4 ms·

Interesting, as an outsider, I've heard horror stories, including how US insurance companies treat patients with chronic medical conditions - trying to avoid co

by zerr 8y ago

Interesting, as an outsider, I've heard horror stories, including how US insurance companies treat patients with chronic medical conditions - trying to avoid compensations as much as possible, even invalidating insurance policies, stating as pre-condition, etc... May I ask, how you (and your family) were treated? Did you got lucky with some particular insurance company, or is it a norm in case one has a decent job? Also interesting, e.g. what happens if you lose your job, decide to go indie or until you find another job... In other words, how safe you feel? (compared to living in Australia with their universal healthcare)

lotsofpulp 8y ago
Health insurance companies are not allowed to deny coverage based on pre existing conditions, and they all have out of pocket maximums (for in network providers - doctors/hospitals that they have deals with), and you can purchase health insurance at healthcare.gov if you don’t have a job. Unless your employer pays a portion for you, expect to spend $4,000 to $8,000 per year per person on health insurance premiums, depending on your age, plus up to $3,000 or so on out of pocket costs assuming you need medical care. It’s just your lifetime’s, up to 65 or whenever Medicare (taxpayer funded care) kicks in, health costs amortized over your whole life and then discounted for age since younger people don’t need as much healthcare. In America, the voters want doctors and hospitals and drug makers to provide everyone, no matter how destitute, with services and medicine. But the voters also don’t want any to pay any additional taxes, so this is all a work around to that. Poor people and old people get subsidized by Medicaid and Medicare (taxpayers) and they pay less or nothing at all, so the providers go after everyone else (middle class) for as much as they can. The bigger employers who have negotiating power can do well for themselves, but the smaller employers/individuals on healthcare.gov get screwed because they don’t have enough negotiating power to prevent getting taken for all they have.
- erentz 8y ago
  > Poor people and old people get subsidized by Medicaid Everyone assumes if youre dirt poor you get Medicaid. But at least for some states as I’ve found out that’s far from true. In Florida for example (we have a poor friend there who is sick) non disabled adults do not ever qualify even if they earn zero dollars.
  - stronglikedan 8y ago
    Interesting. I have a non-disabled friend in the same state that is very poor (lives in a trailer home, cannot get a decent job as an ex-con, etc.), and Medicaid covers all of his medical expenses - even psychiatric. He's not always happy with some of the things they provide, but he's also the type of person that never would be. He gets what he needs, but not always what he wants. Perhaps your poor, sick friend just needs the proper guidance and/or motivation.
    - erentz 8y ago
      I don’t know how your friend qualifies but he is not a single non disabled adult, the qualification requirements are here and very clear: https://www.benefits.gov/benefit/1625 https://www.benefits.gov/benefit/1625 > To qualify for this benefit, you must: > Be over the age of 64; or > Be pregnant or have a child 18 or under; or > Be blind or disabled; or > Have a child, parent, or spouse in your household who is blind or disabled By suggesting my friend needs proper motivation do you mean she should get pregnant so as to qualify?
roganartu 8y ago
We've been here for nearly two years now, but when I was interviewing with the intent of moving to the US I was very direct with employers about our insurance requirements to make sure her quality of care would not be reduced. I turned down some better offers because their insurance was worse (one company would've required her to move to a known-worse treatment until she demonstrated it didn't work for her. This escalating method of treating her condition is well known to have much poorer long-term outcomes but it's cheaper). Re avoiding treating people with chronic conditions, my understanding is that used to be a (state-by-state) thing that the ACA federally outlawed. We live in NYC where the state had already outlawed it, so even if the ACA is rolled back we should be fine. We have very good insurance atm. I would go so far as to say, ignoring the general craziness of dealing with the US system and the occasional billing frustration, we have better coverage now than we did in Australia because _almost everything_ is covered (even most things Australia would consider "elective" and hence one would pay for out of pocket). We pay a token $1/month for premiums because law says we have to contribute and my employer pays our deductible. As long as we stay in-network we have basically no out of pocket costs. If I lose or leave my job I have to find a new one and transfer my visa within 30 days, or leave the country within another 90 days after that. There's a thing called COBRA which allows you to pay a relatively low fee (iirc it's ~$700/m) to continue with exactly the same insurance post-employment for a short period (I think 9-12 months? Unsure exactly). Otherwise we'd just move back to Australia. We're both Australian citizens and we aren't really interested in making the transition to being US permanent residents.
- mikestew 8y ago
  There's a thing called COBRA which allows you to pay a relatively low fee (iirc it's ~$700/m) to continue Boy, are you going to be in for a surprise if you ever utilize COBRA. If there's a "we" involved, plan on about double that, because you will pay the full, undiscounted premium. They don't want you on that plan, and they only do it because of federal law, so they're going to make it as unappealing as possible. insurance post-employment for a short period (I think 9-12 months? Unsure exactly) 18 months.
  - eq_sd_ 8y ago

by zerr 8y ago

lotsofpulp 8y ago

Health insurance companies are not allowed to deny coverage based on pre existing conditions, and they all have out of pocket maximums (for in network providers - doctors/hospitals that they have deals with), and you can purchase health insurance at healthcare.gov if you don’t have a job. Unless your employer pays a portion for you, expect to spend $4,000 to $8,000 per year per person on health insurance premiums, depending on your age, plus up to $3,000 or so on out of pocket costs assuming you need medical care. It’s just your lifetime’s, up to 65 or whenever Medicare (taxpayer funded care) kicks in, health costs amortized over your whole life and then discounted for age since younger people don’t need as much healthcare. In America, the voters want doctors and hospitals and drug makers to provide everyone, no matter how destitute, with services and medicine. But the voters also don’t want any to pay any additional taxes, so this is all a work around to that. Poor people and old people get subsidized by Medicaid and Medicare (taxpayers) and they pay less or nothing at all, so the providers go after everyone else (middle class) for as much as they can. The bigger employers who have negotiating power can do well for themselves, but the smaller employers/individuals on healthcare.gov get screwed because they don’t have enough negotiating power to prevent getting taken for all they have.

erentz 8y ago
> Poor people and old people get subsidized by Medicaid Everyone assumes if youre dirt poor you get Medicaid. But at least for some states as I’ve found out that’s far from true. In Florida for example (we have a poor friend there who is sick) non disabled adults do not ever qualify even if they earn zero dollars.
- stronglikedan 8y ago
  Interesting. I have a non-disabled friend in the same state that is very poor (lives in a trailer home, cannot get a decent job as an ex-con, etc.), and Medicaid covers all of his medical expenses - even psychiatric. He's not always happy with some of the things they provide, but he's also the type of person that never would be. He gets what he needs, but not always what he wants. Perhaps your poor, sick friend just needs the proper guidance and/or motivation.
  - erentz 8y ago
    I don’t know how your friend qualifies but he is not a single non disabled adult, the qualification requirements are here and very clear: https://www.benefits.gov/benefit/1625 https://www.benefits.gov/benefit/1625 > To qualify for this benefit, you must: > Be over the age of 64; or > Be pregnant or have a child 18 or under; or > Be blind or disabled; or > Have a child, parent, or spouse in your household who is blind or disabled By suggesting my friend needs proper motivation do you mean she should get pregnant so as to qualify?

roganartu 8y ago

We've been here for nearly two years now, but when I was interviewing with the intent of moving to the US I was very direct with employers about our insurance requirements to make sure her quality of care would not be reduced. I turned down some better offers because their insurance was worse (one company would've required her to move to a known-worse treatment until she demonstrated it didn't work for her. This escalating method of treating her condition is well known to have much poorer long-term outcomes but it's cheaper). Re avoiding treating people with chronic conditions, my understanding is that used to be a (state-by-state) thing that the ACA federally outlawed. We live in NYC where the state had already outlawed it, so even if the ACA is rolled back we should be fine. We have very good insurance atm. I would go so far as to say, ignoring the general craziness of dealing with the US system and the occasional billing frustration, we have better coverage now than we did in Australia because _almost everything_ is covered (even most things Australia would consider "elective" and hence one would pay for out of pocket). We pay a token $1/month for premiums because law says we have to contribute and my employer pays our deductible. As long as we stay in-network we have basically no out of pocket costs. If I lose or leave my job I have to find a new one and transfer my visa within 30 days, or leave the country within another 90 days after that. There's a thing called COBRA which allows you to pay a relatively low fee (iirc it's ~$700/m) to continue with exactly the same insurance post-employment for a short period (I think 9-12 months? Unsure exactly). Otherwise we'd just move back to Australia. We're both Australian citizens and we aren't really interested in making the transition to being US permanent residents.

mikestew 8y ago
There's a thing called COBRA which allows you to pay a relatively low fee (iirc it's ~$700/m) to continue Boy, are you going to be in for a surprise if you ever utilize COBRA. If there's a "we" involved, plan on about double that, because you will pay the full, undiscounted premium. They don't want you on that plan, and they only do it because of federal law, so they're going to make it as unappealing as possible. insurance post-employment for a short period (I think 9-12 months? Unsure exactly) 18 months.
- eq_sd_ 8y ago