DUers, what is your health insurance situation?

Are you lucky enough to be covered through work, or are you one of these people Michael Moore is talking about and are playing Russian roulette with your health, so to speak.

If you're not covered, explain why and whether you're worried sick that one trip to the hospital could bankrupt you or something drastic like that.


On edit -- (to help others) -- If you pay for an individual plan, would you recommend your insurance company?

and have been for 20 years.

and getting group coverage as a student.

:hug:

I'm covered by my employer and don't pay a red cent for it. :woohoo:

Husband is covered under his employer and we pay about $100 a month for family coverage.

Thank God we have it. His surgery topped out at over $500,000.

:hug:

but they've really upped the co-pays lately. Still, I realize how fortunate I am in comparison.

Thru Unicare, a PPO plan. I'm a contract worker so when I work at hospitals I don't qualify for their health insurance. Ironic thing is, the hospital itself owns the staffing agency I work for and they still don't give the nurses any health insurance!

Office visits: $30 for the first 4 visits/year
Generic meds $10, brand $20
Annual deductible for hospital stay $2000, then it's 80%/20%

Probably not as good as some insurance plans but I really just wanted one that would keep me from having too huge of a hospital bill if I am ever admitted. I am lucky enough (so far) to not have any chronic/acute health problems so I go to the doc maybe once a year.
For the longest time I went without insurance and just went up to Primacare for any doctor visit I needed (usually an annual sinus/resp infection). Much ea$ier to pay for that one visit for $100 than cough up a monthly premium that seemed like a waste of $$ to me since I never had to go to the doc more than once/year.
But after working in a hospital setting you start to realize how quickly you can end up in the hospital with a huge bill so I decided to get get some sort of basic coverage.

Still... medical bills are HUGH!!!1 despite insurance

We could afford it but he had a heart attack at age 44 seven years ago. His insurance left the state and NO ONE will cover him at any price and he is a family physician.

if you work for him (or he has another employee) you can purchase guaranteed issue group health insurance.

you have got to put this out somewhere--let michael moore know about this one since he is doing all the talk shows--this is irony beyond irony.

i never thought of such a circumstance--but i guess it makes sense the way these insurance companies are operating and denying coverage to people.

but the fact that he is a care giver and could be refused care is like the cherry on the cake of this whole mess.

this could definitely be a national human interest story

If I understand correctly, Warpy is an RN, and she couldn't/can't get insurance. The American healthcare insurance business is pro-death. The only pro-life position is to go to single-payer, universal healthcare, and take medical insurance cos. out of the equation.

I was recently laid off with zero severance.
My COBRA notice shows my health insurance premium at $1157/m for a family of 3!!!

I had my kids on the Michigan health plan for kids at
one time and the coverage was better than any plan I've
ever PAID for.

Check it out ASAP. For your kid's sake.

:)

for a single guy in his 20's with nothing at all in my medical history. I didn't have health insurance for 3 years, but I didn't need it anyway.

It's pretty good and I'm happy. For medical/dental/vision I pay about $19/week.

My employer pays it all.

I didn't see that choice.

:thumbsup:

are uninsured! :cry:


One out of three people do not have health insurance.

This is outrageous!

I'm sure there are more now since the number has been growing.

and secondary complications.

If we split, I'm as good as dead.

as long as I don't get married again, I'll have health benefits.

:sarcasm:

but the difference between the birth of Child #1 and Child #2 will make you sick: $200.00 co-pay in 2001, $2,500.00 co-pay in 2005.

Unemployed, SO was canned a year ago from his job thru which I had insurance, have to take several prescription drugs for chronic conditions. I've switched to Costco for my scrips.

No insurance, no pension, living on savings. Both of us.

:cry:

When I'm laid off I'm fucked.

Hey, what could happen!?

I may qualify for state coverage because I'm unemployed. I hope so!
If a person qualifies in MA, they don't have to pay.

--------------------

The Mass. Mandated Health Insurance Law

http://www.lawlib.state.ma.us/healthinsurance.html

An Act Providing Access to Affordable, Quality, Accountable Health Care, St. 2006, c.58.
The New Health Insurance Law. Key provisions of the law include subsidized health insurance
for residents earning less than 300% of the Federal Poverty Level, and low-cost insurance
for all other residents who are not eligible for insurance through their employers.
As of July 1, 2007 all residents will be required to maintain health insurance.

More details are available in:

* Health Care Access and Affordibility Conference Committee Report Summary
* Conference Committee Report Section-by-Section Summary
* Conference Committee's Joint Caucus for House Members April 3, 2006 Prensentation.

Web Resources on the Mandated Insurance Law

Commonwealth Connector. Despite the vague name, this is the state agency managing mandatory health insurance.'

The two basic programs are Commonwealth Care, for lower income residents, and Commonwealth Choice, which will
offer private sector alternatives for those who don't qualify for low-income insurance.

1-877-MA-ENROLL (1-877-623-6765)

I am lucky enough to have my family covered through my workplace's policy, which costs me $768. per month. The policy has no yearly deductible to satisfy this year, or stop loss, it pays 70%. This might be good for healthy people, but my husband had a severe accident two years ago which left him paralyzed, and many, many complications that have required many hospital stays and surgeries. So even with the insurance, without counting the premium payments, I am slowly sinking with the extra 8k to 10k per year in medical bills. And, I feel so lucky to have insurance! I'm not being sarcastic, after seeing SICKO, I am sure I couldn't get my husband insured otherwise.

he might want to apply for SSDI (disability). Regardless of income, you get medicare 2 years from the date of disability -- which should significantly help.

Thanks, but, I make too much money for him to get SSDI, which is so fucked up because I can only take home $800. per month (1k gross) for him to qualify, and so after paying insurance premium, would net me $30. per month if I didn't work! The system is broken. I hope people wake up in this country, and MM is my hero for spreading the message.

you could be making 1,000,000 a year and still get Social Security Disability Insurance (SSDI).

You would not be eligible for SSI(Supplemental Security Insurance) which is probably where the confusion came about. He would not be eligible for Medicaid, but 2 years after date of disability he would be eligible for Medicare.

The University that I am transferring to covers all students that don't otherwise have health insurance. I think that's kinda cool.

but we pay $600 a month for it for just the two of us. There are still deductibles to meet and so on. The good thing is that they pay for a yearly physical for each of us in San Francisco, and fly us out for free, so that's when we take our Outside vacations.

a lot of people don't realize is that is only PART of the story!

If you've never had to be hospitalized, or experienced a serious illness, you don't realize how HIGH those copays & your 20% of that 80%/20% coverage really can get!

I broke my leg last Sept. It's the first time I ever used my health ins. except for the occasional Dr. visit ince every 2-3 years or so. I didn't think the $25 copay was any big deal, and I was satisfied with the status quo. WELL! There was the $100 emergency room copay, and my annual deductible of $250, the copays for all the Drs, and xray techs etc, to tell me I HAD a broken leg. Two days later, I was admitted to the hosp. for surgery to set the compound fracture and put the cast on. My 20% of the bill was $1,780 PLUS an individual bill from all the attending med. people. Then there was a visit each month to the surgeon for xrays to make sure it was healing OK ($40 copays each visit because he's a specialist!) THEN, in Dec. the Dr. said he wanted to remove one of the pins because it was working it's way out and would cause serious problems in the future. Of course he scheduled it for Jan. which is a new year, so I had to start over again with the initial annual deductible of $250, + $100 to do it as an outpatient, and my portion of the Drs charge was $900.

Every time I went to the mailbox I received another bill related to this one incident!

I sure now know why people have to end up decaliring bankruptcy for medical expenses, and THEY HAD INSURANCE!!!!

"insured" doesn't mean what we'd all like to believe it means. I actually paid less for health care when I was uninsured! I was able to get free care at the hospital ad qualified for state sponsored insurance - never paid a dime for anything.

Now that we've got on our feet better and have insurance, we pay a lot more - $400/month for the plan, another couple hundred for dental, $5 copays for reg dr visits, $25 for ER, anywhere from $3-infinity for prescriptions depending on what it is, and the kicker -- I had to have surgery in January and just got directly billed for ANESTHESIA!

Should've asked them for a leather strap and some whiskey.

every month. Blue Advantage. I went without for almost 10 years. My prescription deductible is insane but since I'm not on any medications, I wanted to keep my monthly premiums as low as possible. I pay $141 a month.

as well as high co-payments?

$60 for specialist and Urgent Care
$150 ER

They pay 50% for mental health/substance abuse treatment.

I'm a grad student so it's better than nothing I guess. I'm lucky that my partner has a really good job and she can help me afford it--of course it would be GREAT if I could get HER Federal Government bennies...:mad: but that's not likely to happen anytime soon.

I've lost a lot of my best doctors because they just won't work for what medicaid is willing to pay,
if they ever get paid by medicaid at all. (which they tell me is a problem)

It's a real problem

I lost my Vanderbilt shrink (head of dept)
my Vanderbilt internist (my primary care)
and now my orthopedic surgeon (I've had him for 11 years)

Now I need more spine surgury and
I don't know if the only guy I trust to do it
will do it for the money they'll pay

Union contract covers the policy. Worldwide coverage 100% at present. I pay nothing at the moment but in the past I've had to come up with as much as $1,000.00 every 3 mos. and forfeit the entire pension to carry the coverage. It is NOT looking good at all for '08, I know that already. I'll probably be back having to pay $1,000.00 and forfeiting my entire pension again I suspect because an HMO is coming back into town. :( :puke:

:kick:

I was covered under Medicaid until May. The IL DHS claims that I didn't send in my yearly paperwork in March. I did, but I'm sure that it got filed in the circular file.

I'm going Monday to reapply. I'm a Type II diabetic and I have a problem with my right foot. The podiatrist I see told me it's an ulcer and it has been taken care of ASAP.

Prayers and good thoughts would be appreciated.

You should ask them to and save the travel money.

the phone. When I received the notice in April that I was losing my coverage, I tried for two weeks to call my case worker. I never got through to even leave a message.

However, the application is available on line through the IL DHS website. I downloaded it yesterday and filled it out, so I'm off first thing Monday morning to reapply.

According to the DHS website you can mail or fax the application to the office, but since my paperwork in March never arrived, I'm not taking another chance.

:hug:

notice, i.e. high premiums, higher deductible.

Although, I'm not sure how long they can keep doing that. I'll enjoy it as long as I can. :)

Pay 2/3 of cost for spouse and self. Because we're both under 65 the costs are staggering and have nearly double since 2002 for the same plan. Every month I'm enraged over the amount.

We pay approximately $250 a month, $93 each for Medicare, $55 a month for both of us through backup. Very fortunate since pension plan costs us $12 a month per prescription (husband has six prescriptions, I have four). So very, very fortunate.

And I'm reasonably healthy--I haven't been hospitalized since the birth of my 26 year old, and I haven't been ill. (I feel very, very lucky)

My husband however has Multiple Sclerosis. He has been on every treatment available since he was first diagnosed in 1988. He's been on disability since the early '90's. If a job lost a specific insurance-- If I had to get a new one, I'd always get one without a preexisting condition clause. We've always pain a high premium, plus whatever medical costs. The MS society tries to keep funds available for those who are not insured or under-insured (as well as legal, and other help)and I appreciate that, because the costs of available treatment can be thousands a month if paid out of pocket. He's on Tysabri infusion now--a very promising drug with a prohibitive cost, looking at the pre-insurance bill scares the crap out of me.

So where is my husband if I lose MY job due to health or something else? SSDI pays for quite a bit, the MS society like I mentioned offers help. He'd probably get some of his medication--Continue his MS disease modifying drugs. But things like physical therapy or different specialists he needs to see, those benefits would drop off. He would have to give up certain medications, which could have a profound affect on his health. Anyone with a chronic illness in this country is in a frightening position.

my employer pays it all.

but I've been in all of the situations listed at one time or another.

Our insurance is 100% company paid.

I am one of three partners who own the company.

So while I get the benefit of a group policy, I effectively pay out of my pocket for insurance. $800 a month for Sparkly and me. Kaiser's highest option HMO with out of network benefits like any normal policy.

to use it. We pay $150 every two weeks for the insurance, and about a hundred a month for my medicine. Good thing my husband's blood pressure medicine is cheap.

The owner of the business pays 100% of health and dental benefits.

being Australian we have access to that wonderful little programme called universal health care. Damn that socialised medicine.


Peace

However the coverage has been declining over the last four years. Deductibles have shot up as have prescriptions.

for affordable health coverage for some time now. The individual coverage I have looked at is out of my range as far as premiums and has such a high deductible that it would only kick in for a catastrophic illness or injury.

Yes, I'm covered, which is luckier than many, but the premiums my husband pays are OUTRAGEOUS. His insurance is just for the two of us (our children are adopted through the state, and as a result, we have the state insurance for them) is $85.10 PER WEEK. And, the insurance isn't even good. Co-pays for a regular doctor are only $10, but specialists are $100, hospital visits are $250 (I think). And, when you consider that his insurance wants to DROP me, it gets even worse. I have acquired epilepsy (the result of a coma brought on by a car accident), but haven't had a seizure for almost 10 years. Anyway, they want to drop me b/c they consider my pre-existing condition too risky. :eyes:

But our family was uninsured for about 6 months when we both left the (same) company. It took several months for his new insurance to kick in.

It's been kind of a scary time. He has diabetes and high blood pressure.

I'm applying for it through the the Mass state program. Because of my income level I can buy into the system for about 70.00 a month with a choice of 4 plans, dental, vision and prescriptions included. They subsidize if you make 3 times the Federal poverty level or less. For a family of 4 that is anything less then 61,000. They raised the income levels considerably when health care became mandatory. My boss was going to buy it for me but its cheaper through the state and I'm taking a considerable raise instead.

Self-employed & can't afford any plan out there. My grandson has Medi_Cal, but in our area there's not a decnt doc or clinic that I've been able to find that will accept it.

We are on the 'best guess-self treat-get your meds online-hope you get it right' plan.

and it sucked.

Not too expensive. Pays without jumping through hoops. Deductible not too bad.

"Health Insurance" thing that you speak of?

Its good while it lasts. Our premiums jumped 18% last year. Its costing an employee $890 a month to cover a spouse and "children." Figure how that works for that portion of our workforce making less than $10 and hour.

Something has to give.

I would NOT recommend the HMO I had in the states. (I had a couple from my company - all BAD) Like most others, I could only choose from a few plan-approved doctors, which of course all had massive wait times, and any visit to a specialist had to be pre-approved in triplicate.

Needless to say I don't miss the US system at all.

Civilized need to always be on guard to not let their system to deteriorate to the level of the US one.

that costs us $600 a month for two people with $5,000 deductible per person.

It galls me no end to make that payment every month. We get a notice every year about the price of medical care going up and thus our premium is going up but since we never use it I wonder just who the hell's medical care I'm paying for because it isn't my own.

HSAs suck. You have to pay every single cost until you hit the deductible. That's really hit our finances hard this spring. Then, after you hit the deductible, they pay for everything--except for a certain percentage of prescriptions and all co-pays. Sucks, sucks, sucks!

We've had individual plans and can't recommend any of them! :(

on which he pays a hefty portion of the premiums for healthcare w/prescription/dental/eyecare, and employer picks up the rest. There's still a good-sized deductible and, of course, co-pays to shell out. I only work PT in a multi-physician practice and am not currently eligible for most benefits except 1/2 FT PTO. Last job was PT, benefit-eligible, and employer paid 100% of premiums, but in the last year of employment, employer only paid 50% of premium, and my cost was too high to continue individual policy (spouse not covered at the time). We've been without family coverage during several "dry" spells. Most of all, I think our teeth have suffered and we've gone without and used samples of needed medications passed out by our doctors, bless them, during those times.

I have MS. It pays for all kinds of equipment. Physical Therapy. Amazing.

because our state allows us to have insurance at all because we come under Small Business...and we only have 5 people. We work to pay our insurance it's so high...:-( $22,000....

So far it has been good. My wife's employer offers a better plan than mine. Recently the copays have jumped considerably, but it is still reasonable.

But after seeing Sicko, I have to wonder now: what happens if some asshole insurance administraor decides he going to get his bonus one month by denying care to my family?

I spent a grueling few years waiting for early retirement age after FOX bought out my TV station.

I'm now covered by NewsCorp, the Entertainment Group, that is the umbrella for FOX News, etc. They are self-insured and I have no expectation that they might even be in business 2 or 5 years from now. I hate them as much as any DUer but get a check every month plus my pension from them.

If I lose this, I lose my whole plan to live a normal life.

This is just crazy. The government should be in the health biz, (Like Medicare) I would gladly pay for the insurance that it would give me for the rest of my life.

How many times to you hear from Canadians, of the French, or the Brits, that they hate the health care system? Not many.

I've been self employed for 15 years and have shelled out tens of thousands for health insurance-only to pay tens of thousands for surgeries and emergency room visits that the insurance refused to pay for. I chose a "covered" option in your poll, but I honestly have never felt that I am.

cover surgeries and emergency room visits, less the applicable deductibles?

That makes no sense to me Lorien, unless your annual premiums are very, very low.

What am I misunderstanding?

NOW on PBS did an expose of them last year: http://www.pbs.org/now/transcript/transcriptNOW218_full.html Turns out that many of their customers, like me, were denied any kind of coverage at all-even for emergency room visits and life saving operations. I paid $285.00 a month for the "insurance". Now I'm with Golden Rule. I haven't tried to use it yet, so I don't know if they'll cover anything. Ever since the NASE experience I do everything in my power to remain healthy ( exercise regularly, eat mostly organic veggies and grains and no processed foods, swallow vitamins galore). I'm $32,000 in debt now because of my predatory health insurance company, so unless I'm pretty certain a condition will ultimately kill me I won't see a doctor for anything.

understand why you would boycott, but I'm curious how you manage orleans.

What if you needed major surgery or something? How could you afford that?

Thanks for helping me understand. :)

major surgery? gee--i guess i'll be majorly fucked.

am i worried? well, i try not to think about it.

it's the bury your head in the sand syndrome.

my disgust over the health care situation is focused on the citizenry as a whole, rather than me personally.

if i focused on it personally i could get really depressed (and then i might need more drugs--so fuck that)

bottom line: i'm a member of the 47 million club that michael moore has been talking about.

oh well.

I could probably afford it but having paid for it some years back on my own I found that it was just money down the drain.

what would you do if you needed expensive dental work such as a root canal?

I'm not criticizing you or your decision Raine.

I'm just genuinely interested what your game plan is to deal with health care.

I know there are lots of people who feel as you do which is part of the reason I started this poll!

Just really curious what your thoughts are! :)

I guess and trying to hold on till we get someone in on our side. A leader who will set up something that I can pay for without having to give up other important stuff to afford heath coverage. It worries me but I try not to dwell on it. I'm also taking vitamins and supplements and staying as healthy as I can and being careful about accidents (as careful as anyone can be that is).

health insurance, I always told myself that if someone slammed into me, I hope it killed me rather than put me in the hospital facing a million dollars in bills.

How sad is that? Wishing death.

Since I got laid off last month so, technically I'm covered though its gonna cost me like 400.00 per month

but I pay a co-pay when I go to the doctor.

any area ER is my primary care provider.

and the bill?

fuck em.

I will be seeing Sicko. I guess I was always going to see it, now doubly so.

Consider this (note to potential flamers, I am playing DEVIL'S ADVOCATE HERE): The demographic of DUers, which is skewed to the poorer side due to our egalitarian nature, just as the Bushies and even the Republic Party in general are skewed to wealth becausde of their aristocratic natures, in general and always noting every generality has many exceptions, means that the national average may be a little higher than here.

Still...40% covered through work? That's terrible. I already knew the health care system was bad for the bottom 20% of America, now I am coming to see that number is more like 30 or 40%.

:puke:

How many of us who can afford insurance can also afford to go away this week?

As for my insurance, I'm covered pretty well with Blue Cross but have never really put it to a signifigant test. The last time I had surgery, it was at the bitter end of my Major Medical coverage. They cover my preventative health stuff (grudgingly) but it's hard to know if it would have been cheaper to pay for that myself (given uninsured fee structure). My insurance is now $716 a month (almost double from 4 years ago) and will probably go up again in a couple of years. My dental "insurance" seems to be paid by my dad and he gets cranky about how much the bills can be. I've been missing a tooth for over a year and my parents seem to not be giving it much thought as they take off for Vegas today.

:(

Wife and I are out of work we used to be smack in the middle class. We both were in IT and together made +/- 150K. Those days are gone for us forever our savings are gone and retirement, aint ever gonna happen for us. But good news Verison profits are UP! NAFTA and H1B visas killed our family.

Anyone tells me we wernt skilled at our professions one more time is gonna get it! Nobody asked if we would take a cut in pay in order to retain our jobs.

8643

So, no, I do not think unemployment is at 5%, but likely closer to 10% or higher.

The scary thing is, the bubble of unreality that surrounds Imperial Amerika is almost powerful enough that I might speculate that a Great Depression (in which a mere 30% were unemployed) could be fully hidden from view of the other 70% who have jobs, and who could STILL be convinced at that time that unemployment was still 5%.

we pay a little under $400/month for that coverage AND I just got a bill in the mail a couple of days ago charging me almost $500 for anesthesia I received when I had surgery in January.

I guess anesthesia during surgery is considered elective now.

Bah.

Previously I was lucky to be covered under MassHealth (when I was pregnant with my daughter) and prior to that I was able to get minimal insurance coverage through my college program (at a price of course).

However, when I was younger (ie, dependent on my parents) we were not insured and my parents probably still aren't.

If the surgery was considered medically necessary and was covered, then the anesthesia should be covered too.

By navigating the red-tape properly, you should be able to successfully fight it. I'm not saying all the phone calls will be fun, just that you shouldn't resign yourself to shelling out $500.

seeing what we could do first :D.

Total costs including premiums + medicine and doctors over $30,000 a year (no coverage or limited coverage for help with my children's developmental problems). If I lived in those other cuntries, I'd be sitting well and be able to leave my children a decent future.

They deduct about $3500./yr for BC/BS Federal premiums that provide
family coverage for us and our 17 yo son. When hubby becomes eligible
for Medicare on his next birthday, he gets Medicare part B supplemental from this policy and my son and I will still be covered.

My husband is a physician who was exclusively in private practice
for 6 years from 1988-94. We had no health insurance coverage at that
time as it was so expensive that we decided to take our chances
in 'going bare'. During that time I had several hospitalizations, a C-Section,
and a hysterectomy that we ended up having to pay for ourselves.
Turns out we probably would have gotten our money's worth on the premiums.

Self employed and getting very nervous.

I'm looking for a HSA + catastrophic policy scenario to see if I can find something I can afford.

the premium..however it's only a 70/30 plan with some ridiculous individual/family annual deductible and restrictions on medications and services.

See..this is one of the problems when we say insured vs uninsured. Having insurance doesn't always mean you won't go bankrupt or that everything will be covered. I'm almost as frightened now as I was when we had no insurance.

What we need is health care for all..

I'd much rather pay our "premiums" to a fund for health care where everyone is treated equally and can get care without paying extra. Why continue giving money to insurance companies who are only in it for profit and can deny you coverage/care with a blink of an eye?

I spoke with my elderly neighbor yesterday. They're in their late 70's now and are paying $9600 a yr for supplemental insurance.

My Sil works for a very small employer. She told me her employee plan just for her and my brother cost her employer $18000 a year last year and was going up about 20% for this year. My brother works for a company that doesn't provide insurance of any type.

I wonder how many people/companies are "insurance poor" by paying the ridiculous premiums for some sort of coverage/albeit inadequate?

Which leaves me paying $139 per month for my husband and I.

The big question will be if I can afford coverage with an individual policy. I am not ready to go into the details but I will have to be able to replace my current income PLUS the premium. If I don't see it happening I will have to remain an "employee" which I really hate.

But my co-pay is $25.

at the end of July. I'm thrilled my company will pay 75% of the premium and I'll be paying $100.00 per month which includes dental. I asked the HR rep if I could also get coverage for my SO. Nevada doesn't "recognize" my family so no soup for us!

I have a VA card and was covered while Clinton was in office. Bush came in and changed some of the items on the VA form but I haven't filled it out because I haven't needed to go to the docs.

I just hope if something happens that I can use the VA. I'm not working right now and it's all I have.

employer. I lost my plan when I lost my job. I'm working temporarily now with no benefits whatsoever and can't afford to pay for a policy at all on my own. Hell, if something happened to my husband now, we would lose our home. I have the preexisting condition of cancer and I'm afraid I never will be able to find an insurer again.

My wife works for a huge employer so our cost and coverage is probably better than average. On the other hand with job security these days it could change at any time.