Any Opponauts know anything about healthcare?

"Enginerrrrrrrrr" (Enginerrrrrrrrr)
02/20/2014 at 16:32 • Filed to: None

So I recently quit my job and will be pursuing my masters degree in the fall.

This now means I don't have health insurance, dental, or life insurance anymore. Fun.

So since I am a younger guy, I've never needed to go to the doctor besides the standard immunizations or physicals. Now I know I won't need to go to the doctor in the foreseeable future barring something catastrophic.

That's the problem... if something like that happens, then I and my family will be screwed with out-of-pocket expenses. Hospitals aren't cheap.

This has brought me to check out the Colorado healthcare site to try and find a provider. Now I decided to just look at catastrophic plans, but I can't make much sense out of any of it. It was a lot easier when my healthcare was awesome and I didn't have to pay for anything and could go in for whatever I wanted.

Now...for my entire life I have always had ridiculous healthcare, so I don't even know what a deductible, or even a copay is, everything was free. (Seriously, my parents are military, so they get Tricare, which is the best shit out there, and then my previous Oil Company employer had pretty much the same thing for me).

So...anyone have any tips? I'd rather not be hit by a bus then have to be homelesss because I couldn't afford anything. Also the cheaper the better...but I still don't want to be screwed just to have my teeth cleaned once a year.

/Seriously no clue what's going on

DISCUSSION (19)

IDROVEAPICKUPTRUCK > Enginerrrrrrrrr
02/20/2014 at 16:35

How old are you? You can stay on your parent's insurance until you're 25 or 26 I think. Universities often also offer student health insurance plans that are pretty reasonable, so look into that at whatever school you're going to.

Ilike_cougars > Enginerrrrrrrrr
02/20/2014 at 16:39

Some colleges do offer subsidized health care to full time students, you probably need to check out what they offer. NJIT had a pretty decent one, was around 250 for a semester, this was 3 years ago. Had to pay extra for dental I think..

MoparKetchup > Enginerrrrrrrrr
02/20/2014 at 16:40

Yeap, what idroveapickuptruck said. I cancelled my old one and applied for the university's healthcare. Call them.

Demon-Xanth knows how to operate a street. > Enginerrrrrrrrr
02/20/2014 at 16:44

Costco sells health insurance at surprisingly not hideous rates. And you don't have to buy in bulk.

Textured Soy Protein > Enginerrrrrrrrr
02/20/2014 at 17:08

Deductible - a certain amount of money you have to spend out of pocket before your insurance policy's coverage kicks in. So if your health insurance has a $1000 deductible, you have to spend $1000 out of pocket before your insurance pays for anything .

Copay - a certain amount of money you spend for a specific service like doctor visits or having prescriptions filled. You pay a small amount and the insurance pays the rest. Typically the cheapest copays are on prescriptions, then regular doctor visits, then specialists/urgent care, then emergency room. Like my insurance is $5 copay for generic drugs, $10 for brand name, $25 for doctor visit, $35 for specialist or urgent care, $50 for emergency room.

Typically health insurance plans will not have dental or vision coverage. You can either purchase these separately, or go without.

Your most common cheaper options will likely be HMOs - Health Management Organizations. If you've heard the phrase "in network doctor" that's talking about an HMO. The insurance company has contracts with certain doctors who then are in that insurance company's network. The doctors agree to certain prices they will be paid by the insurance company, in exchange for the insurance company pointing its members in the direction of that doctor. Some HMOs also operate their own clinics where all the doctors in the building are in-network for that company's insurance.

Also sometimes for certain specialist services you may need to either get a referral from your Primary Care Physician, or prior approval from a specific department in the insurance company (like if you want to start seeing a shrink you could have to talk with the mental health people at the insurance company). Depending on the HMO plan, you can have varying levels of coverage for doctors who aren't in the network. This could range from making a little higher copay for out of network doctors, to not being covered at all if you go outside the network.

The next step up from this is a PPO - Preferred Provider Organization. In this type of plan, there's still a network of doctors but you have the option to go to whomever you want. You don't have to worry about referrals from your primary care physician, or prior consent from the insurance company for specialists. There's usually a little higher copay for out of network doctors, and you might have pay yourself then submit a claim, rather than have the provider bill the doctor directly.

The cheapest available option will likely be an HMO plan with a fairly significant deductible of like $5,000+. Which means that you will be paying however much per month for a plan, that will pay out jack shit until you spend $5k of your own money on medical bills.

From there, you can spend more money to get things like lower deductibles, get rid of the deductible entirely, or upgrade from HMO to PPO.

So basically you have to decide if you want the absolute cheapest thing that technically qualifies as health insurance but you will have to spend a bunch more money before it actually kicks in, or spend more on a plan that will actually cover things right away.

One area you can save money is get something with a lower deductible but skimps a bit on the prescription coverage. If you're not on prescription meds, you don't need the extra coverage, and even if you do you might come out ahead with something like the Walgreen's Prescription Savings Club which is like $20/year. Your cost for drugs with the plan is still higher than what you would be spending on copays if you had prescription coverage, but if you add the cost of the prescription coverage to the cost of those copays, it gets a lot closer to the total you spend on drugs with just that discount.

Hope that helps!

desertdog5051 > Textured Soy Protein
02/20/2014 at 18:20

I have sold Health Insurance for 16 years. What you are talking about is pre-Obamacare. Things have changed dramatically now. His best bet is to get a catastrophic or accident plan if he is under 35. Chances are the family will not suffer an illness like heart attack or cancer. However, accidents are the most likely reason for a trip to the ER or a stay in the hospital

desertdog5051 > Enginerrrrrrrrr
02/20/2014 at 18:21

This a copy of my reply to an earlier comment. I have sold Health Insurance for 16 years. What you are talking about is pre-Obamacare. Things have changed dramatically now. His best bet is to get a catastrophic or accident plan if he is under 35. Chances are the family will not suffer an illness like heart attack or cancer. However, accidents are the most likely reason for a trip to the ER or a stay in the hospital

MTY85 > Enginerrrrrrrrr
02/20/2014 at 23:12

Do you have a chronic illness? Are you accident prone? This might sound scary but... why not just go without it? I'm 28 now, haven't had health insurance since I was 21.

Enginerrrrrrrrr > MTY85
02/21/2014 at 11:36

See that's the thing. I'd rather not have something insane happen and then be in debt the rest of my life. I don't see myself getting into any accident or even have to visit the doctor for any reason, but you never know... I can deal with $160/month just in case.

Enginerrrrrrrrr > desertdog5051
02/21/2014 at 11:39

Since the catastrophic plans were the same price level as the bronze plans I just went with a bronze plan in case I need anything. This way I don't need to have an accident in case I need to visit the hospital either.

Enginerrrrrrrrr > Textured Soy Protein
02/21/2014 at 11:44

This response has a lot of great information for anyone needing to know some of the terms. I had no clue what "deductible" meant until I started searching for it. Since I don't plan on using much coverage, I just went with a lower monthly premium and a higher deductible. My plan also covers generic prescription drugs with a low co-pay (without any deductible) and free visits for physicals and such. It also surprisingly covers dental (1 trip/year which is more than what I do now...).
Thanks again for all of the other information. I am sure it will come in handy when I get older and my body starts breaking down ;)

Enginerrrrrrrrr > MoparKetchup
02/21/2014 at 11:45

Yeah I might do that. The problem is the applications still aren't due for fall so I have no clue which school I will be going to yet. I will be checking in to that when I find out in a month or so.

Enginerrrrrrrrr > Ilike_cougars
02/21/2014 at 11:46

Dang yours was good. The school I went to for undergrad was about $450 a semester. Luckily at that time I was still under my parent's insurance. Once I figure out which school I am going to, I will check out their plans.

Enginerrrrrrrrr > IDROVEAPICKUPTRUCK
02/21/2014 at 11:47

I'm mid-twenties, but since I left my parent's insurance I don't think I can go back on it. Plus 26 comes in May...

I will be checking out my student insurance plans once I figure out where I am going to school.

IDROVEAPICKUPTRUCK > Enginerrrrrrrrr
02/21/2014 at 13:01

You should get back on your parents insurance until may, you never know what might happen

Enginerrrrrrrrr > IDROVEAPICKUPTRUCK
02/21/2014 at 13:40

Well I just signed up for a plan through the healthcare site, so I will be covered for a while.

desertdog5051 > Enginerrrrrrrrr
02/21/2014 at 17:42

Good thinking.

MTY85 > Enginerrrrrrrrr
02/25/2014 at 18:02

Let me know if you actually fine insurance for $160 a month WITH dental. We live in the post Obamacare health insurance world.

Enginerrrrrrrrr > MTY85
02/27/2014 at 14:23

Well I guess Obama did something right.

I have dental.