Dealing with the no-health-insurance lifestyle?

January 7, 2007 11:21 AM

Have any tips for living (in the US) without health insurance?

I'm 25, reasonably healthy, don't do anything particularly risky, and I don't have any health insurance. Does anyone have any tips for the health-insurance-less? For those with very limited resources, what's the best way to spend health care money, or get free or low-cost care that isn't awful? Is there care I absolutely need to get regularly?

If it matters, I live in LA, and my income is below $15K/yr.

posted by YoungAmerican to health & fitness (25 comments total)

Brush and floss daily. You can't afford dental problems, but they can be avoided, mostly, with regular care.
posted by SPrintF at 11:24 AM on January 7, 2007

Get a high deductible heath plan. It covers against stuff like breaking your back, or getting cancer, but not much else. It's reasonably cheap as well. Call an insurance agent, and see how cheap they can get it.

Even though you don't make much money, I'm sure you could scrape up $10k in sympathy cash if need be (it helps if you're part crippled as well).

Assuming you have tons of free time, free clinics are everywhere, and are well, free. That can cover most of the regular expenses.

Answering the not asked question: can you increase your income any? 15k works out to about $7/hr at 40hrs/week. You most likely can do better if you look a bit, even a $1/hr bump works out to $2000 over a year, which would be more than enough to cover the heath insurance, plus get an emergency fund going to cover deductibles and other health emergencies.
posted by cschneid at 11:26 AM on January 7, 2007

When I didn't have health insurance through my work I got a temp plan from Blue Cross-Blue Shield. It was pretty inexpensive and it would prevent me from being totally brankrupt of I got hit by a car or something.

If you're sexually active, STD tests at Planned Parenthood can save you a lot of money and grief in the long run.
posted by christinetheslp at 11:36 AM on January 7, 2007

I didn't have health insurance from birth till age 28. (Except for in college, when I assume I had whatever insurance they force you to have -- I'm not sure, 'cause I never used it.) From 28 to 30 I was covered fully through a job and didn't have occasion to use it. Since age 30 I've had major medical ($150/month)... and haven't used it. I pay out-of-pocket for dental and eye care (not too expensive because I haven't required more than teeth cleaning and contacts updates), and I use Planned Parenthood for reproductive health.

In all this time, I've never been ill to the point of needing a prescription or hospital care. All rashes have gone away on their own. The one physical problem I had (car hit me while I was crossing the street while gawking at Christian Slater) required a $700 x-ray (but nothing turned out to have been broken). So, if you're healthy and lucky, you can get by fine. But, had that accident been more damaging, I would have been screwed. Therefore, my health tip for you, especially because you live in LA, is: do not get distracted by B-list celebrities while crossing busy streets.
posted by xo at 11:41 AM on January 7, 2007 [1 favorite]

Look into MediCal. I think you make little enough to qualify.

Also, don't drive if you can help it. I am uninsured for a year and I thought all was hunky-dory. Healthy, 25, like you. I even got my Xanax refills set up to continue after my medical coverage expired (graduating college). The came a drunk driving 19 year old in a rental car at 105 mph. We rolled twice but no major medical problems. If there were any, I would really rather have had the medical insurance. I learned in hard demonstrable fact that there are variables in the health equation.
posted by Ambrosia Voyeur at 12:10 PM on January 7, 2007

cschneid - What do you mean 'sympathy cash'?
posted by crabintheocean at 12:19 PM on January 7, 2007

Are you a college student? Many colleges have health clinics that are available, and many of these clinics will treat not-insignificant issues. The Cal State system, for example. I had broken bones set and cast at the health clinics.
posted by frogan at 12:28 PM on January 7, 2007

sympathy cash - money and/or fundraisers that friends/families/gas station attendants do for sick/crippled people.
One of my acquaintances became a paraplegic from an accident, and we all chipped in a bunch of cash to help with the medical bills and expenses. It's great for the short-term bills, but if you acquire a long-term illness or have lasting effects from an accident, the money won't last long.
See if you can find a high-deductible plan or if you qualify for a low-income state plan.
posted by j at 12:32 PM on January 7, 2007

Schneid -- unfortunately, my long-term career requires me to work a lot for free for a long time, so I while I do make a decent wage when I work for pay, I'm mostly working for free.
posted by YoungAmerican at 12:42 PM on January 7, 2007

Oh, and Abrosia, unfortunately, you have to be either elderly or under 21 to qualify for MediCal if you have no kids.
posted by YoungAmerican at 12:57 PM on January 7, 2007

Do you have doctor and dentist who know about your lack of insurance and will charge you accordingly. Ironically, healthcare for me was cheaper when I didnt have insurance. My doctor would give me a deal and be thrifty with me. Now that I have insurance all that is thrown out the window and what my insurer doesnt pay is a lot more than what I used to pay. Go figure.

You should be looking at catastrophic health insurance or honestly at your income level public-aid and public healthcare. You should be able to get your state's equivalant of food stamps and qualify for some kind of low-income health services. Other than that its the age old advice of eating well ,sleeping well, and getting exercise.
posted by damn dirty ape at 12:59 PM on January 7, 2007

As I have before, I'll again recommend temporary, catastrophic, high deductible insurance. I have it through Assurant, and it's $45 a month. You can only have it for a year or so before you'll have to find another provider. At least you'll be covered if you're in a car wreck or get some horrible illness.
posted by schoolgirl report at 1:10 PM on January 7, 2007

Another vote here for high-deductible insurance. I've got an Assurant plan as well, and I can afford it with my sub-$15K income. I don't live in LA, though.
posted by pullayup at 1:16 PM on January 7, 2007

Contact your nearest county hospital and apply for their Medically Indigent Adult coverage. While the coverage isn't as complete as MediCal's, it does cover major expenses and is available at no cost to all low income Californians (regardless of whether you're a parent).

Dental and vision insurance can be had for $5-15 each per month and a 25 year old should be able to purchase good medical coverage for around $100 or less per month.
posted by buggzzee23 at 1:18 PM on January 7, 2007

California Specific
posted by Xurando at 2:00 PM on January 7, 2007

I'm about to make myself very unpopular, but honestly, if I were you I wouldn't worry about it. I didn't have health insurance for years and years and when the crunch came the state stepped in. If you're poor enough, and you are, then if you get hit by a car they'll pay for it; they aren't going to refuse to treat you because you don't have insurance. Or you can just walk away. You're young enough to walk away and never pay for the hospital bills and eventually they will go away. Actually, in more enlightened states, unpaid hospital bills won't even go on your credit rating. I know this because I have done it. If you get sick enough to go to the doctor, find a free/sliding scale clinic. Expect to be there, miserable, all day: usually you have to show up at like 8:00 am and they'll see you when they see you. But they exist, particularly in cities, call Social Services or look in the yellow pages and find out where the nearest one is in case you ever need it. Expect to be treated like crap; just put up with it.

Try to stay healthy for now and eventually hope you get a job that has health insurance if the whole system hasn't crashed and burned by then. In the meantime hope for the best. Sure, you can rant and rave at me about how this is what's driving insurance rates & medical bills & so on up through the roof, but honestly if you're making 15K a year, as I have done in my life, and as YoungAmerican is doing now, than buying health insurance is a waste of desperately needed money.
posted by mygothlaundry at 2:00 PM on January 7, 2007

I had high deductible, and never used it. My friends (a couple) had a high deductible and are extremely happy they got it, with a tonsilectomy and a torn ACL repair, they needed it (we are all in your age group). It's worth the extra couple of bucks a month. Also worth it: starting a small emergency fund for yourself. It doesn't have to be a huge contribution, but a couple of bucks a week could really assist you later on.
Tell any medical professional you see that you have no health insurance or high deductible insurance, and they will almost always cut your costs, or at least not give you superfluous tests. However, this has a negative effect, as sometimes they will deny that you need something when you really do. Keep informed about your health status, and certainly, find some nursing students or nurses (like myself) and be friends with them. We can be great sources of information and advocate for you.
posted by nursegracer at 2:06 PM on January 7, 2007

In our state (not CA), if you have to go to the hospital and are flat broke, the hospital sends someone to your room to fill out the papers to get you on some kind of welfare for the duration, and you would never see a bill. The county has an STD clinic most places, if you don't have Planned Parenthood handy, and they will cheerfully take care of you from the navel to the knees. As nursegracer points out, nurses are great. They'll tell you if you're going to die or not, or whether they make something from the drugstore you could try on it first.
posted by unrepentanthippie at 3:53 PM on January 7, 2007

If you earn a good salary when you do work and - presumably - that's towards a prospect where you'll make good money in the future then it's all the more important you find the money for catastrophic care insurance.

Someone who has nothing and never will can always just be indigent. They can send collectors after you that you laugh at, tell them you're judgment (sorry XMLicious and Eide) proof and hang up on. Or there's bankruptcy. But if you have prospects for future earnings you don't want someone after you for medical costs.

I have a friend who spent the better part of a decade paying off the costs of an appendix removal, and if you want to see what a modern version of a sisyphian task looks like, check out how long you'll be paying off a $15,000 bill at 14% interest with minimum payments. Your priorities should be food, housing, catastrophic care insurance, in that order.
posted by phearlez at 7:22 PM on January 7, 2007

I haven't had health insurance in years, and I had a pretty bad bike accident a few years back, but I gave a false social security number when I went to the hospital, and I haven't received a phone call or anything since. They knew I had no intention of paying them, and the care I received reflected that, but I'm in one piece now, and everything's a-ok. I wouldn't worry about it. You'll get health insurance eventually, and most employers aren't even giving dental or eye care anymore anyway because it's too expensive for them. My dentist says getting your own dental insurance is a total scam unless you knock all your teeth out or have really crappy teeth that need replacing anyway.
posted by bash at 7:47 PM on January 7, 2007

As evidenced by the comment above (bash), mine is going to be a pretty unpopular comment -- but it's heartfelt, and intended to answer your question.

I live in LA. And I am the "they" everyone seems to be talking about. (As in, "don't worry, they'll pay for it.") If, God forbid, you get cancer, or get hit by a bus, or break your neck doing something goofy, I'm going to end up paying for it when they airlift you to USC. There's no such thing as "free" health care in the US. Just because it's free for you doesn't mean others don't pay for it via higher taxes, insurance rates, and medical costs.

If you qualify for MediCal or welfare -- fine. That's what they're there for. But if you would just rather save the money and eat out once in a while, or buy an ipod, or whatever, then...

Please:

- get Blue Shield catastrophic coverage. It's cheap. I had it when I was 25, and making less than 15K. (Not that long ago, so no whining about today's dollars.) Make it up on the back end by getting the cheap "lifeline" phone service, eating ramen, and taking the bus.

- If you do drive, get car insurance. If you run a red light and smash into me, everyone in my neighborhood will pay for your shiny new prosthetic leg -- while I have to sue your parents for mine.
posted by turducken at 10:10 PM on January 7, 2007

Things have changed. There is no more help from the government, unless you have children.

When I had no health insurance for 20 years, I was lucky that there was still government money. Still, I paid off a few ER visits at US$5/month for years.

I second SPrintF's suggestion of brushing and flossing. I'd have lost my teeth by now if I didn't now have insurance.

Find health care providers you can bargain with, who will work with you, for when you really, really can't ignore a problem any longer. This will be always cheaper than paying off the ER.

Find out your legal rights, if any. I was without insurance mostly in Massachusetts, where they couldn't send you to collection if you were paying at least a few bucks a month on medical debts. If CA has similar laws, you need to know before you get ill.

Find the free clinics now. Most of them suck. Some don't. You won't have time to figure out which is which when you are running a 104 F fever and coughing up blood.

Living without health insurance is an odd kind of balance, where you need to avoid the huge medical bills you get from the ER but can't afford the cheaper care that keep you out of the ER. At first, I ignored everything until it got to ER level. Later, I just went to the ER before I got really sick when I couldn't afford the preventive care. This annoys ER staff, but they are also used to it. But, now the government won't help you even with ER bills.

I'd ask this question at your local public library, and see what local resources they know about.
posted by QIbHom at 5:07 AM on January 8, 2007

I had no health insurance throughout my 20's. I was healthy and lucky. When I needed a scrip, I'd go to a doc-in-the-box, those walk-in private clinics - and Planned Parenthood covered the girl stuff.

The one time in all those years that the situation was something Serious, the doc-in-the-box referred me to the county ER. The hospital treated me, and I set up a payment plan with them.

There's a lot of gray area between "fully insured" and "freeloading." One doesn't have to be insured to receive medical care, but neither does everyone without insurance automatically plan to fraudulently rip off the system.

One thing that I did on more than one occasion to receive free health care: I lived in a big metro area with teaching hospitals and lots of pharma studies. By looking carefully and often, I could almost always find some sort of research study that would require a full health screening. So if you got through preliminary qualification, then you could score a full physical check-up -- bloodwork, the whole bit.
posted by pineapple at 12:41 PM on January 8, 2007

Things have changed. There is no more help from the government, unless you have children.

California covers childless, low income people. A friend of mine in that category just got MIA coverage in San Bernardino County and she is scheduled for surgery to correct carpal tunnel syndrome next week.
posted by buggzzee23 at 3:03 PM on January 8, 2007

Turducken -- I have car insurance that includes medical coverage.
posted by YoungAmerican at 5:04 PM on January 8, 2007