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I'd like to meet one middle class person who's not on a big company's premium plan tell me otherwise. Happy to oblige. I recently looked into this before I qu

by pfedor 14y ago

I'd like to meet one middle class person who's not on a big company's premium plan tell me otherwise. Happy to oblige. I recently looked into this before I quit my job four months ago to spend some time working on hobby projects. So here's the situation as I understood it: (a) There is a law called COBRA which says after you've quit your job the insurance company has to keep you on the same plan you had for the next 18 months (36 months in California), with the same rates your employer was paying, (b) There is a law called HIPAA which says that after you've used up all COBRA the insurance company has to give you coverage regardless of any preexisting conditions, as long as the gap in your coverage was below (I think) 60 days. So someone in my situation (middle class person not on a big company's plan, as you asked) there is no gain from the healthcare reform. Also, while this was not immediately relevant to my situation, I think that (in CA at least) the insurance company cannot deny you coverage based on the preexisting condition if you're below certain age (19 years old I think?). So as long as you've either gotten the coverage below that age or had a job with a group plan at any point later in your life, and had no gaps in coverage since, you are fine. I'm not at all against the healthcare reform, but I suspect that most of the time when people complain about the healthcare situation in the US they just don't know the facts. I also suspect that in many cases when people share their health insurance horror stories, there is something they're not telling you. Like that they had a gap in coverage. Or that they had to take a job because they needed steady income, and saying it was because of health coverage has a better ring to it.

stcredzero 14y ago
> Happy to oblige. I recently looked into this before I quit my job four months ago to spend some time working on hobby projects. I should simply extend this to, "one middle class person who's not had the benefit of being on a big company's premium plan tell me otherwise." If it wasn't for COPBRA and HIPAA, you'd be in a much different situation. > So as long as you've either gotten the coverage below that age or had a job with a group plan at any point later in your life, and had no gaps in coverage since, you are fine. That's a whole lot of stipulations. I think it should just be reduced to the last 3 words. > I also suspect that in many cases when people share their health insurance horror stories, there is something they're not telling you. I see lots of people roll their eyes when I mention my sister's healthcare horror stories. How is it that people know a priori that, "there is something they're not telling you?" There is some clear prejudice operating here -- without exception, people who have that axe to grind don't even let me finish the sentence before their eyes roll. Incidentally, my sister is covered under the plan for the New York City Ballet. She's a dance educator and takes the same classes as the company as enrichment for her job. Even she has a healthcare horror story. She blew out her hamstring during one of those classes. She was scheduled to go in for an MRI to see if she needed surgery, but there was a traffic accident involving a toddler, and they had to MRI the kid first, so she couldn't get her MRI, so the doctors have her stay overnight at the hospital to get her MRI first thing in the morning. Well, it turns out she didn't need surgery, so the insurance company sticks her with over $4000 for the hospital stay! There is nothing I'm not telling you about that.
- clarky07 14y ago
  I quit my job at a tiny company 2 years ago and then I got an individual plan for myself while I worked for myself. Why did she need to stay in the hospital to get an MRI? Couldn't she just wait in the ER until it was her turn? Seems like blown hamstring shouldn't require an overnight hospital stay for any reason ever...
  - stcredzero 14y ago
    > Why did she need to stay in the hospital to get an MRI? Have you tried to get yourself home with a blown hamstring? > Couldn't she just wait in the ER until it was her turn? The toddler in the accident had the last slot of the day. So, are you recommending that she could've just waited all night in the waiting room? > Seems like blown hamstring shouldn't require an overnight hospital stay for any reason ever. She just did what the doctors recommended.
    - clarky07 14y ago
      >Have you tried to get yourself home with a blown hamstring? I assumed she had family in the area. Did she drive herself home the next day with a still blown hamstring? > The toddler in the accident had the last slot of the day. So, are you recommending that she could've just waited all night in the waiting room? For 4k I would have. > She just did what the doctors recommended. I can certainly understand that, but also don't think it needed a hospital stay. The MRI doesn't fix anything, it just tells you how bad things are. She could have had a relative drive her home, sleep in her bed, and drive her back the next day. For the record, I broke my arm playing softball 3 years ago. The paramedics wanted to drive me to the hospital. I told them no, because I knew it would cost 1-2k for the 10 minute drive. Instead I had a friend do it. They didn't ask me to stay overnight for my x-ray, but i did wait for several hours. If for some reason they had asked me stay because it broke (the machine) or wouldn't be ready, you can guarantee I would not have. I know it's really expensive, and there isn't anything they would be doing for me. I'd have gone home and been miserable for free instead of staying and been miserable for 4k. Sometimes you need to question what doctors tell you. They are in the business of helping people, but they are also for profit. Maybe they assumed your insurance would cover it, but that doesn't mean it was necessary.

by pfedor 14y ago

stcredzero 14y ago

> Happy to oblige. I recently looked into this before I quit my job four months ago to spend some time working on hobby projects. I should simply extend this to, "one middle class person who's not had the benefit of being on a big company's premium plan tell me otherwise." If it wasn't for COPBRA and HIPAA, you'd be in a much different situation. > So as long as you've either gotten the coverage below that age or had a job with a group plan at any point later in your life, and had no gaps in coverage since, you are fine. That's a whole lot of stipulations. I think it should just be reduced to the last 3 words. > I also suspect that in many cases when people share their health insurance horror stories, there is something they're not telling you. I see lots of people roll their eyes when I mention my sister's healthcare horror stories. How is it that people know a priori that, "there is something they're not telling you?" There is some clear prejudice operating here -- without exception, people who have that axe to grind don't even let me finish the sentence before their eyes roll. Incidentally, my sister is covered under the plan for the New York City Ballet. She's a dance educator and takes the same classes as the company as enrichment for her job. Even she has a healthcare horror story. She blew out her hamstring during one of those classes. She was scheduled to go in for an MRI to see if she needed surgery, but there was a traffic accident involving a toddler, and they had to MRI the kid first, so she couldn't get her MRI, so the doctors have her stay overnight at the hospital to get her MRI first thing in the morning. Well, it turns out she didn't need surgery, so the insurance company sticks her with over $4000 for the hospital stay! There is nothing I'm not telling you about that.

clarky07 14y ago
I quit my job at a tiny company 2 years ago and then I got an individual plan for myself while I worked for myself. Why did she need to stay in the hospital to get an MRI? Couldn't she just wait in the ER until it was her turn? Seems like blown hamstring shouldn't require an overnight hospital stay for any reason ever...
- stcredzero 14y ago
  > Why did she need to stay in the hospital to get an MRI? Have you tried to get yourself home with a blown hamstring? > Couldn't she just wait in the ER until it was her turn? The toddler in the accident had the last slot of the day. So, are you recommending that she could've just waited all night in the waiting room? > Seems like blown hamstring shouldn't require an overnight hospital stay for any reason ever. She just did what the doctors recommended.
  - clarky07 14y ago
    >Have you tried to get yourself home with a blown hamstring? I assumed she had family in the area. Did she drive herself home the next day with a still blown hamstring? > The toddler in the accident had the last slot of the day. So, are you recommending that she could've just waited all night in the waiting room? For 4k I would have. > She just did what the doctors recommended. I can certainly understand that, but also don't think it needed a hospital stay. The MRI doesn't fix anything, it just tells you how bad things are. She could have had a relative drive her home, sleep in her bed, and drive her back the next day. For the record, I broke my arm playing softball 3 years ago. The paramedics wanted to drive me to the hospital. I told them no, because I knew it would cost 1-2k for the 10 minute drive. Instead I had a friend do it. They didn't ask me to stay overnight for my x-ray, but i did wait for several hours. If for some reason they had asked me stay because it broke (the machine) or wouldn't be ready, you can guarantee I would not have. I know it's really expensive, and there isn't anything they would be doing for me. I'd have gone home and been miserable for free instead of staying and been miserable for 4k. Sometimes you need to question what doctors tell you. They are in the business of helping people, but they are also for profit. Maybe they assumed your insurance would cover it, but that doesn't mean it was necessary.