Health Insurance – HELP! What a F#c*ing nightmare!

Health Insurance – HELP! What a F#c*ing nightmare!

I’ve been very fortunate throughout my life to have had health insurance through an employer directly or, for the last couple of years, as a dependent. In 2017 I quit working full time and became Kurt’s dependent (chuckling under my breath at THAT one). Kurt retired from the Dallas Police Department and I was able to be covered under his policy provided by the City of Dallas. Well, in September of this year Kurt turned 65, which meant he had to terminate his coverage with the City of Dallas and enroll in medicare. So now I need health insurance help.

I can remain on the City of Dallas’ plan, but the premium goes from being just terribly high ($600-ish) to unbearable, ($900 ish). Cigna. I did some research and found BXBS and UnitedHealthcare to be about the same, $874 at the low end, to over $1500 at the high. I only need coverage for 2 and a half years!  At the lowest-priced premium, that’s over $10,000 a year! …NOT including Rx, vision, or dental – thank you very much.


We Need Health Insurance – Help! It’s a F#(@ing Nighmare!

(CAUTION! – Bad Language:)
Me, after reviewing the health insurance premiums.

What is WRONG with our medical system!??! It is just plain effed up. There’s no one reason, but several reasons for this nightmare that is the US medical system. The for-profit system seems counter to the Hippocratic Oath – First Do No Harm. How can an organization that is to do no harm, have a priority of making a profit off of those needing the services? The for-profit status automatically puts the organization/provider into conflict with its customers. Add in all the hoops, loopholes, and bureaucracy, the cheats, scammers and unscrupulous are able to further degrade the system.

Are the government and the insurance companies doing what they’re supposed to do? Are they keeping the public’s best interest in mind? Individuals who take advantage of the system (providers and patients, alike), elected officials and insurance company management that choose self-interest over public interest hurt us all. Our medical system is broken, which makes it impossible to get affordable, meaningful, insurance coverage as an individual not covered by an employer plan nor Medicare.


Insurance Nightmare
My Insurance Nightmare

Here’s my insurance nightmare:

I am a 62-year-old female in fairly good shape. I don’t take any medication other than the typical hormones. While there is some heart disease in my family history, my ticker seems to be running well and my low blood pressure reinforces that. Other than the annual mammogram, regular wellness check, and the once-a-decade colonoscopy, I’ve been to a doctor’s office 3 times in the last 5 years. I get a flu shot every year at CVS and I’ve not been a patient in a hospital since 1997. (Knocking on wood, thank you.)

$10,000 a year premium? Are you KIDDING?

“Trust Me”

After much research, I found UnitedHealthcare’s Golden Rule Insurance Company division. They offer a selection of insurance policies that were developed for people like me; those who may have quit work, but aren’t 65 yet so they aren’t eligible for Medicare coverage. They term the insurance coverage as “short-term”, but it can help you get from 62 to 65. (I didn’t look into coverage available for longer than 3 years, but it would be worth checking into if you need coverage for a longer gap.)

The deductibles on these policies range from $1,000 to $12,500, the co-insurance coverage from 60/40 to 100%, and the maximum lifetime coverage and out-of-pocket maximums range from $250,000 to $2 million and $10,000 (plus deductible) to $0.00, respectively.  As you can imagine, there are multiple policy combinations you could select, so it’s not something you can glance at and figure out quickly. I looked at the variables, studied a few combinations and decided what was most important to me. Here’s what I ended up with. Effective January 1, 2020:


Included

$12,500 deductible

$100% coverage after deductible (0% co-insurance required)

$12,500 maximum out of pocket maximum (the deductible)

$2 million lifetime maximum coverage

NOT Included

Rx  

Dental

Vision

Preventative Care


The premium? If I paid monthly, this would cost $403 a month. I paid for the year and saved over $1,000, so basically it brought the premium down to just over $300 a month. Can you believe it? Yes, I still have to add in the cost of the prescriptions (about $1,500/yr) the Mammogram (about $400-$500), the flu shot ($30-$50), etc., but (knocking on wood, again) if luck (and my ticker) hold out, I’ll have to spend a lot less overall. I’m a bit nervous, however, I’m betting all the negative reviews have to do with uninformed consumers than a disastrous insurance company. Pray for me.

My mind is mush after all this. Has anyone out there gone through the same thing? What insurance options did you find? I’ve signed up for this short-term coverage for 2020, but I’ll have to do this all again for 2021 and again for 2022 until I “get” to sign up for Medicare. If you have any questions about where I looked and how just let me know. Also, let me know if you’ve found anything else you think is a decent health insurance alternative to consider.

It’s amazing how FEW options I found. We may hate the word “socialism”, but when it comes to healthcare, I do think Canada and France have done a few things so much better than we have in the US.



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