View Full Version : Medical Insurance
I know this has been covered before but I cannot find it. What do you all do for medical insurance while hiking? Mine will not cover me in other states.
Rex Clifton
03-22-2018, 19:00
Most plans allow coverage in the event of an emergency, you should check with yours. I think it would be a waste of money to buy additional insurance. Think about it, if you get really sick, you'll probably abandon the hike (at least until you recover) and head on home.
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Starchild
03-22-2018, 20:13
I believe all have to cover emergency room coverage anywhere in the US, though you might have a large deductible, $500 is not uncommon.
What I did was not to require medical assistance. I'm not sure I had any medical insurance back then.
If you are a scuba diver you could checkout the DAN insurance, which though meant for diving does cover medical emergencies while away from home, including rescue and evac costs.
Most plans allow coverage in the event of an emergency, you should check with yours. I think it would be a waste of money to buy additional insurance. Think about it, if you get really sick, you'll probably abandon the hike (at least until you recover) and head on home.
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I do not have any insurance at the moment. I go to a flat rate doctor. So leaving the area I will have none at all.
mrachelson
03-22-2018, 22:23
Since it appears you are from New Zealand I suggest you look into getting some travel insurance before you leave. That ought to cover local emergency care and cost to return home.
peakbagger
03-23-2018, 05:21
I searched for health insurance for vistors to the US and multiple hits popped up https://www.travelinsure.com/products/visit-usa-healthcare/ is one of many.
My guess is the price shouldn't be outrageous as it probably doesn't cover preexisting conditions and is short term so they can put you on a plane back home if its long term issue.
Unless you have zero assets don't go without it. There is a "safety net" that a hospital cant refuse to treat you for an emergency as soon as possible they are going to dump you back on the street and no such thing as follow up care and make you sign away any assets you may own to cover the bill.
I just tried a quote online from CAA.
For six months, $1000 deductible, and for my age (53)....$836
Scratch the above...found a cheaper coverage from Tugo??
$458, $300 deductible, $2 million coverage
Gambit McCrae
03-23-2018, 15:41
My brain track is thinking of insurance during a long hike is this: I get my insurance thru work. If I am not employed, I do not have insurance. Independent insurance has astronomical premiums. If you just go without insurance and file a tax return, you can be penalized $900 for not having it for the entire 12 months. I guess one of the only ways I could thru hike is either to get hitched or pay out the nose.
I just tried a quote online from CAA.
For six months, $1000 deductible, and for my age (53)....$836
Thanks for researching.
AllDownhillFromHere
03-23-2018, 16:19
My brain track is thinking of insurance during a long hike is this: I get my insurance thru work. If I am not employed, I do not have insurance. Independent insurance has astronomical premiums. If you just go without insurance and file a tax return, you can be penalized $900 for not having it for the entire 12 months. I guess one of the only ways I could thru hike is either to get hitched or pay out the nose.
Yep. Reality bites. How would being married help?
MuddyWaters
03-23-2018, 16:27
My brain track is thinking of insurance during a long hike is this: I get my insurance thru work. If I am not employed, I do not have insurance. Independent insurance has astronomical premiums. If you just go without insurance and file a tax return, you can be penalized $900 for not having it for the entire 12 months. I guess one of the only ways I could thru hike is either to get hitched or pay out the nose.
Insurance isn't free.
I paid 3000 plus dollars a year in premiums
And have to meet a $1,500 per person deductible
Before I receive the first penny of benefits.
And I have excellent insurance.
For my family that's usually 5000 plus dollars a year before I receive a penny of benefits.
And my employer-paid portion
Is more like $1,200 per month
So the total is more like $20-21,000 a year.
;
And at that point I still pay 10% coinsurance.
That's what insurance costs.
We could not use best available technology and just let people die instead. Why not? Everyone going to die anyway.....
With a flexible spending account I do get a tax break on my deductible cost of a few hundred dollars.
Under Cobra you can continue your current insurance when you leave a job you just have to pay all of it. Just like you do when you retire. Which is why few can retire now until they qualify for Medicare.
another alternative (at least for some) is medicare!!!!!!!!!!! yay!!!!!!!!!!!! one of the big two reasons retirement works for hiking (see current thread on "thruhike when i retire!") so, just try to get old as fast as you can to be eligible.
One Half
03-23-2018, 18:04
My brain track is thinking of insurance during a long hike is this: I get my insurance thru work. If I am not employed, I do not have insurance. Independent insurance has astronomical premiums. If you just go without insurance and file a tax return, you can be penalized $900 for not having it for the entire 12 months. I guess one of the only ways I could thru hike is either to get hitched or pay out the nose.
if you are unemployed insurance is "unaffordable" and you don't have to pay the penalty. Plus, didn't Trump and team do away with the penalty?
colorado_rob
03-23-2018, 18:20
if you are unemployed insurance is "unaffordable" and you don't have to pay the penalty. Plus, didn't Trump and team do away with the penalty? Yeah, I thought the penalty went away via congressional legislation, how laws are made, our "president" merely signs them, or not.
Anyway, seems like the OP, visiting from NZ, is talking about non US citizens getting some sort of coverage in the USA ("other states") while hiking. Seems like there are some good options posted.
I wonder if this is true, having just returned from NZ: I was told that if you get hurt in NZ, you get treated in NZ for basically free, in other words, since NZ has universal, state paid health care, even non NZ citizens are covered. Mighty nice of those fine folks down there!
(BTW: I'm not trying to start a health care argument, there are of course pros and cons to the different ways it's done around the world).
Plus, didn't Trump and team do away with the penalty?
Only starting in 2019.
It isn't relevant to hikers from out of the country, but the ACA is almost tailor made for American thru hikers to get cheap coverage. Putting aside politics, if you earn more than 133% of the poverty level (below which you would get stuck in Medicaid), you can qualify for very large ACA subsidies, especially if you stay under about 200% of the poverty level. I met a couple on the PCT that was super aware of the intricacies of the ACA and made a point each year in the hiking off season to earn enough to get above 133% of the poverty level and qualify for essentially free health care.
Again, leaving politics aside, the ACA is a godsend for thru hikers working something like half the year at a decent job and hiking the rest of the year.
gracebowen
03-23-2018, 19:51
I'm a veteran (us) and plan on buying veterans advantage. Also although I haven't tested it I think the VA will cover any ER visit if it's an emergency.
The travel medical insurances are popular on other types of trips (cruising seems to be one, since you could more easily be far from help at times and need quick transport, which is going to be costly). While they are generally thinking of things for US citizens out of the US (which most cruises would be at some point), there are likely similar options for those who live out of the US and travel to the US.
There are some plans that are sold annually (or so people have posted) that cover any type of travel, as long as one is a certain distance from home (not certain but something like 200 miles pops to mind). Those types of policies could be useful for hikers who are from other parts of the US away from the east coast hiking the AT (to be the required distance away), or for easterners going to one of the more western US trails.
Starchild
03-24-2018, 18:14
Yeah, I thought the penalty went away via congressional legislation, how laws are made, our "president" merely signs them, or not. ....
IIRC this was a presidential order not to enforce the law, not a act of congress to repeal or change the current law. Either way I believe the penalty no longer applies.
colorado_rob
03-24-2018, 18:44
IIRC this was a presidential order not to enforce the law, not a act of congress to repeal or change the current law. Either way I believe the penalty no longer applies.Could be, and I think you're right in that Trump did declare this earlier on, but later on I thought a repeal of the "individual mandate" was part of the new tax law. The no-insurance penalty, after all , was actually just an additional tax at filing time.
KnightErrant
03-24-2018, 21:42
It isn't relevant to hikers from out of the country, but the ACA is almost tailor made for American thru hikers to get cheap coverage. Putting aside politics, if you earn more than 133% of the poverty level (below which you would get stuck in Medicaid), you can qualify for very large ACA subsidies, especially if you stay under about 200% of the poverty level. I met a couple on the PCT that was super aware of the intricacies of the ACA and made a point each year in the hiking off season to earn enough to get above 133% of the poverty level and qualify for essentially free health care.
Again, leaving politics aside, the ACA is a godsend for thru hikers working something like half the year at a decent job and hiking the rest of the year.
Not so, unfortunately. I moved home to the U.S. from Morocco at Christmas and signed up for a marketplace plan. It seemed good in theory: I listed my Moroccan salary as my "projected" income which worked out nicely because it made me just the right level of poor so that I didn't qualify for Medicaid but I got a big subsidy on the $450 premium, meaning I paid approximately $100 a month. High deductible plan, but good enough to keep me from going bankrupt if I break an ankle or need an emergency appendectomy or something.
However, by the end of January I was getting letters requesting proof of the income I had projected. Of course, I don't have that, because I no longer have the job in Morocco so I was informed that I would lose coverage and have to apply for Medicaid. I was really frustrated because I have saved up to take this time off. I'm not actually poor, so I shouldn't be on government assistance, taking that money and care from people who need it, but I can't afford to pay nearly $500 a month for health insurance while living off of my savings for six months. But without the proof of employment giving you your "projected" income, you can't get those subsidies.
So that's not convenient at all for thru-hikers, because even though it's reasonable of me to expect to find a job easily in September after my thru-hike because my field is in high demand, I can't prove that potential income. And therefore, I don't qualify for subsidies for my ACA plan. (I know that the subsidies are a form of government assistance themselves, but I think it's hardly mooching to expect to pay "only" $100-200 a month for a catastrophic insurance plan as a healthy 24-year-old.)
The long and short of it seems to be that even though ACA was meant to "fill the gaps" for all the uninsured people who were not poor enough for Medicaid but not employed at a job that provided it, it doesn't really do that. Our system does not easily allow for planned time outside the labor force without either paying out the nose for an unsubsidized plan or else risking financial ruin by foregoing insurance. In my case, the solution is to go the slightly embarrassing but pragmatic route of having my parents claim me as a dependent for 2018 to get on their subsidized plan, but that doesn't work for those over 26.
BuckeyeBill
03-25-2018, 01:23
My wife was a Canadian and we went up to visit her relatives. While there, I cut my left index finger trying to cold roast beast. I wrapped a washcloth around to try to stop the bleeding. Six hours later it was still bleeding so i went to the ER and the nurse handed me some betadine scrub and a small brush and told me to scrub my whole left hand. After 15 minutes the Dr. came in and looked at still bleeding and told me I needed stitches. he put 6 stitches and told me to cut them out after 8-10 days. I told him to send the bill to the NYC address and he told me I qualified for free health care because I was married to a Canadian. I did some research afterwards and found out how they pay for the free HC. They have a very high sin tax on various items (i. e. cigarettes, beer, liquor etc). Back in the early to mid 90's, smokes were like $9.50 Canadian. I bought a small bottle of Jack and it ran around $21.00 Canadian.
KnightErrant, I would hazard a guess that your situation is not that typical (problem documenting income from out of the country). I can say that this year is my first on an ACA plan and since I have the ability to control my taxable income, I put in the projection on the ACA site and it was fine. For proof of income, I submitted last year's 1040 which showed a much higher income but stated that I intended to have lower taxable this year to qualify for subsidies.
I had no choice but to go into ACA because I moved to a different state and lost the pre-ACA catastrophic plan I had since well before the ACA became law. ACA premiums, when unsubsidized, are so ruinously high that I am now planning my income to qualify for subsidies every other year. I will recognize higher income next year and pay full freight on ACA. Then in 2020, I'll control my income and again qualify for subsidies. On an averaged basis, this year on, year off strategy should result in overall insurance costs over a period of many years to be tolerable. Perfectly legal and I have no ethical problem with it because I'm being forced into ACA - I was perfectly happy with my old policy and buying any individual policy outside the ACA isn't possible where I live. So work the system.
Most habitual thru hikers probably spend half the year working and half the year hiking. Except for those who can somehow secure very high paid work for those six months, I'd guess that the vast majority would earn enough to escape Medicaid but little enough for big ACA subsidies. Each case will be unique but worth keeping in mind.
Traillium
03-25-2018, 10:00
My wife was a Canadian and we went up to visit her relatives. While there, I cut my left index finger trying to cold roast beast. I wrapped a washcloth around to try to stop the bleeding. Six hours later it was still bleeding so i went to the ER and the nurse handed me some betadine scrub and a small brush and told me to scrub my whole left hand. After 15 minutes the Dr. came in and looked at still bleeding and told me I needed stitches. he put 6 stitches and told me to cut them out after 8-10 days. I told him to send the bill to the NYC address and he told me I qualified for free health care because I was married to a Canadian. I did some research afterwards and found out how they pay for the free HC. They have a very high sin tax on various items (i. e. cigarettes, beer, liquor etc). Back in the early to mid 90's, smokes were like $9.50 Canadian. I bought a small bottle of Jack and it ran around $21.00 Canadian.
Can you imagine knowing that you’ve got great basic health care just because you live here in Canada?
I read the stress-filled threads here about medical coverage, and I listen to my American family members worry about the cost and the uncertainty of making sure they have health coverage that doesn’t approach what we have.
Our health care isn’t perfect, and it suffers from the inevitable inefficiencies of any bureaucracy. BUT WE ARE COVERED.
I’ve often thought we Canucks rephrase ‘the inevitability of death and taxes’ into ‘the inevitability of death and services’. Instead of two negatives, it becomes one negative and one positive. I posit that’s a rather fundamental difference …
BuckeyeBill
03-25-2018, 16:24
Can you imagine knowing that you’ve got great basic health care just because you live here in Canada?
I read the stress-filled threads here about medical coverage, and I listen to my American family members worry about the cost and the uncertainty of making sure they have health coverage that doesn’t approach what we have.
Our health care isn’t perfect, and it suffers from the inevitable inefficiencies of any bureaucracy. BUT WE ARE COVERED.
I’ve often thought we Canucks rephrase ‘the inevitability of death and taxes’ into ‘the inevitability of death and services’. Instead of two negatives, it becomes one negative and one positive. I posit that’s a rather fundamental difference …
We actually lived in NYC at the time and were there for about a week for a family reunion on my wife's side. What gets me is I had enough cash both American and Canadian to pay the ER bill but was told because my wife maintained her Canadian citizenship. their services were free. I tried to give them money and was almost escorted from the building. I told my wife when we get back to NYC to find a Canadian Charity to send a check. To be honest though, that was the first time I had to scrub my injury before being treated.
I see that you are from Orangeville. That's where we were for the reunion. Small world, or 6 degrees of separation.
Ask your current employer about keeping your current insurance (Cobra, they will know) You will have to pay 100% of the cost, but that is usually the best option. You can also try the health insurance exchanges.
Aggie Al
If you filed an income tax return you could use that to show your income for last year. Even though you don't owe any federal income tax you can still file a return as long as you show some income.
Aggie Al
Traillium
03-25-2018, 22:53
We actually lived in NYC at the time and were there for about a week for a family reunion on my wife's side. What gets me is I had enough cash both American and Canadian to pay the ER bill but was told because my wife maintained her Canadian citizenship. their services were free. I tried to give them money and was almost escorted from the building. I told my wife when we get back to NYC to find a Canadian Charity to send a check. To be honest though, that was the first time I had to scrub my injury before being treated.
I see that you are from Orangeville. That's where we were for the reunion. Small world, or 6 degrees of separation.
Small world indeed! Might I know your relatives?
BuckeyeBill
03-26-2018, 21:11
Her maiden Name was Soules, Carol Susan Soules. I called her Calli. I really miss her.