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Old 20-09-2006, 17:15   #1
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health insurance???

Greetings to everyone,

Please help if you can...I seek information about what kind of health insurance you are using while sailing. I realize many out there are retired and with applicable health plans, but that is not our situation. We are two thirty-somethings, healthy, sometimes self employed, and currently sailing in Alaskan waters. I quit my office job last spring, forfeiting what insurance I had.

My research has led me to the new high deductible health insurance plan with Blue Cross. This seems adequate, but I cannot believe better plans don't exist.

I looked into short-term health insurance but would not at all recommend it. If one becomes ill with lasting effects, the short-term plan will cover only through its term. It will NOT renew and the sick person would be entirely without insurance as well as unable to get any.

Any suggestions out there?
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Old 20-09-2006, 23:45   #2
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When I last looked at insurance 9-12 months ago, I found no insurance company that offered an individual plan that was anywhere near as good as a typical group plan. My impression is that insurance companies would prefer not to offer individual insurance, but they make a token effort in order to satisfy state regulators.

I don't remember the blue cross high deductible plan as remarkably good or bad as individual plans go.

As far as I can tell, if you ever answer "yes" to any of the "have you ever been treated for..." questions, you will not get the insurance. Some US states operate an insurance plan for residents who can't get insurance from a privately held company; in Maryland, a rejection letter from any one insurance company is enough to qualify. If necessary, look in to this for your state of residence.

Under US federal law, you can continue on your former employer's health insurance for up to 18 months. You pay the premium plus a fee to your former employer. This is called COBRA, after the bill it was included in. Your employer should offer it to you when you quit, unless they are one of the entities that are exempt.

For you, it's too late for COBRA (you have to ask for it within 45 days). Your only option is either pick one of the individual insurance offerings (possibly falling back to a state-run plan) or go without.

I agree with your evaluation of the short term plans - who needs insurance that disappears if you get sick??
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Old 21-09-2006, 07:23   #3
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We ran into the same problem a couple of years ago when my COBRA coverage ran out. I purchased an individual BCBS policy, which is fine as long as I am in the U.S. For the 4-5 mos. a year that I am in the Bahamas, I hold my breath. My experience with medical care there convinces me to avoid it at all costs (it's cheap, but you get what you pay for). For anything serious, I would get back to the U.S. asap. Unfortunately, the Blues turned down my husband, who ended up with an international medical policy that requires him to be out of the U.S. for 6 mos. a year. As long as he doesn't file two claims from the U.S. that overlap the 6 mo. period, we think he'll be OK.

Bottom line? If you plan to cruise U.S. waters, the BCBS individual policy is not too bad, and certainly better than nothing if you don't want to self-insure. I know I wouldn't.
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Old 21-09-2006, 14:08   #4
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Harriet! You don't have to go without health insurance in the Bahamas. It's actually far less expensive for far better insurance as long as you're not in this screwed up country.

Check into this:


http://www.marinecrewinsurance.com/

I was covered by a Lloyd's of London insurance policy, as was my wife, while we crewed. It was extrememly inexpensive and even covered things like childbirth. If you are outside the US for a certain period (I forget how long - the policy will say), you can be covered for pennies on the dollar.
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Old 21-09-2006, 18:03   #5
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International Health Insurance....some choices (long)

Funny, I've spent the last few days researching this exact same thing. We're presently in Fl but are leaving Jan 07 to go full time cruising. First my wife and I met with an insurance rep who sells a variety of products. My Cobra was a very expensive option. The individual plans all seemed way more expensive than the group plan we've had for years. The best onshore plan seemed to be Blue Cross Blue Shield of Fl, which we were told had a regulated premium structure set by the state, depending on the county and a variety of underwriting factors one has. Their premiums were quite high. I then spent internet time and came up with several other options which seem attractive for our needs. International Medical Group is, apparently, a major underwriter in this area, as many of the plans are underwritten by the IMG home office. Specalty Risk International is another option, as is Global Medical Insurance, once again an IMG subsidiary. If I understood the premise correctly, these plans are offered on the condition that one is outside the USA for at least 6 months. However, care in the US is available, and the premium rates can be found online. The fine print on all these policies is extensive, but there are common factors found in those companies I've researched. InsuranceQuest brokers many plans, and it seems we'll probably follow thru with them, using an IMG policy. I hope this helps any others looking for international health insurance, and planning on leaving the US for extended cruising! Regards. Michael s/v Infini
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Old 08-02-2007, 01:42   #6
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a follow up...

I made the initial post and finally took care of business with regard to health insurance. We purchased the Blue Cross High Deductible plan at $158/month, which covers us both. Yes, sounds cheap, but consider the $8,000 deductible.

FYI: They have deductible options as low as $2,000.

In all my research, as long as we stay in the US (which we will for close to 2 more years) this is the best plan for us. The deductible may seem extreme, but we weighed our options (e.g. cash on hand) and decided to go for it. We are two 30-something healthy people with no histories and if we're ever faced with something that big, we'd have to swallow the anchor anyway.

The only thing I wish I could add to the plan is accident insurance, since the greatest risk of high-expense injury would very likely be an accident (barring something like cancer, that is) while sailing, skiing or the like. Anyway, this combined with our DAN evacuation insurance works for now.

People have added some great information to this thread, so keep at it!
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Old 08-02-2007, 09:05   #7
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Thanks for that followup! We are in a similar age bracket and have been looking for some kind of insurance while in the States (next 3-5 years) paying off our boat. The BC/BS plan sounds reasonable while still here. Very nice.

Thank you.
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Old 08-02-2007, 13:10   #8
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health insurance

Glad to help. I researched a lot and found nothing as comparable or as widespread in terms of network. When we head south to Mexico, basic medical costs and prescriptions are relatively cheap in cash, and dental is great, but we'll always want something to cover catastrophic illness. In a cancer scenario, for otherwise healthy people with a US address, I think it's reasonable to believe you could fly home and use your insurance as if you were just out of the country on vacation. You'd be committing to a move back to the US, but probably would be anyway...

On another note COBRA is not a good option for a healthy person. Way too expensive. The Blue Cross High Deductible is far better.
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Old 08-02-2007, 13:50   #9
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disability insurance

On a different note, if anyone out there has experience purchasing disability insurance, I'd be interested in knowing what it is and how much it costs. As far as I can tell, there are no online sources that provide free quotes unless you call someone and give them all your info. Not a bad thing, but I haven't been motivated yet because I hate sharing all that information with salespeople.

We would consider purchasing disability insurance if it is not cost prohibitive. We have no life insurance because we are both relatively young, educated and able earners with good skills. And we don't have children. But I did just talk myself into a $5/month, $25,000 accidental death policy that covers both of us, just because such an incident would bring instant trauma that would be ever-so-slightly calmed by knowing the costs involved (any sort of transport, funeral home, cremation, last-minute flight, possible boat storage, etc.) would be completely covered and then some.

I'd be interested in hearing from anyone about disability insurance or some type of accident-specific insurance. Being healthy people (knock teak) we can still imagine the possibility of being sidetracked by a catastrophic illness or by a sailing or skiing-related accident. Trying to be safe and cover all our bases!
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Old 08-02-2007, 14:28   #10
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"On another note COBRA is not a good option for a healthy person. Way too expensive. The Blue Cross High Deductible is far better."
Simply not so. COBRA is not a plan. COBRA simply allows an ex-employee to continue their existing coverage at a reduced rate for 18 months. If your previous employer had the exact same policy that you have now, you'd probably be able to keep it as your COBRA coverage for less than $90 per month.

With a deductible that high you have what is more commonly called a "major medical" policy, i.e. something that covers major events and not routine health care. Be very careful with Blue Cross Blue Shield, because they have a longstanding reputation for problems when it comes time to pay claims.
Many years ago I knew someone who was a faculty member at a major university, and as such part of a large BC/BS covered group. He had kidney failure and his first "hospital bill" was just under $99,000 as submitted to BC/BS. They paid about $100 and rejected the rest of the bill on the first go-round. Eventually they paid it all, but like many insurers they seem to have a routine policy--acknowledged by some press interviews with people in the industry--of rejecting valid claims, or claiming they never were received, simply because they can do that and get away with it. They are sadly not alone in doing this, nor has the practice ended.

I spoke to a doctor yesterday who said BC/BS had literally just rejected his claim for a patient. According to BC/BS the patient has two accounts, two policy numbers, so they refuse to pay him anything at all. Now, it should be impossible for the patient to have two BC/BS policies, and even if they do, he's entitled to payment on the policy numbers he gave them. But their answer? They won't pay anything at all, even though they admit the patient is insured with them and the policy is in effect and properly paid.

At least Al Capone was honest about what kind of business he was in: Insurance!
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Old 08-02-2007, 14:32   #11
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insurance

I just dropped an accident insurance from Mutual of Omaha because we picked up a full coverags insurance for the next year. The rates where kind of high. I think $1200 a year and they only paid up to $5000 per accident. However my two college girls were on it so we used it alot....I was hoping that maybe you would let me know what agent or state you picked up the BC/BS from or a site online that I can look at this. We will need something just like that in a year from now and when I look online I can't seem to find it without being in a group or some type of business.
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Old 08-02-2007, 16:02   #12
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I appreciate the feedback, but understand I know exactly what COBRA is and does and if you've gotten your COBRA coverage for $90/month all is can say is "no way...what's the catch? WOWIE ZOWIE!! and more power to you!" Because that would truly be a deal nobody should ever pass up. A super high deductible plan can't ever beat 90 bucks a month, that is true.

I am a healthy thirtysomething with no health issues and when I left my job last spring my COBRA costs were going to be nearly $400/month. Several years prior after leaving a different job, I actually elected to take COBRA and it cost me more than $300/month even then. I will never elect to take COBRA again unless I develop serious health problems and have no choice.

As for the Blue Cross High Deductible plan, I obviously make no claims BC is better than any other as gouging insurance companies go. The whole system is a wreck. Be careful with ALL INSURANCE CLAIMS, no matter the insurer! EVERY single insurance company out there tries to deny claims the first time around. Even if a small fraction of those poor clients choose not to fight the claim, or don't know how, or remain intimidated by the system, the insurer recoups some of its losses. It benefits the insurer to make this a matter of policy. To them, it's a part of doing business. To us, it's simply buyer beware and ALWAYS watch your claims. Ugh, don't even get me started on the state of health care in this country. It nauseates me.

Kasidah, you asked about how to get the BC plan. Do a web search for "blue cross high deductible" and "your state" and you will likely see a number of sites, some better than others. They'll let you search and compare, but ultimately you have to choose one of those companies as your go-between with BC. They'd be your broker. The quote you get is all-inclusive. Please keep in mind it took us a lot of deliberation to decide on such a high deductible. I wouldn't recommend it to everyone. The same plan is available with a $2,000 deductible, and if there are several family members it becomes a better value that way since the deductible is that one price for the whole family. Make sure your plan allows for a health insurance savings accoung (HSA) and if you can afford it then you can put an amount equal to your deductible in the HSA.
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Old 08-02-2007, 16:52   #13
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Quote:
Originally Posted by bluewater
But I did just talk myself into a $5/month, $25,000 accidental death policy that covers both of us, just because such an incident would bring instant trauma that would be ever-so-slightly calmed by knowing the costs involved (any sort of transport, funeral home, cremation, last-minute flight, possible boat storage, etc.) would be completely covered and then some.
Funeral? Cremation? Boat storage? My wife's ready to just dump me overboard if I give up the ghost... ha ha ha If you're not too sentimental, and you're 3 miles offshore, and the body is weighed to sink to the bottom, you're good to go, legally. Although, you might need to come into port to properly register the death (maybe?) before the burial at sea. There is just one small form to fill out for burial at sea.

Ok... maybe this is too morbid and grim. I guess we're not just so sensitive about dying or having funerals. We joke about her just kicking me off the stern when my time's up. Or... possibly having me stuffed and set up in the salon to remind her of her marital vows... ha ha ha!
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Old 08-02-2007, 17:04   #14
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Quote:
Originally Posted by bluewater
I am a healthy thirtysomething with no health issues and when I left my job last spring my COBRA costs were going to be nearly $400/month. Several years prior after leaving a different job, I actually elected to take COBRA and it cost me more than $300/month even then. I will never elect to take COBRA again unless I develop serious health problems and have no choice.
My parents were planning a move to a different state. They had both left their jobs (my mother through redundency, my father through choice). My mother was the one carrying the insurance and decided to continue with COBRA as she has had some health issues, while my father had never been sick a day in his life. A few days after the check for the first month cleared he went into the hospital and was in ICU for over 30 days. Without the insurance they would be beyond ruined. It was $550/month well spent.

Everyone is different, of course, but when it happens it happens. Not every major illness comes on slowly, is age induced or is accident related. They suspect he picked up Legionnaires from cleaning the gutters while getting the house ready to show.
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Old 08-02-2007, 17:27   #15
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"when I left my job last spring my COBRA costs were going to be nearly $400/month. " I don't think I'm getting it across. You "COBRA" costs were nothing. COBRA is just legislation, it is NOT insurance.
If you paid $400 under your COBRA-mandated rate reduction, that means your insurer probabloy paid something like $250-300 when you were an employee, and that your rates would rist to $550-600 when the COBRA mandated rate reduction expired.
What you pay for "COBRA" is a set percent(?) of what your employer previously paid for you, and a set percent of what your own individual coverage under the same or a similar plan would cost you.
If your employer had a 'cafeteria plan' where you could select from among four policies, as many do, your only option under COBRA would be based on the one plan you had selected while still employed. But if those four plans were:
1- $150/month cheap HMO
2- $225/month better HMO
3- $350/month better insurer, high deductible
4- $600/month real insurance with national coverage accepting any provider and low deductible

Then similarly your COBRA coverage might range from $250-$1000 per month, roughly 1.5x whatever your coverage was a a member of the group, because you are still considered a quasi-member of the group.

Without COBRA-mandated reductions, you'd probably pay 2.5-3x what your old payment was.

COBRA just means "Hey, if you canned somebody, they're entitled to continue their insurance coverage for a while till they figure out something else". It is supposed to cover you through your job search and the qualifying period for your next employer, or your other plans. But it is *not* insurance. It will always allow you to maintain your existing policy (or close to it) at a below-market rate. If you find a cheaper policy, that just means there are cheaper policies than what your employer had.
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