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Health insurance, can you afford it or will it break you?

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SeeBen21

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In another thread egodell and Breakfast Diva raised an interesting topic, which I was not thinking about till now.
Is health insurance being affordable for innkeepers? How is it with health insurance cover after you where serious sick e.g. with cancer?
Actually I think I have to face this topic soon. Here in Germany it’s not a big deal, as you have to have a mandatory health insurance, which will cover you what ever will come. You pay 15,5% of your monthly salary for health insurance. It sounds great and on one side it is. As it doesn’t matter what health history you have you will be covered and just choose the health insurance company you want (since beginning this year they are all 15,5% flat)
On the other hand if you don’t have a private health insurance you may wait for an appointment quite long. E.g. I have to wait for a MRT scan for 3 to 6 weeks. If you have a private insurance you can get an appointment much faster.
So my question to you all now how the system in the US works for Innkeepers?
 

JunieBJones (JBJ)

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SeeBen this is a VERY controversial topic in the USA right now. I am afraid this is not a good topic for the forum - or I should say "WARNING WARNING!!!!!!" Yes, this is very political, extremely so.
 

wendydk

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We're lucky, D.'s job of 17 years covered most of the insurance bill for both of us. A GREAT REASON for one of an innkeeping couple to keep working!
 

EmptyNest

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Yes..JB is correct. This is a hot potato in the U.S. currently. I will refrain from commenting on the issues our govt is dealing with. Suffice to say this is a big issue for innkeepers. There is no one good solution..except if you have money and can pay lots for your own health care. It is something our association tried in vain to see if we could swing something for our members, but it still would have ended up costing everyone a fortune.
There is no good solution...right now, other than having a spouse who is still working and carrying the health care for both.
Or like me...I am fortunate to have it as a great retirement benefit...that so far costs me nothing except my co paymments.And I pay for my husbands...very reasonable each month.
 

gillumhouse

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SeeBen21, as of now, in the USA, people have control of both their healthcare (treatment - as in what doctor they want, what hospital, what treatment and if any) and health insurance - as in how much they are willing to pay and if they are willing to pay for it. Hospitals write off uncollectible bills every day - which is why many hospitals have closed, too many wanting FREE heathcare.
DH is now on Medicare (over 65) but I still pay almost $175 per month for his supplemental insurance and another almost $200 per month for his prescriptions. He plans to live forever. In the past, whenever he had a medical disaster (and he has had many), the problem was taken care of and whatever was not covered by insurance I got bills for. And I paid them.
I do not have insurance because I choose to not have it. For me it would be a waste of money. No what ifs, please. IF I get cancer I die. IF I break something, the hospital will set it and I will get a bill which I will pay - in payments. I am only hoping that I get to die with all my remaining marbles intact. Alzheimers is worse than death. I have no fear of losing my possessions to pay medical costs. I worked to pay my own way. No one owes me anything. If I cannot pay, I do not play.
I am going to die, the question is when and from what. It will not matter to me as I will be dead regardless.
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either. Last time DH was in the hospital, the doctor came in on Sunday and said I am ordering a CAT scan. OK, we figured it being the weekend he would get it on Monday. Wrong! They took him down for the scan that day, on Sunday.
 

Mini

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In Canada health care is free, sounds great eh? But, the wait lists to see a specialist are so long that you either die before seeing one or go to the USA and pay through the nose for your treatment. I'm thankful I'm healthy.
 

Don Draper

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It's a frustrating dilemma. We have been fortunate to be able to afford to pay for health insurance for the past year. We have not used it once. This year, our combined monthly premium is increasing substantially, simply because we moved into the next age bracket. I"m sorely tempted to just drop it, when you don't use it you look back and see the thousands of dollars you could have spent on inn improvements, paying down existing debt, or even treating yourself to a vacation or a nice meal out.
We are young and healthy, but it is still a major roll of the dice to go without health insurance. Especially when we handle all the maintenance, etc here at the inn...I'm picturing one of us falling off of a ladder or down the steps carrying a laundry basket. That would be awful, and frankly to pay for out of pocket expenses would probably be catastrophic.
There are unfortunately no easy answers to be had on any front. It'll be interesting to see what unfolds here. I'm optimistic that any change to the existing system will be one in the right direction. As a former allied health professional, I saw firsthand the good, bad and ugly on both the insurer and the provider sides.
 

swirt

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SeeBen21, as of now, in the USA, people have control of both their healthcare (treatment - as in what doctor they want, what hospital, what treatment and if any) and health insurance - as in how much they are willing to pay and if they are willing to pay for it. Hospitals write off uncollectible bills every day - which is why many hospitals have closed, too many wanting FREE heathcare.
DH is now on Medicare (over 65) but I still pay almost $175 per month for his supplemental insurance and another almost $200 per month for his prescriptions. He plans to live forever. In the past, whenever he had a medical disaster (and he has had many), the problem was taken care of and whatever was not covered by insurance I got bills for. And I paid them.
I do not have insurance because I choose to not have it. For me it would be a waste of money. No what ifs, please. IF I get cancer I die. IF I break something, the hospital will set it and I will get a bill which I will pay - in payments. I am only hoping that I get to die with all my remaining marbles intact. Alzheimers is worse than death. I have no fear of losing my possessions to pay medical costs. I worked to pay my own way. No one owes me anything. If I cannot pay, I do not play.
I am going to die, the question is when and from what. It will not matter to me as I will be dead regardless.
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either. Last time DH was in the hospital, the doctor came in on Sunday and said I am ordering a CAT scan. OK, we figured it being the weekend he would get it on Monday. Wrong! They took him down for the scan that day, on Sunday..
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either.
Count yourself lucky if this is the case in your area.
This is the way it was many years ago here. No longer the case in this area. I have "good" insurance. My primary care physician said I needed a CT scan. My insurance said no, it is not warranted we won't pay. Big ticket items have to be pre-authorised by insurance or you pay up front.
My Mother recently had to wait several weeks for an MRI and then another 4 days for a meeting with the doctor to "read" her the results. Now she is waiting 6 more weeks to meet with a neurologisit for the same issue. She has been in pain for nearly 5 months now. Again she has what is considered "good" insurance.
 

swirt

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In our area if you can get insurance as a large group, they can't deny you based on age or preexisting conditions. So that is one reason many people join the local chamber of commerce as it gives them access to getting into a group health plan. Its not cheap, but it is better than average insurance. Without getting it through the group, insurance might be close to unobtainable for some people.
 

Breakfast Diva

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Since you will be living in the U.S, you will need to provide your own health care. It's expensive. The older you get, the more expensive it is. If you have any pre-existing medical condition you'll have a difficult time finding an insurance company that will cover you.
Because SeeBen21 is from out of the country, I think it's important he knows what cost to expect. As stated in another post, we have a small business policy because my DH has an issue (he's "healthy" now) that may develop into something some time in the future and we can't find an insurance company to write him an individual policy. A business policy doesn't have any pre-existing or health questions. Our policy has increased significantly every year. We have a $2,000 per person per year deductible, then it's a 70/30 (they pay 70%, we pay 30%) after our deductible is met. There is a maximum out of pocket of $6,000 per year. The older we get, the more expensive it gets. I am early 50's, DH is early 40's. Our premium is nearly $650 per month.
Also SeeBen21, when you get old and need more care, the government does not take care of you in the U.S. unless you are without any money. If you need to go to a retirement home or assisted living community, it will cost many thousands each month.
If you are planning on coming to the U.S. and living here until you're quite old, I think it's important you're aware that health care is a major issue.
 

gillumhouse

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SeeBen21, as of now, in the USA, people have control of both their healthcare (treatment - as in what doctor they want, what hospital, what treatment and if any) and health insurance - as in how much they are willing to pay and if they are willing to pay for it. Hospitals write off uncollectible bills every day - which is why many hospitals have closed, too many wanting FREE heathcare.
DH is now on Medicare (over 65) but I still pay almost $175 per month for his supplemental insurance and another almost $200 per month for his prescriptions. He plans to live forever. In the past, whenever he had a medical disaster (and he has had many), the problem was taken care of and whatever was not covered by insurance I got bills for. And I paid them.
I do not have insurance because I choose to not have it. For me it would be a waste of money. No what ifs, please. IF I get cancer I die. IF I break something, the hospital will set it and I will get a bill which I will pay - in payments. I am only hoping that I get to die with all my remaining marbles intact. Alzheimers is worse than death. I have no fear of losing my possessions to pay medical costs. I worked to pay my own way. No one owes me anything. If I cannot pay, I do not play.
I am going to die, the question is when and from what. It will not matter to me as I will be dead regardless.
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either. Last time DH was in the hospital, the doctor came in on Sunday and said I am ordering a CAT scan. OK, we figured it being the weekend he would get it on Monday. Wrong! They took him down for the scan that day, on Sunday..
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either.
Count yourself lucky if this is the case in your area.
This is the way it was many years ago here. No longer the case in this area. I have "good" insurance. My primary care physician said I needed a CT scan. My insurance said no, it is not warranted we won't pay. Big ticket items have to be pre-authorised by insurance or you pay up front.
My Mother recently had to wait several weeks for an MRI and then another 4 days for a meeting with the doctor to "read" her the results. Now she is waiting 6 more weeks to meet with a neurologisit for the same issue. She has been in pain for nearly 5 months now. Again she has what is considered "good" insurance.
.
I have one question to ask and one sentence to state and will not say another word on the subject - period.
Can Knowlesl or SeeBen21 change insurance carriers?
DH was not happy with what he was getting from his supplemental carrier and changed insurance companies because he could.
 

sgirouard

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I think it's important to note that, under the current proposal in the US, anyone who opts not to buy health insurance will be fined... up to $3800 per year.
Yahoo news article
 

swirt

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SeeBen21, as of now, in the USA, people have control of both their healthcare (treatment - as in what doctor they want, what hospital, what treatment and if any) and health insurance - as in how much they are willing to pay and if they are willing to pay for it. Hospitals write off uncollectible bills every day - which is why many hospitals have closed, too many wanting FREE heathcare.
DH is now on Medicare (over 65) but I still pay almost $175 per month for his supplemental insurance and another almost $200 per month for his prescriptions. He plans to live forever. In the past, whenever he had a medical disaster (and he has had many), the problem was taken care of and whatever was not covered by insurance I got bills for. And I paid them.
I do not have insurance because I choose to not have it. For me it would be a waste of money. No what ifs, please. IF I get cancer I die. IF I break something, the hospital will set it and I will get a bill which I will pay - in payments. I am only hoping that I get to die with all my remaining marbles intact. Alzheimers is worse than death. I have no fear of losing my possessions to pay medical costs. I worked to pay my own way. No one owes me anything. If I cannot pay, I do not play.
I am going to die, the question is when and from what. It will not matter to me as I will be dead regardless.
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either. Last time DH was in the hospital, the doctor came in on Sunday and said I am ordering a CAT scan. OK, we figured it being the weekend he would get it on Monday. Wrong! They took him down for the scan that day, on Sunday..
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either.
Count yourself lucky if this is the case in your area.
This is the way it was many years ago here. No longer the case in this area. I have "good" insurance. My primary care physician said I needed a CT scan. My insurance said no, it is not warranted we won't pay. Big ticket items have to be pre-authorised by insurance or you pay up front.
My Mother recently had to wait several weeks for an MRI and then another 4 days for a meeting with the doctor to "read" her the results. Now she is waiting 6 more weeks to meet with a neurologisit for the same issue. She has been in pain for nearly 5 months now. Again she has what is considered "good" insurance.
.
I have one question to ask and one sentence to state and will not say another word on the subject - period.
Can Knowlesl or SeeBen21 change insurance carriers?
DH was not happy with what he was getting from his supplemental carrier and changed insurance companies because he could.
.
Can Knowlesl or SeeBen21 change insurance carriers?
I dunno, you'd have to ask them. That wasn't part of my story...now if the question is can I change mine? NO. I'm stuck/blessed with mine from my day job. As a group plan they have to take me. If I was to try and buy my own, I would get denied or be put in a risk pool expensive enough to make it questionable whether it was worth it. Can my Mom change hers, NO, she's stuck/blessed with hers as part of her retirement package.
 

swirt

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I think it's important to note that, under the current proposal in the US, anyone who opts not to buy health insurance will be fined... up to $3800 per year.
Yahoo news article.
And now we are getting into that political arena that we intentionally avoid here.
Lets try to stick to the original question.
 

Copperhead

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In Canada health care is free, sounds great eh? But, the wait lists to see a specialist are so long that you either die before seeing one or go to the USA and pay through the nose for your treatment. I'm thankful I'm healthy..
One other thing about health care in the US, since you plan to live in the US be very careful when looking into private health care insurance. Be sure to get several quotes and if one is far less expensive, read every last word....there are a lot of salespeople out there trying to pass discount programs as Insurance. These discount programs do not provide you with much of anything (if anything at all). You need REAL insurance and as it has already been stated, it is not cheap. There are different tiers in insurance, meaning maybe lower monthly premiums and higher deductables, then higher premiums with lower deductables, some that only cover catastrophic illness, etc. Again, read carefully and if need be consult with a US friend to help you go through them to make the best decision. Good luck!
 

EmptyNest

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SeeBen21, as of now, in the USA, people have control of both their healthcare (treatment - as in what doctor they want, what hospital, what treatment and if any) and health insurance - as in how much they are willing to pay and if they are willing to pay for it. Hospitals write off uncollectible bills every day - which is why many hospitals have closed, too many wanting FREE heathcare.
DH is now on Medicare (over 65) but I still pay almost $175 per month for his supplemental insurance and another almost $200 per month for his prescriptions. He plans to live forever. In the past, whenever he had a medical disaster (and he has had many), the problem was taken care of and whatever was not covered by insurance I got bills for. And I paid them.
I do not have insurance because I choose to not have it. For me it would be a waste of money. No what ifs, please. IF I get cancer I die. IF I break something, the hospital will set it and I will get a bill which I will pay - in payments. I am only hoping that I get to die with all my remaining marbles intact. Alzheimers is worse than death. I have no fear of losing my possessions to pay medical costs. I worked to pay my own way. No one owes me anything. If I cannot pay, I do not play.
I am going to die, the question is when and from what. It will not matter to me as I will be dead regardless.
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either. Last time DH was in the hospital, the doctor came in on Sunday and said I am ordering a CAT scan. OK, we figured it being the weekend he would get it on Monday. Wrong! They took him down for the scan that day, on Sunday..
In the USA currently, if your doctor says you need an MRT, you get it and it will not take 3 to 6 weeks either.
Count yourself lucky if this is the case in your area.
This is the way it was many years ago here. No longer the case in this area. I have "good" insurance. My primary care physician said I needed a CT scan. My insurance said no, it is not warranted we won't pay. Big ticket items have to be pre-authorised by insurance or you pay up front.
My Mother recently had to wait several weeks for an MRI and then another 4 days for a meeting with the doctor to "read" her the results. Now she is waiting 6 more weeks to meet with a neurologisit for the same issue. She has been in pain for nearly 5 months now. Again she has what is considered "good" insurance.
.
wow that shocks me. I was at the specialist last THursday, scheduled my MRI for today and I am back for them to read it tomorrow.
 

muirford

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As swirt mentioned, insurance under a group program gives some protection from cancellation due to a variety of reasons. I don't know of any bed and breakfast organization that has developed such a group program (maybe some states have that I'm unaware of) but we get ours through NASE (National Association of Self-Employed). It's still expensive - we were just hit with a 25% increase in our premium - and we have a huge deductible of $5000, but our monthly premium is under $500. Depending on your age, AARP (American Association of Retired Persons(?)) has group policies available and you can join at age 55. I am not eligible but my DH is - we found those plans to be somewhat more expensive.
There are millions of Americans currently without health insurance coverage - not because they choose to be, but because the premiums are more than their annual incomes, or they have been denied coverage or dropped from coverage due to a health condition. People die here in the U.S. waiting for their insurance companies to approve treatments or because they have been denied coverage for treatment. Those are unfortunate facts, and reasons why it is important, especially as a small business owner, to look at your insurance situation in its entirety before going ahead with or without coverage.
 

egoodell

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SeeBen21 said:
On the other hand if you don’t have a private health insurance you may wait for an appointment quite long. E.g. I have to wait for a MRT scan for 3 to 6 weeks. If you have a private insurance you can get an appointment much faster.
I know people who have had to wait weeks to see a doctor who are on private health insurance here.
Riki
 

egoodell

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From what I understand, it is preferable to obtain your healthcare under the umbrella of a large group. This way, as mentioned before, they are less likely to try and drop you if you become ill. They will fight to drop Mr. and Mrs. Smith rather than an association.
Don't bother to try and find out if there is a B&B Association. That's been tried before and the group is not big enough to impress the big insurance companies.
I am also going to look into home care insurance. ONce my DH and I get old, with no kids to count on, we want insurance to keep us at home or somehwere decent rather than rotting in some disgusting place like where my grandfather ended up.
I am guesing even though we are in good health, with a large deductable my husband and I will be paying $1000 per month for health insurance once I leave work at UVA. I'm stuck here right now just for this indefinately.
Riki
 

The Farmers Daughter

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We have a small business - group health insurance plan. It costs each of us about $400 a month. I would consider it adequate. It is not great. I fight with the insurance company on a regular basis.
Here is a good example. They had been refusing a certain claim because they didn't have my date of birth correct. I fought with them for over 2 years and sent them certified copies of my birth certificate to prove the correct date.
Now they are refusing the claim because the date of service is outside of the 'accepted time frame' .
 

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