6 ms·

Honest question as a Canadian - what do you do about health insurance when you're 50 and get fired from your lifer job? Should you really have been paying for y

• ajross 12y ago
  These days you go to your state exchange (for the putative ex-MS person, that's likely to be https://www.wahealthplanfinder.org/ https://www.wahealthplanfinder.org/), search for a plan, click on it and sign up. It used to be worse, of course. But even then it wasn't a disaster for the case at hand: the COBRA act allowed you to continue to buy your existing plan at the same premiums for a year and a half until you found a new job.
  • kstrauser 12y ago
    COBRA is impossibly expensive for many people. When you simultaneously have your salary drop to $0 and your portions of your insurance premiums triple (say, if you have a spouse and kids covered by the plan), that's a rough situation to be in. About the only good thing about COBRA is that it covers preexisting conditions.
    • dataminded 12y ago
      I can cosign this. Cobra for my wife and I was ~$1000/month.
      • bmelton 12y ago
        Not to contribute to the ACA vs. non-ACA arguments further, but ACA plans for my wife, daughter and myself are more than double that in Maryland. I don't know what the differences would be if I were earning $0 per year, especially as the relevant question (on the form I filled out) was something like "How much do you anticipate earning this year?" which is a question I have no idea how I would answer if I were currently unemployed.
        • krschultz 12y ago
          Then that sounds about on par, because a family plan is usually 2x the cost of a couple's plan.
        • nknighthb 12y ago
          > I don't know what the differences would be if I were earning $0 per year Your premiums would be $0. You would be immediately enrolled in medicaid.
          • bmelton 12y ago
            That is the correct answer. Danke.
        • pgeorgi 12y ago
          I'd answer that with "0", and send them an updated form as soon as things change. Filling out that form is not the time for heroism.
    • usefulcat 12y ago
      It's impossibly expensive because US health insurance is impossibly expensive. It's not like there's a significant extra cost associated with going with COBRA versus an equivalent individual policy. And prior to the start of this year, you might not be able to get an equivalent individual policy at any price. If you had any pre-existing conditions at all, then you definitely would not be able to get equivalent coverage.
      • mistermann 12y ago
        > It's impossibly expensive because US health insurance is impossibly expensive. And US health insurance is impossibly expensive because US health delivery is impossibly expensive. I believe 75% of the real US problem is not insurance, it is the cost of delivery.
    • bodyfour 12y ago
      The other problem with COBRA is that the insurance company has zero interest in customer service. Insurance companies are famously horrible to deal with, but if your employer's plan gives you trouble you'll probably complain to HR. If they get enough complaints, they could lose the contract next time around. They have at least some incentive to keep you happy (or at least non-furious) When you're a COBRA customer you're basically on your own. Good luck getting them to pay up on anything. Can we have a single-payer system now? Please?
      • deleted 12y ago
        [deleted]
    • kyllo 12y ago
      And that within 60 days, you only pay the premium if you use it, because that's how long they give you to enroll in it. So if you get sick/injured within 60 days after being laid off, you can apply for COBRA, pay the premium, and you will be covered retroactively.
  • oddevan 12y ago
    Should be noted that in most cases your employer would cover most of that premium. My insurance went from $10/month (with my employer covering $580) to $590/month on COBRA when I was laid off.
    • nanidin 12y ago
      As a mid 20's single male, I had the same experience. My premiums were fully paid by my employer, so it was quite a shock when the COBRA paperwork came stating the monthly cost would be almost $600/month.
      • chris_mahan 12y ago
        As a mid-45 male with a wife and kid, my cobra 5 years ago was $1200/month, and I was glad to pay it. 14,000 a year is nothing compared to one major incident involving a hospital.
• wyager 12y ago
  A very reasonable thing to do is ask for a higher salary and no company insurance. You end up paying a premium (because the extra salary gets hit by income tax, while if the company had used it to buy insurance it would not have been subject to income tax), but you get to choose your own insurance and it doesn't stop when you leave.
  • smackfu 12y ago
    How is that better than COBRA?
    • mike_h 12y ago
      COBRA rates are 3-4x higher than individual plan insurance every time I've heard about them. In a rapid-churn economy like tech, where people often strike out on their own and companies cease to exist etc., the few $K a year it takes to maintain your own individual plan is something everyone should consider. As you age, starting a new private plan becomes frighteningly expensive, and if ACA doesn't stick, it may become impossible again for many people.
      • usefulcat 12y ago
        At various times, I've used COBRA, I've had individual plans, and I've had group plans for which I've paid the full premium. I've never seen a difference of anywhere remotely close to 3-4x for COBRA versus an equivalent individual plan.
        • mike_h 12y ago
          I only have two personal anecdotes, one 3x and one > 4x. Both for people in their 20s, and I don't know the math but I can imagine that in group plans where rates are flat, young people cost more to insure than individually and older people cost less. Couldn't find any good data but here's a post representative of the top few google hits for COBRA vs. private: http://www.mymoneyblog.com/unemployed-cobra-vs-individual-health-insurance.html http://www.mymoneyblog.com/unemployed-cobra-vs-individual-he...
• walkon 12y ago
  Buying a parallel policy could help. I don't understand why the U.S. government has a tax code that effectively makes the most important type of insurance the easiest to loose.
• fencepost 12y ago
  Prior to the Affordable Care Act / Obamacare, you had up to 18 months of COBRA eligibility, meaning you could stay on your employer's plan but paid all premiums (expensive). During that time you frantically look for a job that includes healthcare coverage. Failing either of those, you might find junk insurance, or you simply go without and hope for good health. If your income is / remains low enough you might qualify for Medicaid, but you pretty much have to be at the poverty level for that. Post-ACA you can now purchase coverage from any of a variety of companies through the exchanges. Rates are limited in that there's now a legal requirement that a minimum percentage of premiums must actually be used to pay for medical expenses (I believe 80 or 85%) so premiums are set accordingly. There are also income based subsidies that you're eligible for of your income is more than 4x the poverty level. There was also an expansion of Medicaid eligibility up to 4x the poverty level with the additional cost being paid by the federal government, but some states have refused that expansion and money. This has left many poor in those states stuck unable to afford premiums and unable to get either subsidies or Medicaid.
  • nextstep 12y ago
    This is a very thorough answer.
  • akg_67 12y ago
    I went through layoff six months ago. ACA definitely has helped with health insurance. If you are unemployed (no income), you are most likely to get subsidy as it is income based. Our premiums after subsidy is little bit higher than what we were paying when I was employed. I wish there was something similar to ACA for dental insurance. Most dental insurance plans on open market are expensive and with ridiculous terms, like 18-month waiting period! We had to take dental insurance plan through COBRA (almost 6 times as expensive as regular employee). Not sure what we will do with dental insurance after 18 months of coverage through COBRA.
    • fencepost 12y ago
      Dental is harder, and (at least in my dentist's opinion) private dental insurance just isn't worth it. I can see the merits of that, because you're less likely to have a catastrophic dental emergency that can bankrupt you. A lot of dental insurance also seems to only cover 50% of the more expensive items. It may be worth looking at how much you're paying each month in premiums and comparing that to the annual out-of-pocket cost for preventive / cleaning visits plus perhaps a filling or two. You may find that all the insurance is really doing is smoothing those payments out without saving you much money unless you have a "years of neglect" situation that you're still working through. It's probably also worth asking your dentist if they have "self-pay" rates comparable to what they're getting from the insurance companies. If they bill $120 but accept $80 from insurance, will they take $80-90 cash from you instead of that $120? Also, for more expensive procedures like crowns, it's very likely that your dentist's office will let you do installments to spread the cost over at least several months. That doesn't really help when you don't have current income and aren't sure when you will have it, but it does relate to smoothing out your expenditures the way insurance premiums do.
• throwaway1dh9 12y ago
  I'm from Europe (Germany). Worried about insurance for your kid? Can't happen here, the government will deal with that. Losing your job? Get paid for one or two years by your work insurance. After that you fall back to a free basic income (for as long as you need). And still this system is generally not exploited: People work hard here. And it's not just unemployment. There are people begging for money on HN regularly, because they are dying (often of cancer) and are now worried about their families. This is just cruel and can't happen that easily on this side of the Atlantic. But it seems US citizens want to live like that. Why?
  • imgabe 12y ago
    Most people don't want to live like that, but health insurance companies profit from the current system and they have deep pockets to influence the government to keep it that way.
  • mistermann 12y ago
    > But it seems US citizens want to live like that. Why? Only "god" knows for sure, but I have a strong suspicion you answered your own question, at least in part: > And still this system is generally not exploited: People work hard here.
    • dfxm12 12y ago
      According to Forbes, Americans' GDP per hour worked is better than that of the Germans, and the Americans are happier while doing it: http://www.forbes.com/sites/susanadams/2013/10/30/the-pursuit-of-happiness/ http://www.forbes.com/sites/susanadams/2013/10/30/the-pursui... This also shows Americans work more than the Germans and this doesn't say anything about how hard people are working, but don't forget the old adage: Don't work harder, don't smarter!
      • mistermann 12y ago
        Agreed, but productivity per hour worked and moral willingness to abuse social programs are two different issues.
• GFK_of_xmaspast 12y ago
  You get sick and die.