Can I buy health insurance for someone without their cooperation?
January 9, 2015 12:12 PM Subscribe
I have a sister in law who has no health insurance. She is fiercely independent. I can easily afford to pay for health insurance for her. She is refusing to let me. My concern is, if she had a serious health issue, we would be on the hook for paying for her treatment. Not legally, but she is family and we just would pay for her to get good treatment. I want to insure myself against this potentially huge expense even if she doesn't want to. Is there any way to do this?
If you had her SS#, DOB, and job information (salary & W-2 stuff), you could pretend to be her and enroll her in a plan via the health exchange in her state. But you'd have to do it with her address, so she'd catch wind of what you were doing when they start mailing her stuff. And you'd have to keep up with any change of life updates, which is a real pain. If she's really against it, I'd probably drop it. Should a serious health issue develop, you could re-visit the issue then (she might even be eligible for better coverage at that point then you could buy, based on her diagnosis and life circumstances).
posted by ThePinkSuperhero at 12:32 PM on January 9, 2015
posted by ThePinkSuperhero at 12:32 PM on January 9, 2015
If you had her SS#, DOB, and job information (salary & W-2 stuff), you could pretend to be her . . .
Intentions aside, this would probably qualify as identity theft and is most definitely not a good idea.
posted by Flipping_Hades_Terwilliger at 12:37 PM on January 9, 2015 [30 favorites]
Intentions aside, this would probably qualify as identity theft and is most definitely not a good idea.
posted by Flipping_Hades_Terwilliger at 12:37 PM on January 9, 2015 [30 favorites]
Have you told her that you are not, under any circumstances, helping her pay medical expenses if she does not have insurance?
Because really, relying on family to help isn't very independent; nor is filing for bankruptcy. Does she understand how insurance works?
It's not a bail out...it's a poker game.
Set your own boundaries and stick to them. What does her husband say?
posted by jrobin276 at 12:42 PM on January 9, 2015 [16 favorites]
Because really, relying on family to help isn't very independent; nor is filing for bankruptcy. Does she understand how insurance works?
It's not a bail out...it's a poker game.
Set your own boundaries and stick to them. What does her husband say?
posted by jrobin276 at 12:42 PM on January 9, 2015 [16 favorites]
I have very little idea of how health insurance works, so take this with a grain of salt, but; is there a way you could invest whatever money you'd spend on the insurance and get some kind of return, entirely by and for yourself, that you could then use to pay for whatever treatment she might need?
That said, it seems to me that since you've asked if this is OK and she's said no, that you should respect that. What you want to do is indeed extremely generous, but if she, for whatever reason, has said not to do it, then it seems wrong to force her into this situation. Whether or not you agree with her boundaries, you need to respect them. You're involving yourself in this situation, albeit with good intentions, and not listening to what she's saying.
posted by Solomon at 12:42 PM on January 9, 2015
That said, it seems to me that since you've asked if this is OK and she's said no, that you should respect that. What you want to do is indeed extremely generous, but if she, for whatever reason, has said not to do it, then it seems wrong to force her into this situation. Whether or not you agree with her boundaries, you need to respect them. You're involving yourself in this situation, albeit with good intentions, and not listening to what she's saying.
posted by Solomon at 12:42 PM on January 9, 2015
Put yourself in her shoes.
This sounds like a boundary that she's drawn for herself that you're not acknowledging. " She is refusing to let me. "
Let your sister in law be an adult about this, and you can be an adult about this as well - while at the same time acknowledging good intentions about this. You're not legally on the hook for anything.
posted by msamye at 12:42 PM on January 9, 2015 [6 favorites]
This sounds like a boundary that she's drawn for herself that you're not acknowledging. " She is refusing to let me. "
Let your sister in law be an adult about this, and you can be an adult about this as well - while at the same time acknowledging good intentions about this. You're not legally on the hook for anything.
posted by msamye at 12:42 PM on January 9, 2015 [6 favorites]
I may be off base here, but your description of her as "fiercely independent" implies that there may be a history of you or other family members trying to do things for her based on your perception of what she wants or needs. In that case, I could understand her resistance. If that is the situation, you need to approach this delicately, first by apologizing for any attempts to overstep boundaries in the past, and only then by raising this question: If something were to seriously go wrong with her health, who would she want to pay for her care? You and the rest of her family, even though it might beggar you? Or the doctors and other medical professionals who would care for her, even though they would pass on the costs to their other patients, thereby raising everyone else's costs? Note that in the latter case, her options for care would be limited and she might not get the treatment required to save her life or to preserve her quality of life.
If you are in the United States of America, you might point out that the penalty for not having insurance increases this year and next, unless she meets one of a small number of criteria for exemption.
You could propose to her that you pay only for a high-deductible plan or for catastrophic health coverage. That would protect you from huge expenses should she get cancer, have a heart attack, or suffer some other serious illness.
Unless she is seriously prepared to die or to be disabled due to a medically preventable or treatable condition, and she knows that she would stick with that conviction should she in fact be injured or taken ill, she is being selfish by not accepting your offer. (Personally, I think that industrialized states should provide universal medical care for their citizens and permanent residents, but if you're in the US or another country whose insurance for non-retired adults is primarily through the private insurance marketplace, anyone who can afford insurance but chooses not to buy it is being a freeloader.)
posted by brianogilvie at 1:12 PM on January 9, 2015 [6 favorites]
If you are in the United States of America, you might point out that the penalty for not having insurance increases this year and next, unless she meets one of a small number of criteria for exemption.
You could propose to her that you pay only for a high-deductible plan or for catastrophic health coverage. That would protect you from huge expenses should she get cancer, have a heart attack, or suffer some other serious illness.
Unless she is seriously prepared to die or to be disabled due to a medically preventable or treatable condition, and she knows that she would stick with that conviction should she in fact be injured or taken ill, she is being selfish by not accepting your offer. (Personally, I think that industrialized states should provide universal medical care for their citizens and permanent residents, but if you're in the US or another country whose insurance for non-retired adults is primarily through the private insurance marketplace, anyone who can afford insurance but chooses not to buy it is being a freeloader.)
posted by brianogilvie at 1:12 PM on January 9, 2015 [6 favorites]
You could go the self-insure-for-someone-else route.
What you can do is figure out approximately how much you'd be paying for her monthly premium ($200-300?) and put it into a low-risk mutual fund or high-yield savings account. You'd then use this money for her health costs if she needs it. If you have an accountant or financial advisor you could also get their thoughts on the best place to put this money (relatively liquid, but hopefully earning at least some money too).
The advantages of this are multiple:
1. If she never needs the money, you can use it for whatever YOU need. Downpayment on a house, retirement, your own unexpected costs.
2. If an unexpected emergency event occurs of your own, you can use the money.
3. You don't need her permission to do this. In fact, I wouldn't even tell her about it in case you do end up needing to use it for your own purposes.
The disadvantage of this, of course, is that she doesn't have health insurance and if something incredibly major were to happen your fund may not be enough to cover it.
However, she's an adult. Legal issues aside, I don't think it's in your place to do anything beyond expressing concern and offering encouragement, or even practical help but only if she asks for it (researching plans, finding room in her budget with her).
The thing to remember about this is that you MUST put on your proverbial oxygen mask first. Make sure you have enough in your own emergency fund, are saving plenty for your own retirement, are meeting your own savings goals first (house/vacation/etc). And if you have any debt (consumer, education, mortgage) - that is your first priority over anything.
posted by Uncle Glendinning at 1:13 PM on January 9, 2015 [13 favorites]
What you can do is figure out approximately how much you'd be paying for her monthly premium ($200-300?) and put it into a low-risk mutual fund or high-yield savings account. You'd then use this money for her health costs if she needs it. If you have an accountant or financial advisor you could also get their thoughts on the best place to put this money (relatively liquid, but hopefully earning at least some money too).
The advantages of this are multiple:
1. If she never needs the money, you can use it for whatever YOU need. Downpayment on a house, retirement, your own unexpected costs.
2. If an unexpected emergency event occurs of your own, you can use the money.
3. You don't need her permission to do this. In fact, I wouldn't even tell her about it in case you do end up needing to use it for your own purposes.
The disadvantage of this, of course, is that she doesn't have health insurance and if something incredibly major were to happen your fund may not be enough to cover it.
However, she's an adult. Legal issues aside, I don't think it's in your place to do anything beyond expressing concern and offering encouragement, or even practical help but only if she asks for it (researching plans, finding room in her budget with her).
The thing to remember about this is that you MUST put on your proverbial oxygen mask first. Make sure you have enough in your own emergency fund, are saving plenty for your own retirement, are meeting your own savings goals first (house/vacation/etc). And if you have any debt (consumer, education, mortgage) - that is your first priority over anything.
posted by Uncle Glendinning at 1:13 PM on January 9, 2015 [13 favorites]
People have the right to go to hell in their own handbasket. Tell your spouse and his sister that if it ever comes about that she needs to avail herself of medical services that you are NOT okay with using your family's money to do so. Then back off and don't talk about it again.
There are only a few more days left in open enrollment, she better get on there and get some damn insurance or else she's being a scofflaw.
posted by Ruthless Bunny at 1:13 PM on January 9, 2015 [9 favorites]
There are only a few more days left in open enrollment, she better get on there and get some damn insurance or else she's being a scofflaw.
posted by Ruthless Bunny at 1:13 PM on January 9, 2015 [9 favorites]
You can't really make an adult do things the way you want them to if the adult does not want to. You can't really enroll her in health insurance without her cooperation. If you really are perfectly happy paying her monthly premium and want to assist financially in the event she has a significant medical event while uninsured, you could pay the monthly premium into a savings account for that purpose. She won't have the benefit of lower negotiated costs, but you might feel more secure in your ability to assist, as well as your ability to draw a line where you won't assist financially any further, but, frankly, I don't think that's necessary (for the reason above, that you need to cover your own needs first).
She's an adult and if she understands the risk she is taking, all you can do is express concern, make your offer to help now, and explain how little you will be able to help if she has a major medical event while uninsured.
posted by crush-onastick at 1:15 PM on January 9, 2015
She's an adult and if she understands the risk she is taking, all you can do is express concern, make your offer to help now, and explain how little you will be able to help if she has a major medical event while uninsured.
posted by crush-onastick at 1:15 PM on January 9, 2015
When you say that she is ferociously independent, what exactly do you mean?
From what you have said about expecting to be on the hook financially if she has a problem, one can infer that she is not a very wealthy person who can afford to pay out of pocket for whatever she wants or needs and therefore sees no point to the financial hedge that "health insurance" is supposed to be.
But is she someone who has decided that whatever the gods or fates have in store for her health is fine by her, and has declared herself a "palliative care / pain relief only" patient as well as a "do not resuscitate"? (Palliative care is not free, but it is much, much cheaper than what passes colloquially as "health care" for the very sick, disabled or aged.)
Or is she someone who just doesn't give a damn, and -- protests of independence aside -- not so deep down secretly inside is perfectly comfortable with the notion that family or the taxpayer will step in if she develops a problem and cannot pay for her own care?
On the other hand, it may be possible that she has done some kind of a cost / benefit analysis of the plans available to her in her area. In my neck of the woods, the plans available on the exchanges cost in a range of $600 to $800 dollars a month and have annual deductibles >$6,000 per year attached with the result that the out of pocket before benefits kick in is challenging for all but the very upper middle and upper classes. Adding insult to injury, these plans reimburse service providers at rates comparable to those of Medicaid; subsequently it is very difficult to find doctors who will take patients with them (or Medicaid). Given this, a reasonable person could conclude that the plans aren't worth the paper they are printed on and take a pass.
That all having been said, she is an adult, and as such, has the right -- and the obligation -- to make decisions for herself. But -- and this is the somewhat un-American part -- she also has the privilege and the obligation to suffer the consequences of the decisions she makes. And this includes the crappy, even more sub-par care one gets as a poor person relying on Medicaid.
P.S.: that idea about using her SSN and personal information to sign her up yourself: this is a profoundly bad idea. Impersonating someone else = identity theft = a felony, and you could be prosecuted. (IANAL / IANYL)
posted by cool breeze at 1:26 PM on January 9, 2015 [2 favorites]
From what you have said about expecting to be on the hook financially if she has a problem, one can infer that she is not a very wealthy person who can afford to pay out of pocket for whatever she wants or needs and therefore sees no point to the financial hedge that "health insurance" is supposed to be.
But is she someone who has decided that whatever the gods or fates have in store for her health is fine by her, and has declared herself a "palliative care / pain relief only" patient as well as a "do not resuscitate"? (Palliative care is not free, but it is much, much cheaper than what passes colloquially as "health care" for the very sick, disabled or aged.)
Or is she someone who just doesn't give a damn, and -- protests of independence aside -- not so deep down secretly inside is perfectly comfortable with the notion that family or the taxpayer will step in if she develops a problem and cannot pay for her own care?
On the other hand, it may be possible that she has done some kind of a cost / benefit analysis of the plans available to her in her area. In my neck of the woods, the plans available on the exchanges cost in a range of $600 to $800 dollars a month and have annual deductibles >$6,000 per year attached with the result that the out of pocket before benefits kick in is challenging for all but the very upper middle and upper classes. Adding insult to injury, these plans reimburse service providers at rates comparable to those of Medicaid; subsequently it is very difficult to find doctors who will take patients with them (or Medicaid). Given this, a reasonable person could conclude that the plans aren't worth the paper they are printed on and take a pass.
That all having been said, she is an adult, and as such, has the right -- and the obligation -- to make decisions for herself. But -- and this is the somewhat un-American part -- she also has the privilege and the obligation to suffer the consequences of the decisions she makes. And this includes the crappy, even more sub-par care one gets as a poor person relying on Medicaid.
P.S.: that idea about using her SSN and personal information to sign her up yourself: this is a profoundly bad idea. Impersonating someone else = identity theft = a felony, and you could be prosecuted. (IANAL / IANYL)
posted by cool breeze at 1:26 PM on January 9, 2015 [2 favorites]
The problem with a self-insurance account is that in the u.s.a medical costs become astronomical very quickly. What seems like a routine procedure can easily come to multiple $10s of thousands. A significant illness, e.g., cancer, multiple $100s of thousands. So prob not a good idea unless you are a good fraction of Bill Gates, in which case you could pay it out of pocket anyway.
posted by Kevin S at 1:33 PM on January 9, 2015 [2 favorites]
posted by Kevin S at 1:33 PM on January 9, 2015 [2 favorites]
I want to insure myself against this potentially huge expense even if she doesn't want to. Is there any way to do this?
Probably not.
I worked in insurance and I have a certificate from a technical college that my former employer paid for that entitles me to some spiffy title like "life and health insurance specialist." In order to purchase insurance on someone else, you need to have an insurable interest in them. That means you need some reason other than "I personally feel like it" -- a reason that society deems legal and above board and so on. The reason for this is because they don't want people, say, taking out life insurance on random strangers and then, oopsy, seeing to it that said random strange has a deadly accident so they can cash in. Your expectation that you would pay for it if she needed something because she's family does not give you the requisite legally required insurable interest.
What you can do is try to either convince your sister that it would be kinder for her to enroll and let you pay the bill so as to avoid a scenario where she is stuck with a big medical bill and you feel compelled to come to the rescue. Alternately, you can try to manipulate her or force the issue by taking the position that "I am willing to pay for insurance for you, but do not come crying to me if you get a big medical bill while uninsured because I won't pay it. You can take what I am offering or nothing. Your call."
posted by Michele in California at 2:11 PM on January 9, 2015 [1 favorite]
Probably not.
I worked in insurance and I have a certificate from a technical college that my former employer paid for that entitles me to some spiffy title like "life and health insurance specialist." In order to purchase insurance on someone else, you need to have an insurable interest in them. That means you need some reason other than "I personally feel like it" -- a reason that society deems legal and above board and so on. The reason for this is because they don't want people, say, taking out life insurance on random strangers and then, oopsy, seeing to it that said random strange has a deadly accident so they can cash in. Your expectation that you would pay for it if she needed something because she's family does not give you the requisite legally required insurable interest.
What you can do is try to either convince your sister that it would be kinder for her to enroll and let you pay the bill so as to avoid a scenario where she is stuck with a big medical bill and you feel compelled to come to the rescue. Alternately, you can try to manipulate her or force the issue by taking the position that "I am willing to pay for insurance for you, but do not come crying to me if you get a big medical bill while uninsured because I won't pay it. You can take what I am offering or nothing. Your call."
If you had her SS#, DOB, and job information (salary & W-2 stuff), you could pretend to be her . . .It might also qualify as insurance fraud. And since insurance companies lose big bucks to fraud, they sometimes have in-house fraud investigators whose sole job it is to track down people doing illegal things and try to get the money back and also sometimes get them put in jail.
Intentions aside, this would probably qualify as identity theft and is most definitely not a good idea.
posted by Michele in California at 2:11 PM on January 9, 2015 [1 favorite]
Can I buy health insurance for someone without their cooperation?
No.
The question now is: Are you on the hook for paying her penalty for not having health insurance? It's going to be over $300 next year, and nearly $700 the next. Does she qualify for Medicaid? Does she know that with health insurance now she can see a doctor for free if it's preventative, and that includes reproductive health?
posted by General Malaise at 3:11 PM on January 9, 2015
No.
The question now is: Are you on the hook for paying her penalty for not having health insurance? It's going to be over $300 next year, and nearly $700 the next. Does she qualify for Medicaid? Does she know that with health insurance now she can see a doctor for free if it's preventative, and that includes reproductive health?
posted by General Malaise at 3:11 PM on January 9, 2015
Not without her cooperation, no. I can't even comprehend how that would work. Can you try having the conversation with her that you'll end up paying for her health anyway if something goes wrong, so you might as well do it the easy way?
posted by jenfullmoon at 8:15 PM on January 9, 2015 [1 favorite]
posted by jenfullmoon at 8:15 PM on January 9, 2015 [1 favorite]
Just putting this out there: is it possible that she's an undocumented immigrant? Perhaps she truly is "fiercely independent" but perhaps there's something else you don't know about. (If this is these case, it's unlikely she'll admit it, at least right now under pressure.) Unfortunately, there's not much you or she can do if that's the case: I have heard some hospitals have funds for folks without documentation but often even free clinics require proof of identification and residency. Along those lines, even DACA recipients are technically eligible for insurance through work but ineligible for insurance through the Affordable Care Act. (Grr!)
In any case, I feel for your frustration and wish you luck. Perhaps calling local hospitals and health-related non-profits and asking how they deal with uninsured patients could help. Dental hygiene schools at community college often offer free or low-cost teeth cleaning, and HIV/AIDS outreach programs often supply testing and treatment free-of-charge to people who can't afford it. If worse comes to worst and she's stuck with a giant medical bill (in her name), you could help her pay it off little by little rather than worry about one giant payment.
posted by smorgasbord at 9:39 PM on January 9, 2015 [1 favorite]
In any case, I feel for your frustration and wish you luck. Perhaps calling local hospitals and health-related non-profits and asking how they deal with uninsured patients could help. Dental hygiene schools at community college often offer free or low-cost teeth cleaning, and HIV/AIDS outreach programs often supply testing and treatment free-of-charge to people who can't afford it. If worse comes to worst and she's stuck with a giant medical bill (in her name), you could help her pay it off little by little rather than worry about one giant payment.
posted by smorgasbord at 9:39 PM on January 9, 2015 [1 favorite]
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posted by JanetLand at 12:21 PM on January 9, 2015