View Full Version : Health Insurance while Thru-hiking?
My boyfriend and I are planning a thru hike for March of 2008. We are both planning on quitting our jobs for the trip, which will leave us without health insurance. I'm not sure whether its worth adding the cost of insurance into our budget. I'm torn between "what do we need insurance for?" and "what if we need insurance?" Any thoughts? Anyone purchase insurance just for the trip? Anyone wish they did?
Thanks for any input!
xine
First of all, it is very expensive, but you are eligible for COBRA coverage when you leave your jobs. There is also many affordable disaster policies (high deductable, low coverage, enough to keep you from being bankrupted) that you could consider.
Or you could just roll the dice.....
Johnny Swank
10-22-2006, 13:25
I rolled the dice but wouldn't recommend it. I think Blue Cross has some sort of disater coverage that Topcat mentioned. I'd suck it up and go that route if i did it again.
Johnny, great website there, looks like you had quite the adventure.
Of your two questions, the right question is "what if we need insurance?" I quit my job of 4 years in June, and was very hesitant to pay almost $300 a month for COBRA coverage, but thank god I did. In August, I cut off the tip of my finger while doing yard work, and needed two surgeries and I'm still going to hand therapy twice a week, all covered. Unfortunately, in this day and age, you just cannot be without health insurance, you just can't. If I didn't have the COBRA coverage, I would not have been completely taken care of the way I was, or I would have about $15,000 in medical bills right now. Sorry to be so pessimistic about the subject :( .
Oh, and welcome to WB xine :welcome , I'm new here too!
Mountain Maiden
10-22-2006, 15:28
Of your two questions, the right question is "what if we need insurance?" I quit my job of 4 years in June, and was very hesitant to pay almost $300 a month for COBRA coverage, but thank god I did. In August, I cut off the tip of my finger while doing yard work, and needed two surgeries and I'm still going to hand therapy twice a week, all covered. Unfortunately, in this day and age, you just cannot be without health insurance, you just can't. If I didn't have the COBRA coverage, I would not have been completely taken care of the way I was, or I would have about $15,000 in medical bills right now. Sorry to be so pessimistic about the subject :( .
Unfortunately, it is not necessarily pessimistic but realistic. Accidents DO happen!! My little "misstep" during my '02 thru-hike cost me $7000 plus. I was just walking along...not jumping off rocks, running up the Trail or taking unnecessary chances, etc. I wouldn't do it again without some kind of coverage.
Sunny aka Sunrise ga-me '02 :sun
Hey I just finished a thru hike and did not personally heve insurance because I cannot afford it. However several people are going to get hurt over your hike. Snake bites, Brown recluse bites, ankle problems, knee, maybe dental. One of my friends got a kidney infection and was hospitalized for three days, another had a blood clot and was also in the hospital. Without insurance these people would have big debt not to mention the six grand each that most people seem to spend on the trip. So definitely get the insurance, I'm not saying that you are going to get hurt but statistically so many people are and it could happen. Any way god luck
mnof1000v
10-22-2006, 15:54
Before I hiked, I considered the merits of going without coverage. I did decide to be covered, and yes, I paid a pretty penny. However, I ran into a nasty foot infection about 850 miles into the trip. It required a hospital visit and medications. Had I not been covered, that expense would have ended my hike prematurely. Instead, I was able to be treated, take time off, and return to the trail. And it could have been worse! I knew a lot of people who got hurt out there. It happens. I echo what was said earlier. Brown recluse bites (I saw three), infections (I had one), broken bones (don't even get me started about how many I heard of) - you never can predict what will happen out there. Even if you're careful.
Pokey2006
10-22-2006, 16:07
You have lots of time before your 2008 hike. Start budgeting now for the insurance coverage, just save up a little more then you had originally planned. It's just too risky out there (twisted ankles, Lyme disease, shin splints, stress fractures) to go without insurance, if you can afford it. If you can't afford it, well, just be careful out there.
I think it is important to remember, you dont need the cadilac of coverages. Shop around, think worse case.
Take a look at trail journals and you will see the number of people who take hospital visits is pretty high.
Thanks for the advice! I think we'll add it to the budget. Thinking about it now, my knees aren't as young as they used to be, and it would probably be a good idea to have some kind of coverage.
DareN- Thanks for the welcome! I've been lurking here for months, and I guess I didn't realize that this was my first post!
Again, thanks for your input!
:sun
Take a look at trail journals and you will see the number of people who take hospital visits is pretty high.
Too bad they didn't have a keyword search, otherwise there's way too many journals to happen upon the accidents that needed medical coverage.
If you took all the hikers that actually did need to seek a doctor or hospital, it would probably be slim. I guess that's why they call it insurance.
fiddlehead
10-22-2006, 18:15
I quit buying health insurance in 1988. (they refused to pay for an emergency because i was away from civilization and didn't get to the hospital for over 24 hours, so i said goobye)
I never looked back. Only would've used it once on my thru in 95 when i got a brown recluse spider bite. It would've cost me between $300-500 if i would not have had the good fortune to see a doctor who was a hiker and did it on the cheap for me.
That's 18 years i would've wasted on fees that perhaps would've covered me and perhaps not (fine print in insurance policies suck)
Contrary to what someone said above: you will NOT get bitten by any snakes. Chances are, you won't need the insurance. If you do, you may be able to afford the medical help for less than the insurance costs. Especially since the internet is here and you can research your problem on line. You may find that you are doing a lot more research than the doctor does.
Health insurance could cost you more than your thru-hike. (which means you may be trading your 2nd one to have peace of mind on the 1st)
Think positive. If you are fit and not accident prone, you may be able to hike more than one year on your alotted money. (and that's a gamble i would take every time)
Hiking lightweight or semi-light is another thing that will keep you from the ER. Stress fractures happen mostly to people who are carrying more than they need to. 1/5 of your body weight is more than you need to carry. (don't believe the mags that say 1/3 )
Anyway, this subject has come up numerous times on whiteblaze. Research the threads. I think you'll find that most 1st timers are too scared to go without, and most repeat thru-hikers don't bother. you'll be healthier when you finish than you ever were.
Pokey2006
10-22-2006, 18:46
I disagree that you'll be healthier at the end of your hike. In some ways, you will be in great shape. However, your immune system will be shot, your levels of stored vitamins and minerals will be dangerously low (potassium levels seemed to become a serious problem for some toward the end), and you will overall just be run down and exhausted.
Don't be fooled into thinking that thru-hiking is not tough on your body.
But I do agree that the insurance question all depends on the state of your finances. If you can possibly swing it, get the insurance.
Toolshed
10-22-2006, 19:40
Hi Xine,
As one who used to work in Claims Administration of an HMO (Managed Care Organization) with a heavy Finance and Managed Care Contracting background and now work in Pharma Contracting, I'd like to weigh in - It will be boring reading, but You or others might find it helpful.
First, You are automatically eligible if you leave your job by federal Law to apply for, and receive COBRA benefits (willful separation or not).
COBRA stands for Consolidated Omnibus Budget Reconciliation Act - The legislation was passed in the 80's at some point.
Anyway, What COBRA allows is that you continue your existing health care coverage, But in that you become responsible for the premium - The employer receives no part of your premium - you are usually billed direct via the Health care organization which is providing coverage.
Now is the time to think about it. since your premium next year depends on what coverage you select now during your employers open enrollment period (assuming you have an option). If you are young and healthy and feel confident, you might choose a "no frills, high deductible catastrophic coverage only" policy which is similar to traditional indemnity coverage in which you have lower premiums but bear more risk in the event of non-catastrophic medical events, an example would be traditional BCBS coverage in which you pay a 20% copay after you meet the annual deductible period of say $1,000-$2,000 (some might have an annual deductible period, some might have a "per medical event" deductible period. It pays to ask this and understand it - It is after all, a contract between you and the health plan, where the employer serves chiefly as a third party administrator.)
If you decide otherwise, you can likely choose the top of the line HMO policy with no (or extremely low) deductibles and $15-$20 co-pays with a great pharmacy rider - BUT you will pay a hefty premium if you go the route of COBRA.
Now here is where the fun begins. Lets say that a typical HMO high end policy that was chosen through your employer has an out of pocket premium of $1,500 per month (you might only be paying $150/month as your employer picks up the rest). If you elect COBRA, this would be your monthly premium.
Lets say that you choose traditional indemnity with no riders, you might be paying $750-$1,000 per month.
BTW, Your age and your health conditions probably won't make a difference in premium cost as your employer likely falls into the "Community Rated" pool where all employees of the Metropolitan Statistical Area electing the same coverage have the same premium - The younger healthier employees, offset the older more illness-prone employees. There are other variations, but this is still a very common rating system and I am speaking in generalities and I don't want to write a book.
Here is where you can game the system - You have 60 days retroactively to elect COBRA. you start your hike and you get 55 days in and you decide you want coverage - Return the COBRA election form and select yes and include 2 months premium in a check. If you get injured on your 10th day and get the bill on the 50th day and it is a lot more than your premium would have been be, Elect COBRA. I believe you can still cancel COBRA at any time, but check and be sure.
Now, You need to determine what are the various REASONABLE possible injuries that could befall you and what the costs associated with them would be. Keep in mind that Hospital in/outpatient care is expensive and those that pay out of pocket pay the highest, but it doesn't mean you can't negotiate 15-20% off your bill - Especially if you offer settlement in full. Most Insurers negotiate rates that are 35%-60% off Usual and Customary Rates, but remember, they are "buying" in bulk.
So, for 6 months, let's say your premiums (each) would be $1,000/month for the plain vanilla policy. Are you young? Are you healthy? Do you have a history of requiring medical treatment? Are you clumsy or athletic?
This is where you must honestly assess yourself. If you don't already have them, then I would forget worrying about genetic issues like Cancer and Diabetes for the short run since the odds are more in your favor of an injury.
Between the 2 of you, do you think you will ring up medical bills great than $10,000-$12,000 over 6 months? And if you injure yourself and require medical care costing $5,000-$6,000 and you pay out of pocket, then you break even. Your propensity for risk will drive this decision, but to make it you need to understand all the risks and how the system works.
So in summing up, you quite February 28th. You have until April 28th to decide if you want COBRA (remember it's retro to day one but you will have to pay the premiums, 2 months worth retro to day one) So in theory you are 1/3 through your hike and if you are feeling comfortable, you can better assess your levels of risk.
Hope this helps - Please PM me if I can be more specific for you
Rick
fiddlehead
10-23-2006, 00:28
Wow, after reading the above, make that 3 thru hikes for the price of one years insurance premiums.
Another possibility: if you get hurt and can't afford medical attention in this country, Thailand's medical costs are aprox 1/4 of the USA's. (it's aprox $800 RT flight)
the_iceman
10-23-2006, 09:18
Wow, when I read this thread it looks like the Brown Recluse is the biggest threat out there. Hell, who cares about bears and boars?
Pokey2006
10-23-2006, 09:25
I was actually surprised by that. I thought a bite from the brown recluse was extremely rare, and fatal when it did occur.
I can only speak from my own experience, but what I saw or heard about, starting with the most common: stress fractures, shin splints, various problems with the knees, and stomach bugs (suspected due to bad water, usually just outside of areas with lots of agriculture -- cows, wild ponies, etc.). Oh, and, of course, Lyme disease, especially as the crowd got further north.
I would worry about stress fractures and Lyme disease way more then spider and snake bites!
Along the lines of this question....I have been without any type of health insurance for over 2 years now. As a veteran, I'm going to my first appointment w/the VA Health System next week, where I only pay like $15.00 to see a doctor.
Does anyone know of there are VA hospitals or some other way to get medical attention at a public/private hospital if a VA facility is nowhere around...along the AT that is?
Toolshed
10-23-2006, 09:54
Michele,
Depending on your age, income and veteran status, you might be unpleasantly surprised to find that you might not qualify completely for Veteran's healthcare benefits, or you may have to pay a hefty copay.
There were changes enacted that put vets into 8 categories and if you had non-service related injuries/disabilities and were below the annual income (or is it asset) theshold, you would qualify for one of the lower classes. I don't know if there have been new changes but check out WWW.VA.GOV for more info and for a list of Veteran Medical Centers and Veteran Outpatient Facilities.
Also, some state-owned puiblic hospitals contract with the VA and offer VA Outpatient care in rural areas where VA Medical Centers or VA Facilities are scarce.
Toolshed
10-23-2006, 09:59
I had another thought on insurance - Those of you thruhiking probably would not require inpatient stays, thereby reducing the risk of high dollar in-patient acute care due to an adverse event.
In addition, if you are young and "homeless" and have no job or assets whiel thruhiking, you might qualify for inidigent care. Not For Profit hospitals - public hospitals service the local commmunities and must provide a certain level of indigent patient care. However, I would not advise trying this if you have assets, you will likely get caught.
Pokey2006
10-23-2006, 10:06
Ya know, if you do need health care, you have no assets, you have little money, you have no health insurance, yes, you can still get the care you need on the trail. Almost every town along the way has an "angel" who can help you out, if you can't find the care on your own. And doctors along the way are used to seeing poor, sick, indigent hikers.
I still say that there's enough time between now and March, 2008 to plan ahead and save up enough money to pay for health insurance. I went without health insurance -- to no real detriment -- but only because I gave myself just a two-month notice before I started my hike. The folks who originally asked this question stated that they have until 2008, an entirely different situation.
So sock away your cash and get the darn health insurance! Better to be safe then sorry.
hammock engineer
10-23-2006, 10:41
I got a short term insurance plan through Athem for my LT hike. It came out to be about $60 for a $250 deductable, 20% copay with a $5000 max copay (I think). I seemed to trip, fall, or roll an ankle enough that I am not going to hike without insurance.
Health insurance varies from state to state. I am licensed in Georgia. The only plans I promote are the ones that allow you to open a tax-advantaged Health Savings Account. In Georgia the three companies that I represent are Kaiser Permanente, Assurant Health and Golden Rule. I would suggest you find an agent who specializes in HSA qualified health plans. Do not get suckered into buying a low deductible plan with doctor visits.
floyd242
10-23-2006, 12:41
Sam's Club and Costco provide many different health care plans for members that are cheaper then most others believe it or not. They also provide a Health Savings Account plan so you can pay for your premiums from a tax-free savings account.
Clark Howard talks about it on his site:
http://clarkhoward.com/shownotes/category/11/365/