# Health / Medical Insurance in USA



## neverknow (Feb 2, 2011)

We have been reading for what seems like days and can't find any post that address this issue. We are a few years away from a early retirement. We are from Indiana and can't wait to get out of here...lol

Our plans include spending the first few yrs cruising the US east coast, Florida and the gulf. Maybe cross to the Islands a few times. Once we have some exp. we'll take off through the Caribbean. 

Our questions is what are most cruisers doing for health insurance coverage both while in the US and once they depart. We are in our late 40's so it will be awhile before we get medicare/medicaid or what ever will be there in 20 yrs.

Are most going without coverage? We can go with a high deductible $20K or more but would like to have something to protect our life's savings. 

If you have insurance can you please tell us who you have the general rates you pay?

We have Anthem now and pay $383/mo for a family of 3. Our son will not be on our insurance when we retire.

Please let's not get started bitching about politics or anything like that.

Thanks


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## apogee1mars (Aug 13, 2011)

Many pensiandos utilize airfare and Hospitals of foreign lands depending on the malady. There is great healthcare by US trained surgeons in many places for a fraction of the cost in the USA. Most even accept a standard heathplan insurance. I like the line in the movie "Bucket List" where Jack Nicholsen says; Out there is some lucky SOB having a heart attack right now. Not far from the truth now days.


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## PBzeer (Nov 11, 2002)

Since I retired (rather than quit), I was able to continue the insurance coverage I had (even though I've only used it 6 times in 29 years) for much less than if I had to buy it new. It's more than sufficient for my cruising plans.


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## Yorksailor (Oct 11, 2009)

we have a US carrier at about $400/month with a high deductable. We pay cash for general thing in the islands.

We also have repatriation insurance through DAN that costs $130/yr

DAN Insurance : Dive Accident, Trip, Dive Equipment, Camera, Group Term Life

While the DAN Premium is primarily scuba dive insurance it also provides repatriation for any medical cause and you do not have to be a diver.

Last year a friend developed cardiac problems while in Bonaire. As the only MD in the mooring field I arranged, at midnight, his evacuation to the US. DAN sent a Lear jet and within less than 20 hr of the problem developing he was in a cardiac unit in Miami. Had it been necessary they would have sent a doctor on the jet but as he was stable they just flew an EMT.

The entire cost of evacuation of over $25,000 was paid for by the insurance and in Miami his US insurance paid. His wife was flown back with him for free.

Medical care in the Caribbean is generally good with US and UK trained doctors but for major thing you need to be back in the US, except that Columbia and Mexico have some good hospitals. The good care is only in the private hospitals, in Trinidad the State hospitals are dreadful and most of the islands are too small to have good care for major problems.

BUPA a British insurance company has good world wide coverage as long as you are not in the USA.

International Individual Health Insurance Quotes

Our boat insurer, IMIS, can also get you health insurance and they are very professional and you can always get them on the phone.

http://www.imis.pro/OnlineServices.htm

Phil MD


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## neverknow (Feb 2, 2011)

WOW I never thought DR Phil would reply....lol

Thanks for the great info. and links to companies. We'll be contacting them shortly.


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## Yorksailor (Oct 11, 2009)

He's a psychologist...I am a real Dr.

Glad to help...enjoy your cruising.

Phil


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## vega1860 (Dec 18, 2006)

neverknow said:


> Please let's not get started bitching about politics or anything like that.
> 
> Thanks


Geez! Take all the fun out of it why don't ya. 

We don't have insurance. We have savings for emergencies, we take care of our health and fitness and we are *VERY* careful.

We have had some medical costs since we set off cruising. I had to have a melanoma removed, my wife had a severe asthma attack that required clinical treatment, we both have needed new eyeglasses.

We wrote the checks.

As always, it's just my opinion:

The insurance business thrives because it bets that you will pay more in premiums than they have to pay out in claims. When you buy an insurance policy you are betting the opposite. Guess who usually wins. We never bet against ourselves. Besides, cruising is about independence and self reliance. You can be neither if you have to make a monthly payment to someone.

But that is just us. We have more confidence in our ability to stay healthy than in any doctor's ability to cure us. And four hundred bucks a month will build a nice emergency fund over time. Not something you want to wait until you are sixty to start on, but better late than never.


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## denverd0n (Jun 20, 2008)

vega1860 said:


> The insurance business thrives because it bets that you will pay more in premiums than they have to pay out in claims.


A minor quibble... What the insurance company is actually betting is that ON AVERAGE, among all of the people they insure, the group will pay more in premiums than they have to pay out in claims. Some people pay in lots and collect very little, while others pay in very little and collect--quite literally--millions in benefits.

And, as an insurance buyer, I'm not really making a bet at all. I know the likelihood that I will get back everything I've paid over my lifetime is very small. Rather I am choosing to pay a modest amount that I can afford, in order to be absolutely certain that a catastrophic medical condition will not bankrupt me.


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## zboss (Mar 26, 2006)

denverd0n said:


> Rather I am choosing to pay a modest amount that I can afford, in order to be absolutely certain that a catastrophic medical condition will not bankrupt me.


These days - with all of the 'not covered' claims being returned - you can't even make a bet on that!


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## denverd0n (Jun 20, 2008)

zboss said:


> These days - with all of the 'not covered' claims being returned - you can't even make a bet on that!


Of course you can. If you read and understand the policy that you are buying, then you will never have a problem with claims that are not covered.

The problem, of course, is that all too many people sign on the dotted line without bothering to read what it is that they are signing.


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## vega1860 (Dec 18, 2006)

denverd0n said:


> A minor quibble... What the insurance company is actually betting is that ON AVERAGE, among all of the people they insure, the group will pay more in premiums than they have to pay out in claims. Some people pay in lots and collect very little, while others pay in very little and collect--quite literally--millions in benefits.
> 
> And, as an insurance buyer, I'm not really making a bet at all. I know the likelihood that I will get back everything I've paid over my lifetime is very small. Rather I am choosing to pay a modest amount that I can afford, in order to be absolutely certain that a catastrophic medical condition will not bankrupt me.


What works for me will most certainly not work for everyone. It is just an option. For some, it may be just the ticket. For others it may be foolish in the extreme.

My *opinion* on this is that this is a matter of individual choice and personal responsibility. (Deleted: a long rant about insurance in general)

"Let your conscience be your guide" Jimminy Cricket


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## hellosailor (Apr 11, 2006)

Sounds like you want a "major medical" policy. Yes there's lot of places with cheap medical care, and every month or so you also hear about injured folks (US and native) being medevaced from Columbia, Mexico, Venezuala...all the way back to Miami-Jackson Medical Center, because it is the ONLY "class one trauma center" within a thousand miles.

Medevac coverage and some way to cover a crisis in the US aren't totally obsolete, yet.


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## neverknow (Feb 2, 2011)

For a minute I thought we were going to start a long discussion about the political side of insurance companies. Thanks for not going there.

However, I understand the risk involved and yes the insurance company is in business to make money that's why they are there. Thus the name "COMPANY" The only way they stay in business is to make a profit.

What we were trying to find out is if anyone has come up with a plan to minimize the risk of a catastrophic bankrupting medical issue. To us "bankrupting" means 100's of thousands of dollars in expenses. We are willing to risk say $25K-$50K for lower premiums however we have yet to find a deductible over $10K, with the exception of a few at $20K with the same premium as a $10K policy.

At some point you have to drawl the line. For us that line is higher than what insurance companies are offering.

Dr. Phil MD had a great post and some ideas. Vega has some as well.

I guess I'm worried about finally getting out there with a nice $500K retirement account and having something stupid happen requiring surgery and waking up as broke as a 18 year old out of high school.

I'd even go without boat insurance given all I'd lose is the cost to replace the boat (sans liability). But medical cost can go on forever.


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## neverknow (Feb 2, 2011)

For a minute I thought we were going to start a long discussion about the political side of insurance companies. Thanks for not going there.

However, I understand the risk involved and yes the insurance company is in business to make money that's why they are there. Thus the name "COMPANY" The only way they stay in business is to make a profit.

What we were trying to find out is if anyone has come up with a plan to minimize the risk of a catastrophic bankrupting medical issue. To us "bankrupting" means 100's of thousands of dollars in expenses. We are willing to risk say $25K-$50K for lower premiums however we have yet to find a deductible over $10K, with the exception of a few at $20K with the same premium as a $10K policy.

At some point you have to drawl the line. For us that line is higher than what insurance companies are offering.

Dr. Phil MD had a great post and some ideas. Vega has some as well.

I guess I'm worried about finally getting out there with a nice $500K retirement account and having something stupid happen requiring surgery and waking up as broke as a 18 year old out of high school.

I'd even go without boat insurance given all I'd lose is the cost to replace the boat (sans liability). But medical cost can go on forever.


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## neverknow (Feb 2, 2011)

ooops sorry for the double reply our internet sucks sometimes


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## vega1860 (Dec 18, 2006)

neverknow said:


> For a minute I thought we were going to start a long discussion about the political side of insurance companies. Thanks for not going there.


Well, you asked us not to. Just a matter of respect. Had you not, I might have pointed out that, under current US law, the question is moot. We will all be required to purchase health insurance (Estimated cost about $400 per month) in 2013. The IRS is already hiring additional personnel to handle collections.

So don't worry. Be happy. It's all taken care of.


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## neverknow (Feb 2, 2011)

vega1860 said:


> Well, you asked us not to. Just a matter of respect. Had you not, I might have pointed out that, under current US law, the question is moot. We will all be required to purchase health insurance (Estimated cost about $400 per month) in 2013. The IRS is already hiring additional personnel to handle collections.
> 
> So don't worry. Be happy. It's all taken care of.


That's something we have not heard the details on yet. We have to make plans for what is going on today.


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## hellosailor (Apr 11, 2006)

"However, I understand the risk involved and yes the insurance company is in business to make money that's why they are there. "
Acutally, that's only half correct. There are "mutual" companies, which are owned by the policy holders, and there are commercial insurers, who are in business to make profits. As a shopper? You can't tell the difference, although the mutual companies in theory will have lower premiums, as they are not paying out profits.

This is a lousy time to be buying medical insurance in the US, as all the vendors are hedging their bets versus ObamaCare being thrown out by the courts and meanwhile changing all their limits and terms to try to conform with it. or not.

I'm not entirely sure what the game behind ObamaCare is, it could have easily been structured in a way that would have totally avoided the court challenges, and ObamaAndCompany are smart enough to know that very well. So...the question becomes whether they wanted rampant confusion (in chaos lies profit!) or did they intend for it to fail, like Bill & Hillary did last time around?

Either way...I wouldn't bet a plugged nickel on how the courts will deal with this one, so be prepared to watch for policy changes and expect to need to change insurers at leaast once by 2015, when the full thing may either be implemented, rejected, or restructured once again.

Meanwhile, look out for coverage limits (per incident, lifetime coverage, annual coverage) in policies you see now. When one costs three times as much as the other "same" coverage, it usually means the cheaper one has a terribly low cap on what they'll pay out per incident, per year, or per lifetime. Often less than one "hit by a bus" needs.


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