Health Insurance for a thru hike

[saralynne1982]

Hi All!
Trying to budget for my thru hike in 2015 and looking at what I need to do for health insurance. What are the rest of you doing? To give some context I am currently a nonprofit administrator who will be taking a sabbatical and 32 yo. I am not sure what I am and am not eligible for with the new healthcare laws and where I should begin looking. Any ideas or assistance you can give?

Thanks!

[Dogwood]

I want to hear this. I'm totally bewildered with the same question as it applies to myself.

[2015 Lady Thru-Hiker]

Thanks for asking the question first saralynne. One of the things I've starting thinking about as well. How would Cobra fit into the this? Also wondering about "trip insurance". I know one of the docs I worked with had it for a hike he took in the Himalayans and it turned out to be a good thing. They ended up having to helicopter him out when he fell and dislocated his artificial hip.

[rocketsocks]

Hi All!
Trying to budget for my thru hike in 2015 and looking at what I need to do for health insurance. What are the rest of you doing? To give some context I am currently a nonprofit administrator who will be taking a sabbatical and 32 yo. I am not sure what I am and am not eligible for with the new healthcare laws and where I should begin looking. Any ideas or assistance you can give?

Thanks!
.....apparently neither are the founders, your not alone. I'd check with your health care provider though, as it seems these things are constantly changing. Fortunately I don't have to do this just yet (affordable health care act) and still have a policy in place, but that may change in the future, and I'll be asking the same question...good luck with it, do let us know what ya find out.

[rocketsocks]

.....apparently neither are the founders, your not alone. I'd check with your health care provider though, as it seems these things are constantly changing. Fortunately I don't have to do this just yet (affordable health care act) and still have a policy in place, but that may change in the future, and I'll be asking the same question...good luck with it, do let us know what ya find out.I'm sorry I thought for some reason you had health care now...I see though you don't mention that, so I gotta assume you don't. In that case, good luck, you know as much as I about navigating the site then. Save your money though, I sounds as though it won't be cheap with the deductibles, and some changes go into effect next year I believe, then again the following year. I'm not a fan of this...sorry/not sorry but that's the way I feel about it.

[Just Bill]

Trip insurance- not for a hike.

Cobra- allows continued coverage in the event of a termination. You simply take over payments from your current employer so the existing policy can continue.

Affordable Care Act- Many benefits- buying non-group, personal insurance was very difficult previously. No pre-existing conditions issues any more, and you have access to the same plans offered to regular employer groups. Politics aside- from an average Joe, individual it's a very good deal. You can make arguments from the other side- but buying individual insurance is way easier and cheaper. HMO's were once the end of the world too- now they are standard practice.

Assuming you have decent health- you will pay out of pocket anyway with any standard deductible plans at a reasonable monthly premium. Roughly a 2500-5000 deductible. So unless you have a medical condition and plan to visit a physician often, it makes little sense to pay for a higher level of coverage as that could easily cost you $500 per month extra. So basically you are better off buying a "catastrophic" coverage plan. A high deductible, low monthly premium plan.

Assuming a regular hike- you'll pay out of pocket anyway for a doc visit or basic meds even with a mid level plan. An ER visit will still cost you $500 or so. So say you- contract Lyme, see a doc, need a script and fill it. You'll spend $250 to see the doc and $50 to fill the script. Maybe you break your toe and need an ER visit. $500 for the ER, $500 for Xrays. So you dropped $1300 in medical expenses.

You could easily pay $500 per month OVER a standard catastrophic coverage plan with a high deductible. Or- $1300 divided by six=$215 per month versus $500. So you could put $3000 in the bank ($500/mo x 6 months) and cover your out of pocket costs and save money instead of buying "full coverage". Add insult to injury- you haven't met your deductible anyway yet- so you will still pay the $1300 on top of your higher premium. You would actually pay $4300 on this hike over the cost of a cheap plan.

I am unsure what individual premiums are now, but around $250 per month sounds right. This covers you for major stuff only. I was paying $465 per month for basic $5000 deductible 80/20 coverage prior to taking my current job. This was for me, wife, and son. Prior to "Obamacare", I paid $567 and had no maternity coverage. (It was considered a pre-existing condition more or less under the old rules)

My current employer pays roughly $1200 per month, I pay an additional $160 (pretax) plus my employer set aside $4100 in an HSA account. This is for "Gold" level coverage, 100% coverage after $5000 deductible. I only pay $900 though as a result of the HSA (plus my monthly premium) However, as I was expecting a child- this was a sound investment/choice. I paid $900 plus $1920 (160x12) to receive 100% versus 80/20 coverage. A $10k labor and delivery bill would have cost 2k (20%) even if my deductible was met with 80/20 coverage. After this year, I will drop back to regular 80/20 coverage (silver) with a 5k deductible and no monthly payment. If everyone in my family sees the doc once at $250 each- it is still cheaper than the $1920 additional I pay now.

Jump on the website though, get a quote for bottom of the barrel coverage and price it out.
Depending on your income, you may qualify for subsidies as well.
https://www.healthcare.gov/

In my personal experience both self employed and with employers- you are better off pocketing the premium difference and paying for the few issues that arise than trying to buy full or even mid level coverage if you don't expect issues. Even a true disaster- bad fall, broken leg & multiple injuries may not eat up your $5k deductible. You could easily pay $1,000 per month extra for the "best" coverage. I would rather put the 12k in the bank and cover the costs out of pocket than give it away if nothing does happen. Even an 80/20 plan "caps out" at say 20k out of pocket.

On the plus side, having insurance coverage means the insurer will get you the negotiated rate even if you are responsible for the bill.

Very long story short-
Put money in the bank and buy the cheapest coverage you can get if you are concerned, have a family, or are over 40.
If you are healthy, unlikely to suddenly develop a serious long term issue, and hiking- you may be best off simply putting your money in the bank and self insuring (paying out of pocket period with no backup)

As an aside- you can also speak to physicians or providers about the "cash" price. While you won't have this talk with the ER nurse, if you are stopping in a clinic for some antibiotics in a trail town, or even for an x-ray- it does exist. Paying cash means the cost will not go towards your deductible- but from a real life cash-flow standpoint- you will likely save money.

FWIW- I have been a plan administrator, self employed, and self insured person. I don't know all the ins and outs of the new plans by any means- I am more educated on the topic than your average bear- but take all this advice with a grain of salt and do your own homework. I found if you look at your coverage from a cashflow/annual cost rather than a monthly premium- cash in hand is typically the better choice for most. It is very confusing- even most plan administrators don't have answers.

You can also use an insurance broker now (much like car insurance) to assist you in your purchase, my auto, home, life, and health insurance were all sold to me via the same guy.

[rocketsocks]

JB I for one appreciate you breaking that down like that, very helpful indeed. I really do want all to have coverage, and the best part of the bill is the pre-existing condition clause...I just hope most can afford to pay, time will tell. I've already had one doctor drop out of the insurance game all together, and another say "if it comes to that I'll just go do something else" meaning quit practicing. Many boutique doctors have popped up in my area, and someone close to me, her Doctor wants $5,000 up front as a retainer...(she's been seeing him for years and years) and then $275.00 a visit...most won't be able to afford this. Again, I do appreciate your time to break that down.

[Just Bill]

That was easy- 35 Year old male-
Worst Plan-146/mo- 6k deductible- annual cost if nothing happens- $1752
Premium plan 438/mo- 1000 deductible/1500 max- annual cost if nothing happens- $5256

Worst plan- worst case- out of pocket max- $12,700+1752
Premium plan- worst case- out of pocket max- 1500+5256

scenario above- 1300 in expenses during a hike-
Worst Plan-1300 + 1752=3052 (annual)
Premium Plan- $1300 + 5256=6556

Diffence in annual premium- (5256-1752)=3504
Almost exactly what you need, in cash, to cover your costs for the worst plan in a typical scenario.
More importantly- if nothing happens- enough money to hike another trail or two.

If you have a catastrophic event-your 15k out of pocket costs with the worst plan will likely be the least of your problems.

Cue Colin Fletcher quote-

But if you judge safety to be the paramount consideration in life you should never, under any circumstances, go on long hikes alone. Don’t take short hikes alone, either – or, for that matter, go anywhere alone. And avoid at all costs such foolhardy activities as driving, falling in love, or inhaling air that is almost certainly riddled with deadly germs. Wear wool next to the skin. Insure every good and chattel you possess against every conceivable contingency the future might bring, even if the premiums half-cripple the present. Never cross an intersection against a red light, even when you can see all roads are clear for miles. And never, of course, explore the guts of an idea that seems as if it might threaten one of your more cherished beliefs. In your wisdom you will probably live to be a ripe old age. But you may discover, just before you die, that you have been dead for a long, long time.

[Just Bill]

JB I for one appreciate you breaking that down like that, very helpful indeed. I really do want all to have coverage, and the best part of the bill is the pre-existing condition clause...I just hope most can afford to pay, time will tell. I've already had one doctor drop out of the insurance game all together, and another say "if it comes to that I'll just go do something else" meaning quit practicing. Many boutique doctors have popped up in my area, and someone close to me, her Doctor wants $5,000 up front as a retainer...(she's been seeing him for years and years) and then $275.00 a visit...most won't be able to afford this. Again, I do appreciate your time to break that down.

Different problem.
Individually pretty good.
Employers and independent doc's- pretty up in the air.
Specialists- have always been tricky...

Going to be messy for awhile for sure. For hikers, or self-employed- It's pretty sweet.

[rocketsocks]

That was easy- 35 Year old male-
Worst Plan-146/mo- 6k deductible- annual cost if nothing happens- $1752
Premium plan 438/mo- 1000 deductible/1500 max- annual cost if nothing happens- $5256

Worst plan- worst case- out of pocket max- $12,700+1752
Premium plan- worst case- out of pocket max- 1500+5256

scenario above- 1300 in expenses during a hike-
Worst Plan-1300 + 1752=3052 (annual)
Premium Plan- $1300 + 5256=6556

Diffence in annual premium- (5256-1752)=3504
Almost exactly what you need, in cash, to cover your costs for the worst plan in a typical scenario.
More importantly- if nothing happens- enough money to hike another trail or two.

If you have a catastrophic event-your 15k out of pocket costs with the worst plan will likely be the least of your problems.

Cue Colin Fletcher quote-

But if you judge safety to be the paramount consideration in life you should never, under any circumstances, go on long hikes alone. Don’t take short hikes alone, either – or, for that matter, go anywhere alone. And avoid at all costs such foolhardy activities as driving, falling in love, or inhaling air that is almost certainly riddled with deadly germs. Wear wool next to the skin. Insure every good and chattel you possess against every conceivable contingency the future might bring, even if the premiums half-cripple the present. Never cross an intersection against a red light, even when you can see all roads are clear for miles. And never, of course, explore the guts of an idea that seems as if it might threaten one of your more cherished beliefs. In your wisdom you will probably live to be a ripe old age. But you may discover, just before you die, that you have been dead for a long, long time.
Brilliant!

[rocketsocks]

Brilliant!
Sorry that's the best I can do at 1:30 in the mornin' :D gettin' ready to shut this operation down.

[sympathetic joy]

Check out World Nomads:

http://www.worldnomads.com/


They are geared for international travel but domestic travel health insurance is possible. A 6 month policy is $335. They do have a rule for domestic travel that it only covers you if you're more than 100 miles from 'your' home.

http://www.worldnomads.com/travel-insurance/prices-and-benefits-country.aspx?Country=USA

You should call or write them with any questions. I used them for a 1 month policy when I was traveling overseas. Luckily I didn't have to use the policy. Hiking is one of the covered activities for USA residents under their standard plan.

http://www.worldnomads.com/travel-insurance/adventure-travel-insurance.aspx

[saralynne1982]

Thanks everyone-I will start doing some research and see what I find! I'll report anything good back to the group

[meat803]

Health insurance is a scam. Live healthy and save your money. If you live debt free, live within your means, and save money, you will have more than enough cash to cover any medical costs you incur. That is of course if you eat right and maintain a healthy lifestyle. As a member of this site you are probably healthier than 90% of Americans. I refuse to share a policy with those slobs. I agree with a lot JustBill said in his first post.

[Not Sunshine]

Disagree: live healthy and you won't need health insurance.

Believing that NOTHING could ever happen to you is completely ignorant. Accidents happen. Slip on ice - ankle fracture. Catch one wrong groove skiing - ACL tear. Trip over your dog's leash - wrist fracture. Believing that insurance is a "scam" and nothing medically could ever happen to you is absolutely irresponsible. (which - let me tell you from experience, ACL injuries are not planned events) If you're hurt without insurance, you'd better have $10,000 in a bank account to pay for your surgery/doctors bills if you expect you'll be repaired. Or expect to be told you'll have to wait months for charity care - if you get approved [you don't get charity care if you actually MAKE any money or OWN anything of value - because it's expected of adults in society today to take care of themselves].

I applaud those users on this site who TAKE RESPONSIBILITY FOR THEMSELVES (most of you do). I do not agree with those who believe society "owes" them a free ride and then turn around and complain they have to wait 4 months to see a specialist when they don't fork over a DIME [the entitled's]

I digress.

When I tore my ACL, my knee was so unstable, I could not bear ANY weight on it. I was totally handicapped. I had surgery and 6 months of physical therapy - today I am pain free and just completed my first triathalon pain free and am planning a section hike of the smokies. I am an absolute SUCCESS story and it only cost me $3,000.

I don't take any daily medications - I eat healthy and exercise regularly. I opted for a cheaper-up-front High Deductible plan and was eligible for a tax-deferred Health Savings Account - money put in my "HSA" is not only tax deductible but never expires or gets taken away from me - it EVEN earns interest.

The money I saved on lower monthly premiums (high deductibles have lower monthly premiums) I put into that HSA so that if I GOT injured or sick, I would have money put aside JUST FOR HEALTHCARE bills - which was totally TAX DEDUCTIBLE - to cover my higher deductible cost.

Plus, if I did have prescriptions, I get a discount on those costs through my insurance company...as well as doctors visits as long as I stay in-network. My recent visit to a specialist (new patient, endocrine) was $98. No $50 or $100 copay. $98 was the total cost of the visit.

In my opinion: the high deductible plan is the way to go if you (1) don't take medications daily and (2) don't run to the ER/private doctor for every stubbed toe and runny nose. [and I don't mean to offend anyone who takes daily medications and whose provider needs to see them every 3-6 months for refills].

If I were thru-hiking, I would hope for NO visits to the ER/urgent care...and save money on that high monthly premium. I would INVEST that saved money in an HSA just in case I were to get hurt. Because if you DO get hurt while attempting a thru-hike, you'd better have enough in savings to cover the deductible - you're hurt: you probably won't be able to find a job in your hurt state.

In reality - if you find ways to get GOOD nutrition into any section/thru hike - you'll be healthier walking all day in the woods than you would be sitting in front of a computer all day. I'm hoping I can attempt when I'm retired. :) Hopefully I'll be in my early 60s.

[perrymk]

JustBill - Thanks for a great breakdown, the kind of thing I need to see to break down costs. You saved me some time.
sympathetic joy - thanks for the insurance source. I was wondering if such services existed. I figured they had to, but one never knows,

For my two cents, veterans can apply for VA healthcare. The last I read on the VA website is that it meets the ACA (Obamacare) requirements. Eligibility rules changed a few years ago. Now it pretty much reads either you have a service related dsiability or are destitute. Either one means full, free medical care even for non-service related issues. Despite recent news reports, most VA facilites provide reasonable care and the ones in my area typically get high marks.

As for myself, when I got out of the service I just assumed the VA was for service related issues and as I left healthy, I had no need so didn't apply. Part of me thinks I did the right thing regardless (I wouldn't want to take an appointment from someone more deserving, that is, with a service related issue), but part of me would rather not have to fork over the cash when the time comes. Fortunately, while I do not qualifiy according to most definitions as a wealthy man, I am employed with medical insurance and doing reasonably well both financially and healthwise.

To any recently discharged veterans, now is the best time to apply. You don't have to use it but it is a nice backup plan. Don't wait until you find a job that provides healthcare and are then ineligible.

[Alligator]

Health insurance is a scam. Live healthy and save your money. If you live debt free, live within your means, and save money, you will have more than enough cash to cover any medical costs you incur. That is of course if you eat right and maintain a healthy lifestyle. As a member of this site you are probably healthier than 90% of Americans. I refuse to share a policy with those slobs. I agree with a lot JustBill said in his first post.I eat healthy and exercise regularly and have done so for a most of my life. I also have a $250,000 heart. That was just to fix it, does not include a couple hospitalizations to resynch it. Plus back and rotator cuff surgery. My wife's medication runs about $10,000 a year. She exercises less but still eats well. We were both covered before diagnoses. To think you will not need it by eating right and exercising is not accurate. Nor should you think you will be able to amass the needed $ prior to an illness. You may be struck young or even during your prime earning years.

I do not know the ins and outs of the current health care laws but I would recommend having some plan that would cover catastrophic illnesses.

[meat803]

I eat healthy and exercise regularly and have done so for a most of my life. I also have a $250,000 heart. That was just to fix it, does not include a couple hospitalizations to resynch it. Plus back and rotator cuff surgery. My wife's medication runs about $10,000 a year. She exercises less but still eats well. We were both covered before diagnoses. To think you will not need it by eating right and exercising is not accurate. Nor should you think you will be able to amass the needed $ prior to an illness. You may be struck young or even during your prime earning years.

I do not know the ins and outs of the current health care laws but I would recommend having some plan that would cover catastrophic illnesses.

Do the insurance companies run a charity or did they have to charge far more than your expenses to cover your costs, their operating costs, and 13 billion in profits? Sometimes yes as an individual you can come out the winner. Much like the Lottery. But as a whole, you are more likely to pay much more into a system then you will ever get out. As a overall healthy individual you are most likely going to be fitting the bill for someone that does not take care of themselves. Head up to walmart and look around. These are the slugs you are "sharing" coverage with.

If you want insurance then by all means go for it. But on a logical level, the system takes in more in premiums than it ever pays out by design. This is a fact that you cannot argue. When I accepted this fact, I decided to no longer participate as I know I can invest/save my money in a manner that will provide for my own needs. Most people live paycheck to paycheck and cannot handle this responsibility.

Someone once told me that in ancient China you only paid your doctor if you were healthy. When you got sick, he had to treat you for free. It was in his interest for you to not be sick. Today the exact opposite is true. I have found they prefer to treat your condition with expensive drugs and procedures, rather that find the root and cure it. They have a vested interest to support that business model. Get heart disease and the doctor may briefly mention exercise and diet. But more importantly he will prescribe some drug that will supposedly fix what ails you. The drug may help, but side effects and altering your body chemistry can cause numerous other problems that they will have to address. And the cycle continues.

One more thing I would like to add is that cash paying customers get huge discounts on medical bills vs those that pay with insurance. I recently took my son in for immunizations and they quoted me 360$ at the end. I informed them I was paying cash and then they said oh, then it is 180.

[Just Bill]

That was easy- 35 Year old male-
Worst Plan-146/mo- 6k deductible- annual cost if nothing happens- $1752

Worst plan- worst case- out of pocket max- $12,700+1752

Diffence in annual premium- (5256-1752)=3504


Regardless of politics, the business of health care, or the speculation. The whole point of insurance is that you do not KNOW what life will bring. You can gamble in either direction.
I'm more one to hedge my bets, and regarding money- cash is king.

The numbers above are what matter to most, relatively healthy, young and even middle aged folks.

Take this example longer term-
Bottom of the barrel plan costs you $1752 annually.
You save $3504 per year making this choice.
Whether you take tax advantage with a self funded HSA or have enough discipline to set your own aside...

Your bottom of the barrel plan has a max annual out of pocket of 12,700 plus premiums.
$12700/3504= 3.62. As in, after 3.62 years- or the fourth year- you have saved enough in premium difference to fund the 12,700 dollars needed in a catastrophic health event.

If you self funded- you would be putting in 1752 a year since you bought no plan.
Assume a catastrophic event occurs costing $25,000. It would take 14.26 years of absolutely nothing happening for you to self fund this incident.
If you saw a Doc once a year, at $150 per visit- it would now take you (25k/(1752-150) 15.6 years to save enough. Roughly from age 25 to age 40.

Some level of coverage makes sense to avoid financial ruin in the event of something serious.
Bottom of the barrel- return on savings means you effectively have the best coverage available within 4 years time. And continue to save on cheaper premiums.
The best coverage available means you will likely loose money and fund the pool.
No coverage is unrealistic, and akin to gambling with your money IMO. Perhaps under age 30-35 you could make the argument, after that- you are playing a loosing hand.

[Just Bill]

One more thing I would like to add is that cash paying customers get huge discounts on medical bills vs those that pay with insurance. I recently took my son in for immunizations and they quoted me 360$ at the end. I informed them I was paying cash and then they said oh, then it is 180.

In actuality- you did not receive a cash price. You received the negotiated rate.
Not picking on you- just passing on info.

A doc bill the insurance $360, $500, $1000- whatever really. In actuality they know the insurance company pays $180. Period.
This silly game they play costs us all money. Simply billing the published/negotiated rate would save us all headaches and money.

Offering to pay cash, typically gets you the negotiated rate.
Because of liability insurance, and actual CASH, as in off the books, transaction is increasingly rare. That would have been $75-$150.
However, if you come back and sue/complain/etc. Since the provider took cash and did not put the transaction on the books they would not be covered by their liability insurance.

True cash prices are more likely to be found at a small clinic when passing through, where the Doc actually owns the office and is willing to make the judgement call. Something simple like you come in with an infected blister and need a script for anti-biotic.

[hikeandbike5]

Bottom of the barrel plan costs you $1752 annually.
where are you getting these numbers from?

[Just Bill]

Regarding my post above-
regarding self funding (no insurance)
Keep something in mind- that's only $25k. Which is nothing. If you need a heart like Gator- with zero insurance coverage- you are self funding the whole deal. There are very few people who can recover from 100k, 200k or more.
Put another way-
$1,752/year times 60 years of coverage- $105,120
So a $100k event justifies base level coverage in your lifetime. 100k, unfortunately, is nothing in regards to healthcare costs.

My family was billed roughly 28,000 to bring a baby into this world, via natural birth, with no drugs or specialists needed.
I have two kids. Forget catastrophe- two happy events would have cost me roughly 50k out of pocket if self funding. I am 35, and already recovered half of my 100k of lifetime premiums.

[Just Bill]

where are you getting these numbers from?

https://www.healthcare.gov/
these are my local quotes- 35 year old, in illinois, in cook county.
Your numbers may vary.

Reimbursements-
Looking again, I tried 50k income- no supplements. typed in 40k income- and I was told supplements are available.
Didn't get any more into it again myself, but I recall that aide is available to supplement the cost depending on income level.

[Alligator]

Believe me meat803, I understand insurance of any kind is a negative return. There's overhead to pay on it. Just like you pay the house at the casino. It's a long term negative. Insurance works because the catastrophic event is too much for one individual to bear. Auto insurance is the same way. Even lesser than catastrophic events are expensive as far as medical costs (e.g. MRI). Our OP isn't likely to have a few hundred thousand dollars squared away anyway, and not likely to be able to squirrel that much plus tge cost of a thruhike in the mean time. That's like twice as much money she'd need.

[wdanner]

Health insurance is a scam. Live healthy and save your money. If you live debt free, live within your means, and save money, you will have more than enough cash to cover any medical costs you incur. That is of course if you eat right and maintain a healthy lifestyle. As a member of this site you are probably healthier than 90% of Americans. I refuse to share a policy with those slobs. I agree with a lot JustBill said in his first post.

I wish this were true. Some times things just go wrong. Like when I jumped to spike that volleyball. My left knee popped when I landed. It'll never be the same. At 30. Or like when my Dad was riding his bike and a car clipped him going 50 mph. There's an incident that wasn't even self-created. Guy was driving drunk. Dad had no insurance and the basic 2 day hospital stay with nothing but bloodwork and an MRI was $30,000. The owner of the vehicle only carried $25,000 worth of coverage so it didn't even cover the first two days, let alone the months of pain medication afterward or the treatments he should have gotten but never did because he had no money. If he owned anything of value the hospital would have gone after his assets. About the only time it pays to be a pauper.

You just never know what will happen. Catastrophic insurance at a minimum is the only intelligent choice.

[Another Kevin]

Believe me meat803, I understand insurance of any kind is a negative return. There's overhead to pay on it. Just like you pay the house at the casino. It's a long term negative. Insurance works because the catastrophic event is too much for one individual to bear.

Health insurance sometimes actually works out to be a positive return, simply because it's a collective bargaining arrangement. The insurance company is negotiating costs with the providers, and sometimes can get a much better price than you would individually. (Of course, you can always go begging a hospital administrator for a better deal, and often get it, but it feels like begging, not bargaining.) In fact, for most healthcare other than the catastrophic variety, I wouldn't mind a high-deductible fee-for-service arrangement, as long as I can pay someone else a little bit to negotiate fees so I don't get gouged.

The big flaw in the current system is on the settlement side. I have personal horror stories about being chased by collection agents for bills that my insurance had already settled, or that were never presented to the insurer. And everyone - provider, insurer, and collection agent - is simply saying "we know the charges are fraudulent, but paying them is the only way to make them go away." And apparently that racket is perfectly legal, because everyone can blame someone else.

[Just Bill]

The option sympathetic joy posted is an excellent one most likely. Well worth researching and likely a more on topic answer for a Thru.

Regarding insurance in general- the rule of thumb taught to me. You only need to cover your ASSets if you have something to cover.

If you are a broke 23 year old college grad with a massively negative net worth and nothing to lose (financially)- it will cost you less out of pocket to just pay in the event something happens. Likely you are better off keeping your $1500 in the bank instead of making insurance payments, as the most likely thing to happen medically is nothing at all. If something catastrophic happens, the worst thing that happens financially is you go bankrupt I suppose.

I personally made that choice/took that risk, even as a business owner, into my late 20's. I had no health insurance on my first thru, and paid roughly $500 for medical services out of pocket. I would consider that expense unusual and still would not have made a different choice if I were to do it again.

The OP is 30, likely the age when the financial scale starts to tip in your favor a bit and you have some assets to cover, and a higher risk of having medical expenses. As I mentioned- a happy accident- like a pregnancy still costs money. The rules are still a bit murky on this but if you get knocked up- you can't go get insurance and be covered 100%, even though it is technically a "pre-existing condition". The birth may get covered, but the pre-care may not. The reason to keep coverage going is because of this tricky area, the rules are set up so that you can't drop insurance when healthy, and pick it up when needed. So just because there are no pre-existing conditions exclusions, does not mean you can pay a doc $150 to diagnose you with cancer and then run out and get insurance to cover you before your next visit.

As Kevin points out though- having any coverage at all- allows you access to the insurance rates your insurer has negotiated with your provider, regardless of deductible. The Doc can bill anything they want, but the rate is $98 on my insurance. Even though I am paying the $98 out of pocket- I have the insurer to negotiate the bill. Crappy coverage still buys you something.

Insurance is always a negative return on average, when you are the un-average person and something happens, it is a positive. I didn't get in a car wreck this month, but several thousand people did who greatly value the coverage and are net positive on their investment.

[Alligator]

I understand your point Another Kevin but I am highly skeptical that the amount of money the insurance companies consume for operating expenses (+ possible profit) is less than the amount of money they might save consumers through rate bargaining.

This isn't what the OP asked about though. Let's get back on track about navigating the new healthcare regs because carrying insurance on the hike comes up nearly every year.

It might be helpful to know same basics about her current insurance or lack if.

[saralynne1982]

OP here-I have a PPO network plan with a 2500 deductible and a heath savings account. However, my organization is switching to a new plan in coming months so I am not sure what the features of the new plan. I know I originally used the term sabbatical, but I am actually planning on resigning from my organization and relocating after my thru-hike. I considered the Cobra option and can see how much that will cost when the time comes, but I have found in the past that is usually higher then some higher deductible plans I could choose. I am rather healthy but do take a daily medication. I also only pursue medical care for preventative care or as a last resort.

[magneto]

Any discussion of the cost of insurance plans without knowing the list of coverages, exclusions and providers is useless. Read the fine print on those healthcare.gov plans and you will understand how they arrived at their pricing: by covering less, excluding more and restricting providers. Nothing is free - including health care. You have to pay - either self-pay or insurance. Pre-existing conditions now covered? Sure - but look at the deductibles, copays and providers. You might have a condition that no one on your plan treats.

[Offshore]

Health insurance is a scam. Live healthy and save your money. If you live debt free, live within your means, and save money, you will have more than enough cash to cover any medical costs you incur. That is of course if you eat right and maintain a healthy lifestyle. As a member of this site you are probably healthier than 90% of Americans. I refuse to share a policy with those slobs. I agree with a lot JustBill said in his first post.

Let's hope you never have to prove yourself wrong, but meanwhile medical bills remain the number one cause of bankruptcy. At age 37 you are quickly leaving the "invincibility demographic"...

[magneto]

It is possible to negotiate for healthcare services, even big ones, without using insurance. Insurance has distorted the market and made everything more expensive.

It is completely reasonable for a they hiker to pay out of pocket or make payment arrangements for needs on the trail. You don't need insurance to hike and a fall with broken bones won't bankrupt you.

[sympathetic joy]

It is possible to negotiate for healthcare services, even big ones, without using insurance. Insurance has distorted the market and made everything more expensive.

It is completely reasonable for a they hiker to pay out of pocket or make payment arrangements for needs on the trail. You don't need insurance to hike and a fall with broken bones won't bankrupt you.


Just to make sure people understand part of the issue - if you don't have insurance - and something happens to you and you seek out care - and you think you can negotiate treatment - you may be in for a big surprise.

Doctors, hospitals, and even emergency rooms can deny to treat you if they think they may not get paid.

If you go to an emergency room, by law they have to exam you and if your condition is acute 'stabilize' you. But they don't have to treat you.

If you do get treated, something like a torn acl would cost at least $20,000 (http://health.costhelper.com/acl-reconstruction.html).

[magneto]

They don't have to treat you even with insurance. They can demand you pay the whole deductible on your plan first, which can be thousands of dollars.

Once stabilized you can go home and seek out proper care. There are many alternate ways to pay even for a $20K procedure. These range from payment plans with the surgeon to third party financing. It's like buying a car. You pay so much a month plus interest.

I've used such services for non-insured incidents, it's not so bad.

Without insurance, things can be a lot cheaper because you can negotiate directly for a cash price.

[Offshore]

Without insurance, things can be a lot cheaper because you can negotiate directly for a cash price.

I'm no fan of the heath insurance industry but I am a pragmatist. One of the biggest benefits of having insurance is that the insurance company negotiates discounted fees for services with providers. Even if you are paying cash because you haven't met your deductible, you get the benefit of these negotiated discounts.

Its just naive to believe that you have anywhere near the negotiation position as the large insurers. If you are uninsured, you actually wind up being charged the highest prices because providers price their services with the expectation that the fees will be negotiated down for insured patients. The difference is made up with higher fees charged to cash patients. So, except for the most minor of illness or injury, the uninsured patient either owes a ton of money or uses charity care or skips out on the bill (thus raising cost for the rest of us who actually take responsibility for ourselves and mitigate our risks with insurance). The whole rugged individualism thing just goes so far before reality kicks you in the rear.

[magneto]

That's not been my experience. You can pay for major medical expenses over time, just like everything else in this world or you can pay up front with and insurance policy.

Many providers would rather not deal with insurance and will happily give a big discount for cash or for a non-insurance payment plan.

In Massachusetts I had a procedure at Brigham and Women's hospital that the hospital billed the insurance company $66K for. The surgeon quoted me $20K soup-to-nuts to do the same procedure with him directly at a smaller hospital and that price included a small insurance policy to cover unforeseen complications. He even offers financing to cover the costs.

I don't think the insurance company paid 66K but that is what the hospital billed. It is bull**** and an example of how insurance distorts the market.

[slbirdnerd]

What JUST BILL said! I am a plan administrator. Anyone who needs to buy insurance should try to shop the Exchange first (Affordable Care Act/"Obamacare").

Here is the link: https://www.healthcare.gov/marketplace/b/welcome/

[rickb]

Many providers would rather not deal with insurance and will happily give a big discount for cash or for a non-insurance payment.

Private insurance typically pays more than the the Medicare schedule. My understanding is that if a provider offers any discount that is substantially below what Medicare would pay, they get slapped pretty hard-- and might be removed from the Medicare program altogether.

I could be wrong.

Probably a moot point if what you are looking at is a bill that breaks you whether it is discounted or not. So much comes into play-- are you looking to ensure the best possible health care if you need it? Protect your own assets? Your families?

One thing is for sure, a great may people pay for stranger's healthcare in addition to their own.

[magneto]

I'm not talking about Medicare. Medicare is insurance for the non-working elderly. Medicare pays a set reimbursement rate they is very, very low. Many doctors don't accept it anymore.

Why would it "break you" to pay off a big medical bill over 5 years? Just make a deal for something you can afford.

People that work in the finance office of medical practices are not automatically jerks. They understand people need time to pay. It is also profitable business for the medical practice. They want your business and will work with you.

I just gave you an example of a surgeon who deals direct, including financing.


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[magneto]

And the health care exchanges are a joke. I pay $1900 a month for coverage for my family. This is traditional Blue Cross coverage that includes a decent provider network. It is not a cut-rate plan offered by healthcare.gov. So that is ~$25k per year, every year. No way we use that much.


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[Ktaadn]

You just never know what will happen. Catastrophic insurance at a minimum is the only intelligent choice.

I think catastrophic insurance should actually be the maximum and only intelligent choice. That is the reason that insurance was created in the first place, to save you from catastrophic loss. I mean that for all insurance, not just health.

[Offshore]

And the health care exchanges are a joke. I pay $1900 a month for coverage for my family. This is traditional Blue Cross coverage that includes a decent provider network. It is not a cut-rate plan offered by healthcare.gov. So that is ~$25k per year, every year. No way we use that much.


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Then why do you carry insurance? Why not self-insure and negotiate as you go along as you seem to be advocating to the OP?

[magneto]

I live in Massachusetts and I am required by law to carry medical insurance.

With the kind of money I am paying, it may be worth it for me to buy a very minimal government insurance policy and then self insure the rest of the way. I am considering that.


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[Offshore]

I live in Massachusetts and I am required by law to carry medical insurance.

With the kind of money I am paying, it may be worth it for me to buy a very minimal government insurance policy and then self insure the rest of the way. I am considering that.

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That would seem to make sense. Go for a high deductible plan with a healthcare savings account for some added tax benefits.

[magneto]

My PCP doesn't take insurance as primary payment. He charges a flat fee for the year and that gives me access to him directly, via his cell phone. We settle up for services each visit, but due to the flat fee structure, payment is not always due for each visit.

He will take my insurance when payment is due but he says it is increasingly more expensive each year to do so. I've seen the regs as I believe him.

Before he switched to this style of practice, he had whole staff positions dedicated to processing insurance claims. Now all that is gone and he has fewer patients, resulting in better service.

This model of medicine makes at lot more sense to me and I spend a lot less time dealing with doctors.


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[magneto]

That would seem to make sense. Go for a high deductible plan with a healthcare savings account for some added tax benefits.

Unfortunately, the ACA is making that HSAs illegal. You have to choose the crappiest plan available to avoid the income tax surcharge - then pay the rest out of pocket. It will be after tax dollars but freedom isn't free. So if you want out of Caesar's system, you have to pay him for the privilege.

Now, let's return to hiking...


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[Offshore]

Unfortunately, the ACA is making that HSAs illegal.

Not true, most bronze level ACA plans let you have an HSA.

But getting back to the thrus out there -

Remember that under the Affordable Care Act, if a parent's plan covers children, they can be added to or kept on a parent's health insurance policy until they turn 26 years old. Children can join or remain on a parent's plan even if they are married, not living with their parent, attending school, not financially dependent on their parents or eligible to enroll in their own employer’s plan. These rules apply to both job-based plans and individual plans bought inside or outside the Marketplace. So if you are under 26, stay on a parent's plan if possible.

As to the original poster who is 32 and taking a sabbatical and will be back to work, I'd ask your employer about options for health insurance continuation. An idea would be to offer to pay both the employer and employee portions of the premium (sort of like COBRA works if you leave a job). You'll at least get the benefit of the group policy rate.

[BuckeyeBill]

I have been reading this thread from the beginning and thought I would chime in on a related subject. My father's doctor told my dad that he had just lust attended a conference sponsored by an insurance company. They told him (the doctor) that if they were spending more than 10 (ten) minutes with a patient they were losing money.

I have seen my own doctor come in the room listen to my stomach (Crohn's disease) and ask me how I feel. I tell him fine.Total time 5 minutes and he checks a medium visit on the patient billing sheet. My pulmonary doctor does the same thing. At times I feel cheated but at least I am not fighting a flare in my gut and I can breath OK.

[Just Bill]

I have been reading this thread from the beginning and thought I would chime in on a related subject. My father's doctor told my dad that he had just lust attended a conference sponsored by an insurance company. They told him (the doctor) that if they were spending more than 10 (ten) minutes with a patient they were losing money.

I have seen my own doctor come in the room listen to my stomach (Crohn's disease) and ask me how I feel. I tell him fine.Total time 5 minutes and he checks a medium visit on the patient billing sheet. My pulmonary doctor does the same thing. At times I feel cheated but at least I am not fighting a flare in my gut and I can breath OK.

My mother (A nurse) left the bedside long ago for insurance coding, case management, and physician group consulting. It is quite sad really. As far as I understand- the medium visit is an internal metric used by a physician consulting group- the insurance company doesn't pay by the hour, only by the visit- but the bean counters the doctor's group pays to bean count do track the doc's production that way. Many of those little remarks on the paperwork are for internal billing methods.

The Doc is losing money if he is there longer than 10 minutes per hour because 20 minutes of that hour are wasted in office overhead simply to bill an amount they can't collect. The doc's groups and consultants have added "creative billing" into the mix and further messed up things, putting the insurance company on guard or forcing them to reduce payments. You can bill a $90 office visit, or break it down into each band-aide and asprin and collect $95 for a month. Eventually the payer figures it out and pays you $90 again. Or more often- they are more creative than you and you get $80. Then the doc group cries about not getting paid and hires a new consulting firm.

Hopefully, much like car insurance, mandatory insurance is the first step in cleaning up this mess for us all.
No other form of insurance I have dealt with is as convoluted or spends so much money insuring itself from itself. There is not an entire industry of workers out there disputing, misfiling, consulting, or outright stealing for Auto, Home, or life insurance. Have you ever heard of a company having a plan administrator for their vehicle insurance? My current company had 55 vehicles at one point, which required virtually no overhead. But we had a full time plan admin, and no less than three consulting firms to review claims and ensure that our HSA was not being abused by the insurance company. So now the employer needs their own consultants to outwit the doctor's and insurance company consultants.

Malpractice insurance is a significant cost for docs, but no other industry has such a complicated and expensive system of billing for services, and as a result this overhead is passed on. Everyone knows the negotiated rate is say $90, why the doc bills $180 to the insurance company to review and reduces is beyond me. If you take XYZ insurance, you are aware of what XYZ insurance pays regarding it's negotiated rate. Why you would intentionally add another 30-45 days to your receivables turn-around when you know you can only bill $90 is silly. Add carrying the costs incurred for the service for 90 days to add insult to injury. Receivable turn-around puts construction companies out of business, I have no sympathy for the Doc's in this regard.

A scary thought, mostly off topic- physical insurance companies (like home, auto, property) are currently paying roughly $1.16 in claims for ever $1.00 they collect. (Lowest number I heard) Generally these companies are not exempted from "Act of God" coverage. As in, you can't deny a flood insurance claim by declaring the flood an act of god. HOWEVER, in an interesting turn of events for global warming, it may be possible to deny coverage due to "acts of man" beyond the data available to the insurer. The insurance companies are currently working to declare events that exceed available 100/500 year data as the result of human induced global warming, and therefore not covered. The insurance companies are not set up to cover 100 year events every five years, and that system will not tolerate it for much longer. So global warming advocates suddenly have a powerful interest mobilizing...

Just another exciting prospect on the horizon.:rolleyes:

[magneto]

Insurance companies can pay out more on claims than they collect in premiums and still make money because they invest the premium dollars they collect and earn a rate of return.


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[Alligator]

I am going to ask again for people to dial in the conversation to address the OP's question.

For instance, how might changing residency affect her insurance? How do states determine this and are there common rules? If she relocates, it may be beneficial to maintain one or another plan until she makes a transition. Is there some kind of grace period to do this, because rates between say SD and MA may be very different.

[Just Bill]

Yar- no more from me, rounded the bend somewhere in there into crazy town.:o

[sympathetic joy]

Check out World Nomads:

http://www.worldnomads.com/


They are geared for international travel but domestic travel health insurance is possible. A 6 month policy is $335. They do have a rule for domestic travel that it only covers you if you're more than 100 miles from 'your' home.

http://www.worldnomads.com/travel-insurance/prices-and-benefits-country.aspx?Country=USA

You should call or write them with any questions. I used them for a 1 month policy when I was traveling overseas. Luckily I didn't have to use the policy. Hiking is one of the covered activities for USA residents under their standard plan.

http://www.worldnomads.com/travel-insurance/adventure-travel-insurance.aspx

I"m not one to quote myself - but with all the side chatter I didn't want this to get lost. I still think this has the most potential for the OP.

[no-name]

In my experience, there is what the health provider charges and the negotiated rate they will get from the insurance company.
I am always amazed at the difference between the amount that is billed and then what the heath care provider actually gets paid (bcause of insurance). Alot of people have financial trouble because they are charged the full amount
I see the benefit of having a heath insuance card as a way to get the lower negotiated rate.
I wonder what the cheapest card I can get at 49, just to give me "negotiated" rates?

[Aussie Legs]

I plan to take out international travel insurance (I'm from Australia) - I'm hoping that will be enough to cover any health issues/doctor's trips that I might encounter along the way... I'm assuming I'd have to pay upfront and then claim it back later. All this discussion about health cover is a huge eye opener - Australia's health system must be pretty good... anyone can enter ED and become a "public patient", meaning they don't pay for any treatment they receive while there. I really should get around to getting some health care cover back here though, in case I have to have physio or something on my return (although this could be covered by travel insurance if it's a result of an accident that occurs while overseas). Any other hikers coming internationally?

[2015 Lady Thru-Hiker]

I"m not one to quote myself - but with all the side chatter I didn't want this to get lost. I still think this has the most potential for the OP.

Don't know about the OP but I will be in pretty much the same situation and plan to look into the domestic insurance option. If it is only around 300-500 dollars I'll probably do it. Falling and breaking my wrist while hiking in NY cost me over 500 with insurance.

[Traveler]

OP here-I have a PPO network plan with a 2500 deductible and a heath savings account. However, my organization is switching to a new plan in coming months so I am not sure what the features of the new plan. I know I originally used the term sabbatical, but I am actually planning on resigning from my organization and relocating after my thru-hike. I considered the Cobra option and can see how much that will cost when the time comes, but I have found in the past that is usually higher then some higher deductible plans I could choose. I am rather healthy but do take a daily medication. I also only pursue medical care for preventative care or as a last resort.

Keep in mind COBRA plans will require you to pay the full cost of your insurance that is incurred by your employer. For example, if you pay 150 a month you will pay that, plus the balance of cost your employer subsidizes you. On that initial cost of 150 you may find a 400 dollar monthly bill. Its not a lot, but if its not considered it may come as a surprise.

[Offshore]

Keep in mind COBRA plans will require you to pay the full cost of your insurance that is incurred by your employer.

+1 - and you may find that the employer share for which you are now responsible is 2x - 3x your former share of the premium. Terminating employment may allow the OP to qualify for a special enrollment period under the ACA exchange in their state, so its worth checking out the cost of COBRA vs. the state exchanges.

[fiddlehead]

It's an old argument on whiteblaze.
There are those who feel you need it, and others who think it's a waste of money.
I'm in the latter group.
Always have been.
But, now that i have a son, I went out and bought some.
Breaks my heart every time the bill comes.
Still haven't used it.

I did 3 or 4 thru-hikes on the money I saved by not paying before.

Why do you think Warren Buffet is one of the richest guys in the world.
Where do you think he has most of his assets? (it ain't coke)

[Offshore]

But, now that i have a son, I went out and bought some.
Breaks my heart every time the bill comes.
Still haven't used it.)

I can appreciate your frustration. I'm come to terms that part of what you buy with insurance is peace of mind - and only you can judge what that's worth to you. I never complain about not using my health insurance - that means things are going well.

[MuddyWaters]

Everyone knows the negotiated rate is say $90, why the doc bills $180 to the insurance company to review and reduces is beyond me. If you take XYZ insurance, you are aware of what XYZ insurance pays regarding it's negotiated rate. Why you would intentionally add another 30-45 days to your receivables turn-around when you know you can only bill $90 is silly. Add carrying the costs incurred for the service for 90 days to add insult to injury. Receivable turn-around puts construction companies out of business, I have no sympathy for the Doc's in this regard.



For the percentage of treatments that you dont receive payment for, which would you rather write off against your taxes as a loss. 90, or 180? But its much worse than that, the billed charge may be 10x greater than the insurance negotiated payment. Writing off uncollected charges can net you more income than collected ones.

They arent losing money.

[sympathetic joy]

For the percentage of treatments that you dont receive payment for, which would you rather write off against your taxes as a loss. 90, or 180? But its much worse than that, the billed charge may be 10x greater than the insurance negotiated payment. Writing off uncollected charges can net you more income than collected ones.

They arent losing money.

I don't think there is a tax advantage when a doctor writes off an unpaid medical bill. They could send the debt to collections but getting only pennies on the dollar isn't much of an advantage either.


Let’s get the bad news out of the way first: If you sell your services, you cannot deduct an unpaid bill as a bad debt. No tax deduction is allowed for time you devoted to the client or customer who doesn’t pay. The tax code rationale is that if you could deduct the value of unpaid services, it would be too easy to inflate your bills and claim large bad debt deductions—and too hard for the IRS to catch you.

http://www.unclefed.com/AuthorsRow/Daily/fwdbaddebts.html

[Dogwood]

Many thanks to all who contributed. Somehow it didn't get over the cliff political either. :) I can say I definitely learned much about health insurance options. Being usually self employed or a part time consultant while periodically interjecting multi month hikes makes it harder(ie; definitely more costlier!!!) for me under the new health care law(ACA, Obama Care) as opposed to what I used to do something akin to what Magneto did(HSA) by saving on the side specifically budgeting for healthcare costs allotting a disciplined % of my income or through longer term financing through my medical providers OR being part of a collective(NOT insurance) that negotiated lower rates on specific procedures like dental work. BUT, I've been fortunate to largely not need major $$$ value treatments OR was out of work unemployed when one major $$$$ healthcare emergency occurred needing open heart surgery of which I didn't pay anything other than what I could afford at a top notch NJ Heart and Lung Center. In many ways, not being a typical full time employee(these days that's considered 30+ hrs per week) 52 wks per yr I will pay more in healthcare costs and my options are fewer NOT greater under the ACA. So much for it being affordable for me!~ When I hike oversees I will consider the option given by Sympathetic Joy.

[Pedaling Fool]

It's an old argument on whiteblaze.
There are those who feel you need it, and others who think it's a waste of money.
I'm in the latter group.
Always have been.
But, now that i have a son, I went out and bought some.
Breaks my heart every time the bill comes.
Still haven't used it.

I did 3 or 4 thru-hikes on the money I saved by not paying before.

Why do you think Warren Buffet is one of the richest guys in the world.
Where do you think he has most of his assets? (it ain't coke)
Reminds me of my time in the military, spending tons of time practicing certain evolutions. Kind of makes you want to employ them or else what's the point:)

[ZenRabbit]

Did you have a nap

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[ZenRabbit]

Did you have a nap

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Hahaha, it can darn sure save your health. Lol

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[10-K]

Not true, most bronze level ACA plans let you have an HSA.


Correct, and the HSA is one of the best retirement savings vehicles available because unlike an IRA (either ROTH or traditional), there are no limits on income and the money contributed does not have to be earned income.

We use a bronze plan coupled with an HSA, contribute the max to the HSA each year, and never touch the HSA for medical expenses.

[Toolshed]

Insurance is simply not a scam...
I've been fortunate enough to work in the health care industry - I did work in Finance for an HMO. And many HCO's have razor thin margins. A big benefit of having basic insurance (and what many do not understand) id that if something happens, even if you have a high deductible, you will pay the rates negotiated by the plan and not what the max that a hospital could bill for. case in point - a basic chest xray - A hospital nmight bill you $600-$900 as a cash paying patient. You might be able to negotiate it down to $300-400 if you are lucky.. CMS pays about $11.79 for a chest Xray. Insurance might negotiate $25-$50 for that same x-ray. you would get that negotiated rate. It is a big plus if you have heavy InP or OutP medical expenses.

I have always taken great care of myself, I'm a military vet, I eat right, former runner, biker and bodybuilder. (not all at once). I have had 4 heart surgeries for a bad aortic valve, over the past 12 years. total bill from hospitals - over $2M. total out of pocket with deductibles and copay's just under $20K. Life happens,

On another note, my 6 year old daughter - fastest runner in her class, participates in gymnastics, lacrosse, and was recently chosen as a U9 soccer player. She Was swimming at the start of July and had an arterial venous formation in her brain burst and went into a stroke and seizure. She was Mercy-flighted to a top Childrens hospital where she underwent multiple brain surgeries in attempts to save her life. She made it and after 7 weeks in Ped ICU, she was recently discharged to inpatient Rehab where she is partially paralyzed and learning to walk and use her right hand again, if her right side comes back.. Total cost - well over a Million$$.
insurance saved us from bankruptcy, although I would gladly go through it to save her her life. Life throws you curve-balls and accidents illnesses and diseases happen. I hope you are one of the lucky ones and never need hospitalization, but it happens and insurance can make a huge difference in your care and quality of life.

[jjozgrunt]

I plan to take out international travel insurance (I'm from Australia) - I'm hoping that will be enough to cover any health issues/doctor's trips that I might encounter along the way... I'm assuming I'd have to pay upfront and then claim it back later. All this discussion about health cover is a huge eye opener - Australia's health system must be pretty good... anyone can enter ED and become a "public patient", meaning they don't pay for any treatment they receive while there. I really should get around to getting some health care cover back here though, in case I have to have physio or something on my return (although this could be covered by travel insurance if it's a result of an accident that occurs while overseas). Any other hikers coming internationally?

G'day Legs

Make sure that you get a top quality cover as not all are created equal. Don't just opt for the cheapest, been there done that and suffered because of it. I use QBE and have had to use it to get treatment and evacuated from Madagascar with a serious form of malaria and they were excellent. There is a reason that they ask if you are traveling to the states and that is because compared to ours it is very expensive. Make sure you compare what you get and limits, the higher the better for the states.

JJ

[Just Bill]

Insurance is simply not a scam...
I've been fortunate enough to work in the health care industry - I did work in Finance for an HMO. And many HCO's have razor thin margins. A big benefit of having basic insurance (and what many do not understand) id that if something happens, even if you have a high deductible, you will pay the rates negotiated by the plan and not what the max that a hospital could bill for. case in point - a basic chest xray - A hospital nmight bill you $600-$900 as a cash paying patient. You might be able to negotiate it down to $300-400 if you are lucky.. CMS pays about $11.79 for a chest Xray. Insurance might negotiate $25-$50 for that same x-ray. you would get that negotiated rate. It is a big plus if you have heavy InP or OutP medical expenses.

I have always taken great care of myself, I'm a military vet, I eat right, former runner, biker and bodybuilder. (not all at once). I have had 4 heart surgeries for a bad aortic valve, over the past 12 years. total bill from hospitals - over $2M. total out of pocket with deductibles and copay's just under $20K. Life happens,

On another note, my 6 year old daughter - fastest runner in her class, participates in gymnastics, lacrosse, and was recently chosen as a U9 soccer player. She Was swimming at the start of July and had an arterial venous formation in her brain burst and went into a stroke and seizure. She was Mercy-flighted to a top Childrens hospital where she underwent multiple brain surgeries in attempts to save her life. She made it and after 7 weeks in Ped ICU, she was recently discharged to inpatient Rehab where she is partially paralyzed and learning to walk and use her right hand again, if her right side comes back.. Total cost - well over a Million$$.
insurance saved us from bankruptcy, although I would gladly go through it to save her her life. Life throws you curve-balls and accidents illnesses and diseases happen. I hope you are one of the lucky ones and never need hospitalization, but it happens and insurance can make a huge difference in your care and quality of life.

Best wishes to your daughter, you and your family.
Tough story...