US health insurance too complicated ?

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SUMMARY

The discussion centers on the complexities and costs of obtaining private health insurance in the United States, particularly for individuals planning to stay for a short period. Participants noted that monthly premiums can range from $100 to $700, influenced by factors such as location, age, and health status. The conversation highlighted the importance of understanding insurance networks, as coverage can vary significantly between plans. Additionally, it was suggested that individuals consider catastrophic insurance for short-term stays, which typically offers lower premiums while covering major medical expenses.

PREREQUISITES
  • Understanding of US health insurance terminology, including "catastrophic insurance" and "insurance networks."
  • Familiarity with factors affecting health insurance costs, such as age, smoking status, and pre-existing conditions.
  • Knowledge of major health insurance providers, such as Aetna.
  • Awareness of the differences between employer-sponsored and private health insurance plans.
NEXT STEPS
  • Research "catastrophic health insurance plans" for short-term stays in the US.
  • Explore the differences between "in-network" and "out-of-network" providers in health insurance.
  • Investigate the health insurance offerings from major providers like Aetna.
  • Learn about the implications of pre-existing conditions on health insurance premiums.
USEFUL FOR

Individuals planning to travel or reside temporarily in the US, freelancers, self-employed professionals, and anyone seeking to understand the intricacies of private health insurance in the US.

oldtobor
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I may have to go to the US for a period of 3 months to 2 years. I want to buy my own health insurance because either I work on my own or not at all or in modest paying jobs that don't offer health insurance. How much would it cost me to buy my own in the US ?

I saw a documentary explaining this on a European TV channel. It seemed quite complicated, depending on whether you live in a city or suburbs it seems the price for your private insurance can be between 100 and 700 dollars a month.
There also seems to be a struggle between doctors, hospitals etc. for expenses so even if you have an insurance, in many suburbs doctors and hospitals wouldn't cover it. I was suprised by how complicated the whole issue was! Is there any simple rule of thumb I can use to estimate how much it would cost ? I intend to be in a suburb NJ or PA. Also many in the program said they simply don't pay anything even after they go to the hospital.
 
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Other people must have more experience then this on me because this whole suburb vs. city price difference is news to me. If your a single person it should be about $200 a month unless your a drug addict/smoker/history of dieing lol. The whole thing about the 'struggle between doctors and hospitals' is again, news to me. If you have insurance, your good to go. there's absolutely no reason why hospitals wouldn't take you, ESPECIALLY if you have insurance.

Talk to your/a travel agent, they will help you figure it out.

And who said they don't pay anything? Did they mean the health insurance provider refused to pay or the person didnt have to pay because their health insurance payed all of it?

oh just kidding, check this link out for help

http://www.agencyinfo.net/iv/medical/medical.htm
 
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Private health insurance is going to cost a lot more than $200/month! It won't even be that low through an employer, but private insurance is even more expensive. I don't know about suburbs vs cities, but more likely there will be variations from state to state. Other things that will affect your cost are your age, whether you smoke or not, have any pre-existing conditions (they won't cover you for those), or any other risk factors that might make you more expensive for them.

The issue about hospitals and doctors probably refers to needing to see the primary care provider who accepts your insurance plan to get referrals to anyone else. Depending on the plan, your insurance might cover you at any hospital or only at those within that insurance companies network, but that only applies to scheduled procedures, not emergencies.

It is complicated. I think it's one of the reasons health care costs are so high here in the US, because doctors have to spend a lot of time and pay employees just to help figure out all the insurance regulations to get paid.
 
Are you serious moonbear? My family pays about $500 every 2 weeks and its 2 adults, 1 being a long time smoker, and 1 child.

And yah, i guess that's what they were talken about, the network thing. 1 program allows you to go to any doctor, 1 only let's you go to one in the network. The type that allows you to only go to ones in the network will still allow you to go to ones outside of the network but you would need to get permission from the health care company.

I think health costs are so high now because of the procedures we can get. Sci-fi stuff 20 years ago is now in the 'everyman's hands :D
 
Pengwuino said:
Are you serious moonbear? My family pays about $500 every 2 weeks and its 2 adults, 1 being a long time smoker, and 1 child.
That's the odd thing, it doesn't cost that much to add on the rest of the family once you pay for the first person. So, while my employer pays most of my healthcare costs, which are exhorbitant rates, if I wanted to add a spouse or dependent, I think it's only an extra $100/month. Through an employer, your health status doesn't count much because the rate is negotiated on a group total with the assumption that some people are low risk and some are high risk and the rest fall somewhere in between. But when you have to pay for yourself, such as if you're self-employed or unemployed, it can be pretty exhorbitant, because you don't have the benefit of being part of a larger group that sort of equalizes costs.

I think health costs are so high now because of the procedures we can get. Sci-fi stuff 20 years ago is now in the 'everyman's hands :D
That partly increases costs too, as well as all the unnecessary procedures people get simply because they can (that's the downside to being insured; people rationalize that they pay a small fortune for insurance, so they're going to get their money's worth, so go to the doctor for every stupid thing that doesn't need a doctor's care). But I've heard of doctors who are leaving insurance networks and patients just pay per visit just like the old days, and it's turning out cheaper for doctor and patient (the doctor can keep costs down by not dealing with all the insurance red tape, and in turn can pass those savings to the patients, AND have more time to spend with the patients because they don't have insurers breathing down their necks to spend only 5 min with a patient and then move on to the next paying customer).

Anyway, I think if someone is going to be here just a short time, they should look into just catastrophic insurance; the ones that aren't going to cover regular office visits, because you probably won't need those and can always pay cash if you do need them, but that will cover hospitalization if you need it. Those plans can be less expensive because the insurers know a young, healthy person isn't likely to need it.
 
Wow i thought it was the other way around. First adult or 2 is cheap, once you start adding kids costs go crazy. I remember the reason was that kids are alllllways going to the doctor and have all those shots to do and parents bring kids into the doctors for any lil pain or problem.
 
Thanks a lot for the replies! It seems even more complicated now! Maybe I can just get by with no insurance and then just go to the hospital in case of a real emergency. The US hospitals always take you in in case of a real emergency. Then after I'm OK just leave the hospital and tell them I can't pay because I don't have the money. Is that feasable?

How do people in the US get by paying more than 500 dollars a month for insurance ? Aside for those insured by companies, if you have a modest job 800 dollars a month, you could not really pay it.
 
Yah that's what most illegal immigrants do. We end up paying huge amounts of money for them adn they just run away (like what you would do).

And $800 a month is not considered modest in the US. Thats absolute bare minimum after tax you can make if you do actually work the normal 40 hours a week. And $500 a month would mean you probably have some health risks (such as smoking) which means you deserve to be paying that much. For all Americans, whether many of them want to admit it or not, can budget for health care just like we budget for mandatory car insurance.
 
Pengwuino said:
For all Americans, whether many of them want to admit it or not, can budget for health care just like we budget for mandatory car insurance.

Car insurance is between 1000 and 2000 US dollars a year, from what I read above medical insurance goes between 4000 and 6000 dollars a year. It seems like a lot to me!
 
  • #10
Moonbear said:
Private health insurance is going to cost a lot more than $200/month!
IIRC, I pay $160 or so through Aetna. Look into Aetna, (aetna.com), oldtobor.
 

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