Gap in domestic Health Insurance coverage, expect higher premiums?
The insurance company is must assume you do have a preexisting condition you are unaware of.  The reason for that is that Affordable Care Act precludes the Insurance company from denying coverage of them if you do.  Insurance companies are businesses.  They are in business to make money(unless you have a nonprofit insurer).  They can not do that if you can buy insurance only when you need for them to pay out.  So even though you may not have a preexisting condition, they are precluded from requiring an examination that would detect the most expensive preexisting conditions (hidden cancers, neurological, autoimmune disorders).  So the companies must do what takes business sense and either deny you coverage or charge a rate that covers the risk they would be forced to take.   In your question on travel there was a response that suggested you get international health insurance instead of travel health insurance that would be considered credible coverage.  You are trying to save money which on a personal level is a good idea.  However that is against the societal and business need that you maintain health coverage during your healthy times to cover the costs of those who need expensive treatment.  So you will be monetarily penalized should you choose to reenter the society of insured people.  Once you have paid the higher rate for up to 18 months you should be able to get a better policy for people who have had continuous coverage.  Alternately you may be lucky enough to start working for a company that provides health insurance with out requiring continuous coverage. I bought Health Insurance for myself after a period without it, and my premiums were not terrible. I was a 27 year old man, living in California, no preexisting conditions, and I paid approximately 90$ a month. This was for a standard Health Insurance plan.  However, when I moved back to NY a little while later, insurance companies wanted almost $500/month for catastrophic coverage.  So, from personal experience, my answer is that price varies widely by state. Different states have different regulations as to what Health Insurance Companies need to cover and at what price. In NY, Health Insurance companies can't charge different rates according to age. Also, in NY, there is a price spiral, where the price is so high, few people buy it, so they have to raise the price because not enough well people are in the pool, so fewer people buy it.... To test it out, go to an online insurance broker, like ehealthinsurace, and put in your proposed information, including that you haven't been covered for a period. This way you will know.
"It seems like if that were true, then if everyone were in one group, you'd get the biggest discount of all.  My preference has been for single payer, but recently I saw a guy suggesting single-group, multi-payer, or SGMP. This was just a comment from a physician in a medical journal, and I don't have the link and haven't been able to find out anything more about it, but it seems intriguing. It had something to do with insurance companies bidding to provide coverage services.  edit: [Here it is](http://www.nejm.org/doi/full/10.1056/NEJMp1211514#t=comments):  &gt; JOEL SPALTER, MD | Physician - Infectious Diseases | Disclosure: None  &gt; FAYETTEVILLE AR  &gt; October 02, 2012  &gt; Single Group Multi-Payer  &gt; True reform resulting in universal health insurance and access to care is achieved by state mandates for insurance with replacement of individual or group underwriting with underwriting by ""Dutch auction"" for a percentage of the single group consisting of all of the residents of a State – Single Group – Multi-Payer (SGMP). Each successful insurance company would be responsible for payment of the percentage of the total costs for medical services equal to the percentage of the population insured. This preserves the integrity of the bidding process.    &gt; States are free to establish the public contribution to premiums. SGMP prevents exclusion of insurance for pre-existing conditions or due to genetic background, absent individual underwriting; guarantees maintenance of health care insurance independent of place, or even existence of employment; assures equality of access to providers due to a single established remuneration scale; and assures patients' choice of providers free from any empanelling by insurance companies. Market forces will govern providers' attempts to gain and hold market share.   &gt; A single group eases statistical comparison, with EMR, of 50, State patterns of care." "&gt;If you have more people in an insurance pool, premium costs go down, which is the whole point of the individual mandate.  The costs depend very, Very, VERY much on WHO the people in the ""pool"" are -- actuarial data shows that older people (almost invariably and by definition) have significantly higher costs, ergo this is why their premiums have been higher (or if a particular pool has an inordinate number of older people in it, why everyone in that pool's premiums are higher, because they are essentially an *average*; and the younger members are in essence subsidizing the older ones -- conversely if a firm has almost entirely young, single people, premium costs are significantly {*significantly*} lower).  One of the things the legislation does though is place an artificial limitation of the premium price differential -- ergo younger people will (across the board) be seeing a HUGE increase in premium costs (because the law is essentially mandating a major increased operating LOSS on the older pool members, the cost WILL be shifted to the younger people).  End result is that premiums for younger people will increase several times over -- which will make buying a policy (which in the past was relatively cheap for young &amp; healthy people) a significantly more difficult burden -- and that will *naturally* make paying the ""fine"" far more financially pragmatic.  This is especially true since the OTHER provision of the law is that known pre-existing conditions cannot be used to exclude or change the premium cost -- so, should the individual be diagnosed with something they can, after the fact, still purchase coverage.  Basically it is like being able to buy a lottery ticket AFTER the number have been drawn.  It is an inherently unstable and unsustainable system." "This is only partly true.  The main problem is that the average person is not a fully informed healthcare consumer.   For example if you go to your local doctor with lower back pain: One doctor might prescribe a whole bunch of expensive diagnostics tests; another might tell you to go to a physiotherapist; and yet another might tell you to take some cheap pain killers and come back in six weeks time if nothing has changed. Most people will have no way of knowing which is the best course of action. Then, in a country like the US which is very litigiousness, all the doctors will recommend the most comprehensive and expensive care-package so that they don't get sued.   Ultimately economists do not work in healthcare and are not qualified to recommend the best financial model for healthcare delivery.  To quote Donney ""Who knew that healthcare was so complicated?"" certainly not the economists." An article linked from cnn.com has some great advice, which I think are good rules of thumb. Also, at least my insurance gives a premium price for those who haven't filed a claim in 5 or more years for homeowners or rental insurance. See if you have a similar discount, will loose it, and guess how much that will cost you over 5 years. My rule of thumb: Your premium might go up quite a bit, possibly as much as triple, especially for a large claim. But, it is certainly worth it if you are going to get more than triple your premium through your claim. The worst case: Mortgage mandated insurance, which will be about triple your current cost. Health insurance is tough, as you know, because the offerings vary dramatically by State, and there is the added complication of the Affordable Care Act, which depending on where and who you are has had either a good or bad impact on the available options. If you are a sole proprietor or other business person, I'd advise talking to someone at a local chamber of commerce. Also, professional organizations like the IEEE or ACM (for IT professionals) often offer catastrophic medical or other health plans. Some employer plans give you the option to continue coverage at a higher cost when COBRA lapses as well. If you can't afford a comprehensive plan, make sure to get something to protect you against pre-existing conditions or hospitalization. At some point, there will even be non wealthy nations with better healthcare.       Anyone who is well travelled, or from another country knows how horrific the US healthcare system is.   The media talks about poor people, but it's awful for the middle to upper middle class too in comparison to alternatives.        It constantly shocks me this is not a bigger public issue.  If only the general population realized what the alternative looks like.  Not perfect by any means, but so much better. "This is the best tl;dr I could make, [original](https://www.aier.org/blog/academics-lift-veil-medical-protectionism) reduced by 79%. (I'm a bot) ***** &gt; In 2011 a total of 538 items required a CON license, and 37 states were enforcing CON laws.  &gt; Non-CON states provide higher-quality services, and the costs of unregulated medical care have not risen dramatically, as claimed by proponents of CON programs.  &gt; According to him, &amp;quot;So-called &amp;#039;certificate of need&amp;#039; laws increase costs for consumers by protecting inefficient hospitals and other health care providers from competition. The theory behind such laws is that since the government has completely unleashed demand by insulating consumers from the cost of their health insurance and medical care, the government must contain supply to keep spending from getting out of hand.""   ***** [**Extended Summary**](http://np.reddit.com/r/autotldr/comments/70ixsd/academics_lift_the_veil_on_medical_protectionism/) | [FAQ](http://np.reddit.com/r/autotldr/comments/31b9fm/faq_autotldr_bot/ ""Version 1.65, ~211185 tl;drs so far."") | [Feedback](http://np.reddit.com/message/compose?to=%23autotldr ""PM's and comments are monitored, constructive feedback is welcome."") | *Top* *keywords*: **laws**^#1 **CON**^#2 **state**^#3 **care**^#4 **Health**^#5" While I can't say how it is in the Philippines, my wife the insurance broker leads me to believe that individual insurance is more expensive than group coverages in the US almost always.  So much so that people will go to great extents to form any sort of business just to insure themselves. If however it is cheaper, can't you simply opt out of your employer's plan?  If you can opt out, will your employer give you any of the money they aren't paying for your insurance? If you can't opt out, or if you paycheck doesn't grow, I can't see why you would want additional coverage especially at such a young age.  Should you lose your job in the near future and you worry about, go get the insurance then. EDIT One big advantage is if you get personal insurance, you might need to get an exam to qualify, and it is likely the younger you are the better you will qualify. But again, you already have insurance that covers you so I would advise keeping the group policy is probably better. According to Money Girl, home insurance premiums are higher if you have a poor credit score. You might self-insure though if you are wealthy. I'm not disputing that. I just said in answer to the guy pointing out that indonesian people earn less that this price might be higher than what the locals pay. Often hospitals will have higher prices for foreigners with insurance etc. So I was actually strengthening your point. This is very interesting, and I am fully in support of the US moving to a single-payer system such as we have here in the UK, but I am a little confused. US costs are markedly higher than the second most expensive country, that's clear. However, by my reading of the data presented, it seems as though no distinction is made between the government paying for health care, and the individual paying for health care. Much of that 1.4t is coming out of the individual's pocket, rather than the insurance company's, and that for me is the crux of the whole issue. Unfortunately I've seen every single example you've provided from the health care providers perspective.  Trust me, they aren't happy about the situation either - hence the reason they will demand up front payment from you based on who your insurance carrier is.  I could name a few of the top brand name insurance companies in this country that do all of this to their clients.   Medical billing is an incredibly over complicated beast.  One that insurance companies have been doing everything they can to make worse over the years.  The codes can change annually and there are MANY different codes which can cover the exact same situation.  Sure the insurance company might cover gallstones, but if you happen to be pregnant, well, that may not covered even though the treatment is the exact same. What can you do? Consider locating a new insurance company.  You do have options and don't have to go with the one your company uses.  The downside is that this is going to take quite a bit of research on your part and it will end up costing you more money on your monthly premiums simply because your company won't be footing part of the bill.   Talk to other co-workers and see if their experiences match yours.  If so, try to get a large enough group together to approach management and demand resolution.   A third potential avenue is to get politically involved - but I'm enough of a pessimist that I doubt that would do any good.  From what I've seen, neither major political party's current position actually does anything to solve the problem. A fourth option is suing the insurance company - but that is going to be incredibly expensive and take forever.  You might have better luck getting together with a bunch of local people and demand your attorney general review the billing/payment practices. Again, this is going to require a LOT of effort. A fifth option is to attempt to cash pay your bills and submit them yourself to the insurance company for reimbursement.  If you do this you can likely negotiate lower bills with the medical provider.  For anything less than about $2,000 I negotiate the amount prior to service.  Believe me when I say that providers are more than happy to give decent discounts if they know they won't have to deal with the insurance companies themselves.  Slightly more work for you, but could be far cheaper in the long run. Article was about insurers not liking the uncertainty. Some insurers want Obamacare repealed, some of them want it to stay. But they all don't want to political climate of uncertainty. A situation where people wouldn't be mandated to buy insurance because they don't fear the IRS actually requiring them, but where the actual regulations haven't been changed yet is a nightmare for insurers. "Not aying you're wron, but do you have any sources showing that young people's premiums will go up SEVERAL times over?  I think your argument would be more convincing with numbers instead of using words like ""far"" and ""significantly""" Prediction: costs won't go down.    The basis for that is the cost of insurance for health has never gone down in the history of that product mainly due to the fixed market.  There is competition, but pricing is so rigged as health insurance companies and employers have completely removed pricing from consumers experience.    Until everyone has individual/independent insurance away from their jobs, healthcare costs will never be in check. When employers gtfo of your business and stop providing benefits and people have to buy their own insurance, that is the only time there will be any real market or real pricing in healthcare/medical.