Does a healthy person need health insurance?

[bw77]

OK, this is somewhat bicycle related. I'm 57, healthy, have not had health insurance for almost 8 years, and have not needed it so far. I now have the chance to buy a good health insurance plan for 300/month, through my girlfriend/domestic partner. I'm not worried about getting sick, but every time I ride my bike, I am concerned about the possibility of a bike related accident. Maybe I don't see a pothole and fall off the bike, maybe an uninsured driver hits me. To me 300 is a lot of money for something I have not needed in the past.

Would like to hear what others think.

Thanks.

Bill

[GoJavs]

If you can afford it, do it.

[CNY rider]

Absolutely.

Nobody plans on having a major illness. The fact remains that as you age, health problems become more likely.

Intensive treatments for the two major illnesses likely to strike your age group (cardiovascular disease and cancer) could bankrupt you in a shockingly short period of time.

Buy the insurance.

[chuckred]

Yes...

I've never needed my seatbelts, but I still wear them!

[Blue Jays]

ABSOLUTELY! A few nights in the hospital from an unpredicted medical problem or accident could cost multiple thousands of dollars.
You should without-a-doubt take that coverage, even at half your age it would be wisely prudent.

[djg]

I don't understand why anybody who is not flat broke goes around without health insurance. There are all sorts of options in the market, and people have different degrees of risk aversion, but everybody runs some non-trivial risk of something that could (if they're not fabulously wealthy) entail a catastrophic financial loss for them, independent of how lousy a health issue came upon them. 300 bucks per month is a nice subsidized deal for a luxury everything-covered sort of policy. Another option that makes sense for lots of healthy folks is a high deductible policy, which tends to be much less expensive. Basically, in the latter case, you self-insure for all ordinary costs -- a regular doctor visit, maybe an ER visit or two -- a bunch of stuff is on you. At the same time, if something goes horribly wrong, and you need 25K or 50 or 100 or who-knows-what, you have coverage. Obviously, it makes sense to research the policies themselves, the providers, beneficiary satisfaction, etc. before making your own call.

[weiwentg]

Obama was saying something like anyone would get insurance if they could afford it ... guess he was wrong.

regardless, everyone should have insurance. sure, $300/mo could go to bike parts. but as everyone else said, you never know. that is the reason you buy insurance.

as djg said, investigate the catastrophic coverage only option or an HSA at the minimum. however, at 57, you're approaching the age where chronic diseases may start manifesting, and they can cost you a lot. I would not go with an HSA at age 57. in fact, I would not go with an HSA at age 27 unless I would otherwise be broke. the catastrophic coverage only options are basically for the young and just starting out.

[catulle]

You're healthy until you're not. And just then you'll wish you had insurance. Moreover, if you buy insurance now that you're healthy you'll get to pay less than when you'll be older and/or sick. Like everything else, insurance is another leach that your body must endure.

[Kevan]

If you can afford it, do it.

If you can't afford it, do it.

$300 is chump change compared to the alternative.

[alancw3]

i am 60 and never have had a health related claim. several years ago my private policy was approaching $600/month so i went the high deductible route. i recently made a change and for $215/month now have a $5000 deductible policy that i am comfortable with. so you may be able to get coverage you are comfortable with for less than $300/month.

[AgilisMerlin]

i pay $540.00 a month on full blue cross/shield for family...........

roughly 7 grand a year.........................

it is all relative.

you don't need insurance if you are healthy
you need insurance if you are sick

.............public healthcare...................

great idea on paper, during conversation, and the usual hot election topic............................ :fight:

[coopdog]

Yes. If you love your girlfriend and don't won't to be a potential drain on the rest of society, you'll need health insurance.

I'd add that you need (really everyone needs) disability insurance. On any given year, people are far more likely to become permanently disabled (i.e. unable to produce an income) than to get killed. This is especially true of cyclists.

[ZippRider]

I am 43 and had a kidney stone a few years back without insurance. It ended up costing me $13,000. 2 ER visits, 1 night stay in the hospital / surgery..

So, you never know when something might happen..

[DarrenCT]

i was playing with my cat and he accidentally bit my arm and it got all swollen and infected. i think it was called cellulitus.

you never know *** will happen!

http://img405.imageshack.us/img405/9845/catzs6.jpg (http://imageshack.us)

[pdbrye]

i pay $540.00 a month on full blue cross/shield for family...........

roughly 7 grand a year.........................

it is all relative.

you don't need insurance if you are healthy
you need insurance if you are sick

.............public healthcare...................

:

Man, where do you live? Here in the NY metro area, it costs $1500-2000/ mo. for a decent but not great family plan. Thats with high $2000 per person deductibles out of network. Don't get me strarted on healthcare :argue:

I spend $20-25k per year for my family! $300/ month is a no brainer...

[rnhood]

I don't understand why anybody who is not flat broke goes around without health insurance. There are all sorts of options in the market, and people have different degrees of risk aversion, but everybody runs some non-trivial risk of something that could (if they're not fabulously wealthy) entail a catastrophic financial loss for them, independent of how lousy a health issue came upon them. 300 bucks per month is a nice subsidized deal for a luxury everything-covered sort of policy. Another option that makes sense for lots of healthy folks is a high deductible policy, which tends to be much less expensive. Basically, in the latter case, you self-insure for all ordinary costs -- a regular doctor visit, maybe an ER visit or two -- a bunch of stuff is on you. At the same time, if something goes horribly wrong, and you need 25K or 50 or 100 or who-knows-what, you have coverage. Obviously, it makes sense to research the policies themselves, the providers, beneficiary satisfaction, etc. before making your own call.

I basically agree with this. Also, most employers offer some type of group plan and, these can be quite reasonable and, are quite good.

[malcolm]

CNY is absolutely correct. I'm going to give you an example of why you need insurance. A close friend of mine last week was diagnosed with metastatic lung cancer. He is a marathoner and never smoked a day in his life. He is 53 years old and felt well until he developed some back pain and cough. Thankfully he is insured. I can't tell you how many men your age I see that are healthy, but have an MI or even something less life threatening like gall bladder disease or appendicitis. Too many medical problems can come out of nowhere especially among healthy people and even a simple surgery or short hospital stay can be catastrophic. It is foolish to be able to afford insurance and not have it, my 2 cents.

[Onno]

I too find this question a little mind-boggling. Do any of us think twice about insuring our house or car? One is far more likely to need health insurance, and the potential costs are way, way higher.

I suppose it's ultimately a matter, or problem, of perception. If you've gone without health insurance, or never had it, I suppose it might seem possible to keep living without it. I've lived much of my life in Canada, where of course everyone is insured, and health insurance seems as natural as breathing. It was only when I moved to the US, and talked to some people without insurance, that I even conceived of the possibility of living without insurance. I suppose there are smart ways of doing this--having a medical savings account, for instance, so that one still goes (and pays for) regular check ups, though even here a serious illness will lead to bankruptcy. But most people without insurance will forgo preventive medicine altogether, and just wait for illnesses to become severe before they will shell out the money for medical care.

[Frankwurst]

Yes...

I've never needed my seatbelts, but I still wear them!

+1 and not to sound pessimistic but at your (our) age sh#t starts to break down just like it does in an older car no matter how well it's been maintained.:beer:

[sjbraun]

As you get older, you'll be surprised by what can happen to your health.
I went in for a 50 year check up a couple of years ago. I was feeling fine, but the routine lab work was a bit off. We checked again; it was worse. Still felt great, but was sent to an oncologist anyway. Boy was I surprised to learn that I had a blood cancer, chronic lymphocytic leukemia.
Over the last two years, my lab charges have exceeded $10K per year.
To date, I have not required treatment, just quarterly monitoring of blood work.
Should I need chemo, it will make the lab charges look insignificant.
If I hadn't had insurance in place, I'd never get it now.

And remember, we're cyclist. We participate in an activity with inherent risks.
Even something relatively minor like a broken clavicle or wrist will cost you thousands to treat.

I guess you need to determine your risk tolerance. I suppose if you've got millions in the bank, you could get by without insurance, but if not....

Now, enough of this depressing topic, I've gotta go for a ride.

Steve
Tucson

[Dave]

It is not wise to go without helath insurance, although as you get older, it does get much more expensive, even if you have perfect health and are not overweight. If you have certain preexisting conditions, it can be nearly impossible to get insurance, except through an employer's group plan. That's one reason to seek an employer who offers group health insurance - you can't be turned down for it.

Everyone should have some sort of medical insurance, even if it is a $5,000 deductible plan. Anyone can come down with a major illness, or be involved in a car (or bike) accident that results in hundreds of thousands of dollars in medical bills. If you've ever had surgery or any major diagnostic procedure, look at the bill and you'll find that the charges submitted to the insurance company are often 2-4 times the amount that the insurance company actually pays the doctors and hospitals. If you have no insurance, you get to pay the 2-4 times higher rate, instead of a 20% copay of the much smaller amount.

Insurance laws that affect costs do vary from one state to another. Costs also very substantially depending on where you live within a given state. Here in Colorado, it can cost up to 50% more to get insurance if you live in the mountains, far from a major metro area. Apparently NY has some outrageous laws, because individual health insurance is MUCH higher there, than any other state that I know of. I worked for an online insurance broker for a couple of years, who sold in 45 states. We could never get a decent rate for NY residents. Anyone who could get into a group plan was advised to do so, even though we didn't make a sale.

Prices for $5,000 deductible policies can cost as little as $50 per month for young men under 30. Women's rates are always a little higher and maternity coverage is also a large additional charge, if elected.

[RABikes2]

Get the insurance. Everybody here has given you plenty of reasons and examples why you should. Paying $300 a month for coverage is nothing when you consider the alternative. I'm self-employed, 53, and pay $600 a month for just me. For $300 a month and peace of mind, you shouldn't hesitate.

RA

[Ken Robb]

You're healthy until you're not. And just then you'll wish you had insurance. Moreover, if you buy insurance now that you're healthy you'll get to pay less than when you'll be older and/or sick. Like everything else, insurance is another leach that your body must endure.

My Blue Cross premium goes up every year due to my advancing age and increasing health care costs. Every health insurance plan I have seen works that way. Too bad it's not like whole life where your premium is fixed for life.
Another reason to get insurance while you're healthy is to ensure that you can buy it at any price. At 57 you are getting to where a surprise illness is more likely. I'll turn 65 next Sunday and just registered for Medicare so my out-of-pocket expense will go donw a lot from the $600 a month I have been paying. BTW, 3 years ago my bike-riding Doctor told me I looked great at my annula physical. He called me the next day and said "You're not as good as you look! You have diabetes." Thta would have made me hard to insure.

[RABikes2]

My Blue Cross premium goes up every year due to my advancing age and increasing health care costs. Every health insurance plan I have seen works that way. Too bad it's not like whole life where your premium is fixed for life.
The past two April's (anniversary month), the insurance company raised my monthly rate $150, so in 24 months, the monthly payment went from $300 to $600. If it happens again this April, my insurance payment will be more than my mortgage payment. Yes, I'm looking for more affordable coverage (pre-existing conditions, early 50's, and self-employed, make insurance shopping ... crazy).
RA

[johnnymossville]

I have to say, with two young kids it was a bit stressful. If it was just me, I'd probably get the absolute minimum coverage possible or none.

[William]

You're healthy until you're not. And just then you'll wish you had insurance. Moreover, if you buy insurance now that you're healthy you'll get to pay less than when you'll be older and/or sick. Like everything else, insurance is another leach that your body must endure.

Bingo!

I have been very healthy and active all my life. Been involved in many sports over the years, and have been in many sanctioned (and unsanctioned) fights with no major injuries. As many of you know my appendix burst (then formed an abscess which also burst) just recently and major abdominal surgery was required with a week stay in the hospital. This was not really a controllable thing. Just happened out of the blue. after receiving the hospital bill, which came to over $17,000 (and that's not including the surgeon's bill), I thank my stars that we have health insurance.

It doesn't matter how healthy you are now. Get it for the "what if" and "Oh *****". Once something happens, you can't change your mind to get coverage for what happened to you. You'll have to eat it.

If you can afford it, get it. A variation on my mantra:

"I'd rather have it and not need it, then need it and not have it".



William

[1centaur]

The #1 rule of video golf: if you can't take the downside, don't take the risk.

Take your winning streak and put it in the bank. Buy the insurance. Losing a lifetime of savings over a health issue would put you in an unredeemable hole for the rest of your life.

[avalonracing]

Here's another fun story:

This past fall, my mother who is 62 and otherwise very heathy was unexpectedly diagnosed with leukemia. She has major medical health insurance but does not have prescription insurance for medicine (she didn't opt for it because she never gets sick and doesn't like medicine).

The annual cost for her prescription for the leukemia drug Gleevec?... $70,000 per year!!!

We've been able to work something out with the manufacturer and her insurance company (Novartis and Blue Cross and Blue Shield) but nevertheless not getting full coverage was a bad idea.

Her doctor at Hopkins said, "leukemia bankrupts people".

Get the insurance.

[jerk]

i am an idiot and never go to the doctor or the dentist because i fear that they will tell me that i am sick. sort of crazy....nonetheless, you need health insurance. everyone needs health insurance and you are more of an idiot than i am if you do not have it but can afford it. the united states is the only industrialized country in the world without universal health care and this country has pretty poor infant mortality rates, life expectency, obesity figures compared to other industrialized countries with similar levels of gdp per capita.

nonetheless, as abraham lincoln once said, "if you can't afford healthcare, try not getting sick."

or maybe that was ronald regan. i get all the great republican presidents confused.

jerk

[swoop]

usa cycling has insurance for medical expenses for injuries (rather than illness). its 30 a month and covers 25k.

[1happygirl]

Cover your ASSets!

If you have anything at all (property-house, car, savings, etc) get the insurance, otherwise if you do get sick:

fill out the forms at the hospital for assitance and let 'em write it off.

Also if you want to have property in the future (think loans etc)

[dnades]

I went to have a wen removed from the back of my head. Small bump but not too much trouble. I figured maybe 500-1000.00 to get it done. Not having insurance(this may not be covered by insurance anyway since it is cosmetic) I called a couple of doctors up in VT thinking it would be less expensive than here in NYC. It broke down like this: 150.00 for doctor to examine wen, 450.00 for removal(medium size, large was 750.00), facility fee (operating room at local hospital) 5,000.00, anesthesia etc., then another fee to look at wen to determine if cancerous(I stopped at the facility fee).
What I find remarkable is that if you have insurance those costs that are billed to the insurance company are reduced substantially(50% or more). It is a pretty good racket having the uninsured subsidize the insured. Of course if you can't afford the insurance in the first place then you really can't afford the health care . I have heard in some states you can pay just what the insurance companies pay but I am not sure which states have those rules on the books.

So my take is that the actual facilities, equipment, and drugs are what are ridiculously expensive rather than the doctor's or surgeon's fees. For my scenario the doctor was going to make about 10% of the overall cost which was within my budget to get it done. I was completely blown away by the facility fee.

At 300.00/month I would do it. At this point you want to avoid bankruptcy. Kind of a racket but until the system is changed there aren't too many alternatives. You can of course become a vegetarian and exercise regularly and take the time to care for yourself. Hard to do in our culture.

[Sandy]

OK, this is somewhat bicycle related. I'm 57, healthy, have not had health insurance for almost 8 years, and have not needed it so far. I now have the chance to buy a good health insurance plan for 300/month, through my girlfriend/domestic partner. I'm not worried about getting sick, but every time I ride my bike, I am concerned about the possibility of a bike related accident. Maybe I don't see a pothole and fall off the bike, maybe an uninsured driver hits me. To me 300 is a lot of money for something I have not needed in the past.

Would like to hear what others think.

Thanks.

Bill

I have not read any other posts in this thread. Just happened to read this initial post. A response to your question is remarkably simple and clear. Immediately add yourself to the health plan.The $300 per month for a good health plan is very cheap. You are 57 years old. You say that you are healthy- hopefully so- but do you really even know that for sure? As you don't have health insurance, and feel as if you are healthy, you probably don't visit doctors that often and I would guess that you probably have not had my recent physicals. A bicycle accident should be way down your list of why you might want health insurance. What about heart disease, cancer, diabetes, kidney disease, orthopedic problems, mental,...., as you get older. 57 is not old for sure, but it is not young either.

One should have good health insurance for the catastrophic events that MUCH TOO OFTEN OCCUR in one's life. Talk to a freind about how much a single stay in a hospital costs- for an emergency room visit, or in/out surgery, a short stay for some medical problem, ...., and then inquire about longer stays and chronic problems. My sister had open heart surgery back in 1993 and stayed in the hospital for only a few days. The bills were literally 10s of thousands of dollars.

You want to lose all of your monetary reserve? Easy way to do it- Get sick and go to the hospital for an extended stay. without med insurance. Very easy to reach $100,000 of medical bills (doctors/surgeon/operating room/after hospital visits/medicines/....). My wife takes a lot of med for a particular medical problem. Recently, I went to the pharmacy to pick up a lot of her meds (3 months worth). If we did not have some prescription insurance, I would have had to pay abouy $4600- meds alone.

You have been fortunate to remain healthy. I have been married to my wife for over 26 years and literally have not been sick one single day. But I would never ever be without health insurance. I have used it for colonoscopys, dermatologist visits, somewhat regular medical check ups, diagnostic visits to medical specialists, eurologist visits and prostate biopsies, ...., and the list goes on.

In time you WILL use your medical insurance as you will age and will have health issues. You may even have them now and not even know about them.

Pay the $300/month. It eventually will undoubtedly save you so much more. Don't take the chance of losing so much of your existing equity without it. It is a real no brainer to me. So crystal clear. I don't have to read what anyone else even has to say.


Sandy

[malcolm]

Trust me the uninsured do not in any way shape or form subsidize the cost of health care for the insured. The crazy system that is in place is all based on the amount that medicare will pay for a given diagnosis. Most physicians/hospitals then bill Medicare + a given percent, or the amount medicare will pay plus 25 or 50 percent given the setting. It is usually stated 1.25 or 1.5 medicare this will be the amount presented to the insurance company then they will determine how much they will actually pay. Blue Cross usually pays around the medicare sum, although in some instances medicare actually pays better. The cost of the uninsured are seen in elevated hospital and facility charges and the cost of the insured persons premium. The reason the uninsured bill is more is because you are seeing this same billing process, the insurance companies just don't pay it all. This is why a lot of procedure based specialists used to not take medicare, because the amount collected on what was billed made it not worth their time to operate on medicare patients. I don't think that is so much the case anymore reimbursment has evened out to some degree. It can be pretty interesting to see the difference between several payers for the same problem sometimes it can be quite dramatic. It has always made me feel good about a system where I bill 25-50% more than I know I'll get paid, just kinda seems crooked from the get go.

[weiwentg]

What I find remarkable is that if you have insurance those costs that are billed to the insurance company are reduced substantially(50% or more). It is a pretty good racket having the uninsured subsidize the insured. Of course if you can't afford the insurance in the first place then you really can't afford the health care . I have heard in some states you can pay just what the insurance companies pay but I am not sure which states have those rules on the books.



what malcolm said in response is correct. it is the insured (private and Medicare) that generally subsidize the uninsured (and those on Medicaid). I agree it isn't right to have a higher charge for those who can't afford it, but hospitals usually write a lot of that care off. those who can afford the full fee out of pocket are pretty rare.

oh, and you can negotiate with the hospital. if you're uninsured, you very often get a discount. the hospital I interned at (public health student) gave a sliding scale discount all the way up to 4x the federal poverty level, which is about $80k for a family of 4, or $40k for a single person. ok, they only gave you a 5% discount if you were at 4x FPL. and yes, you can have a fairly high income and be uninsured. a lot of self-employed people are in this position - isn't it odd that if you want to start your own business and have a shot at the American Dream, you may have to give up health insurance?

[davids]

Absolutely.

There's a little insurance office I pass on my way to the train in the morning. Their sign says, "Budget all risk!" Now, you can argue whether you need to budget all risk, but that's the idea behind insurance. And the risk of needing to pay for medical care at some point in your life is pretty high.

You don't know what might happen. Despite your history, you are at risk of needing medical care in the future - we all are. If you don't have insurance when you need care, you've got the potential to suffer complete and utter financial ruin.

[nm87710]

let 'em write it off

What about personal integrity?
You know
Keeping your word

[Fixed]

OK, this is somewhat bicycle related. I'm 57, healthy, have not had health insurance for almost 8 years, and have not needed it so far. I now have the chance to buy a good health insurance plan for 300/month, through my girlfriend/domestic partner. I'm not worried about getting sick, but every time I ride my bike, I am concerned about the possibility of a bike related accident. Maybe I don't see a pothole and fall off the bike, maybe an uninsured driver hits me. To me 300 is a lot of money for something I have not needed in the past.

Would like to hear what others think.

Thanks.

Bill
bill the definition on a healthy man ?

someone who has not be tested enough
cheers imho :beer:

[ada@prorider.or]

. I now have the chance to buy a good health insurance plan for 300/month,

Thats less we are paying here ,i never complain.
You cannot buy health, care you can!
In a split second the world can look differant .
Do it you won´t regret it

[thejen12]

+1 on what everyone else said about why to get insurance, and one more thing. If you ever do get that "dreaded" diagnosis of a chronic illness, at that point you may not be able to get insurance if you don't already have it.

Jenn

[Bud_E]

Nothing personal but if you don't have coverage and you have discoverable ( or whatever the legal term is ) assets and you can actually afford it, you're an azz if you don't get it. At the very least get some kind of catastrophic high deductible coverage. For an example if Blue Cross doesn't compensate you a cent for a visit to the emergency room, just their negotiated discount will save you thousands ( if not tens of thousands ) of dollars.

I'm going on 55, and I'm a pretty healthy guy but out of left field in the last year or two I've required 2 procedures for kidney stones and an operation for hernia. I've got news for you -- you're not superman -- eventually something's going to come up.... unless you're wealthy -- in which case you can self-insure and so never mind.

[bw77]

I want to sincerely thank everyone who replied to my question. I have decided to sign up for the health insurance asap.

I think I am healthy, but, as several people pointed out, it's in part because I have not had any tests in over 10 years. So I will schedule a physical soon, too.

Thanks again for your comments.

Bill

[Pete Serotta]

Glad to hear it. Yes schedule that physical ASAP, As an add said "**** comes at us all of a sudden" - - we are healthy until we find out we are not"

I want to sincerely thank everyone who replied to my question. I have decided to sign up for the health insurance asap.

I think I am healthy, but, as several people pointed out, it's in part because I have not had any tests in over 10 years. So I will schedule a physical soon, too.

Thanks again for your comments.

Bill

[keno]

those pulmonary embolisms in '06 would have set me back about $60K, and that's an ailment that likely resulted from being an endurance rider (so-called economy class disease). We're more likely to get blood clots from long airplane flights, sitting in a car for long spells, at our desks, than the run-of-the-mill couch potatoe.

keno

[bostondrunk]

You don't need it. Don't get it. Buy tubulars instead.



Well someone had to argue against it!!!!


I like living where it is free (sort of..)

[CNY rider]

You don't need it. Don't get it. Buy tubulars instead.



Well someone had to argue against it!!!!


I like living where it is free (sort of..)


So BD how do you feel about apple pies and puppies?

[bostondrunk]

So BD how do you feel about apple pies and puppies?

I like puppies! I'll pass on the pie..

[1happygirl]

What about personal integrity?
You know
Keeping your word

Sorry, dry humor doesn't translate well. I was also being a contrarian. I do agree with you. As a former provider in a county facility I see it. I believe the OP is paying taxes (I assume). There is so much wrong with the system. The people that should get the help don't and vice versa. Don't get me started. I think we are all being held hostage by the insurance industry.

Don't even get me started on auto insurance!!!!


(yeah half way to 100 posts--9900 more and I'll beat BBD)