Insurance Question?

[WindingRoad]

So I am in the process of buying insurance for myself, since I am a bike commuter I am curious how it works if, God forbid, I get hit by a car and sent to the ER? I was looking at deductibles and trying to guess which might be best but then I wondered if it's the car's fault does their insurance have to cover it then? I don't know what would happen if they don't have insurance either? Hmmmmmmmmm... anyone have any ideas?

[Catrin]

So I am in the process of buying insurance for myself, since I am a bike commuter I am curious how it works if, God forbid, I get hit by a car and sent to the ER? I was looking at deductibles and trying to guess which might be best but then I wondered if it's the car's fault does their insurance have to cover it then? I don't know what would happen if they don't have insurance either? Hmmmmmmmmm... anyone have any ideas?

I asked my insurance company this question and couldn't pin them down. They said, basically, "it depends on the situation" - though everyone agreed that the OP insurance would cover it if they had any...

I see motorcycle insurance, why isn't there bike insurance? According to my insurance company we are considered pedestrians as it isn't a motorized vehicle

[OakLeaf]

Do you have a car or motorcycle? If so, get uninsured/underinsured motorist coverage. Get the highest limits of liability you can afford, because your UIM limits can be no higher than your liability limits.

Are you talking about health insurance you're buying for yourself? Worry more about things that won't be covered by someone else's liability...

[WindingRoad]

I have a crappy car so I only carry liability on it. I don't think I can add UIM then can I?

I am looking for a policy for myself for individual health coverage. I don't have an employer per se and my school's plan sucks. The plan I have now isn't useful with routine coverage so I'm trying to get a copay plan but now i started worrying about the fact that I commute and the whole 'what if' scenario. Maybe I should just stop looking so hard and just get what I can afford. I need to stop worrying about the 'what if's' for now before I go crazy. Besides the sky isn't falling just yet

[JennK13]

My insurance is what my employer provides me, so I didnt have to search. When we've had accidents in the past - motorcycle, auto, sporting (i play softball as well as ride among other things - and I'm a klutz!) Whether we've gone to the ER or the doctor after an accident, the medical insurance company has sent us a survey asking us if the injury was the result of an accident, and if so, can some other insurance cover the fees. My guess is that IF someone else was at fault, they, the insurance company, would go after that company. So far, it's never involved another party.
If you're looking for additional help in case of accidents, you might consider something like Aflac. Since we lead such active lives with a higher probability of serious injury, I carry aflac. It's relatively affordable and the pay back is pretty simple and quick. I smacked my hand in a virtual baseball game at Dave & Busters in a drunken stuper and thought I broke my knuckle. Went to the Dr two days later, paid my $20 copay, and Aflac paid me $120 for the "accident". I find it very useful since I'm prone to injury in sports - an extra $120 for spraining an ankle or dislocating a shoulder is very helpful for me

[OakLeaf]

You should be able to get UIM without having comp or collision. AFAIK it's only the liability that it's tied to. Depending on where you live it can be rather expensive, but IMO it's totally worth it. I carry the highest limits of liability on my motorcycles for just that reason. You have to have a motor vehicle and liability insurance on it to get UIM, but you don't have to be operating the motor vehicle to collect on it, at least in Ohio.

But as far as health insurance ... as you've probably already found, you could buy a very nice car every single year for what individual health insurance costs. Get what you can afford. I'd go for catastrophic coverage that covers a variety of different conditions and treatments, over something with a lower deductible that would probably be useless for a serious illness or injury.

If you're self-employed you might look at a Health Savings Account - the tax savings there are substantial.

[Aggie_Ama]

When DH ran into the back of a parked 18 wheeler his health insurance wanted to try to go after the guy. It was totally DH's fault but they wanted to pin it on the poor truck driver. Being that my Pawpaw was an interstate trucker I felt bad knowing those guys often have terrible benefits and he might get in trouble with his employer. Turns out he could prove he was legally parked as it was legal to park in this bike lane to deliver to the building he had to deliver to. We paid the co-pay and deductible.

I carry the lower deductible because I am on two maintenance medications and a total klutz. It is more expensive but less out of pocket if I need it. I think I figured out the amount more I pay is less than the difference in deductibles if I do have a wreck/accident and over the course of the year the lower co-pays mean I break even otherwise. Of course I am a mountain biker so I believe my odds are higher of eventually seeing the ER.

Of course I helped a friend look for insurance for her daughter and wowsers, in your case I would get what I can afford and have a savings account building.

[Irulan]

I have a crappy car so I only carry liability on it. I don't think I can add UIM then can I?

I am looking for a policy for myself for individual health coverage. I don't have an employer per se and my school's plan sucks. The plan I have now isn't useful with routine coverage so I'm trying to get a copay plan but now i started worrying about the fact that I commute and the whole 'what if' scenario. Maybe I should just stop looking so hard and just get what I can afford. I need to stop worrying about the 'what if's' for now before I go crazy. Besides the sky isn't falling just yet

Premera/Bluecross has the Lifewise program in many states. It is decent high deductible program to self insure by.

Self insurance is not THAT expensive unless you want a gold plated plan. We currently pay $400/mo for three adults, (one student, one over 50) for a high deductible plan tied to a HSA. One younger adult was $88 a month through asuris.

Careful, there are a lot of crappy plans out there that will weasel out of real coverage. Go with a respected company.

[OakLeaf]

What you refer to as "gold plated" is really pretty minimal compared to what everyone had 30-40 years ago. It's pretty minimal compared to what a lot of people had 10 years ago. It's nearly impossible to get a comprehensive plan that isn't at least a PPO, and it's actually more common to have an out-of-pocket maximum in a high-deductible plan, these days, than a regular plan.

And it may be the only thing that's available to someone who's coming over from COBRA or another policy. To be eligible for open enrollment, you have to have been uninsured for a certain period of time. Not everyone wants to take that risk.


ETA - Also, I'm 50. Expect your insurance to go up by 35-40% every time you hit a milestone age.

[Irulan]

What you refer to as "gold plated" is really pretty minimal compared to what everyone had 30-40 years ago. It's pretty minimal compared to what a lot of people had 10 years ago.

And it may be the only thing that's available to someone who's coming over from COBRA or another policy. To be eligible for open enrollment, you have to have been uninsured for a certain period of time. Not everyone wants to take that risk.

well, I don't know about that. I looked at some self insure plans that had a premium for one person between $800-1200 a month, that had a $100 deductible, $1000 out of pocket maximum, $10 copay, full prescription coverage. In my book, that's pretty gold plated IMO, and if you can afford that, great.

I've never had a plan ( even prior to self employment) that didn't have some sort extensive PPO list to go off of, so I don't consider that a deal breaker. My primary care guy is contracted with every plan in the region. I've also never had a plan that didn't have a maximum of out of pocket expenses. Even my son's gold plated plan has a $1200 maximum out of pocket.

We have been self insuring (self employed) for years now that having to deal with COBRA is way in the dark dark past.

It's important to have something, even if it's just a catastrophic plan. I have an acquaintance who chose to not insure and then had to mortgage her house after a road bike crash. That would be great if you were taking that money you might have spent on a premium and put it aside, but even if you did do that, it's not going to cover the huge expenses that can occur in a serious situation.

well whatever. Shop around, talk to qualified broker, don't go with fly by night stuff advertised on the web/tv and educate yourself.

[OakLeaf]

My premium is $1750 per month for one person, $500 deductible, 20% in-network co-pay, out-of-network copays that I've seen up to 70%, yes prescription coverage, no out-of-pocket maximum, no vision, no dental, $2 million lifetime limit that I'm afraid to even ask how close I am to reaching. Minimal physical therapy, no occupational therapy (i.e., no non-surgical treatment for hand injuries, since that's all done by OTs), minimal mental health coverage (no parity even with the new law, because it's an individual policy).

My husband's is about the same.

Up until two years ago I had only minimal pre-existing conditions (which even then precluded me from getting any other insurance), and he has none.

We're lucky to be able to afford it, it's true. Considering the state of medical care in this country, I've seriously considered ditching it. But then I'll see something happen, like the son of a friend of mine got Legionnaire's disease and was in the hospital for two weeks ... another son of a friend had a non-displaced cervical fracture ... things that modern health care really can do something about, that would cost me tens of thousands of dollars after insurance. And I realize that even though I can afford insurance, I probably can't afford to go without it.

[Irulan]

Hmm. I wonder how much of the different is regional.

Three adults(49, 50, 21), $400 a month, 6000K into an HSA, $1700 individual deductible, $5K out of pocket per individual max, no prescription coverage, no vision, 10% copay after you reach deductible; 2 million max.

So folks, between me and Oakleaf you can see there is a whole wide range of choices.

[Irulan]

To go back to OP's question, if you are in an accident, and it's someone else's fault, yes, their insurance should pay. Ideally your insurance wil deal with their insurance and you don't have to do much. This is if you are dealing with a good insurance company.

There are a couple of scenarios, depending on how YOUR insurance operates.
1. Your insurance pays the bills and deals with going after the other guy, you pay nothing.
2. You pay the bills, submit them to your insurance for reimbursement who then goes after the other guy.
3. You try and get their insurance to pay directly. Remember it's the other guys insurances job to give you as little as possible.
4. You pay out of pocket and try to get the other guys' insurance to reimburse you.

[WindingRoad]

I have been looking long and hard at United Healthcare's major medical plan. It sucks but I really can't afford to get decent major medical AND have options for routine care. I can afford dental but that is about it, I am on a grad student budget and there isn't much fudge room. I have insurance now through Assurant and it's pretty lame for what I'm getting. It has a 3,500 deductible and is still only going to cover the big things. The plan with UH I'm looking at has a lower deductible and I have the option to add dental for $20 extra per month. I realize this isn't the ideal situation but I have to make some sacrifices. Aghaa I just don't know what to do!

[Crankin]

Wow, I believe there is a regional, or even a state-by-state difference. Before our mandated universal health insurance law, my son had good coverage for about 250.00 a month when he first graduated. I have no idea how he found this. After a year, the law passed, and he was able to get excellent Blue Cross coverage for $200.00 a month. It has a reasonable deductible, dental coverage, pays for check-ups, etc. Since he works for a company with 7 employees, he does not get health care. This is his last week there, after five years. His new employer offers 2 levels of plans (premium and basic) which seems reasonable for a single person, but is really a lot for couples (he's getting married next year).
I know some people don't think our law is good, and some think it's the work of the devil, i.e. socialism, but without it, my son would have had a real issue getting insurance, since he obviously does not fall into the "free care" category, but he doesn't make a huge amount of money. He has used it a few times and never had any problems and he has a decent pcp affiliated with Brigham and Women's.