Health Insurance

don't forget that the companies pay much of your premiums (or so i think). they don't just get charged $40 p/m

They do, but my understanding is that it's sort of a bulk buying agreement.  So an individual might be charged $600 per month, a small company $500 and a larger company even less. 

one thing to remember is that if you have any lapse in coverage you are likely to get screwed for any pre-existing conditions. :/

Long-term care isn't part of the NHS. Not including Scotland, where long-term care is  paid for, it's funded pretty much the way it is in the US - you're responsible for paying for your own care until you are down to a certain low level of savings. In the UK, the value of your house is included as part of your assets, meaning that you have to sell your house or transfer ownership - I don't know if that's true of the US.

How are you defining long-term care? Do you mean convalescence? Or cancer care? I'm confused.

They do, but my understanding is that it's sort of a bulk buying agreement.  So an individual might be charged $600 per month, a small company $500 and a larger company even less. 

But the insurers can't charge the individuals the same as they do companies exactly for that reason - bulk.  They can afford to charge companies less because some of their employees won't need much care at all, so they in essence subsidize those that do.  Whereas an individual is just a simple liability. 

If you're willing to risk going without insurance (or simply cannot afford anything other than catastrophic cover, or cannot afford anything at all), check to see if your state has a discounted plan for children.  New York does - if you qualify you can purchase *relatively* inexpensive high quality/coverage insurance for your kids that will get them well-child doctors visits, hospital cover, etc.  Here's the NYS Child Health Plus site: http://www.health.state.ny.us/nysdoh/chplus/index.htm

New York's health plan is also available to adults who don't have children.

How are you defining long-term care? Do you mean convalescence? Or cancer care? I'm confused.

The rules about which is long-term care and which is healthcare are actually very confusing and not clear or intuitive.  I have something about this at work from stuff I researched quite a while back but I don't remember off the top of my head.

From the Wanless report:

distinguishing needs at the boundary of health care (free at the point of delivery, including NHS continuing care) and social care (means-tested) creates considerable anger and distress among older people and their families. The interface has become a flashpoint for arguments about inequities in
the system.

The operation of two parallel systems (of health and social care), and the difficulty of
distinguishing between needs at the boundary of these systems, is at its most acute with
continuing care. There is evidence that the eligibility criteria are insufficiently responsive to
the health needs of older people, individuals with chronic degenerative and progressive
conditions (such as motor neurone disease and Parkinson’s disease) and people with
mental health needs. In the pivotal Pointon case, the Ombudsman upheld Barbara
Pointon’s complaint that her husband, with dementia, had wrongly been denied
continuing care. It was judged that the eligibility criteria had concentrated too heavily on
physical health care needs and failed to take adequate account of mental health care and
psychological needs. Most recently (January 2006), in the Grogan case the judge rejected
Bexley NHS Care Trust’s decision not to fully fund care for a disabled 65-year-old woman
with multiple needs, saying that the criteria drawn up by the South East London Strategic
Health Authority were ‘fatally flawed’ as they did not reflect the fact that those with a
primary health need should be NHS funded.
A new national eligibility framework for continuing care is currently under development,
which needs to improve consistency, take full account of physical and psychological
needs, and clarify the interface between NHS continuing care and RNCC free nursing care.
However, it will not address the fundamental underlying tension which results from the
operation of two parallel but largely separate systems for meeting health and social care
needs. The shifting boundary only adds to that tension. As the Health Committee
observed: ‘In practice the boundary between the two services has shifted over time, so
that the long term care responsibilities of the NHS have reduced substantially, and people
who in the past would have been cared for in NHS long stay wards are now often
accommodated in nursing homes. This means that responsibility for funding long term
care has to a major extent been shunted from the NHS to local authorities and individual
patients and their families.’ (House of Commons Health Committee 2005, para 41)

Note - this only applies to England

For those moving back without jobs, check out goldenrule.com (owned by UnitedHealthcare). We filled out an application online and were approved a few days later. Reasonable price ($310 per month for myself and DH), we have a United Healthcare network and can choose any doctor, even a specialist without a referral. Deductable is $1500 per person (you can choose your deductable which will increase/decrease your monthly premium), office visit co-pay is $35. Prescription prices are good, can't remember but something between $15-$25 generic/name brand. There are some other good features to the plan (annual physical, gyn - pap, mamo) can't remember them all since its new for us. Overall a fully comprehensive healthcare plan.

We went through a broker that I found online because I didn't know which insurance company to go for but you can go directly to the link above.

For the OP: Did you come up with a solution?

thanks for that link Jules!   Very reasonable and I think we might go with them!

You can buy temprary health insurance with Blue Cross.  Health insurance can be affordable if you get very high deductible and you pay 20% of every claim. The problem is that if you can't get it through your job they can deny you coverage for any reason. My husband was denied coverage because he is overweight. The state of California has insurance for who is denied but there was 1 year waiting list. It was also really expensive for us because my husband was in Law School and only working part time but we could not qualify for medicaid. CHIP is also a federal program that covers children but if you are looking for something temporary will not work since the application takes at least a month.  The thing is the care that you get in the US is usually very good but it is a very unfair system. When my husband was making very little money we were paying 3 times what we are paying now that he is an attorney and makes good money.
I also have a friend that had a surgery with complication and they had to clean an infected area. They told there that normaly they would put her to sleep but since she didn't have insurance they could not do that. She said it was extremely painful.

I checked out the website and put in me, my wife and my daughter for Baltimore area and about 92 plans came up.  The cheapest monthly options were $208 but with $2500 deductible or $230 with $1200 deductible (and I think some other costs).  A heck of a lot of deductible if you need to use it!

Does anyone know, I heard about the legislation in Massachusetts where everyone in the State is meant to have coverage but I think those who are in work need to purchase it through work - not sure if that's true or how exactly it works.  What would happen to someone who moved to Mass without a job and needed some kind of healthcare, would the State pick up the cost?  Or would they assess your net worth and make a decison on that or what would they do?

Does anyone know, I heard about the legislation in Massachusetts where everyone in the State is meant to have coverage but I think those who are in work need to purchase it through work - not sure if that's true or how exactly it works.  What would happen to someone who moved to Mass without a job and needed some kind of healthcare, would the State pick up the cost?  Or would they assess your net worth and make a decison on that or what would they do?

I'm currently living in Massachusetts (NB: Massachusetts is not a State... ), but even I'm not totally clear on the current plan, so a quick trip to wikipedia was in order.

There's no requirement to purchase through employment (employers with more than 10 employees who do not provide coverage are taxed by the Commonwealth).

Those who earn less than the federal poverty line but do not qualify for Medicaid can obtain a policy at effectively no charge from the Commonwealth Health Insurance Connector (which basically works out bulk insurance deals with private insurers); those who make up to 300% of the poverty line pay for their policies on a means-tested basis.  Failure to be insured (or to obtain a waiver for either religious objection to health insurance or a lack of affordable policies) results in various tax penalties; in '07 it was merely the loss of personal income exemption, while from '08 onwards half of the cheapest annual premium will be added to your income tax bill.

I think this system is an improvement over both the normal US system and the more state-controlled system of the UK, but the basic idea is better implemented by Singapore (the Netherlands served as the model for the Massachusetts system; the jury is still out on whether it's effective or not).

IMO, the system the USA should move to would have the individual coverage mandate with employer-provided health coverage strongly discouraged.  Eradication of employer-provided health coverage is the most important step to reform of the entire system: every problem is traceable to that response to WWII-era wage controls.  EPHC adversely affects workforce mobility, reduces insurability for those outside of the EPHC system, and prevents a proper market from developing.  Ending the tax-favored status of EPHC would be a great start (i.e. considering health insurance premiums as taxable income).

Going along with this, various regulations requiring minimum coverages, like regulations setting a minimum price for anything (e.g. minimum wage), should be abolished: at best such regulations have no effect on things (if they happen to be perfectly calibrated such that they are right where the market decided the price/offering should be)... otherwise they have the effect of preventing people from getting coverage (for minimum wages, read being employed) or even more perversely may reduce the level of coverage being received (for minimum wages, read wages received).  The mandate should only require a fairly high deductible (probably $5k, maybe even $10k) coverage for a catastrophic illness.

Beyond this, routine care/preventive maintenance should be held to be the responsibility of the individual, though aggregate health-care expenditure (comprising the catastrophic insurance premium plus the cost of drugs, preventive/routine care, spending up to the deductible, plus applicable contributions to a savings account earmarked for paying health expenses) would be limited to a set percentage of income (first by making anything above say 10% of AGI tax deductible and anything above say 15% of after-tax income earn a tax credit).

Individuals are generally more capable of making health decisions and weighing the cost/benefit equation than a bureaucrat.

The coverage mandate is, of course, problematic for an advocate of the free market.  However, health insurance suffers from a major information asymmetry: you know far more about your body's health than a prospective insurer does.  Since the decision to buy insurance is fundamentally a bet that you will make sufficient claims (and thus the decision not to buy insurance is a bet that you won't need to make sufficient claims), it follows that it is eminently rational for, for example, most men under 30 to forego health insurance as they're unlikely to need it and the premium money is basically being thrown away.  The effect of the pull-out of those guys is that the prices for everybody else have to increase which means that a few more people decide that the expected value of their claims is far exceeded by the expected value of the premiums and pull out which continues the cycle.  The solution is thus to prevent the healthiest from opting out.  The options then basically become an NHS-style system (with a near-monopoly for the state in the provision of and payment for health services), a system with a government monopoly on catastrophic care coverage (IINM, Germany and France basically follow that model), and a system with private (regulated) insurance and a mandate to purchase.  Of those three, the one that allows for the freest system (even if it involves the government purchasing private insurance for those with less than a certain ability to pay) is the latter and thus I support it, as the different coverage options reduce the one-size-fits-all models offered by the former two (and by the employer-provided system currently in the States).

We bit the bullet and bought insurance...it's about $300 monthly with Blue Cross and Blue shield in VA.  We opted for a higher $5000 deductible and lower copays.     I looked into the short term insurance and found it really high for what it is... I need something that will allow me to take my son to the DR if he gets sick not just someone to pay 80% for long term care.   

We bit the bullet and bought insurance...it's about $300 monthly with Blue Cross and Blue shield in VA. 

I'm looking to add me (and my kids) onto my husband's Carefirst (BCBS) policy. Was that $300 a month for just you? We're in Maryland.