you're in a same-sex partnership, which means that in most of the US, including Florida, the healthier party will probably not be able to carry insurance for less-healthy partner. You will pay out your nose for any coverage at all, and many things will not be covered. Your saving grace will be that if push comes to shove and you find yourself with tens or hundreds of thousands of dollars in medical bills, you can move back to Canada.
As someone who has chronic health conditions and is in a queer relationship with someone else who has chronic health conditions, I can tell you that I would cut off a limb to be able to move to Canada.
posted by MeghanC at 12:18 PM on June 24, 2011
No insurer will sell an individual policy to your partner, until forced to in 2014.
Not true. Some certainly, but not all. Besides, you can provide a certificate of credible coverage, as you've got access to the Canadian system, so that really helps.
But ballpark premium? Somewhere in the "metric assload" range. Hundreds and hundreds of dollars a month, to be more specific.
Also, don't bet on being able to get coverage through your employer. Not all US employers offer benefits to partners that aren't spouses. Florida only recognizes heterosexual marriage, so whether or not your employer will is really a crap shoot. Just sayin'.
posted by valkyryn at 1:06 PM on June 24, 2011
Not true. Some certainly, but not all. Besides, you can provide a certificate of credible coverage, as you've got access to the Canadian system, so that really helps.
But ballpark premium? Somewhere in the "metric assload" range. Hundreds and hundreds of dollars a month, to be more specific.
Also, don't bet on being able to get coverage through your employer. Not all US employers offer benefits to partners that aren't spouses. Florida only recognizes heterosexual marriage, so whether or not your employer will is really a crap shoot. Just sayin'.
posted by valkyryn at 1:06 PM on June 24, 2011
I am in individual living in FLA. I pay for my own health insurance. To keep the cost down, I have what is sometimes referred to as a catastrophic care policy. Basically, that means that I have a $5,000 annual deductible.
So, really, with my health insurance policy, I have to basically pay for all my own health care. It is only after I exceed $5,000 for the year, then the insurance will kick.
I am healthy, I have never exceeded the deductible amount. I pay just over $2,000 per year.
posted by Flood at 1:49 PM on June 24, 2011
So, really, with my health insurance policy, I have to basically pay for all my own health care. It is only after I exceed $5,000 for the year, then the insurance will kick.
I am healthy, I have never exceeded the deductible amount. I pay just over $2,000 per year.
posted by Flood at 1:49 PM on June 24, 2011
I don't know if your partner's ongoing condition happen to be a mental health condition. If that is the case, consider that although most states have laws mandating some type or option of insurance coverage of mental health issues, most are tame enough to be partly or totally meaningless, and Florida's especially so. It only requires THE OPTION of mental health coverage (presumably at whatever price the company has a whim to offer it, and if your company can't afford it, you're out of luck), and only for group and HMO plans, not for individual ones.
Has the federal government done anything to address this? Yes and no. Federal parity laws only require that covered mental-health-related costs be covered at the same level as costs for other illnesses--not THAT they be covered, but that if they are covered, they are at the same level. Any individual plan has the option of covering some things but not others: testing but not therapy, therapy but not hospitalization, no medications at all, etc.
A company can also refuse to insure you unless you sign one or more riders, and those riders can be really stringent, for example, "We will never pay for any medication related to the gastrointestinal system", simply because I admitted to having gastroesophageal reflux disease. What if I were to get stomach cancer? Too bad, out of luck.
So if your partner will not be getting insurance through a job, it would not surprise me if (s)he is unable to find an individual plan with any mental health coverage at all. If there is one, it may turn out to be so expensive as to make paying out-of-pocket the smartest course. Yes indeedy! We gamble with our lives in the insurance game here in the good old U.S. of A.
I'm not a lawyer or an insurance professional, but that's what a reading of http://www.ncsl.org/default.aspx?tabid=14352 gives me. Depressing.
posted by gillyflower at 4:27 PM on June 24, 2011
Has the federal government done anything to address this? Yes and no. Federal parity laws only require that covered mental-health-related costs be covered at the same level as costs for other illnesses--not THAT they be covered, but that if they are covered, they are at the same level. Any individual plan has the option of covering some things but not others: testing but not therapy, therapy but not hospitalization, no medications at all, etc.
A company can also refuse to insure you unless you sign one or more riders, and those riders can be really stringent, for example, "We will never pay for any medication related to the gastrointestinal system", simply because I admitted to having gastroesophageal reflux disease. What if I were to get stomach cancer? Too bad, out of luck.
So if your partner will not be getting insurance through a job, it would not surprise me if (s)he is unable to find an individual plan with any mental health coverage at all. If there is one, it may turn out to be so expensive as to make paying out-of-pocket the smartest course. Yes indeedy! We gamble with our lives in the insurance game here in the good old U.S. of A.
I'm not a lawyer or an insurance professional, but that's what a reading of http://www.ncsl.org/default.aspx?tabid=14352 gives me. Depressing.
posted by gillyflower at 4:27 PM on June 24, 2011
Besides, you can provide a certificate of credible coverage, as you've got access to the Canadian system, so that really helps.
Coverage is based on residency, so if you move out of province for six months you lose coverage and don't regain it until you have established residency in the province again (I think that takes six weeks or three months?). Unless I am misunderstanding what credible coverage means in this context.
I agree you are nuts to consider moving AWAY from health care unless you are independently wealthy.
posted by saucysault at 6:41 PM on June 24, 2011
Coverage is based on residency, so if you move out of province for six months you lose coverage and don't regain it until you have established residency in the province again (I think that takes six weeks or three months?). Unless I am misunderstanding what credible coverage means in this context.
I agree you are nuts to consider moving AWAY from health care unless you are independently wealthy.
posted by saucysault at 6:41 PM on June 24, 2011
Thank you all very much for the answers. I guess my fantasy isn't practical.
posted by Paquda at 7:05 PM on June 24, 2011
posted by Paquda at 7:05 PM on June 24, 2011
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posted by Paquda at 11:40 AM on June 24, 2011