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Should I live without health insurance for the next year or so?
November 20, 2012 11:37 AM   Subscribe

Should I live without health insurance for the next year or so?

As is the custom, my insurance company raised my rates for my birthday, making my health insurance $200/mo. Not bad, I know, but that's with a $5k deductible. Last year I brought home about $17k pre-tax, so this is a significant chunk of change.

I run a business with a partner. I think my premiums are tax deductible (I have an email in to my accountant as well, on that front). But I'm not sure my income is high enough for that to matter a whole lot.

I'm 30-year-old woman, and in good health generally. I don't take any medications, I exercise regularly, no chronic conditions I'm aware of. I pay my therapist in cash when I see her as necessary and have for years. I've had a couple of major, completely random health problems in the last 4 years, and that's it (broken leg, and a detached retina). Each of those ran me $1500-$2000 out-of-pocket.

My insurance currently covers neither pregnancy NOR birth control (don't even try to wrap your brain around that one). I'm in Illinois (was there any doubt this was a question from the USA?), and have the pink card (a medicaid-type thing), so I've got lady-bits exams covered. And also thanks to that I have an IUD, so an unexpected pregnancy will be REALLY unexpected.

My dental coverage is actually pretty good. I had some significant work done this year. I'm seeing my dentist today and will ask about a potential plan for taking some time off. I'm sure she'll be thrilled. But barring an emergency, I should be ok, and maybe able to pay cash for a regular checkup or two in the next year.

I do appreciate that I've got Blue Cross Blue Shield PPO, and can basically call up the best doctors and get an appointment with no problem. I consider this the main benefit of my insurance coverage. I recently found a GP I love, so I imagine if something comes up in the next year, I could get an appointment and pay in cash if necessary.

These new insurance exchanges and "Obamacare" and all of that starts in early 2014, right? And I believe that being denied coverage, especially for whatever the Man deems "pre-existing," especially after a lapse in coverage, will be illegal, right? And it looks like I may be able to have my little S-Corp arrange better coverage for me/my partner/employees we may have by then when this all goes in effect, right? I know it's all a huge unknown, but this seems to be an ok gamble to me. Am I insane? What's the dental situation with the new health care laws, does anyone have any idea?
posted by anonymous to Health & Fitness (62 answers total) 3 users marked this as a favorite
 
DO NOT DO THIS!

It just takes one week in the hospital without insurance to totally bankrupt you for many years to come. Your health is a great unknown, and being injured or getting an infection or cancer or just about anything can rack up tens (if not hundreds) of thousands of dollars in medical bills that would be covered with insurance.
posted by xingcat at 11:41 AM on November 20, 2012 [14 favorites]


$200 is so cheap compared to what most people pay, I don't know why you would want to ditch it.
posted by Ideefixe at 11:43 AM on November 20, 2012 [7 favorites]


I imagine if something comes up in the next year, I could get an appointment and pay in cash if necessary.

If "something comes up" then it's going to cost you a lot more than a few hundred dollars for the appointment.

Am I insane?

Maybe not, but this is a horrible idea. There are millions of people at your age who seem otherwise healthy and then develop a very expensive medical condition without warning. It's not a gamble you should take.
posted by grouse at 11:46 AM on November 20, 2012 [1 favorite]


Your health is a great unknown, and being injured or getting an infection or cancer or just about anything can rack up tens (if not hundreds) of thousands of dollars in medical bills that would be covered with insurance.

Actually, a one week stay in the hospital alone could cost many tens of thousands of dollars. Don't risk this, especially when your monthly outlay is that low. (I know, it seems like a lot in relation to your take-home. But think about $80,000 in comparison to your take home.)
posted by elizardbits at 11:47 AM on November 20, 2012


Can you just shop around for cheaper insurance? Do not go without it, though.
posted by chaiminda at 11:48 AM on November 20, 2012


Should I live without health insurance for the next year or so?
No. Not unless you literally cannot pay for food and rent. 30 is around the time lots of other stuff starts to pop up and you do not want to be uninsured for them.
posted by barnone at 11:48 AM on November 20, 2012 [1 favorite]


Nope. Not at all.

This is a terrible idea. I've been healthy forever, then I got a pre-cancerous thing. Thank goodness I had insurance because I was able to make decisions that weren't based on money.
posted by Ruthless Bunny at 11:49 AM on November 20, 2012 [2 favorites]


Just to underscore this (I am a little passionate on the subject), I take 3 medications that, without them, I'd be totally dead. On insurance, they cost me $100/month.

Without insurance, they'd cost $3,500/month.
posted by xingcat at 11:50 AM on November 20, 2012 [1 favorite]


$200/month is really not bad, unfortunately. Even if you just wind up in the hospital once over the next year, I think you'd come out ahead.
posted by mlle valentine at 11:50 AM on November 20, 2012


When I was 30, I was healthy. Then, suddenly, I developed an autoimmune disorder. The same thing happened to at least 5 of my close female-identified friends and many other cis-gendered women in their 30's. It's not worth the risk - especially not with the experience of my community and the physiological changes that start to occur in your 30's. I think it's risky to do and if you can afford insurance, you should keep it. Otherwise, the costs could be astronomical (even basic blood work adds up quickly).
posted by anya32 at 11:56 AM on November 20, 2012 [1 favorite]


I live in a country with socialised health care, so I don't pretend to have any US-specific clue here. But my first thought is: what if you get appendicitis? Get hit by a car? Get cancer? Get a serious respiratory illness out of the blue? Sustain a spinal injury?

All of these things have happened to friends of mine at your age or younger. Of course, you would have to be unlucky for any of them to happen. Sadly, people are regularly unlucky. I just wouldn't risk it in your situation.
posted by rubbish bin night at 11:56 AM on November 20, 2012


I didn't have access to affordable insurance for 2 years. had to claim bankruptcy earlier this year after my kidney stone ER visit, appointments and surgery. And a trip to the ER for an ovarian cyst rupture. $44,000. Luckily I have affordable insurance as of last month.
posted by KogeLiz at 11:58 AM on November 20, 2012 [3 favorites]


I pay more for healthcare than I pay for rent. I have a pre-existing that's barely an issue right now, costs very little to monitor, and won't really hit the fan for maybe another 10-15 years -- possibly three different presidential administrations from now. I still would never, ever drop it.
posted by mochapickle at 12:00 PM on November 20, 2012


$200 is so cheap compared to what most people pay, I don't know why you would want to ditch it.

Mine is about $150, with the same deductible, and I made way less that you last year, so I completely understand why you'd want to ditch it. But I wouldn't. I went without health insurance for several years in my early 20s and as it happened I was fine, but I just wouldn't do it now. For one thing all sorts of stupid little expensive things start to go wrong with your health when you're over 30. If your insurance is like mine, it won't cover all of each Dr's appointment for those things, but it will cover part of each, and that helps. For another, it's hit-by-a-bus insurance in case you get hit by a bus. I know how much it sucks to be paying the $200 you don't have every month and getting nothing in return, but anyone really can get hit by a bus, proverbial or otherwise.
posted by DestinationUnknown at 12:03 PM on November 20, 2012


This could literally screw your health, finances, and coverage options for the rest of your life if something (something you are not capable of predicting) happens. I really encourage you not to go a single day uncovered.
posted by anonnymoose at 12:06 PM on November 20, 2012


If there is any way possible to do so, keep the insurance. Sure as shooting, if you drop it, this next year will be the year from medical hell. In the US, the risk is just too great to go uninsured.

FWIW, my family's $1,200/mo. policy also carries a $5000 deductible. I think that level is quickly becoming the standard.
posted by Thorzdad at 12:06 PM on November 20, 2012


Can you raise your deductible even higher and get a cheaper monthly payment? Can you call an independent insurance broker and see if they can find another plan that is cheaper?
posted by CathyG at 12:07 PM on November 20, 2012


If you had broken your leg without health insurance, you would very possibly be in debt for more than what you make in a year right now. It was only $1500-2000 out of pocket because you were paying negotiated rates (the rates the insurance company has negotiated with the hospital)--which you get because you have health insurance.
posted by needs more cowbell at 12:11 PM on November 20, 2012 [7 favorites]


Seriously, no. I had my appendix out two years ago and the hospital bill ended up being over $25,000. For a laparoscopic procedure that kept me in the hospital for fewer than 12 hours (fewer than 8 if you don't count the four hours I waited in the emergency room in horrible pain.) Random weird stuff can happen anytime. Don't give up your health insurance!
posted by Daily Alice at 12:11 PM on November 20, 2012 [1 favorite]


Don't do this for only $200 a month. I went without when my only option was Cobra after I left my job, but that was three times the price and I was living off of savings.
posted by empath at 12:13 PM on November 20, 2012


At age 23, in perfect health, I suddenly needed an appendectomy. It cost $12,000 and that was 20+ years ago.
posted by BlahLaLa at 12:14 PM on November 20, 2012 [1 favorite]


My appendectomy cost my insurance company $40,000 two years ago.
posted by Sidhedevil at 12:17 PM on November 20, 2012 [1 favorite]


Just came back to say that my out-patient laser surgery, and associated blood work, pathology labs, etc, was $25,000.

My thing was a whole lotta nothing. I was in and out of the hosptial in 3 hours. Imagine how much it would have been if I had been in there overnight!
posted by Ruthless Bunny at 12:21 PM on November 20, 2012


And also thanks to that I have an IUD, so an unexpected pregnancy will be REALLY unexpected.

...but it can still happen to about 1 in 1000 women. As do burst appendixes (I had one of these when I was six and nearly died thanks to misdiagnosis - the same thing is likely if you put off seeing your doctor when you get pains), accidents, and early warning signs for more serious conditions which you may put off checking out as you'll be uninsured.
posted by mippy at 12:24 PM on November 20, 2012


To drive home the point everyone above has been making, I'll add my horror story:

Aged 26, healthy and happy. Then one day, I have a bit of a fever and feel run down. A week later, I have a confirmed case of pneumonia. A month later, I'm the sickest I've ever been and my doctor has me spend the night in the hospital because my symptoms are confusing and I have trouble breathing.

The bill for that night? That ONE. NIGHT. in the hospital? In which I needed no procedures at all, except a CAT scan? Over $8000.

Think of all the different ways you can end up potentially needing a night in the hospital. Think of all the other things you could end up needing, even more expensive that just a night's stay.
posted by meese at 12:26 PM on November 20, 2012


Before my wife and I turned 30, neither of us had been to a doctor for more than minor things in about a decade. Once we both turned 30, I was hospitalized and had to have my gallbladder out, I got a severe infection that required high-grade antibiotics, and I had to have a number of tests run for various things. She wound up in the hospital a couple times for various issues and had to have major surgery that was $3000 WITH insurance. We're averaging about a Major Thing per year.

That's not even counting the time she had to go to the ER twice for double-you-over-so-bad-you're-crying-pain and the doctors ran a bunch of tests, then shrugged and sent her home with Tylenol, then Advil. Cost for that was $1000, again, with insurance. And nothing was obviously wrong with her (at least according to the tests they ran).
posted by Ghostride The Whip at 12:31 PM on November 20, 2012


I was healthy as a horse but developed type 1 diabetes at age 38. No hospital stay in my case, but a LOT of doctor's appointments, medicine, and gadgets. I wear an insulin pump, which costs around $8000, I think.

And forget weird illnesses that can strike out of the blue -- you can get in a car accident, or hit while crossing the street.
posted by kestrel251 at 12:33 PM on November 20, 2012


How willing are you to declare bankruptcy? How would it affect your business? What clinics and subsidized care are available in your area? How's your ability to work, rent, and get around without an on-the-books source of income?

If you were willing and able to declare bankruptcy and live with bad credit for a while (or simply ignore it and hide your income and assets from judgments) and there were decent charity or religious hospitals/clinics in the area, I'd consider it.
posted by the young rope-rider at 12:34 PM on November 20, 2012 [3 favorites]


Even if nothing happens, going for a period uninsured can make future insurers deny you or jack up the price.
posted by radioamy at 12:44 PM on November 20, 2012 [2 favorites]


A friend of mine -- healthy as a horse -- was in an accident in his early 30s and broke his neck (he had emergency-only coverage through his record label, so that covered the trip to the hospital and a portion of the immediate ER bills only). Thanks to luck and six-bordering-on-seven figures worth of great medical care and rehabilitation, he is still alive and well, and will be paying off the bills for the rest of his life.

Don't do it.
posted by scody at 12:48 PM on November 20, 2012 [1 favorite]


It doesn't matter how healthy you are now, how well you take care of yourself, how careful you are about your surroundings, exercise, daily living, driving, whatever. There are so many things completely outside of your control, that can cause you to need immediate, ongoing, and/or emergency medical care.

I hate our broken insurance system. But the consequences of not having insurance are too great to take the kind of risk you're considering taking.

As was said up-thread, unless you have to choose between starvation/homelessness and health insurance, do NOT give up your existing coverage.
posted by moxiequz at 12:48 PM on November 20, 2012 [1 favorite]


I was 29, and fine one day and the next day it felt like I had a UTI. Ten months, numerous appointments, unpleasant lab test, blood tests, and a good smattering of ultrasounds... I have chronic idiopathic overactive bladder, and maybe PCOS. I was fine, and now I have this forever, for no reason at all. I suspect I've outlaid at least a couple k, and that's with the blood tests, urine tests, pap smear, and ultrasounds all free....

We're all fine... until one day you're not. And you run your own business... so if you stop, your income stops. At the very least, I get paid sick leave I can use to cover my myriad of appointments (hourly, I've used up an entire week of sick leave just getting diagnosed!).
posted by jrobin276 at 12:58 PM on November 20, 2012


Things you cannot plan for or predict that are fucking serious: Appendicitis. ACL split. Ovarian cancer. Any one of those will set you back 10k minimum and start counting up from there. This is potentially the worst $200 you will try to save from your monthly budget ever.
posted by DarlingBri at 1:06 PM on November 20, 2012 [6 favorites]


Obviously the answer to this question is no, but I wanted to elaborate on why.

Your current insurance has a $5K deductible, which means that it is basically catastophic coverage. If anything minor happens to you, you're going to have to cover it yourself. What you're paying $200 a month for is to insure against something very serious and major happening to you, which you have no way of being able to foresee regardless of what you have told us about your background and your health.

I think if you look at it that way you will see why trying to anticipate more common/routine healthcare things you will be more likely to need is irrelevant - you are paying $200/month for protection against something that will ruin you financially. It's a question of risk tolerance, but thank goodness, most people don't think this risk is worth running (because once you are bankrupt, other taxpayers and insured people are subsidizing your care! So your decision to go 'bareback' on health insurance is not just a choice that affects you alone).
posted by treehorn+bunny at 1:12 PM on November 20, 2012 [6 favorites]


Don't do this. When I was 30 I started going blind in one eye - over 100K in tests and treatment in 10 months helped me keep the vision in the other eye. If I hadn't had health insurance I'd be blind now. Catastrophic health problems happen to otherwise perfectly healthy people.
posted by PorcineWithMe at 1:16 PM on November 20, 2012 [1 favorite]


I've lived without health insurance for 11.5 years. I would absolutely NOT recommend it if you can afford to have insurance. If I had the money, I would gladly pay it to avoid the enormous stress I carry around day in and day out in fear of injury and illness.
posted by asciident at 1:38 PM on November 20, 2012


The $200 protects the lifestyle you are currently enjoying. What good is the savings if you lose everything?

Better:

Find a way to either generate $2400 extra a year, or cut back on something.
posted by Kruger5 at 1:48 PM on November 20, 2012 [3 favorites]


My 5 year old son was pretty sick and we ended up in the emergency room. His care consisted of a few bags of fluids (he was dehydrated) and a bag of antibiotics (for pneumonia). He never saw a doctor - only PAs and nurses. We were there for a few hours. The hospital bill was over $10,000. Thankfully we had insurance and only paid a few hundred bucks.

The best part - not debating whether he was sick enough to warrant the expense of an e.r. visit or doctor visit. I didn't blink an eye. I took him in to get him the care he needed without a second thought of the finances/insurance. THAT, to me, is the best thing about having insurance - knowing that money really won't be an issue and I won't be sitting around wondering if I, or my children, are really sick enough.
posted by Sassyfras at 2:03 PM on November 20, 2012


Close to 70k for my appendix last year, which burst in a complex way and required two weeks of hospitalization.
posted by slateyness at 2:09 PM on November 20, 2012


I can understand why you'd consider it, and I'm not sure I agree with the other posters.

Do you own your own home? (ie. would you lose your home if you had to pay big bills?)

Does your current salary actually qualify you for Family Health Plus? (if available in your state)

What would it take to qualify for Medicaid if something awful happened? If you don't have a lot of income and you don't own a lot (like a house or property) it might not take much to qualify for Medicaid if something bad happened. You don't make a big salary, and I'd bet you wouldn't have an income coming in if you were laid out.

How marginalized are you? That is, do you appear middle class, white, educated -- because signing up for Medicaid can be awful, and getting good care can be difficult -- but the closer you look to middle class, the better experience of it you'll have.

How good is your insurance, actually? Is this a crappy company that is going to use every loophole available to deny your claims? Assuming you blow through your deductible, how much will the insurance company pay out -- what's their maximum per year?

Will you feel shame if you have to declare bankruptcy? Will you blame yourself or recognize the shitty position our country puts people in. Do you have family you could live with if you went under? Can you start again?

I don't think this is the no-brainier people think it is. But do some more homework.
posted by vitabellosi at 2:13 PM on November 20, 2012 [2 favorites]


Check to see what the cap is on what your insurer will pay out. If there's not all that long a gap between the $5k you have to pay and the maximum they'll pay in a year, I don't see much point in it.

Below a certain income point, I really question what the point of having a high-deductible plan is at all. If the deductible alone is more than you can reasonably pay, why bother?

I'm sure someone's got good answers for why it's a good idea -- but I figure I'll just be going without until 2014, since the 30-day pre-existing condition ship has already sailed.
posted by asperity at 2:21 PM on November 20, 2012


can basically call up the best doctors and get an appointment with no problem. I consider this the main benefit of my insurance coverage.

Actually, the main benefit of your insurance coverage is that you are somewhat less likely to be bankrupted by an unforeseen health matter. All those bills you paid with your insurance? Take one of your old bills from your broken leg or your detached retina, and explore what it would have cost you to fix without heath insurance, because the answer is many many multiples of what you paid out of pocket. Blue Cross is a big insurer and able to negotiate cheaper rates than even smaller insurance companies, so take that into account too.

Until the dust settles and we really understand what provisions of Obamacare are going to be implemented and how exactly they are going to be implemented, do not mess with your existing insurance. I know that $2400 is a big chunk of $17K. I personally loathe health insurance companies and it pains me to find myself arguing that you should continue to give them money.

Twelve years ago I was a healthy woman in her early thirties. I had left the firm where I was working and doing contract work. I did not have health insurance, and I was unable to obtain it due to having had an abnormal pap smear a few years earlier. (Whee! Remember: once you have a gap in coverage, previous health issues can make it harder to get coverage later.) One day I was walking down the street, and a pickup truck coming towards me blew out a tire, flipped over, and landed on the sidewalk, about 30 feet from where I was walking. If I had left my apartment a few moments earlier, that truck would have hit me. My first thought was "Oh shit, I don't have health insurance. "

You just cannot predict what might happen. That is what insurance is for.
posted by ambrosia at 2:31 PM on November 20, 2012


If the deductible alone is more than you can reasonably pay, why bother?

Because at some point in your life you will likely be able to pay back $5,000, whereas owing $50,000 is a recipe for bankruptcy.

If there's not all that long a gap between the $5k you have to pay and the maximum they'll pay in a year, I don't see much point in it.

I suspect you misunderstand an aspect of U.S. medical insurance programs. The out-of-pocket expense limit (often just a few thousand dollars) is how much the insured has to pay out before the insurance program starts paying 100% of the cost. For the BlueCross BlueShield of Illinois BlueEdge Individual HSA 5000 plan, the out-of-pocket expense limit is $5,000, meaning the plan pays all covered in-network hospital and medical expenses after you pay the deductible.

Some plans do have an annual payment limit, but the plan above does not have one listed, and the Affordable Care Act (ACA) mandates that such limits must be at least $2 million for essential health services. A big, big difference between that and a $5,000 deductible. For plans beginning 1 January 2014, the ACA will mandate no limit at all.
posted by grouse at 2:43 PM on November 20, 2012 [4 favorites]


Seconding what asperity said. People unfortunately rarely take a close look at their health insurance until they need to call upon it, and then it's too late. Read over the fine print. What are the exclusions? What is the yearly cap? What exactly is covered in an emergency? For example, if you are brought into the ER with an immediate need to operate, what happens when the anesthesiologist who is on duty at the moment is out of network for your insurance? You're screwed, is what you are, because now you are personally liable for the anesthesiologist bill - or any other specialist who happens to treat you and is out of network; when it's an elective procedure, you may be able to do your due diligence and check that everyone who is going to be treating you is in network*, but when you're brought in an ambulance from a car accident, you may not be in a position to pick and choose and determine who is treating you because you may be unconscious.

I know of way, way, way too many people who thought they were covered, until they went to have something done, and came out with bankruptcy-inducing bills despite having what they thought was "really good insurance".

IOW: take a close look at your insurance.

That said, $200 a month is a pittance - relatively speaking. I fully understand that it's a huge amount given your income, but it's tiny given what the costs of insurance can be out there for someone in your situation. On balance, therefore, I'd say it's a small price to pay for some peace of mind - if nothing else. I say, keep it. People underestimate how a lack of insurance impacts their life even if they have no health issues and no reason to use it - the psychological stress alone can distort your decision-making process and your work/play options. Remember: it's not only about your health, but about your psychological well-being. Keep it.

*this is extra, extra tricky - a physician may be in network at one institution, but not in network when he's working ER at a different one you happen to be brought to, and a thousand other ways in which they get you - including treatment options etc. It's a minefield and I feel sorry for those who have to navigate it from their sickbed.
posted by VikingSword at 2:46 PM on November 20, 2012


The nice thing about a PPO is that they will still pay even for out-of-network care, just at a lower reimbursement rate. The BlueEdge 5000 plan pays 80% to out-of-network providers. And there's an out-of-network out-of-pocket maximum too, but it's an additional $5,000 after the deductible is paid. The one thing to watch out for is that they will only pay 80% of their maximum allowed rate for in-network providers, and the out-of-network providers have not agreed to discount their rates. So for a portion of the bill you will owe 100%. But I've successfully argued down an unreasonable out-of-network rate after the fact to pay just the in-network rate (your mileage will almost certainly vary).

I do think it is bullshit that in-network hospitals are allowed to use out-of-network anesthesiologists.
posted by grouse at 2:54 PM on November 20, 2012 [1 favorite]


Because at some point in your life you will likely be able to pay back $5,000, whereas owing $50,000 is a recipe for bankruptcy.

I question how long the various providers you owe give you to pay that $5k before they sue you. In my experience, not that long.

It is a wonderful thing that the annual payment limits will be lifted -- I have been offered a plan before that had such a low annual payment limit that it genuinely would not fully cover a single ER trip to set a broken arm, and I wouldn't recommend that to anyone as a good financial option. (I was working a part-time second job in retail that I'd taken specifically to get health insurance. The plan I finally saw was so offensive I took to displaying it to customers.)

Given that the OP's got the option of keeping the same plan -- and avoiding not only the actual 30-day gap in coverage that'll allow them to deny all claims forever but also the slight change in paperwork in which they taunt you with the possibility that they'll deny all your claims -- that may be the best thing to do. But reading all the small-print material is vital.
posted by asperity at 3:15 PM on November 20, 2012


I did this when just a little younger than you, for a few years more. And I don't have a horror story, but!

I found that I was way more risk averse in silly little ways that ruined my fun - no, I didn't feel like I could go ice skating with my coworkers (what if I fell?). I was a lot more frightened of bad weather while driving. I became a bit of a hypochondriac, because I was always worried about maybe having to go to the doctor. So consider, too, your ability to weather anxiety, even if you do stay entirely well. Sorry you're having to make this decision, I know it stinks!
posted by ldthomps at 3:24 PM on November 20, 2012 [2 favorites]


I question how long the various providers you owe give you to pay that $5k before they sue you.

If you negotiate a payment plan -- even a piddling plan where you pay $25 a month -- you can keep this at bay. My friend paying off the untold bills to fix his broken neck did it this way (he pays more than $25/month, obviously, but he most certainly didn't have to pay the hundreds of thousands outright). Most hospitals and billing services, in my (unfortunately fairly vast) experience are quite willing to do this.
posted by scody at 3:29 PM on November 20, 2012


I question how long the various providers you owe give you to pay that $5k before they sue you. In my experience, not that long.

If you enter into a payment plan rather than ignoring the bills or just saying "I can't pay" - every hospital I've ever dealt with. Uninsured maternity - $9k vaginal, 14k C-section - is very very common and so far nobody has been sued for the baby.
posted by DarlingBri at 3:45 PM on November 20, 2012


The nice thing about a PPO is that they will still pay even for out-of-network care, just at a lower reimbursement rate.

You should really check your own policy. We went from a plan that covered out of network to one that looked the same but did not cover it. Unless this is a regulation I'm not aware of, the letter designation isn't always telling.
posted by the young rope-rider at 3:55 PM on November 20, 2012


First, don't cancel your insurance for all the reasons everyone has already stated.

Now, though, here are a couple more options that you might consider.

1. Dental insurance is very cheap purchased on its own. It might be worth looking into whether it would be cheaper to cancel the dental portion of your existing insurance and purchase dental independently.

2. If you have vision correction insurance, cancel that.

3. If you need or foresee the need for prescription medication, you might look at health-care plans from a private practice. These are becoming more common. This is not insurance, it is more like a membership plan, a set monthly fee that will buy you office visits and written prescriptions for a nominal rate.
posted by nedpwolf at 4:02 PM on November 20, 2012


Well, this is where I get burned at the stake but honestly, I'd drop it. I haven't had insurance since I got laid off in 2010 and so far, I'm kind of managing and I'm almost 20 years older than you. It's not great, but it's doable. Yes, I've had medical bills. I'm not paying them. What, exactly, do people think they're going to do? Debtor's prison doesn't exist anymore. If you declare bankruptcy, they cannot take your house or your car. Yes, your credit will go to shit but trust me, if you've been unemployed for over a year and then wildly underemployed for another one, your credit is already long gone, so who cares?

If you don't have any real assets - and if you're making 17K before taxes, then you are really seriously poor and probably don't have any - than if you do have an emergency, you won't have to pay for it. When you end up in the hospital after the bus hits you, ask for a social worker and beg for help. You'd be surprised at the programs that exist for the genuinely poor and you are, you know, genuinely low income. You're taking home what, $250 a week? That extra $200 a month you're not paying for health insurance could make your life a lot better.

I have quite a few friends without health insurance. It is not so great. I don't recommend it. I would not have chosen it as a lifestyle. But. It is possible.
posted by mygothlaundry at 6:15 PM on November 20, 2012 [6 favorites]


When you end up in the hospital after the bus hits you, ask for a social worker and beg for help.

This may work for a one-time disastrous accident, like a bus hitting you, but I can tell you it's no strategy for long-term medical care -- say, for cancer. An ER is willing (and obliged) to stabilize you if you're in crisis, but a cancer center isn't necessarily willing (and certainly not obliged) to provide a year's worth of radiation, surgery, and chemo. It's true that some medical centers/organizations have programs for low-income patients, but -- having been through half a million dollars worth of cancer treatment less than two years ago -- I wouldn't want to count on it.
posted by scody at 8:09 PM on November 20, 2012 [2 favorites]


Anytime the question is "should I go without health insurance", the answer is NO. One accident can mean bankruptcy and the end of your future as you know it.
posted by markblasco at 9:33 PM on November 20, 2012


No, don't do it. At 30 I was fairly healthy.

At 31 I was diagnosed with diabetes and high blood pressure. At 33 I was diagnosed with kidney cancer. Our insurance paid well over half a million dollars over 18 months. If it wasn't for insurance it is very likely I would be dead by now. Keep your insurance if at all possible.
posted by SuzySmith at 11:47 PM on November 20, 2012


Don't do it. I've had several kidney stones that cost over $35,000 each plus a week out of work, and those were just the ones that didn't require an overnight hospital stay or ER visit.
posted by JaneL at 6:38 AM on November 21, 2012


I would probably do it. I'm not saying it's a good idea, but I probably would. I did for years. A lot of my friends, did too, though mostly in our 20s.... I have it now and never use it.

There's a lot of charity care organizations in the worst case scenarios- one of my good friends appendixes burst and I think she got almost all of it written off. If you got pregnant, you probably qualify for medicaid on what you make — again, I know half a dozen people that had babies this way, and these were not "poor" people- just people that didn't have insurance.

Prepare to be your own healthcare advocate, for sure, and get a list of free or reduced cost health clinics in your area so if you do get sick, you can still get some services.
posted by Rocket26 at 4:03 PM on November 21, 2012


Debtor's prison doesn't exist anymore.

Not true, depends on the state.
posted by Ghostride The Whip at 9:04 PM on November 21, 2012


You know that going without health insurance is gambling. You can save some scratch by winning the bet, but your losses are catastrophic if you lose.

My family went without health insurance for almost a decade and were perfectly healthy. We seemed like we had won the bet. When you win the bet, it feels like you've made a smart decision. And then one of our family members was diagnosed with cancer. Cancer treatment is in the multiple six-figures. I think we've learned our lesson.
posted by WCF at 12:11 AM on November 22, 2012


Yes, I've had medical bills. I'm not paying them. What, exactly, do people think they're going to do?

Taking this attitude means you're taking advantage of most other people in the system. The folks who are insured or who have assets at risk who want to avoid going into bankruptcy, because those folks have to pay higher costs to help subsidize your care if you're not paying - and the hospital, which regardless of whether it is nonprofit, is a business, and can fail like any other business if it takes too many losses. Yes, I believe that health is a human right that we are all entitled to, but not paying bills you could afford to pay because you feel like you deserve not to have to pay is essentially theft, even though you won't be arrested for it. I hope no one's takeaway message from this thread is "hey, if I've got very little to lose, I might as well not bother paying my insurance premiums even if I could afford them." Hard to be very smug about that sort of strategy.

This may work for a one-time disastrous accident, like a bus hitting you, but I can tell you it's no strategy for long-term medical care...

Agreed with the assertion about cancer care, but wanted to add re: people who have been pedestrians struck by vehicles... such injuries often involve long-term care, i.e. months of physical therapy, or multiple orthopedic surgeries, and too many, sadly, also involve neurologic injury that creates a lifelong disability and need for care that may put you in a nursing home (this is typically after an astronomically expensive lengthy neuro ICU stay).
posted by treehorn+bunny at 8:10 PM on November 24, 2012 [3 favorites]


not paying bills you could afford to pay

I cannot. I don't know about the OP, but my guess is that s/he's making about what I'm making, which is to say, around $200 or $250 a week. On that (which is slightly less than half of what I made before I got laid off two years ago) I can pay my bills - barely, just barely - and pay for food with the help of $100 a month in food stamps for myself and my daughter and the animals and that's it. There isn't any left over for an extra bill, medical or otherwise. I wish there was, but there isn't. And in my state - and many others - while I qualify for medicaid under income guidelines, medicaid is only granted to children and adults with disabilities. So it's all very well to say that yes, you should have insurance and you should pay your bills but you know what? Sometimes you just have to pick and choose and say fuck it. My electricity and gas are more important to me than the $700 ER bill.
posted by mygothlaundry at 9:36 PM on November 29, 2012


Ghostride the Whip, from your link:

Under the law, debtors aren't arrested for nonpayment, but rather for failing to respond to court hearings, pay legal fines, or otherwise showing "contempt of court" in connection with a creditor lawsuit.

That is not debtor's prison, despite the Yahoo! headline.
posted by DarlingBri at 7:56 AM on November 30, 2012


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