New widow needs health insurance

16 years ago

MY PROBLEM: My husband passed away, suddenly, this past April, leaving me and my stepson without health insurance after June of this year. We can COBRA, but it is terribly expensive.

QUESTION: How can I afford health insurance for me and my 17-yr. old stepson? The lowest quotes I have received have been $500-600 PER MONTH with a $1,000 deductible and 20% coinsurance. My GOD - there's NO WAY I have that kind of money! I am 57.

Any direction/suggestions would be so much appreciated, as we are now on a single/limited income. Thank you, in advance, for any help you can offer.

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Comments (25)

steve_o
16 years ago
First of all, my condolences for your loss ...

As far as finding insurance, shop around. You can "let your fingers do the walking". Your best bet is an independent insurance agent, not one aligned with just one insurer. An independent has more flexibility in finding a good rate for you -- more companies to draw from. If you live in a larger city, there may be more than one independent agent at different firms who may have access to different companies.

If none of those work for you, check benefits you may have available to you or your stepson or even your husband through affinity groups (trade unions, college alumni organizations, hobby groups, etc.), professional associations, etc. There are organizations out there which essentially create a "group" of insureds from people across the country who are in the same line of business. The association with a group spreads the risk and could get you a better premium. Check your folders of "stuff" and hobby and trade journals.

A third possibility might be that your metropolitan area/county/state offers group coverage similar to that described in the previous paragraph.

Finally, seriously consider your actual insurance needs. You simply may not be able to replace the coverage your husband had. If you are okay with changing your doctor(s) or going with a higher deductible/copay, etc., you may save on the premium. Insurance should cover catastrophes, not serve as a budget mechanism. And don't forget that medical expenses are deductible on federal income taxes if they fall above a certain percentage of your (now-reduced) income.

Good luck.
kudzu9
16 years ago
Some states do offer decent health coverage at affordable rates to people in your situation. By all means call your State insurance commissioner's office, and/or the State Dept. of Health or its equivalent. Also, contact your elected representatives at the State and Federal levels. They have staff who can look into this and steer you toward possible resources you might not be aware of. These people are paid with your tax dollars, and you might be surprised what they can do for you if you approach them with an assertive, but polite, attitude.
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We are discussing some of this on another thread that started out about retirement advice. No surprise soaring health care costs would come up there, eh? If a smoker pays more for life insurance and a driver with a bad record pays more for auto insurance, why shouldn't someone who *chooses* an unhealthy lifestyle (overeating, smoking, drug abuse) pay more for health insurance? Why should those who choose healthy lifestyles subsidize these people? (I'm leaving the funding for Public Health out of this because it benefits all of society.) Please, let's not inflame this with Sky Is Falling rhetoric about punishing people with bad genes who have, say Huntington's, and won't be insurable! This is about *choices* people make in their lives that affect their health -- and should, IMO, affect their insurance costs. Your doctor tells you to: loose weight; exercise; stop smoking; stop drinking; stop other drugs. You don't do it because...your family 'runs to fat'; you don't have time to exercise; if you quit smoking you'll gain weight; you 'need to relax with alcohol'; you're too stressed without 'recreational' drugs. He's not asking you to change your genes, but to make changes individuals CAN and DO make. If you won't change, should the rest of the people in your insurance "pool" (who very well may have had to make hard changes themselves) pay for the unhealthy risks you take?
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Late husband worked for a health insurance company, and that was the last time we had a health insurance benefit. When he left that job, we got catastrophic care insurance, with a huge deductible. We eventually opened HSAs as well. Over the last ten years, each of us has had jobs that offered health insurance plans. We looked at the cost (to the employee) of those company plans, and the benefits, and restrictions imposed. We compared them to the cost of our current plans and benefits, (when you pay yourself, you chose who you want with no restrictions). The HSA balance creeps up over time, allowing more payments, (dental, doctor's office visits, optometrist exams,) on a schedule we controlled, instead of what the company plans would allow. Employers have been hit hard the last few years, too. The workplace plans we were offered had higher premiums than our individual accounts with Unnamed Health Insurance Company, and were not of more value to us. In spite of being a "catastrophic care" policy with a high deductible, It seems to be paying for things, or making partial payments for things, every time i turn around. Tick removed from back at walk-in facility: Paid half the bill. Prophylactic medication in case I was exposed to Lyme disease: I was stunned to have the couple bucks and change it cost. I asked the pharmacist "Isn't there a minimum dispensing fee?" Yes, she said, but the insurance covers it. If I hadn't had that policy, it would have been twenty dollars or so, for two pills. As it was, I paid less than three dollars out of pocket. I'm actually quite happy with the situation I'm in: the fewer people sticking there noses into my health care (policy wonks in DC or that lady in personnel) the better I like it. And it had no bearing on Poor Late Husband's demise: He had lung cancer, quite likely from his thirty eight years of smoking two packs a day. There were unusual circumstances that contributed to his sudden death only five weeks after diagnosis. No amount of chemo, surgery etc., would have saved him. I had a cancer scare myself, actually less than three months after his passing. I asked a nurse what would happen if I had cancer, and my insurance didn't cover treatment. She said she didn't know how that worked, and she said the doctors and nurses take precautions to not know anything about the finances of patients. That way, she said, those with or without insurance are treated the same way while in the hospital. I think it's stupid to go without insurance to have more money for lattes and cell phones, but I defend others' rights to spend the money they earn in a way that they find valuable. As for people who "End up in the emergency room because they couldn't afford a doctor" I've personally known, lived near, worked with some of those people...and they abused the emergency room option so they wouldn't have to pay. I've heard them rationalize taking a child with an earache to the emergency room to avoid a $20 co-pay at the doctor's office, and the hassle of scheduling an appointment. Then in the next breath they griped that they had to wait so long to be seen.
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Dedtired...I too had to pay the same the year before Medicare. When on Cobra it is required that the HI take you and cannot deny due to pre-existing conditions. Was with mine for 5 years, but they just kept kicking up the premiums to the last year at 759 a mo. At 65 I found a supplement plan for $90 a month, they pay 100% of what is left after Medicare regardless of the need. Signed for 3 years option to keep the monthly cost. Every year after the 3 it goes up now about 20%, but the coverage remains the same. This year could be the last to afford them. No other insurance will cover me if I lose this. So I'll be in the same situation as many of you. A broker told me that with specific medications and/or condition, a company adds about $50 per item to the monthly cost...if they will even accept you. Health Insurance is for the wealthy or healthy. I'm with all of you, what to do without insurance and am floored by the many posting here without. I know what my medical costs will be for a year and weigh that in to the insurance cost to me...for now. Have mentioned more than once to others that if my IQ was even 1 level down, would never figure any of this out. And the older we get the worse it is to know what to do. Medicare changes are two thick books and one had best know what is and isn't. They have taken away 2/3 of the approved medications. When I asked the pharmacy about one of mine, he said it was due to too many falls from the elderly using it. Jeesh, I use it to keep from falling. We are all in trouble health wise, growing older with all the new research to resolve so many conditions isn't going to do any of us any good. Health insurance will be too costly to utilize great advances. Admission I do not understand what is being created for health coverage by the gov. It eludes me with crazy details. OT. Our state now has a law that if you are stopped for anything when driving or get in an accident and taking a medication that cautions driving while using it, they can charge you with a DUI. I'm waiting for a DUI law because of my age.
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The trouble with LTC insurance is that it is like health or auto insurance - carriers enter the market, and some of them price poorly and end up leaving the market. A good carrier may close a book of business (e.g., stop selling a particular type of policy) and come out with a slightly different policy calculated to provide a better profit margin or improved mortality. This is the way insurance works, it's just good business to them. LTC is not a new product at all. Met Life has been selling LTC insurance for 25 years. Lincoln Benefit (I think I accidentally listed it above as Lincoln National, which is a different company) has a huge block of LTC business and for many years was the low-cost carrier. They are owned by Allstate and are in no danger of going under. They closed their current book of business to bring out a completely new LTC product, one of the new hybrid LTC/annuity policies. None of their existing policyholders will see any raise in premiums or adjustment to the terms of their current policies; the "book" is merely closed for new business. That's how a GOOD carrier works, as opposed to a bad one. Where do you find a good carrier? That's the difficulty, you need to find a good agent, not just a "friend who works in the insurance business." Hard to find, just like trying to find a good car mechanic, LOL! Nursing homes around here vary from $3500 to $6000 month. Even if our policy does not cover all the costs, a drain of $1000/mo is a lot better than $72,000 per year, I'm sure you'd agree. The reason I don't rely on the statistic about nursing home care only being needed for an average of 2 years is that as the Boomer population ages, I believe that length of stay average will rise rapidly. And in fact, the largest growing age group in the US is the group over age 80. Since our policy pays for at home care as well as convalescent or nursing care, we feel we have done what we can to MINIMIZE risk. You cannot eliminate all risk; it's impossible. A recent article in the WSJournal calculated that someone with a net worth of at least $5M wouldn't need LTC insurance. Remember that these days, being worth $1M or $2M is so commonplace that the government statistics don't even track it any longer; the bar is now at $100M+. There is no way my DH and I could afford long-term care without insurance. Even though our net worth is well over $1M we simply don't have that kind of liquidity without having to sell the house. My DH had a minor stroke at 50 -- not only is he virtually uninsurable now, but his mortality got halved right there. His chances of being disabled as he ages are considerably higher. Had we waited to obtain LTC insurance for even a few years, we would never have been able to afford it even if we could have found a carrier willing to write a policy on him. I agree that not having health insurance is foolish; on the other hand, if you can stagger along until age 65 (and assuming that somewhere along the line your employer or spouse's employer paid the Medicare A costs) a Medigap policy with zero-doughnut drug benefit is available at a relatively reasonable cost, certainly a lot less than the $900/mo cost (for an individual; $1200/mo for a couple) for my husband's current employer HMO plan. But it is almost a certainty that somewhere down the line, if you and/or your spouse live long enough, one of you will need LTC. And right now, nobody will pay for that except you. With all the disadvantages of private insurance, the fact remains, waiting for the government to take care of your LTC needs is a very dicey proposition indeed. What I point out to most younger people I know is that if they are going to buy a home and have children, they really need term life insurance. Nowadays with most couples dependent upon two incomes to make it, it is disastrous to consider burdening your lives with debt and obligations without buying life insurance. As mortality has improved, the premiums for term life have dropped substantially in the last couple of years. $40/mo will buy a $500K level premium term for 20 years on a 40-yr old in good health. When I worked at a financial planner's office for a while, it was interesting to see that there were quite a few clients who were widows, from ages 50-75. Their major assets were the home and insurance proceeds. Without the latter, some of them would have been in serious financial difficulties. My apologies for seeming to get OT here, but my point is that if you are going to own a home, there is not just health insurance but other insurance issues which are just as important for long term financial planning. To ignore them is being penny-wise and possibly pound-foolish. Thinking that "the odds are it won't happen to me" is taking a big risk. Nothing wrong with that, but I often wonder why people are willing to take such huge risks with their personal retirement finances when they are so often vociferous in proclaiming they want minimal risk when investing in the stock market.
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cathie54
16 years ago
I'm so sorry for you and your son's loss!

In our "rich" country, one would think we have it all.

My "un-hubby" (been together for over 20 years, but never married) didn't have insurance for many years. He FINALLY got approved for V.A. coverage. I "could" have certain benefits also - IF we were married.

MAYBE - if your DH served in war - you could get benefits there? (I don't know - just a thot)

WOW! At those quotes for medical insurance and the co-pays...you or your step-son could go to college to BECOME a Doctor! (If he's not interested..."MAKE" him interested! Bribe him if necessary! just kidding)

I know this is not anything to make light of...It's just that I, myself, am so terribly irritated by the "system" in our "rich" country.

When I was working and had benefits, I could go to any Doc. I had a variety of "specialists" as well as a G.P. who was really good. Shortly after I lost benefits, I lost all my Docs (because I had to move out of area), and to this day I have only found ONE good Doc (for Physical Therapy only). I'm stuck in an HMO, and no good docs so far.
I certainly hope you find something soon - before you have to fork out all that $$$ to cobra, etc.

I truly am sorry for you and son's sudden loss! How are you doing? (other than the insurance issue)

I'll say a prayer for you and son...and, I hope someone will come along with answers for you. HUGS!
partst
16 years ago
So sorry for your loss. You must be in a state of shock and sorrow.

I would call, or check out www.socialsecurity.org, Social Security and see what is available for you and your stepson. Widows benefits start at age 60 so that will not be of any help for now but your stepson son is covered until he is 18 and longer if he is a full time student. The FAQ section will answer a lot and if you find out what your benefit will be at age 60 it may help you figure out how you can keep it together until then.

As stated above check with the state insurance commission. Call your county health department maybe they can point you in some direction or to an agency you may not think about. Resources are out there you just may have to do some work to find the.

Good luck and again I am so sorry for you loss
amoretti
16 years ago
As others have said, condolences.
I want to echo the comment above: I had two friends in similar situations get health insurance through groups--one through a college alumni association; the other through the Modern Language Association (yes, this is a group for people in higher education, but the person in question was not! At the time, they took dues from anyone interested in modern languages--that would include everyone).

If you are in generally good health, I would look into a high deductible policy. I don't know if anyone can hook into those medical savings accounts for the self-employed (which would allow you to put away pretax $$)for the deductible and to deduct your payments.
quiltglo
16 years ago
Since you are over 50, check and see if AARP has coverage in your state. For your son, you might check with the school district to see who offers policies to students. Ours gives out flyers and I was looking at it the other day. $105 a month and granted the coverage wasn't perfect, but it was better than nothing. With him covered, you may be able to find a more reasonable single policy.

For a family policy with that low of a deductible, I have to tell you the rate is not bad at all. Two single policies may be less than a family, but you'll have to start budgeting for those cash expenses.

I'm very sorry for you loss. Many families just don't realize how much an employer is paying for insurance.

Gloria
joyfulguy
16 years ago
I am sorry that you have had the suffering that goes along with the loss of a loved one.

I suggest that you call all of your friends, especially people in a similar situation to yours, (convenient if you have email addresses for a number of them).

Often our friends (even ones from away back years ago) are a wonderful resource ... that often we don't think about tapping.

It's spirit-enhancing to visit with them, as well.

ole joyful
blondy61049_aol_com
12 years ago
I am a widow and havent had health insurance since april of 2010, i do have health problems, i was wondering if you could help me with insurance that would be affordable for me, since my only income is my social security. please help me.
kudzu9
12 years ago
Have you already tried the suggestions I made in my previous post above?
evaf555
12 years ago
Starbucks has been famous for years for their policy of offering group health insurance for part time employees.

however, they aren't the only ones. I have a relative who has started working for the Golden Arches. Any employee who works as little as *one hour a week* may purchase group health insurance. The employee portion of the payment is $25 a week. Yes, you read that right.

It isn't a Cadillac plan, but if someone truly *needed* insurance, this option is available. If someone considers him- or herself too good to work there, then they have the option of having no insurance at all.
zone_8grandma
12 years ago
I am so sorry for your loss.

If your health is reasonably good, you might look into an HDHP (High Deductible Health Plan). The deductibe is usually around $1500 and up per year before the benefits kick in. But the premiums are much more reasonable. That way, you pay for regular health care issues, but you are covered in the event of a serious illness or injury.

My son has one (he's in his mid 40's) The deductible is $5000, but the monthly premium is $128.

My husband also has one. His deductible is $1400/yr. The premium is $32 because his former employer helps pay the premium. A regular policy would have cost him over $100/mo.

Recently, HDHP policies have started to cover some preventive care as well. My husband's policy paid for most of the cost of his annual physical.
vala55
12 years ago
You might just get hospitalization insurance and pay doctor visits our of pocket. I know someone who did that. You might also find a job that offers health benefits. Stores like Walmart offers it, it's not good insurance but better than nothing.
tom418
12 years ago
"You might just get hospitalization insurance and pay doctor visits our of pocket. I know someone who did that. You might also find a job that offers health benefits. Stores like Walmart offers it, it's not good insurance but better than nothing."

This is EXACTLY the type of insurance that healthy people should be buying.

Unfortunately, once Mandatory Health Insurance kicks in, this type of plan may be "unacceptable" to the gov't, as it is in Massachusetts. Why? Because by not buying a "deluxe" policy, you would not be subsidizing the people
who can't get along without $10 copays, and having their chronic conditions covered.

kay: I think vala55 gave some good advice, assuming you're resonably healthy.
feedingfrenzy
12 years ago
Don't know where you got your info from, tom148, but it's wrong. In fact, health care reform is expected to further encourage enrollment in high-deductible health plans because such plans are expected to be a key offering in the insurance exchanges being set up in many states to help the uninsured find health coverage. And HDHP plans certainly are available in Massachusetts.

Anyone contemplating buying an HDHP must be prepared to meet the costs of the deductables and co-pays. That means you'll have to pay out of pocket for most of your routine care, and even a minor illness or injury can wind up costing you thousands of dollars. That's why most people set up Health Savings Accounts, which permit you to pay these costs using pretax dollars. These are avalaible to individuals, BTW.

And forget Walmart as a source of low-cost insurance. Part-time employees at Wally's (and that's the vast majority of their employees) must work for two years before they're eligible to enroll.
tom418
12 years ago
Ok, Feeding Frenzy, here'e where I got my "wrong" information. Maybe you should go to that couple's defense.

http://sayanythingblog.com/entry/massachusetts_couple_fined_for_not_having_adequate_health_insurance/

And, BTW, I'm 56 and in the past 36 years, have spent a total of less than $800 for unscheduled health care. So that's why I have no need for a low copay plan. My health record speaks for itself. When two thirds of americans are overweight ( a leading cause of health problems) and I'm fit, yeah, I get really mad about mandates!

Mandatory insurance was a demand made by the insurance companies in exchange for coverage for pre existing conditions. I suppose we should require everyone to purchase homewoners insurance so that uninsured people whose houses have burnt down can buy new insurance and expect to be reimbursed for their losses of years ago.

Here is a link that might be useful: Mass Couple Fined
sushipup1
12 years ago
Glad to hear that you are immune from health problems, Tom. My brother thought that he was, too, until he fell and broke his hip, and wound up with about $100K medical bills plus $20K in rehab costs while learning to walk again.

Such is the road to bankruptcy.
tom418
12 years ago
Sushipup: In what way would a high -deductable plan (like the MA couple I mentioned had) be useless?

If you were an insurance company, would you prefer to underwrite someone like me, or someone born with diabetes, or cardiac problems? Think hard now.
feedingfrenzy
12 years ago
I read your link tom418 (which is to a blog, BTW), and I stand by what I said. There are many HDHPs available in Mass, but they do have to meet minimum standards. That by no means makes them "deluxe" policies, to use your term.

For example, in order not to trigger the tax (or fine, if you prefer), a MASS HDHP: must not limit benefit payments because an individual develops Alzheimer's, mental illness, alcoholism or other chemical dependency after the policy is issued; it can't have a pre-existing condition limitation that lasts for more than six months after the policy's effective date; it must be guaranteed renewable or non-cancelable, etc, etc.

Standards like these are a long, long way from demanding that people can only buy "delux" plans, which is what your post claims. What will happen and who will pay their health care costs if one or both of the Williams eventually develops Alzheimer's and their policy doesn't cover it and they, themselves, run out of money? Why should the rest of the taxpayers of Mass pay for them just because they opted for the cheapest type of insurance they thought they could get away with?

Apparently, the plan the Williams couple has doesn't meet the minimum standards, but there's just no way to tell why from your link because no further info is provided. So given that you don't have the foggiest idea what their plan covers and doesn't cover, your question "In what way would a high -deductable plan (like the MA couple I mentioned had) be useless?" can be answered, "Don't know exactly, but maybe in a lot of ways."
joyfulguy
12 years ago
Greetings again, Kay Jones,

I hope/trust that you have got settled into a new lifestyle, following your bereavement, four years ago.

I hope also that you were able to find adequate health coverage at a reasonable rate.

I have another suggestion, a substantially tongue-in-cheek one, I admit, to offer ...

... move to Canada, maybe?

ole joyfuelled
jakkom
12 years ago
Trouble is, ole joyful, so many Americans have been doing that, that British Columbia has enacted huge barriers to immigrants. Otherwise, my MIL would have moved up there to be with her 200+ relatives in Vancouver.

The rest of the world looks on in amazement as the US continues to waste enormous amounts of money by refusing to go to a single-pay system.
feedingfrenzy
12 years ago
Great place but too cold!
topsiebeezelbub
12 years ago
I am so sorry to hear of your loss. I too am a widow with no insurance, although I worked and carried my own policy for over 20 years, then the company folded...not because of a bad economy but because the CEO and top execs took enormous bonuses and perks like yachts, jets, race cars and even an island! They robbed the company poor and the competition is still doing fine, so can't blame the economy. I am just praying to stay healthy till I turn 65. If I have a fall or get in a car accident, I'm done for. Only in America, Huh!
emilynewhome
12 years ago
I believe your stepson qualifies for this;
http://www.dcf.state.fl.us/programs/access/medicaid.shtml
dreamgarden
12 years ago
"The rest of the world looks on in amazement as the US continues to waste enormous amounts of money by refusing to go to a single-pay system."

I can see why.

What To Do About Big Pharma And The Sick Care Industry

"Big Pharma is at least as damaging to the physical health of our society as the Banksters on Wall Street are to our personal finances.

We also believe the banking and health-care (a.k.a. sick care) industries have pockets so deep, they are able to significantly influence the decisions made by law makers in Washington to pretend and extend the current system, all the while enriching themselves."

Nothing will change until our government stops letting greedy, corrupt interests meddle with public health policy.

A link that might be useful:

www.retireworldwide.com/health-and-wellness/what-to-do-about-big-pharma-and-the-sick-care-industry/
kayjones
Original Author
12 years ago
OJ, I am doing fine in Florida. I decided a Health Savings Account would work best for our health care needs - thank GOD my stepson and I are healthy. Thanks to everyone for the input.

New widow needs health insurance

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