No health insurance, future problems?

November 8, 2005 1:22 PM

Going without insurance for a period of time. What happens if disaster strikes?

I've done well for myself. Had a good job and saved up. I now would like to change careers though. But first, I'd like to take a year off to do a little hiking.

I do see one possible problem however. Obviously I'm leaving my job's insurance behind. I'm healthy, but what if disaster strikes? Cancer, heart disease, hiv, anything that would be a life long problem. The way I understand it, from that point on if I got insurance through another job those things wouldn't be covered, correct? I'd be responsible for all treatments and drugs for the rest of my life? Am I missing something?

I need to make sure I'm always insured because if something bad happens I'll always be uninsured for that problem?

posted by gtr to Health & Fitness (17 answers total)

This is a no-brainer. Buy an individual insurance policy to cover you for the year off.
posted by reverendX at 1:26 PM on November 8, 2005

Response by poster: I understand that. But eventually I would return to a job where I would try to get on their policy. It's my understanding that they wouldn't cover illnessses previously obtained. At least that's my understanding.
posted by gtr at 1:32 PM on November 8, 2005

Not to sound like a shill, but Blue Cross and Blue Shield has a health insurance plan specifically designed (marketed) for young people in CA and CO that don't have employer coverage (I don't know where you are located). You have a larger deductible than your traditional insurance and on some plans the doctor visits are limited per year, but the monthly payments are low. In other words, it is designed for people with lower income, but also who don't get sick that often, but then again need some back-up if they get in a car wreck.

I do not work for them, I have just read about it recently and think it's actually a decent idea from an industry not much known for their decency.
posted by Pollomacho at 1:34 PM on November 8, 2005

Best answer: I need to make sure I'm always insured because if something bad happens I'll always be uninsured for that problem?

Essentially, yes. If you're young and healthy, you should be able to get insurance with a relatively high deductable for very little outlay (under $100 a month). (Something like what's offered at tonik.com -- I'm not recommending them, just pointing at something that fits the description).

If something bad happens, health-wise, you're going to end up paying your deductable out-of-pocket -- but you'll be continually insured, so when you move insurers when you take a new job, your new insurer will cover it.

Incidentally, while hiking is not a particularly dangerous activity in general, it is an activity that involves very expensive rescues. If for some reason you needed to be evacuated from the woods, a $5k deductable is going to look very cheap. I don't think I'd want to go into the backcountry uninsured, regardless of my concerns for future uninsurability.
posted by toxic at 1:37 PM on November 8, 2005

Response by poster: If something bad happens, health-wise, you're going to end up paying your deductable out-of-pocket -- but you'll be continually insured, so when you move insurers when you take a new job, your new insurer will cover it.

Oh, I see. I always thought that being continually insured had to be through the same company. So if I leave my job, but remain insured, and then get another job, I can switch to their insurance, and there isn't a problem?
posted by gtr at 1:40 PM on November 8, 2005

Response by poster: I don't think I'd want to go into the backcountry uninsured, regardless of my concerns for future uninsurability.

I'm going to remain insured. I thought however that if for example I got cancer nothing would be covered when I switched to a new insurance company (with a job for example).
posted by gtr at 1:42 PM on November 8, 2005

Best answer: If you get new insurance from an employer (group plan) when you go back to work they are required to cover all pre-existing condiitons after one year as far as I know. They are also required to immediately cover any conditions that were previously covered by a group plan but not an individual one. ie if you get cancer on your individual plan and then get a new job and new insurance they may not cover you for a year but if you were covered under COBRA or a group plan for at least 18 months continuously with less than a 63 day break in coverage they would have to cover you right away for any and all pre-existing conditions. Again this is AFAIK. This may also vary depending on state: I would call your state labour office and ask to speak to their HIPPA or insurance person and they can tell you for sure.
posted by fshgrl at 1:42 PM on November 8, 2005

Best answer: Pre-existing conditions.

You can be denied coverage for up to a year, for conditions you've had within the six months prior to joining a plan (that's very general; any number of conditions and caveats and state laws may apply). After the year, the plan would have to cover you for all conditions, even things you discovered just before joining the plan.

So, you could "wait out" certain problems. Back problems? Maybe you can wait a year for surgery in order to have it covered. The problem comes if during your hike, you discover you have brain cancer and need $100,000 in care right now.

ReverendX's advice is correct. You can buy a rather weak policy - i.e., only really reimburses you if you have something catastrophic happen - for not a lot of money. And this will eliminate the pre-existing condition problem - if you switch from your individual, temporary plan to a group (employer) plan, they'll cover your brain surgery from day 1.

If you have any decent assets at all, this is the way to go.

If you have no assets, of course, you skip coverage and throw yourself on the mercy of emergency rooms if you get sick, like 16% of the U.S. population. If you get brain cancer you'll die.
posted by jellicle at 1:43 PM on November 8, 2005

Response by poster: Thanks so much for the help guys. I feel much better now.
posted by gtr at 1:48 PM on November 8, 2005

Best answer: So if I leave my job, but remain insured, and then get another job, I can switch to their insurance, and there isn't a problem?

Correct. You can transfer onto a group plan (i.e., an employer's plan) with no regard to preexisting conditions as long as you have had health insurance (whether group or individual) within the previous 63 days.

If you have not had health insurance within the previous 63 days, then the insurer under a group plan has the right to exclude any pre-existing conditions from coverage for a certain period of time (say, 12 months).
posted by scody at 1:52 PM on November 8, 2005

Best answer: Your current employer must, by law, offer to extend your current coverage. This is known as COBRA coverage. You will, of course, have to pay the full cost of this coverage (as opposed to the greatly subsidized or even fully paid benefit you enjoy now).

COBRA coverage is fully creditable, meaning it satisfies the pre-existing condition regulations that your new employer's plan might carry. As long as you pay your premiums until you get a new job, you're fine. Everything the plan covers will be covered, pre-existing or no.

Insurance is for peace of mind, and it sounds like you want it. COBRA coverage is the way to go.
posted by deadfather at 1:55 PM on November 8, 2005

FYI, some plans--especially cheaper plans--exclude what they term as "hazardous pursuits." Normally this is defined as bungee jumping, skydiving, ATVing, &c, but it's not unheard of for this to include hiking above 5,000 meters. Not sure what your plans are, but, you know, caveat emptor.
posted by deadfather at 2:08 PM on November 8, 2005

Definitely get on whatever policy you can. The insurance companies use their bulk buying power to negotiate deep discounts with the medical industry. The uninsured frequently get charged substantially higher rates [1, 2, 3] because the medicial industry has to make up all those discounted services somewhere and the uninsured are the only ones without the group buying power.

Paying 100% of the costs for treatment billed through an insurance plan is likely going to be cheaper than paying 100% of the bill you'd get as a self-payer. Also, you've got a better shot at being to pay it off over time if necessary. Whereas self-payers often are expected to pay upfront for non-emergency care. So even when your policy excludes a pre-existing condition or three, you wind up being better off paying whatever charge the insurer is going to eventually pass over to you than being without insurance at all.

I speak from bitter experience.
posted by nakedcodemonkey at 2:26 PM on November 8, 2005

I'm about to cut my job like a bad habit... and won't have healthcare... Pollomacho mentions that Tonik Health works in Colorado/California... do I have to move to one of those states to get coverage or is their hope for something like that in Jersey. Worth noting... i'm a freelance webdesigner turning pro.... any groups I can join to help subsidize my healthcare?
posted by matimer at 6:18 AM on November 9, 2005

Going without insurance for a period of time

Just don't. As others have said you can buy it yourself, via COBRA or Blue Crosss or another option via HealthInsurance.com or any of a number of independent vendors.

From an earlier post I made on the issue:

I have a friend who's in his 7th year of making payments on a simple appendectomy. At the age he was when he had the problem he could have been insured for as little as $40 a month. Imagine how much a major injury could have amounted up to.

Don't be penny-wise and dollar-foolish. $600 is a small investment to stave off bankruptcy and/or a lifetime or debt.
posted by phearlez at 8:57 AM on November 9, 2005

Forgot to mention - you can pretty much bet COBRA is going to be more expensive than buying it yourself, direct. Don't get sticker shock when you look into that and just write it off completely.
posted by phearlez at 8:58 AM on November 9, 2005

Tonik Insurance by Blue Cross is a great plan, and we love the all inclusive copay for the docs and the ER. My Wife and i purchased the Sound Insurance which is about the same plan by Unicare in Texas.

Tonik covers Colorado, nevada and California, and Unicare sound covers Unicare Texas and Unicare Illinois and I got it at www.NoiseHealth.com from Kathy Harrison a Unicare Agent. Call her it was approved same day, her number is toll free 866-526-9669 she can help with the Sound I am not sure about Tonik since it is not UniCare
posted by jeffcline at 8:01 AM on August 13, 2006