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theotherbrady
10-02-2016, 19:12
I'm sure this has been discussed before but it's a new year and there are always new things. My wife and I are planning a through hike next year and we are wondering what our options are for health insurance. What have you done? What are you planning on doing?


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Uncle Joe
10-02-2016, 20:10
My company has an accidental addition I can add in case I fall and hurt myself. The rep said, "A broken bone is worth about $4k in cash!" All for about $4 a paycheck. Giving my proclivity to hiking and mountain biking I'm considering it. :-?

Venchka
10-02-2016, 20:23
What kind of health insurance makes you pay extra for accidents??????????
I'm glad that I worked for people who took care of their employees.
OP:
COBRA? ObamaCare? Medicare?????

Wayne

Uncle Joe
10-02-2016, 21:20
What kind of health insurance makes you pay extra for accidents??????????
I'm glad that I worked for people who took care of their employees.
OP:
COBRA? ObamaCare? Medicare?????

Wayne

No, sorry this is more supplemental. It would give you some immediate cash as opposed to just covering your medical.

Venchka
10-02-2016, 22:36
Oh. Like short term disability. Got it.
Wayne


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turtle fast
10-03-2016, 03:38
Off to the exchanges and pray you find something somewhat laughably "affordable". You could check the private insurance market as well. With the Obama care law, you have to have insurance or your penalized. So for a thru-hiker who isn't actively working, it's an added economic burden. Before, you could purchase lower cost catastrophic insurance to cover you but the Obamacare law terminated them.

MuddyWaters
10-03-2016, 06:32
Yep, not to be snarky, but your option for healthcare ( required by law) has nothing to do with hiking.

Majority of thruhikers are on mommy and daddys insurance still, so not a big issue for them to be unemployed. People less than retirement/medicare age that want to quit job to hike .....have to be able to cover their healthcare expenses, and other things.

Engine
10-03-2016, 06:40
I just retired last month and had some tough choices to make regarding insurance. I could have kept what was a pretty good policy from my employer, but I would have had to foot the entire $1,690 a month to cover both of us. I shopped around and found a better policy (max out of pocket $2,000 ea. annually) for $1,300 a month. That still hurt like hell, but what are you going to do...Insurance premiums suck until you need it, then they're a bargain.

I can tell you this, be very careful when shopping for a policy! There are companies out there preying on unsuspecting customers with policies that promise great coverage for less than 1/2 what you would pay elsewhere. Then you find out they don't cover major medical (heart attack, etc..) and you could end up screwed. A classic case of "If it sounds too good to be true..."

egilbe
10-03-2016, 07:13
I just retired last month and had some tough choices to make regarding insurance. I could have kept what was a pretty good policy from my employer, but I would have had to foot the entire $1,690 a month to cover both of us. I shopped around and found a better policy (max out of pocket $2,000 ea. annually) for $1,300 a month. That still hurt like hell, but what are you going to do...Insurance premiums suck until you need it, then they're a bargain.

I can tell you this, be very careful when shopping for a policy! There are companies out there preying on unsuspecting customers with policies that promise great coverage for less than 1/2 what you would pay elsewhere. Then you find out they don't cover major medical (heart attack, etc..) and you could end up screwed. A classic case of "If it sounds too good to be true..."

You know, if you are in good health, you are better off saving that $1300 a month and paying the penalty, at least for a few years. Obamacare was a bill of goods sold fraudulently to the American people.

Traveler
10-03-2016, 07:22
I'm sure this has been discussed before but it's a new year and there are always new things. My wife and I are planning a through hike next year and we are wondering what our options are for health insurance. What have you done? What are you planning on doing?

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Politics and questionable opinions of insurance aside, if you are currently insured through an employer and are taking a leave of absence, or will be quitting, you can continue your insurance policy via COBRA. This allows those leaving a company to access the health insurance policy the corporation provides, though you will pay the rate the company pays/paid for the insurance, usually doubling the cost. For example, if you have a policy now that costs you about $300 a month plus deductibles, you will probably be able to get it via COBRA for about $600 per month plus deductibles.

I would not advise one take on a trip like this without health insurance, its a long walk with a lot of hazards to ones health along the way that can cripple you financially if not prepared.

Derf
10-03-2016, 07:31
I'm sure this has been discussed before but it's a new year and there are always new things. My wife and I are planning a through hike next year and we are wondering what our options are for health insurance. What have you done? What are you planning on doing?


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My wife and I have used Allianz travel insurance in the past in 2015 they paid out over $5000.00 in claims for a trip to the ER and a one night stay in the hospital. They paid for the ambulance ride down to the last pill. Now with that said remember they do it through refunding you. They paid so fast that I never used any of our money. I think we paid like $48.00 for 7 months worth of coverage to cover the entire hike. It is all about how you fill in box's for a quote. Since we were hiking we only applied for medical and evacuation insurance which was what we were concerned about.
One stipulations is we had to be more than 100 miles away from home when we started and we had that covered.
Here is a link to them.
http://www.dpbolvw.net/click-7270627-10908424-1455930935000

Now if you want health insurance others have given great advice from cobra to other types of policies. As a vet I have the VA so it came down to my wife we did all of her yearly exams before leaving and while she was still covered with her plan. The doctor new what we were doing and prescribed different meds for the hike from doxycycline to some medicine for upset stomach that you put under your tongue, sorry do not remember the name but I can tell you it was great to have and cost $72.00 without insurance.

Best of luck on your hike.

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One Half
10-03-2016, 09:56
Off to the exchanges and pray you find something somewhat laughably "affordable". You could check the private insurance market as well. With the Obama care law, you have to have insurance or your penalized. So for a thru-hiker who isn't actively working, it's an added economic burden. Before, you could purchase lower cost catastrophic insurance to cover you but the Obamacare law terminated them.

If you aren't working you don't pay a penalty as the cost of insurance is capped based on income. We haven't had health insurance since they ACA went into effect. Can no longer afford the employer coverage! And have never paid a penalty. Google it: exceptions to health care penalty or some such. Use the IRS website. It explains all the exemptions.


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Engine
10-03-2016, 10:38
You know, if you are in good health, you are better off saving that $1300 a month and paying the penalty, at least for a few years. Obamacare was a bill of goods sold fraudulently to the American people.

As a former career Paramedic/Firefighter, you'll find no one more likely to agree with you about the current mess we call our national health care system. But, unfortunately, a couple of issues with cancer in the past 5 years have left me withy no choice but to maintain quality health care coverage. I went with a private policy through the same provider I had with my former employer. I trusted they would reliably cover any issues, which they have over the past few years to the tune of about $120,000.

nuknees
10-03-2016, 11:17
As an Unemployed migrant, or otherwise indigent, I thought no hospital anywhere could refuse to treat someone. Granted that's for life threatening emergencies. For things like a sore throut, colds, infected blisters, there should be free clinical care facilities some what nearby...you may have to hitch to get to one of course.
Am I incorrect in my assumptions?

rickb
10-03-2016, 11:25
You know, if you are in good health, you are better off saving that $1300 a month and paying the penalty, at least for a few years. Obamacare was a bill of goods sold fraudulently to the American people.

Depends.

If you are well into your career with a paid-off home and some non-IRA money you plan on using to buy groceries with when you are 70, lack of health insurance can be a risk.

Spirit Walker
10-03-2016, 12:11
If you do get insurance via the ACA exchange, make sure that it has an open network of providers (like BC-BS). Most of the cheaper options have a very limited network that may not work if you go to a doctor while you're hiking and far from your homebase. They will pay for emergency care - or at least a portion of it - but not follow-up if you are not in your home area.

When I was thruhiking, I didn't bother with insurance. I only needed to see a doctor once in 5 thuhikes. Now that I'm older, I have insurance in case of something catastrophic like cancer, but it is pretty useless for lesser medical issues because of the $5000 deductible.

BillyGr
10-03-2016, 12:19
You know, if you are in good health, you are better off saving that $1300 a month and paying the penalty, at least for a few years. Obamacare was a bill of goods sold fraudulently to the American people.

Or save a good chunk of that by going for one of the higher deductible policies out there.
That way you still save quite a bit on the insurance cost (which you can then have should you need it) and while you wind up paying most or all the cost if you need to go to a doctor for something simple you are at least covered should something happen that requires more costly care like a hospital visit or surgery (one of those things that turns into a 6 figure bill otherwise).

Coffee
10-03-2016, 12:35
Putting aside politics, it is not uncommon for thru hikers, especially younger ones, to get ACA policies that are sometimes almost fully subsidized. Since thru hikers aren't working half of the year, subsidies are likely especially for those who don't have high paying jobs the rest of the year.

This is just a statement of fact. Whether it should be this way is beside the point

Engine
10-03-2016, 13:15
As an Unemployed migrant, or otherwise indigent, I thought no hospital anywhere could refuse to treat someone. Granted that's for life threatening emergencies. For things like a sore throut, colds, infected blisters, there should be free clinical care facilities some what nearby...you may have to hitch to get to one of course.
Am I incorrect in my assumptions?

Yes, you are incorrect, there is no free medical care. Someone has to pay for it...

jeffmeh
10-03-2016, 13:16
Yes, you are incorrect, there is no free medical care. Someone has to pay for it...

+1. Same as lunch....

Panzer1
10-03-2016, 13:27
I believe hospitals are permitted to pass along costs that can't be paid by a patient to other patients that can pay. this is what keeps hospitals from going bankrupt.

Just Bill
10-03-2016, 13:30
Putting aside politics, it is not uncommon for thru hikers, especially younger ones, to get ACA policies that are sometimes almost fully subsidized. Since thru hikers aren't working half of the year, subsidies are likely especially for those who don't have high paying jobs the rest of the year.

This is just a statement of fact. Whether it should be this way is beside the point

Agree with this.
Also- for a relatively healthy person- a catastrophic plan (high deductible) can be purchased through the healthcare.gov website if there is a change in coverage outside open enrollment. You can purchase through private insurance as well but you need to be slightly more careful. You do get some tax breaks too if your income is below 50-60k or so (household).

I'd say you're best off with a catastrophic plan for something big and keeping the rest in hand for a clinic visit or two for minor stuff. Let's face it- you break something or have some thing serious happen you're going home for follow up care. Every plan covers emergency visits out of network- but 99.9% of the time you're heading home and can deal with follow-up within network.

Just Bill
10-03-2016, 13:43
I believe hospitals are permitted to pass along costs that can't be paid by a patient to other patients that can pay. this is what keeps hospitals from going bankrupt.

And part of the plan with mandatory health insurance too (kinda like mandatory auto owners insurance was.)

Regardless of the politics- next time you're a out hiking (not you personally Panzer) might wanna think a bit on things...

The largest populations are baby boomers and millenials. Seniors or the greatest generation (boomers parents) are a much larger group historically than ever before. And kids and folks my age fill things out- with only folks my age paying premiums really.

Have a baby- somebody is getting a 12-40k bill. Plus pre-natal care.
Have a heart attack or other fairly common medical crisis for folks aged 50-70 and likely you're getting a 100k bill at minimum. Plus follow up care.
Grandparents can chew up 10k a day for ER care. Even simply dropping dead is a bit rare as they bring folks into the hospital to linger for an extra week at 100k.

So you think on the 100 or so people you know or in your nuclear family... and how many babies were born or surgeries took place, or minor health services took place.

Even if everyone in that pool paid $500 a month (which they don't), for all 12 months of the year... that's 600k.
Two grandkids born, one adult with a grabber and heart surgery follow-up, an aunt with breast cancer, and finally great grandpa passing away and that pool of 100 folks likely pissed away or even overspent their premium pool just that year alone.

That's pretty much the health insurance problem- nothing to do with politics- just simple math.

Uncle Joe
10-03-2016, 13:55
...That's pretty much the health insurance problem- nothing to do with politics- just simple math.


Part of the simple math is exorbitant costs. One side of the argument says, "Hey, a heart attack can cost you $100k!" The other side is, "It shouldn't cost $100k!"

Sarcasm the elf
10-03-2016, 14:24
Part of the simple math is exorbitant costs. One side of the argument says, "Hey, a heart attack can cost you $100k!" The other side is, "It shouldn't cost $100k!"

When I looked into it some years back, close to 40% of the country's healthcare costs come from overhead and administration, both because of how insurance companies and by medical facilities operate. It's a nutty system to put it politely...

Uncle Joe
10-03-2016, 15:11
When I looked into it some years back, close to 40% of the country's healthcare costs come from overhead and administration, both because of how insurance companies and by medical facilities operate. It's a nutty system to put it politely...

It is crazy. Then you have a system that has been built on passing costs to each other and not strictly a market-driven system. Bandaids for $2 each didn't come about by market forces or Walgreen's would be selling them for that. It happens because of the unnatural (if you will) relationship between insurance companies and the medical community.

DavidNH
10-03-2016, 15:21
go on cobra. You'll have same policy you had while working but you pay full cost of the premiums. That is good for up to 18 months.

Coffee
10-03-2016, 15:29
It happens because of the unnatural (if you will) relationship between insurance companies and the medical community.

Exactly. It isn't a normal market where the end consumer of a service negotiates with the provider on price and quality. Similar markets where consumers and providers have a more normal relationship (dentistry, veterinarians) have more transparent pricing and more room to negotiate.

Just Bill
10-03-2016, 15:31
Part of the simple math is exorbitant costs. One side of the argument says, "Hey, a heart attack can cost you $100k!" The other side is, "It shouldn't cost $100k!"

agree...
Until uninsured folks stop ending up in the "general overhead" category it's hard to fix that part of the cost. (That's a political part of a solution)
It would help some of the administrative costs on all sides if you cut out the 4 rounds of "billing" and counter billing before a check finally gets cut for the amount everyone knew it would be in the first place- but that could be done right now and cut overhead for both sides- though medical billing is a big industry in it's own right so hard to (politically) cut all those jobs out.
Can't say much for tort reform as I don't care much for that part of things in either direction- but that's a form of overhead too.
Not sure about you, but if it comes time to get my engine repaired I'd rather be at the dealer (hospital) than jiffy lube (some clinic)- so hard to put a fair value on healthcare overall when it's your personal care.

You also have the traditional insurance company model of profiting on investments in the market or other sectors having been turned on it's head in the last decade at the worst possible time given the highest risk pool. If the decades long investments of un-used premiums had not collapsed (or been squandered/stolen by execs) then the funds would be there to cover a good portion of this pool of people today. Instead we must all simply cough up more and more dough to mitigate our personal risks to make up for the folks who were supposed to do that for a living and failed (or succeeded if you ask my stock broker/investment banker buddies).

So even if medical costs somehow all got cut in half... it still might not do it.
A generation ago- college aged kids were mainly out working (or at least hitting the street with a useful bachelors degree and earning by 25), now they are on their parents plans with deep debt and no real prospects. Fewer companies in general offer health insurance as standard for full time workers (or play games with payroll/hours to dodge it), so for some time a large portion of the working population no premiums. And the number of folks living from 80-100 is unprecedented as well.

Not sure there will ever be a solution as 2-3 generations used to pay mainly for 1 generation at a time. And to be blunt- you had a heart attack or cancer and you probably didn't make it long enough to rack up a 5-10 years of aftercare/surgeries or recover at all. Now you have 3-4 generations of folks drawing from the same pool of depleted funds and no good solution for that issue except to come back to all of us and tell us to keep dumping in more money.

It's very ugly, specially for someone my age dealing with parents, grandparents, and children as the only member of the workforce and trying to care for everyone involved.
If you have nothing to lose, that's one thing, but if you do... no option but to pay the premiums as intelligently as you can.

Sorry for the drift... this has come up a few times and so does the politics.

Few folks take a risk- usually mostly broke folks with nothing to lose. (Or college kids still covered)
Few folks keep insurance through Cobra.
Few folks pick up a catastrophic plan.
Few folks get some sort of trip/travel insurance and cross their fingers.
Some folks just factor in health care into their costs of a thru.

Just what you're up for depending on your financial position or risk tolerance.

If you do want to thank "Obummercare" for one thing you could not do before that benefits hikers tremendously- it's that you can drop and pick up a plan with no (real) penalty either during open enrollment or under certain conditions outside that time (like layoff or loss of coverage). It is much easier to buy a plan (without egregious exclusions or hidden gaps) than it ever was before. At least now- if you buy insurance- you may have to navigate some networks or deal with some hassles... but you won't pay a bunch of money in premiums only to find out that there are gaps or an encyclopedia's worth of excluded conditions.

In addition there are no longer blackout or waiting periods for coverage to take effect (mostly). So your policy won't say- preclude you from having a child within 24 months of signing up- or preclude non-emergency surgery, etc. So in the recent past a hiker who wanted to withdraw from insurance coverage could face some very real restrictions once they re-entered the work force or tried to restart their insurance. I personally paid cash for a decent bit of my wife's OB/GYN care as I was between jobs and could not, for any amount of money, purchase a private insurance policy that would even cover having children- it just wasn't an option for an individuals or small employers prior to the ACA. Thankfully the ACA went into law in time to cover the delivery etc... but if it had been a few years ago I would likely have had to file bankruptcy- not because I couldn't pay for health insurance- but because I simply wasn't even allowed to buy it. Happened all the time- and bankruptcy or not- somebody paid the bill when folks came in for healthcare not covered by their insurance- you know things like pregnancy, cancer, or the reasons you have insurance in the first place.

So like it or not- ACA has many good implications for a hiker (or anyone) leaving the workforce, switching policies (due to job change), small business owners or individuals.
There are some downsides for honest midsize employers- but most of those get mucked up in the overall mess that healthcare is for the foreseeable future, not because of actual issues with the new laws.
There is also intentional confusion and spin from insurers who feel it is unfair to actually provide insurance to those they collect premiums from.

Alligator
10-03-2016, 15:58
Hey folks let's keep the discussion on the options for insurance available and not why the system is in place or the mechanics of paying for the system.

Thanks.

volleypc
10-03-2016, 16:03
I am curious how student health insurance works. I read a while back about retirees taking classes just to save on health insurance because the student rates were cheaper. If you have a college nearby on the quarter system and you take classes for a quarter (Jan-Mar) can you keep the same insurance for the year? Or do you buy insurance for the length of the school term?

Just Bill
10-03-2016, 16:13
Hey folks let's keep the discussion on the options for insurance available and not why the system is in place or the mechanics of paying for the system.

Thanks.

Bad Bill... sorry:datz

Raid
10-22-2016, 19:07
Our son is in Law School, over 26 and not working where they offer insurance. We contacted the agent that handles our car insurance and found out they sell health insurance also. We found a few others that offer health insurance, the cost for $2000.00 deductible ranged from $175.00 to $184.00 per month, comparing apples to apples, they were all very close to the same cost for the same coverage. We were told those costs were similar to what we would find on the Health Insurance Exchange (Obama Care,) but we would not have to deal with the headaches of the exchange. Since I work for a hospital, I can tell you, there were initially some issues with the Exchange, not sure if there still is. For the record, ER's might not refuse you service, but the bill still has to paid at some time.

jjozgrunt
10-23-2016, 03:37
Bloo$y Hell I'm glad I'm not an American. $576us for unlimited cover with a $140 excess, in the states for 7 1/2 months, with travel insurance. I'm actually covered under reciprocal rights VA agreement, but noticed that the VA hospitals and care don't receive very good reviews. So I'm paying for my own medical insurance cost for my time there.

What's it actually cost to go to a local doctor? I might need to make sure I have extra money available just in case, as except for hospital care I have to pay for it and claim it back when I return.

slbirdnerd
10-24-2016, 08:17
For individual coverage, I've had luck in the past with Golden Rule which is now owned by United Healthcare. They have a national network so that's a plus. It was very affordable for me in my mid-30s. I'd look for individual coverage as opposed to buying on the Marketplace. (HR lady speaking.)

LucyInColor
04-23-2017, 11:32
I am covered through Kaiser, which is an HMO. This is my first year with them & am still figuring much of it out. My understanding is they cover out of network emergencies, but therein lies the dilemma. I was with an excellent company three years ago & was in network when I broke my arm. An ambulance ride to the ER, surgery with a plate & screws, two nights in the hospital, follow up visits, drugs & 40 PT sessions cost over $100,000, but my share was only $600. Had I been covered by Kaiser then I would probably have received pain meds & been transported to a Kaiser hospital for surgery. Not as good, but doable. If I break a bone on the AT I'm a very painful plane ride & days away from a Kaiser hospital. (can you even fly with an unstable broken bone)? At the very best I'm out of network & paying $6,000 in higher deductibles & co-pays. I plan to hedge my bets by buying a travel accident policy for the six day section hike I'm planning in August. It may be a waste of money, hopefully I won't need it, but it will give me peace of mind if I find myself carried off the trail in a litter.

LucyInColor
04-24-2017, 18:36
This may be useful info to anyone with health insurance. As I said earlier, I am with Kaiser, which is an HMO. I will definitely be out of network when I hike the AT. I contacted my agent before I bought a supplemental travel policy, fully expecting him to tell me to buy one. He's an insurance agent, after all. I am not sure what a compliant plan is, but I bought my policy through Obama Care. He said:

Your plan covers emergencies no matter where you are in the US. For situations involving ambulance, ER, Urgent Care, Hospitalization, Emergency procedures you need to do nothing to make sure you are not subject to any expenses above and beyond your deductible. This is now true with every compliant plan in the United States. There is no limit on your benefits for emergencies and there is not a separate deductible. If you become hospitalized than the hospital and Kaiser will work together to determine if relocation is necessary. Otherwise they would perform any necessary procedures, stabilize and release you. Your follow up care would need to be provided at an in-network facility. In short, no need to buy any additional insurance as you are covered for emergencies with no question.

I guess the moral is - call your agent before you purchase supplemental insurance.

Cynthia_T
02-28-2019, 06:02
I have another insurance question. We plan to conduct IVF abroad (https://ivf-international.com) next year. I am already doing tests and have completed a full diagnosis with my husband. Will insurance cover this procedure?

trailmercury
02-28-2019, 15:33
I have another insurance question. We plan to conduct IVF abroad (https://ivf-international.com) next year. I am already doing tests and have completed a full diagnosis with my husband. Will insurance cover this procedure?


Best way to get answers about what your insurance covers is to call and ask them.

Venchka
02-28-2019, 16:49
Best way to get answers about what your insurance covers is to call and ask them.
Ditto. Should have asked before starting.
Wayne

MuddyWaters
02-28-2019, 17:10
Best way to get answers about what your insurance covers is to call and ask them.

+

But generally, insurance doesnt cover anything outside of US.

And.....fine print to watch out for.....complications and follow up of uncovered procedures may be expresslly not covered. Leaving you in hook for $$$$

trailmercury
02-28-2019, 17:29
+

But generally, insurance doesnt cover anything outside of US.

And.....fine print to watch out for.....complications and follow up of uncovered procedures may be expresslly not covered. Leaving you in hook for $$$$
Agreed
and typically insurance doesn't cover IVF in the US either (individual plans may vary of course, best to know your own benefits coverage)