Trail Health Insurance

[McPick]

While planning my AT hike, a year ago, I tried to find some kind of health insurance. For various reasons I won't go into here, I was unsuccessful. Fortunately, though, I didn't need it. Let me tell you that I consider myself extremely lucky in that regard. Accidents can and do happen in the wink of an eye. Some kind of emergency insurance for ER visits, etc would have given me greater piece of mind on the trail.

Today, (Happy Valentine's Day ‘07) I changed my homeowners and auto policies to State Farm. During that meeting the topic of health insurance, and my inability to purchase any, came up. I told the agent that I'd searched "everywhere" including all the suggestions listed on WhiteBlaze a year ago for some kind (any kind) of health insurance, but couldn't get one.

He suggested I consider State Farm’s Supplemental Medical Insurance. It pays up to a certain limit for ER visits and hospital room charges. I asked a few questions and then bought it. Had I known about this insurance a year ago, I would have bought it in a heartbeat.

If you are planning to hike the Appalachian Trail (or for any reason) and can’t get the usual kinds of health insurance please call a State Farm office and inquire about this insurance. It certainly worked for me.

Good luck!

[Ronin]

Hey McPick. Good point. This is an excerpt from Weasel's backpacker law article:

As “Cutman11” (who is a doctor) correctly has said:

“I am a practicing General Surgeon and it is the law in the USA that one cannot be denied an initial assessment evaluation (ER Doc talks with you and examines you) if you present to the hospital emergency dept. You do not need ID or insurance. *** Whether or not you have insurance really has no bearing on how timely you are seen, and in some cases, the doc actually does not know if you have insurance or not. He is obligated to treat your [emergency] problems. If the facility...you present at has the capacity, personnel and technical capability, it is obligated to provide
care, regardless of your ability to pay."

Food for thought.

[jesse]

McPick,
I am a licemced agent in GA. I am not familiar with the SF policy that you bought, however, I am not too keen on most supplemental policiies I have seen.
Does the money come directly to you as a cash payment to spend how you want (like AFLAC) or, does it go directly to the health care provider. If it is the former (like AFLAC) do not tell the DR or the hospital that you have this coverage. If they know about it, they will try and get you to assign the claim to them. If you do this you will not see a dime. If it is the latter, it will probbably only cover a small amount of the total bill, and you still will owe a lot of money.
Supplemental policies are not designed as a substitue for health insurance. I do not think I would have sold you that policy.

[hammock engineer]

Hey McPick. Good point. This is an excerpt from Weasel's backpacker law article:

As “Cutman11” (who is a doctor) correctly has said:

“I am a practicing General Surgeon and it is the law in the USA that one cannot be denied an initial assessment evaluation (ER Doc talks with you and examines you) if you present to the hospital emergency dept. You do not need ID or insurance. *** Whether or not you have insurance really has no bearing on how timely you are seen, and in some cases, the doc actually does not know if you have insurance or not. He is obligated to treat your [emergency] problems. If the facility...you present at has the capacity, personnel and technical capability, it is obligated to provide
care, regardless of your ability to pay."

Food for thought.

That is true. You will be treated and recieve all the medical help you need. Then they will hand you the bill and send you on the way.

I am picking up short term insurance. I found a good agent who set me up with a good policy for around $42 a month. The max payment for me will not send me to the poor house.

But to each their own.

[orangebug]

Your age may allow you to get such a low premium, but for many of us, basic coverage as a single person will be 10 times that each month, or more.

If possible, see if you can afford a Health Savings Account. It works much like an IRA and is attached to a high deductible health insurance policy. There are tax and other advantages to it. Going bare without insurance is a risk, as healthcare debts are one of the most common causes of personal bankruptsy.

What was mentioned about ERs having to treat an emergency is correct. However, you may find it hard to get referred to another facility for definitive treatment. We had an example of that a few years ago for a hiker who fell down Blue Mountain into Unicoi Gap, broke his wrist, and couldn't get it set for over a day.

You will also have problems getting follow up care once the emergency is stabilized.

[The Weasel]

You must be "stabilized" and, in most cases, that will include further treatment. You can't be forcibly discharged if you are not medically stable.

The Weasel


Your age may allow you to get such a low premium, but for many of us, basic coverage as a single person will be 10 times that each month, or more.

If possible, see if you can afford a Health Savings Account. It works much like an IRA and is attached to a high deductible health insurance policy. There are tax and other advantages to it. Going bare without insurance is a risk, as healthcare debts are one of the most common causes of personal bankruptsy.

What was mentioned about ERs having to treat an emergency is correct. However, you may find it hard to get referred to another facility for definitive treatment. We had an example of that a few years ago for a hiker who fell down Blue Mountain into Unicoi Gap, broke his wrist, and couldn't get it set for over a day.

You will also have problems getting follow up care once the emergency is stabilized.

[McPick]

McPick,
I am a licemced agent in GA. I am not familiar with the SF policy that you bought, however, I am not too keen on most supplemental policiies I have seen.
Does the money come directly to you as a cash payment to spend how you want (like AFLAC) or, does it go directly to the health care provider. If it is the former (like AFLAC) do not tell the DR or the hospital that you have this coverage. If they know about it, they will try and get you to assign the claim to them. If you do this you will not see a dime. If it is the latter, it will probbably only cover a small amount of the total bill, and you still will owe a lot of money.
Supplemental policies are not designed as a substitue for health insurance. I do not think I would have sold you that policy.

Hi ya Jessebrent,

This policy is in no way intended to replace health insurance. As I understood the provisions from my agent in Missouri, the policy I bought will offset the cost of an ER visit, or visits depending on the circumstance. Plus, if I’m hospitalized the policy will pay a daily benefit between $100 and $250. (My choice when I bought the policy.) Otherwise, I have nothing.

Further, as I understood the presentation, and from reading the promo glossy, benefits are paid directly to me. This policy will likely not cover all the costs of an emergency room visit. However, one visit and the policy is paid for and more.

From my point of view, having this type of coverage beats not having anything. Would you agree? I appreciate that emergency rooms must provide care regardless of the patient’s ability to pay. But I also realize that practice is one of the reasons healthcare costs are skyrocketing. You probably see that in your agency if you offer healthcare insurance. Bottom line is that hospital administrators must pass along those costs. Seems to me that everybody’s premiums go up every year.

Please remember from my original statements, I searched for health insurance extensively, prior to leaving for my hike. I had no luck and was certainly apprehensive regarding injury and was cautious on the trail. I even did research on the locations of FQHCs* in communities near the trail in case I needed medical attention.

This policy, at the very least, covers part of the cost of receiving medical care in case of an emergency. What policy would you have sold me? Are you aware of other choices?

(*Federally Qualified Community Health Centers or sometimes called CHC, Community Health Centers)

[jesse]

Mcpick,
I assume that since you could not get coverage you have some type of uninsurable condition (diabetes, cancer, heart disease, etc) therfore i would not be able to get you covered. The only options uninsurable people have is either go to work for a company that provides group coverage, or get on a spouse plan. I know that sucks, but that is the way it is.
The reason I do not like supplemental policies is they do not provide adaquate coverage. I am going to make up some numbers here to give an example:
Suppose you are hospitalized and the total bill is $80,000. Your Supplemental policy pays you $10,000. You still owe $70,000. How much better off are you if you are left owing $70K vs 80K. You are sunk either way.
The only reason to buy insurance is to prevent catastophic loss. Supplemental insurance IMO does not qualify.
Keep in mind, I have not seen your policy, so I am not giving you specific advice, I am simply talking in general terms.

[Boat Drinks]

I got 180 days of coverage for 417.00. Time Insurance, Indemnity, 2500.00 deductible, 20% co-pay, 4500.00 TOTAL out of pocket.

This is not good for anything BUT really bad accidents that would cost more than 4500.00, but will keep me from going bankrupt should that occasion arise!

[Bravo]

I got 180 days of coverage for 417.00. Time Insurance, Indemnity, 2500.00 deductible, 20% co-pay, 4500.00 TOTAL out of pocket.

This is not good for anything BUT really bad accidents that would cost more than 4500.00, but will keep me from going bankrupt should that occasion arise!

You break your ankle or leg and take an ambulance ride you're over $4,500 for sure. Better yet take a chopper and that could be 5-10k right there.

[Boat Drinks]

You break your ankle or leg and take an ambulance ride you're over $4,500 for sure. Better yet take a chopper and that could be 5-10k right there.


Exactly! When I screw up, it's gonna have to be a big one to get me off the trail.....

[Toolshed]

I do agree with the others on emergent care. I do think many confuse health care coverage with the ability to seek and obtain emergent care.

There might be another option for McPick State Inurance plans.(I had written a long response, but in working with my laptop, I accidently hit the "back" key and lost it all even after I went forward again).
Some states are looking to roll this out. In this situation any employer not offering employee coverage would have to pay 3% of their payroll into the fund. States may vary - Some are further along than others.

However, I did look at the policy very briefly. It appears there is a 5-year grandfathering on pre-ex conditions. In addition, do they pay you if you have a semi-private room or just a private room? Is there also a waiting period before coverage beings? I realized you asked a few questions, but I would look to see if you have a 30-day "free look" and if so, spend the next few days getting someone you know and trust to review the policy and think about your odds of having something happen that is included and or excluded versusu the amount of premium you are paying.

I am against any kind of supplemental policy in lieu of insurance, but then I do not know McPick's circumstances. There was an article recently in Time or BW about folks being tied to their jobs for health care coverage. This may the very situation where McPick needs to change employment in order to obtain group coverage that includes Pre-ex conditions. (great point Jesse Brent - Choose your spouse and/or career wisely).

[hopefulhiker]

One thing I asked my doctor to do was give me a prescription for a good antibiotic in advance.. I had an infected blister and it really helped me out...

[hammock engineer]

Make sure it is covered in different states. Some only cover you in certain areas.