Dumping my Health Insurance

I'm self employed and have been for 10 years. When we first bought our health insurance we paid about $200 a month with a $1500 deductible.  Not too bad and it saves us from the poor house if something catastrophic happens.  Last week we got another rate hike.  We now pay almost $500 a month with a $5000 deductible.  That will be just under $6000 in premiums this year. $6000 is ALOT of money to me.  

I can't help but wonder when I will say "uncle" and just give it up. We are seriously considering ditching it now and saving the money.  In a another 4-5 years I can see it being my house payment.  I will NOT pay that much for health insurance that I don't even use.  I feel like I will just be pissing away the $$ for the next few years anyhow.  Last year my wife had some problems and we ran up $5200 in medical bills.  So we spent $10,000 and the insurance kicked in $200.  Damn, they saved our ass there, huh?  With Bush talking about eliminating the deduction for employees benefits to pay for more tax cuts maybe I would be better off.  Maybe this crisis is about to hit the tipping point.

Any advice?

•  Depends on the state

  Depends on what state you are in - there are programs out there hidden in the fray. If you are in NY, I could definitely point you in the right direction for some help.  There are state-sponsored programs for people in your situation in NY.  

  by GregNYC on Fri Nov 26, 2004 at 08:18:16 PM PDT

  •  NC

    So, we are SOL on getting any help.  Every other year I get fed up and go look for another plan but it's a waste of time.  They are all expensive.

    by wph on Fri Nov 26, 2004 at 08:32:26 PM PDT

    •  You could...

      Well, since you are self-employed I imagine you could "work" your claimed income to meet the following criteria (see below) - though your assets may come into play depending on the full scope of the law otlining the entitlement. The full-proof way under the current Bush plan is to get divorced and your kids would likely then be eligible, straight-up, for Medicaid if your wife does not work and she had custody. Horiible thought, I know, but people do it - especially if their child is chronically sick. So sad what Americans might have to resort to.  Here is the info for NC:

      North Carolina provides health insurance for its children, free, or at a reduced price. Who are eligible?

      Children who are 19 and below, whose families earn an income higher than required for Medicaid but still not enough to afford private insurance. What is the income level for eligibility? The family income should be between 150% and 200% of the federal poverty level. Lilly earns about $24,980 annually and $2,082 monthly. This figure for a family of 2 puts her below the 200% mark of the poverty level as per the U.S. Department of Health and Human Services.

      Full link:
      North Carolina Free or Reduced Cost Health Insurance for Children  

      by GregNYC on Fri Nov 26, 2004 at 08:50:42 PM PDT

      •  divorce for insurance

        The only thing wrong with divorcing and staying together is the evangelical religious right wing may have them stoned for adultry .

        by bojangle on Fri Nov 26, 2004 at 09:23:25 PM PDT

•  I have no advice

  
  but you have all my empathy.

  I had a home business and raised my daughter by myself.  I had Blue Cross insurance for us two.  I think I paid around $125-150 in the 1980s.  By 1990, it was $300/month with a $500 deductible, and the rates went up, up, up.  Eventually, I could no longer afford it.

  Do you have children?  If not, you might want to risk going without.

  But, if you have children, it may be a necessity.  When she was just over two years old, my daughter aspirated a peanut, which required a pediatric thoracic surgeon.  When she was 5, she had her tonsils taken out.  Having insurance saved the day on both occasions.

  by SusanHu on Fri Nov 26, 2004 at 08:19:39 PM PDT

  •  1 Child

    We have 9 year old daughter. She is in very good health.  That's the thing, we got it just too have some "holy shit!!!!" insurance.  I don't care if it pays for regular visits or meds,  I just want soemthing affordable to keep from being in debt the rest of my life should something happen.  It just isn't affordable.   The Reps talk about their health savings plan.   It basically is what we have except it will cost more and maybe you can get a little cash refund in the future. What a crock of shit.  How many people have to suffer before something is done?

    How much is a tonsilectomy these days?

    by wph on Fri Nov 26, 2004 at 08:31:11 PM PDT

    •  Check with the school

      Some schools have cheap insurance for kids--my daughter's did and I used it for a couple of years (she is now 17).  Also, many physicians have medication samples and if they know you have no insurance, they can give you samples.  Check and see if anything you belong to offers insurance (e.g. Sam's Club, or any groups like AAA).  Sometimes there are group rates you can take advantage of, or affordable catastrophic insurance.

      You're not alone.  Other healthy people I know are opting out and putting that money in an account where it earns interest and is available for medical necessities.  Also, check with your workplace about a "cafeteria plan", where you can put aside expected amounts each year (DON'T overestimate or you lose the excess), and that money is not taxed.

      by elizsan on Fri Nov 26, 2004 at 08:45:07 PM PDT

    •  Have you joined the big discussion

      
      in the thread from the surgeon?

      by SusanHu on Fri Nov 26, 2004 at 11:08:01 PM PDT

•  Here in Pennsylvania....

  I know both Aetna and Blue Cross have programs where you can get a pretty good discount on your insurance if you meet certain financial conditions. They don't advertise it, you have to call up and ask the carriers about any insurance programs for people with low incomes or the self-employed.

  I would imagine this applies to all states.

  Also, if your income's low enough, you might be able to get your daughter on your state's CHIPS program.

  Another option (again, here in PA - not sure about the rest of the country): sometimes the self-employed can get a group rate through their local Chamber of Commerce or small business association.

  by uberblonde on Fri Nov 26, 2004 at 08:40:32 PM PDT

•  There's a catch

  I'm in a similar position. I was paying $600/month for health insurance, but this month it just went up to $700/month. Last year I had 5 routine doctor's visits, so I figure they cost me approximately $1400 per visit. I am now unemployed and near retirement, and my health insurance eats up about a third of my monthly budget.

  But I've hesitated to drop it for two reasons. For one, in Massachusetts, if you maintain continuous insurance coverage, you cannot be rejected for non-group insurance and don't have to go through a waiting period when you start new insurance. But the thing that really bugs me (and this was exposed in the Boston Globe recently) is that doctors and hospitals routinely gouge uninsured patients, charging them 3-4 times more than they would charge an insurance company for comparable services. So you're insuring against a risk that is multiplied if you're not insured against it. Sort of a catch-22.

  by lesliet on Fri Nov 26, 2004 at 09:20:57 PM PDT

•  I'm sorry not to have any good advice for you

  By going without insurance, you're essentially gambling on continued good health.  I can understand why you're considering it, given the insurance costs.

  A week or so ago someone here posted what I thought was a good idea.  The suggestion was that the Democratic Party become an organization that offers group health insurance.  Even if it were only coverage for catastrophic health problems, it would solve a major problem for plenty of people who can manage the cost of normal medical care but who would be wiped out by an emergency.

  by ScientistMom in NY on Fri Nov 26, 2004 at 09:22:54 PM PDT

•  the math...

  You now have a guaranteed loss of $6000 and carry the ANNUAL risk of $15,000 (assuming your deductible is per person and not per family).

  Maybe you should consider a huge "per cause" deductible of say $25,000 instead of an annual deductible; and supplement the plan with cancer/serious illness coverage.  If you are healthy and shop around you might find something at much lower cost.

  Then the equation will look more like a guaranteed loss of $4000 and the lifetime risk of normal occurance stuff of $25,000 and lower if you have one of the covered events on the cancer/serious illness plan.  Also, many of those  cancer plans provide good yearly stipends for screenings such as mammograms and colon exams which can make them a pretty good buy in your circumstances.

  Just brainstorming -- hope this helps...

  by casamurphy on Fri Nov 26, 2004 at 11:00:56 PM PDT

•  Self-insure?

  If you took the money you sent to insurance companies each month and invested it in a money-market fund, even a savings account, you could build a cash cushion.

  As someone else pointed out, people without insurance are charged at a higher rate by hospitals and doctors. They, in effect, pay retail while those covered by large insurance plans pay wholesale.

  But here's the part no one tells you: Those rates are negotiable after the fact. You can, in fact, negotiate large hospital bills down, sometimes as much as 50%, depending on your circumstances.

  In the process of becoming very pro-active about my own health care (because I, too, am self-employed and cannot afford so-called insurance), I've realized that the American insurance industry operates a lot like the Bush administration--it creates a climate of fear in which you are told there's nothing you can do to protect yourself and you have to cede all power to big daddy.

  by Mnemosyne on Sat Nov 27, 2004 at 08:01:09 AM PDT