Medical Insurance & Costs

[Rick R]

FinallyFree:To answer your question about cost of travel health ins, every company has many different fees depending on age and health of the applicant. I suggest that you go to:
Medipac Travel Insurance - Canadian Snowbird Association
where you can fill out the application and get a price without committing to anything.

Mike: To answer your question about the amount paid by OHIP for a foreign hospital stay, go to:
Travelling Outside Canada - Ontario Health Insurance (OHIP) - Publications - Public Information - MOHLTC

[Mike OReilly]

Originally Posted by Rick R

Mike: To answer your question about the amount paid by OHIP for a foreign hospital stay, go to:
Travelling Outside Canada - Ontario Health Insurance (OHIP) - Publications - Public Information - MOHLTC

Thank you Rick. Perfect link.

The info is pretty clear:

OHIP (and presumably other Canadian public health insurers) covers:

• Only in the case of full-blown medical emergencies. "The treatment must be rendered in relation to an illness, disease, condition or injury that is acute and unexpected, arose outside of Canada, and requires immediate treatment."
• Physician costs are limited to what an Ontario doctor would receive.
• Outpatient emergency room services are paid at $50/day
• Inpatient services (hospital stays) OHIP will pay $200 CDN per day or $400/day for "operating room, coronary care unit, intensive care unit, neonatal or pediatric special care unit."

What does the typical American hospital charge for these services? From all I've read, it is far more than these rates. But I've also learned that it's really only the USA that this is a problem. In most other countries, medical services are not insanely expensive.

So for Canadians like me who is heading south from the Great Lakes, I just have to either avoid the US by doing the offshore route, pass through as fast as possible, live with the risk, or buy extra insurance.

[BandB]

Originally Posted by Mike OReilly

Thank you Rick. Perfect link.

The info is pretty clear:

OHIP (and presumably other Canadian public health insurers) covers:

• Only in the case of full-blown medical emergencies. "The treatment must be rendered in relation to an illness, disease, condition or injury that is acute and unexpected, arose outside of Canada, and requires immediate treatment."
• Physician costs are limited to what an Ontario doctor would receive.
• Outpatient emergency room services are paid at $50/day
• Inpatient services (hospital stays) OHIP will pay $200 CDN per day or $400/day for "operating room, coronary care unit, intensive care unit, neonatal or pediatric special care unit."

What does the typical American hospital charge for these services? From all I've read, it is far more than these rates. But I've also learned that it's really only the USA that this is a problem. In most other countries, medical services are not insanely expensive.

So for Canadians like me who is heading south from the Great Lakes, I just have to either avoid the US by doing the offshore route, pass through as fast as possible, live with the risk, or buy extra insurance.

One problem is that US hospitals have retail rates and then they have rates that are contracted with insurers. The insurer rate is generally 60% less than the retail rate. So part of it when not insured is negotiation. A typical emergency room visit would be $600-$1500. A hospital stay would typically run a minimum of $1000 per day and up to $4000 or so. Now other countries hospital stays are usually less than $1500 per day, some much less.

The real fear becomes something like open heart surgery where the total cost could be anywhere from $15,000 to $100,000 for the entire stay.

It's for this reason I recommend some form of supplemental, major medical or travel insurance. On those you're not trying though to cover the $500-$3000 bills or the amounts already covered by your Canadian insurance. You're just trying to cover major costs not covered by your insurance. Therefore, the rates can be more affordable than you might think.

If all you do is get sick or have an injury there is an area of care in the US short of hospitals. It's urgent care. These are centers that will take you quickly and can handle most issues. They also will cost moderate amounts. And they take any patients. A typical urgent care visit to see a doctor will cost $100-150. If x-rays are required, maybe $200-250. If CT's are required, then $300-500. They can provide many services that only hospitals provide in some countries.

So you're really looking only for a policy to handle hospital admissions or surgeries. That won't cost like a full policy would.

[sailorboy1]

So since I know how to use the search function I ended up at a thread I started. But reading I doubt a reopening will stay on track, but just maybe so:

CRUISERS what are you doing and paying for health insurance? What does your plan cover/exclude in the cost/price far as locations, conditions, deductibles?

Really any health cost info is welcome except general rants because rants don't solve anything.

[colemj]

Do you specifically want info from US cruisers only? Even that will vary highly depending on state of residence.

Mark

[BandB]

Two groups of people to be insured. Group one is those staying in the US or near it. Then it's the standard land policies. We're in Florida where small group plans are readily available to any business. Also simple things like joining the chamber of commerce give more access.

The second group is those cruising internationally. For some of those choices, I'd suggest googling "Yacht Crew Insurance." And, yes, it's not just large yachts and large crews. Some will insure individuals. Some of these are the same companies that insure traveling students, missionaries and others.

In many cases you're only looking for emergency type care so you can save money by having a rather high deductible. If you have a cold or cut, you'll be paying out of pocket, but a trip to the hospital then will use the insurance in those cases.

[sailorboy1]

Originally Posted by colemj

Do you specifically want info from US cruisers only? Even that will vary highly depending on state of residence.

Mark

No all is welcome, this is a world wide forum. On the other hand I used to think I would have to get out of the US just due to health insurance, but now wonder if that has changed. So people in the US who have cruised the US before/after Obamacare and how US health insurance has changed would be welcome (for cruiser considerations).

[blackcatscooter]

We're cruising in US waters for the next year. He's 56 and I'm 52. We just purchased a short term policy for one year through United Health One for $4500 for the annual premium, has $5000/person deductible, and then pays 80% after that with max out of pocket of $10K/person. We don't have any of the pre-existing conditions that aren't covered, so we're fine with this policy.

After this first year, we are leaving the country and will be changing to an international policy through IMG that excludes the U.S. and Canada for about $3700/year premium, with a $10000/person deductible and they pay 100% after that for almost everything else.

Our plan is that if either of us develops a condition that makes us uninsurable through either of these plans, then we sign up for Obamacare with Humana and pay a $9100 annual premium, and a $12,600 total deductible, then the plan pays %100.


Sent from my iPad using Cruisers Sailing Forum

[avb3]

As a Canadian, my healthcare is covered, except when out of country. The most expensive to insure is the US, where I happen to have my boat and condo.

As such, I buy emergency care insurance with a $5K deductible. If something serious were to occur, the insurance stabilizes me, and medivacs me back to Canada, which is cheaper than hospital stays in the US for the insurance company. It costs me $850 for 6 months, with one precondition.

If your looking for routine things, you many want to consider Mexico. I know numerous people here who get their dental work done just across the US/Mexico border, for a fraction of US or Canadian dental costs, and they all feel the care and quality is at least as high as here... but then most of those dentists are trained in the US or Canada anyways.

[Dennis.G]

FYI I am USA citizen and below is specific to USA.

The Affordable Care Act and the insurance exchange has done wonders for our family, allowing us to get health insurance that covers us and my wife's existing medical condition and at affordable rates. We are using Blue Cross of Michigan. It does cover urgent/emergency care out of state and out of country. It covers 90%, has reasonable copays, has out of pocket cap of $1000 per year, and is costing us less than half what our previous insurance us. Costs to individual will vary depending on income.

If you are US citizen and having issue with affording health insurance you need to be get on healthcare.gov website. Open enrollment for next year ends December 15th.

[Mike OReilly]

Originally Posted by avb3

As a Canadian, my healthcare is covered, except when out of country. The most expensive to insure is the US, where I happen to have my boat and condo.

As such, I buy emergency care insurance with a $5K deductible. If something serious were to occur, the insurance stabilizes me, and medivacs me back to Canada, which is cheaper than hospital stays in the US for the insurance company. It costs me $850 for 6 months, with one precondition.

If your looking for routine things, you many want to consider Mexico. I know numerous people here who get their dental work done just across the US/Mexico border, for a fraction of US or Canadian dental costs, and they all feel the care and quality is at least as high as here... but then most of those dentists are trained in the US or Canada anyways.

Thanks AVB. This is good info for us Canadians. We're moving closer to US waters, so may have to made a decision about coverage in the next year or so. I am constantly blown away with the high costs of US insurance as quoted by blackcatscooter. Even your numbers seem ridiculously high, but they are doable.

I have a friend and fellow Canadian who now resides in Mexico most of the time. He's pretty much given up on trying to maintain his Canadian healthcare eligibility. He uses the Mexican system for health and simply pays as he goes. It is cheap (compared to US, or even Canadian prices), but the care appears to be top-notch.

[jcapo]

Originally Posted by Dennis.G

If you are US citizen and having issue with affording health insurance you need to be get on healthcare.gov website. Open enrollment for next year ends December 15th.

2015 open enrollment period for all insurance sold in the US ends Februrary 15, 2015 not December 15, 2014. December 15, 2014 is the deadline if you want coverage to start Januarry 1, 2015. Its all a mess and much more costly for some of us.

https://www.healthcare.gov/marketplace-deadlines/2015/

[CaptTom]

Originally Posted by blackcatscooter

We're cruising in US waters for the next year. He's 56 and I'm 52. We just purchased a short term policy for one year through United Health One for $4500 for the annual premium, has $5000/person deductible, and then pays 80% after that with max out of pocket of $10K/person. We don't have any of the pre-existing conditions that aren't covered, so we're fine with this policy...

Thanks! That's exactly the kind of information that I (and probably the OP) was hoping people would post; a succinct, first-hand, non-political example. I'm looking to pull the trigger on my retirement plan in a little over a year, and real numbers are always helpful.

[Triumphant]

From an earlier post

We are from the UK as well, which may limit some offerings

Having looked at a number of offerings, We have just taken out medical insurance with Bishop Skinner Marine see below. £720 (about $1200) per year for the two of us

Contact details
Mike Nightingale
Manager - Bishop Skinner Marine

Bluefin, Kingfisher House, 12 Hoffmanns Way, Chelmsford, CM1 1GU.
t: 01245 291164 m: 07584 489555 f: 01245 291291 e: mike.nightingale@bluefingroup.co.uk
Insurance Broker | Bluefin Group
Home | Bishop Skinner

Others we looked at
Cigna were really expensive and when they discovered we lived aboard and moved around in the boat, they ran away

DAN offer emergency cover only

[Dennis.G]

Originally Posted by jcapo

2015 open enrollment period for all insurance sold in the US ends Februrary 15, 2015 not December 15, 2014. December 15, 2014 is the deadline if you want coverage to start Januarry 1, 2015. Its all a mess and much more costly for some of us.

https://www.healthcare.gov/marketplace-deadlines/2015/

Thanks for clarifying that.

It is a bit messy, but as there are now 15 million people that previously were without US health insurance that are now insured, I would say that things are moving in the right direction.

US health insurance rose an average of 4% from last year, and an average family in the US now pays $16,000 a year. This is sick, but indications are that without the Affordable Care Act this would have been even worse.