US health insurance too complicated ?

In summary, private health insurance in the US can be expensive, with prices ranging from $100 to $700 per month depending on location and individual factors. There may also be difficulties with finding doctors and hospitals that accept certain insurance plans. The cost of insurance is also affected by age, smoking status, pre-existing conditions, and other risk factors. The complex regulations and procedures involved in insurance may also contribute to the high healthcare costs in the US. It may be more cost-effective to opt for catastrophic insurance if staying in the US for a short period of time.
  • #1
oldtobor
132
0
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.
 
Physics news on Phys.org
  • #2
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. Theres 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
 
Last edited:
  • #3
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.
 
  • #4
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
 
  • #5
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.
 
  • #6
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.
 
  • #7
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.
 
  • #8
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.
 
  • #9
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.
 

Related to US health insurance too complicated ?

1. What makes US health insurance so complicated?

US health insurance is complicated for a number of reasons. One of the main reasons is the lack of a single-payer system, which means that there are multiple insurance companies and plans to choose from. This can lead to confusion and difficulty in understanding the differences between plans. Additionally, the constantly changing laws and regulations surrounding health insurance make it even more complicated.

2. How do I know which health insurance plan is right for me?

Choosing the right health insurance plan can be overwhelming. It is important to carefully consider your own healthcare needs and budget when comparing plans. Some key factors to consider are the monthly premiums, deductibles, and out-of-pocket costs, as well as the coverage for specific services and medications that you may need.

3. What is the difference between a PPO and an HMO?

A PPO (Preferred Provider Organization) is a type of health insurance plan that allows you to see any healthcare provider within the network, without needing a referral. However, if you choose to see a provider outside of the network, you may have to pay more out-of-pocket costs. An HMO (Health Maintenance Organization) also has a network of providers, but typically requires you to choose a primary care physician and get a referral to see a specialist. HMOs often have lower out-of-pocket costs compared to PPOs.

4. Are pre-existing conditions covered under US health insurance?

Under the Affordable Care Act, insurance companies are not allowed to deny coverage or charge more because of a pre-existing condition. This means that individuals with pre-existing conditions can still get coverage, but they may have to pay higher premiums. However, there are some short-term or limited-duration plans that may not cover pre-existing conditions.

5. Can I change my health insurance plan at any time?

In most cases, you can only change your health insurance plan during the open enrollment period, which usually takes place once a year. However, there are certain life events, such as getting married or having a baby, that may qualify you for a special enrollment period where you can make changes to your plan. It is important to check with your insurance provider for specific details and deadlines.

Similar threads

  • General Discussion
Replies
22
Views
1K
Replies
10
Views
1K
Replies
10
Views
1K
  • General Discussion
Replies
9
Views
943
Replies
39
Views
15K
  • General Discussion
Replies
5
Views
2K
Replies
65
Views
8K
  • Biology and Medical
Replies
2
Views
956
  • General Discussion
5
Replies
160
Views
19K
  • General Discussion
2
Replies
46
Views
3K
Back
Top