Need to buy health insurance for two months in the USA.

[fuzzybabybunny]

I just got back to the USA after a two year absence and need to get health insurance.

I'm outside of the open enrollment period and don't qualify for a special enrollment period (all I did was travel for two years and I'm only back because my mom is getting surgery).

I see plans with a ~$2,500 deductible and max out of pocket of ~$8,000.

So let me get this straight:

- I pay the premium each month.

- For *anything* totalling under $2,500, I'm just going to be paying out of pocket, right? If I go get a physical, blood screening, etc I'm basically going to just be paying out of pocket, as if I didn't have any insurance.

- In the case of something major, insurance will limit my out of pocket to $8,000.

- So if I'm healthy and/or only rack of $2,499 in out of pocket bills, I'm basically giving my premium money to the insurance company with zero benefits.

 

[Matthiasa]

Also noting that those values are for in-network services anything else will not be covered... But yeah that is how health insurance works, the healthy pay for the sick.

 

[fuzzybabybunny]

Also noting that those values are for in-network services anything else will not be covered... But yeah that is how health insurance works, the healthy pay for the sick.

But even if I was in-network, but under the $2500 deductible, I'm essentially not covered, because I'm paying everything out of pocket.

Right?

"Hey, you're "covered" because you're in-network but you still gotta pay the entire bill yourself."

Do I at least get a special rate from an in-network doctor for what I pay out of pocket? Like I pay the rate that the insurance company itself would normally pay versus just some random guy walking in from the street?

 

[Matthiasa]

It really depends on how the plan is worded but often yes until you hit that deductible you are paying for everything with regards to doctor and hospital visits. Medications get treated a bit differently are likely to be covered at some set percentage until max out of pocket is hit. Although, even just a few hours in a hospital will hit that 8k max while you are in the US.

 

[UnklSnappy]

You get peace of mind that your not on the hook for a 50k -250k+ bill should something happen to you.

 

[lxskllr]

Walk carefully, watch your back, and you gotta die some time.

 

[fuzzybabybunny]

You get peace of mind that your not on the hook for a 50k -250k+ bill should something happen to you.

But if you're looking to do some standard maintenance and preventative screenings health insurance is useless?

I'm 31 and relatively healthy. I'm not sick, but that's not the point. I want to be responsible and prevent any possible future medical conditions that'll be costly for everyone, which means I want screenings and regular doctor visits. But I think having to pay $2,500 (or $8,000 for the maximum out if pocket) per year *just* to get screened and have some preventative measures done is too much.

 

[lxskllr]

But if you're looking to do some standard maintenance and preventative screenings health insurance is useless?

I'm 31 and relatively healthy. I'm not sick, but that's not the point. I want to be responsible and prevent any possible future medical conditions that'll be costly for everyone, which means I want screenings and regular doctor visits. But I think having to pay $2,500 (or $8,000 for the maximum out if pocket) per year *just* to get screened and have some preventative measures done is too much.

Two months falls between "screenings and regular doctor visits". Don't you have insurance from where you're coming from, or can get some kind of traveler insurance?

 

[ponyo]

But if you're looking to do some standard maintenance and preventative screenings health insurance is useless?

I'm 31 and relatively healthy. I'm not sick, but that's not the point. I want to be responsible and prevent any possible future medical conditions that'll be costly for everyone, which means I want screenings and regular doctor visits. But I think having to pay $2,500 (or $8,000 for the maximum out if pocket) per year *just* to get screened and have some preventative measures done is too much.

Welcome to the healthcare in the US. If you're self-employed, bend over and take it.

 

[fuzzybabybunny]

Two months falls between "screenings and regular doctor visits". Don't you have insurance from where you're coming from, or can get some kind of traveler insurance?

I'm an American citizen that's been away for years. Even if I lived here permanently the result is the same - pay for insurance but still end up paying thousands out of pocket for preventative screenings or simple doctor's visits. I just went in yesterday to a local clinic in Ohio for a simple lung infection and got charged $150 for a 10 minute visit and told to wait it out. A simple X-ray would have been an additional $200.

Traveler's insurance covers emergencies. Doesn't tend to cover blood screenings or physicals.

 

[ponyo]

I'm an American citizen that's been away for years. Even if I lived here permanently the result is the same - pay for insurance but still end up paying thousands for screenings. I just went in yesterday to a local clinic in Ohio for a simple lung infection and got charged $150 for a 10 minute visit and told to wait it out.

Traveler's insurance covers emergencies. Doesn't tend to cover blood screenings or physicals.

It hasn't changed much since you left. Don't act surprised.

 

[fuzzybabybunny]

It hasn't changed much since you left. Don't act surprised.

Are there things like a minimum number of services that health insurance has to provide that is shielded from the deductible requirement?

Like one free physical and blood screening a year?

 

[lxskllr]

Pretty sure obamacare gives you a physical. Dunno about about blood screening, but getting both would certainly be cheaper paying cash unless you plan on using the insurance.

 

[shabby]

I just got back to the USA after a two year absence and need to get health insurance.

Did you have free healthcare in the place you were staying at before?

 

[fuzzybabybunny]

Pretty sure obamacare gives you a physical. Dunno about about blood screening, but getting both would certainly be cheaper paying cash unless you plan on using the insurance.

A physical includes blood screening, right? I would imagine that there are federal regulations stipulating the minimum items that the annual physical needs to include?

What has your annual physical been like?

 

[fuzzybabybunny]

Did you have free healthcare in the place you were staying at before?

In New Zealand, despite being a tourist, yes, I had their national insurance for free and even used it a couple times.

In Japan, no. But I had traveler's insurance for emergencies.

In China, had travelers insurance.

In Hong Kong, had travelers insurance and paid for things like blood screenings out of pocket which were relatively affordable.

In Australia, I bought insurance because as a tourist I don't qualify for their taxpayer-funded national healthcare, but I never got the chance to use the insurance I bought.

 

[lxskllr]

A physical includes blood screening, right? I would imagine that there are federal regulations stipulating the minimum items that the annual physical needs to include?

What has your annual physical been like?

I don't get physicals. My plan is to keep going til I don't. If I have an issue, I pay cash. If I run out of cash, I'll die; just like everyone else.

 

[Slew Foot]

youre supposed to get 3 free physcials and screening stuff like colonoscopies for free. Not sure about routine bloodwork.

 

[shortylickens]

Whats this about free colonoscopies?

 

[Dr. Detroit]

Don't act surprised. Obama Care has not changed in years.

Why are people so upset about insuring their body when they are happy to pay car insurance with a $1000 deductible on their precious $25K car.

How much is your body worth?

http://obamacarefacts.com/questions/exactly-covered-preventative-care-obamacare/

 

[Carson Dyle]

Why are people so upset about insuring their body when they are happy to pay car insurance with a $1000 deductible on their precious $25K car.

Happy?? LOL. See how many people would be carrying any auto insurance at all if it wasn't mandated in most states.

 

[soulcougher73]

Might be better off just sticking the premium aside for 2 months and not get insurance and using that if anything comes up

 

[Ferzerp]

But even if I was in-network, but under the $2500 deductible, I'm essentially not covered, because I'm paying everything out of pocket.

Right?

"Hey, you're "covered" because you're in-network but you still gotta pay the entire bill yourself."

Do I at least get a special rate from an in-network doctor for what I pay out of pocket? Like I pay the rate that the insurance company itself would normally pay versus just some random guy walking in from the street?

Yes, your rate on most things will be something like 20% of the billed amount. The visit itself usually isn't negotiated down that much, but things like lab work and all the other extra line items typically are. I think my most recent example is a battery of lab work that for some reason wasn't submitted to my insurance. The initial bill was $1061, and then after getting the missing insurance sorted out, I ended up paying $150ish despite the insurance actually not paying anything.

 

[Ken g6]

There is a benefit to high deductible health plans even before you reach the deductible. Insurance companies negotiate lower rates for their customers, so they don't reach the deductible as soon as they would paying full price. This means high deductible health plans provide you a discount on health care.

 

[boomerang]

Seems to me that if the OP was compliant with the law he'd have had at the very least Obamacare for the past several years. The OP was required to file tax returns every year regardless of where his income was earned and those tax returns required that he had coverage under an approved plan or the penalty tax would have had to have been paid.