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Old 27-08-2010, 11:05   #1
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Health Insurance for Cruising / Liveaboard Kids

Hi Everyone!
So what do full time liveaboards/cruisers with children do for health insurance? My husband and I are making our plans to become a liveaboard family and the health insurance is one thing that keeps coming back to our "no more cublicle jobs" dream.
Thanks for any help!
Belypet
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Old 29-08-2010, 08:38   #2
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Generally, health care fees in other parts of the world are much more affordable. We are still in the States, but we ditched our health insurance a few years ago and have not regretted it. If we were much older, we might choose differently but we've found for routine stuff once you pay the premiums and the copays, you don't really save any money.

We had planned a homebirth and ended up having to transfer to a hospital. Every single service provider from the OB to the hospital offered a significant discount for cash. All in all, we ended up paying about twice what we would have paid for insurance premiums and copay but this was a very unusual event. If we compare the cost for the hospital birth vs. insurance premiums for the 5 years since we ditched our insurance, we actually come out ahead by about $5000.

Yes, we take the baby in for regular checkups with a pediatrician. My discounted cost for a visit is $65 a month. No way could I get insurance for that and I would still have a $10 copay.

We are healthy, the kids are healthy so other than a policy for catastrophic care we don't feel the need to insure. The most likely hospital fee while we are cruising will be for an accidental broken limb or stitches. Neither of which will come close to costing what an insurance policy will.
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Old 31-08-2010, 22:18   #3
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Assuming the OP is living in the USA and not intending to cruise outside the USA, then health insurance is a major expense. Not having it can be a serious problem should a major accident or injury happen that results in permanent health problems. True you can walk into any public hospital's emergency ward and get treated under "welfare" provisions or State Medicaid. But now you have a "pre-existing" condition which can eliminate you from getting future coverage at a reasonable rate. You would be forced into "pool" insurance which will probably be many multiples more expensive than not having that "pre-existing" condition.
- - If you plan on cruising to someplace outside the USA, then the whole situation is significantly different and significantly more affordable. However, if you ever plan to return to live in the USA then again, not have an existing coverage prior to leaving and/or again having a medical incident that sets up a "pre-existing" condition puts you right back into the highest premium pool. Paying lower premiums now even if you do not use the insurance can save you significant money later when you return or get into the older age brackets.
- - Needless to say, it is a major problem to fathom whether carrying coverage while you are healthy versus waiting until you are older or more prone to adverse health to get insurance is cost effective or not.
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Old 01-09-2010, 08:36   #4
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osirissail, I'd just like to point out that A: Healthcare reform, once it is enacted will prevent exclusion due to preexisiting conditions. (not saying I like or don't like the healthcare package, just that things will be changing)
and B: You can always go into the ER or doctor, receive treatment and pay the bill. Not everyone who doesn't have insurance relies o Medicaid or welfare.

Again, you have to take your age, health etc into account but to believe that you must have health insurance in order to get quality care in the US is just not true. Our baby was born in the States, 4 months ago. We had an unexpected hosptial birth and we STILL came out ahead paying cash than we would have by paying insurance premiums for the past 5 years- scratch that I looked at the numbers. We came out ahead after 3 years of not paying premiums.

Not saying everyone should ditch their health insurance but if you are healthy, have an emergency fund in place it is doable. We carry a catastrophic policy which is not that expensive and protects us should we encounter a major, life threatening illness.
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Old 01-09-2010, 08:47   #5
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For we seniors, Medicare/Supplemental Insurance works in Puerto Rico and the USVI's.
In the French Islands outpatient services were free. I always left a donation. I believe the same is true in Granada.
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Old 01-09-2010, 15:59   #6
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Quote:
Originally Posted by Mimsy View Post
. . . Not everyone who doesn't have insurance relies o Medicaid or welfare.

Again, you have to take your age, health etc into account but to believe that you must have health insurance in order to get quality care in the US is just not true. . . .

Not saying everyone should ditch their health insurance but if you are healthy, have an emergency fund in place it is doable. We carry a catastrophic policy which is not that expensive and protects us should we encounter a major, life threatening illness.
All very true, but I didn't say you would be refused medical insurance but more than likely you would be - just like what happened with automobile insurance - you might be placed in a "pool" of high risk people for whom - just like automobile insurance - the cost of the premium is rather high compared with folks who have continued a "record of continuous coverage" while they are healthy.

What will eventually "actually" happen after the new Health Care Insurance Reform law/package is implemented is unknown so we can only make educated guesses. My guess is that they will follow the pattern of automobile insurance which is also a mandatory program. Who knows?

But your last sentence states that you have been carrying medical insurance all along - and like a lot of folks I know it is the "Major Medical" insurance.

Most of the doctors I know have a 3 level pricing system these days. First level is like "retail" where the numbers are set very high. Nobody pays this rate but it is necessary in order to keep the actual rates the insurance/government pays at a livable level. The next level is the actual level of payment they can expect to get back from the insurance/medicare/medicaid which I call "wholesale." Finally there is the "cash price" level which is significantly less to the higher two levels and for the doctors I know it goes directly into their pockets. They are willing to take pennies on the dollar if they don't have to do all the paperwork and BS and delayed payment that the various insurance/government processing involves.
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Old 01-09-2010, 16:50   #7
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Quote:
Originally Posted by osirissail View Post

Most of the doctors I know have a 3 level pricing system these days. First level is like "retail" where the numbers are set very high. Nobody pays this rate but it is necessary in order to keep the actual rates the insurance/government pays at a livable level. The next level is the actual level of payment they can expect to get back from the insurance/medicare/medicaid which I call "wholesale." Finally there is the "cash price" level which is significantly less to the higher two levels and for the doctors I know it goes directly into their pockets. They are willing to take pennies on the dollar if they don't have to do all the paperwork and BS and delayed payment that the various insurance/government processing involves.
I was employed by several hospitals for over 30 years, to write/maintain the computer billing programs, and I find your statements to be very facual and correct.
There is, however, an additional level of payment that some doctors practice from their office, free service to those in dire need.
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