Advertisement
YOU ARE HERE: LAT HomeCollectionsHealth

Health 411

Don't let under-26 son go without insurance

The risk, and the potential cost, is too great for him and his parents.

May 30, 2011|By Lisa Zamosky, Special to the Los Angeles Times
  • It's never a good idea to forgo health insurance if you can avoid it, even for the young and healthy: An accident or unexpected illness can cost you dearly.
It's never a good idea to forgo health insurance if you can avoid it,… (Luis Sinco / Los Angeles…)

My son graduates from USC this year. He doesn't have a job lined up with health insurance. Because he is under 26 years old, we can put him back on our employer plan, but it's almost $400 per month! I want to help our son out, but that's ridiculous. He's healthy, so I am considering maybe just not insuring him until he can get his own through work.

It's never a good idea to forgo health insurance if you can avoid it, even for the young and healthy: An accident or unexpected illness can cost you dearly. "It doesn't take much to rack up a lot of money in hospital bills. Even one trip to the ER can cost hundreds or thousands of dollars," says Aaron Smith, executive director of Young Invincibles, a Washington, D.C.-based nonprofit that advocates for young adults.

Also consider: If you claim your son as a dependent on your tax return, you may be on the hook for his medical bills, warns Anthony Wright, executive director of the healthcare advocacy coalition Health Access California. "I've seen hospitals go after parents," he says.

There's another risk in going without insurance. Federal law guarantees your son a policy from private insurers as long as he can show he's had continuous medical coverage. A gap would make it difficult for him to buy insurance on his own if he develops an illness or is injured while uninsured, at least for now. When the health reform law takes full effect in 2014, insurers will no longer be able to deny coverage to people with preexisting health conditions.

If your employer-based insurance is too expensive, your best bet is the private insurance market. Since your son is healthy, there's a good chance he'll find a cheaper plan than the one offered by your employer. Just be aware that less expensive plans tend to have higher deductibles and are more bare-bones in their benefit offerings. "Let the buyer beware with regard to buying insurance on the individual market," Wright advises.

Be sure to pay close attention to all the fine print to get a true sense of how much a plan will cost. Look beyond the monthly premium and check on annual deductibles (the amount you pay before insurance coverage kicks in), co-pays (the fixed dollar amount you pay for medical services like a doctor visit or prescriptions), coinsurance (the percentage of medical expenses you're responsible for) and the cost of prescription drugs.

Check for plans and prices in your area at the federal government website Healthcare.gov. It's also a good idea to consult with someone knowledgeable about the insurance market in your area. You can find agents who specialize in health insurance on the National Assn. of Health Underwriters website, nahu.org (click "search" on the home page menu to find member agents). Another option is to compare and purchase insurance at any number of online brokerages, including ehealthinsurance.com, insuremonkey.com, healthcompare.com and healthplanone.com.

For information about the health insurance options available to college grads, check out the Young Invincibles' tool kit: Go to http://www.younginvincibles.org and click on "tools" on the menu.

My husband and I are both covered under my employer's health insurance. He turns 65 this year and will be eligible for Medicare. Should he sign up for Medicare, and how will that coverage affect his private insurance?

A number of factors will play into whether your husband should sign up for Medicare right now. And you'll have to carefully consider various pieces of Medicare — Parts A, B and D — and how each applies to your situation. Here's how it breaks down.

Regardless of anything else, your husband may as well sign up for Medicare Part A, which helps to pay for inpatient hospital care, says Vicki Gottlich, senior policy attorney for the Center for Medicare Advocacy, a nonprofit education and advocacy organization. "There's no cost to it," she says — and in the event that he's hospitalized, Medicare might cover services that your employer-sponsored insurance does not.

Medicare Part B, on the other hand, which covers outpatient care, will cost you a monthly premium. If your employer has 20 or more employees, you can delay signing up without incurring a penalty. Many working seniors choose not to pay for Medicare Part B (as well as Part D, for prescription drugs) coverage because it duplicates their employer's plan.

It pays to do a little math before you decide what to do: Your best move will depend on how much you're spending on your husband's outpatient healthcare and whether your current costs are higher than the Part B premium would be.

Advertisement
Los Angeles Times Articles
|
|
|