how do US professional runners (like at least sub 2:16 marathoner types) get health insurance?

buffet rule not wrote:

Jeff Wigand wrote:

I should have clarified: an MRI in a private clinic/possible. Why was that not an option?

Maybe it was. I don't know. Are there a lot of private clinics in Canada with MRI machines? I can't imagine that there is a huge market in Canada where people come out of pocket $2K for MRIs.

That's really just about the best system available, isn't it? Everyone has a minimum level of coverage, no one goes bankrupt from medical problems, if you want a procedure or test like your friend did with his MRI, he can go the private route to get it done sooner and the per person cost for health care is a fraction of what it is in the US.

One of the major problems with health insurance in this country is that everyone has been more or less brainwashed into thinking we have the best system in the world. For the very rich, yes, this is true. However, for everyone else, we're not even in the top 10 by almost every metric available. Also, we pay way more per person than any other country.

I understand that a lot of people do not like the idea of socialized medicine, but we have to be realistic. If we are paying more than everyone else and on the average getting sicker, having more infants dying, and living shorter lives than all these other "socialized" or "semi-socialized" countries, you have to stop and think we might be doing something wrong.

Also, to group all of Europe together is naive. They almost all have universal health insurance but Germany and England for example are very different in the way coverage is provided. For those that are interested in universal coverage but don't like the idea of totally socialized medicine, read up on the Bismarck Model.

genetic_dysfunction wrote:

Te reality is that an elite marathoner is likely to need far more medical attention than a generally healthy person who runs say 20 miles a week or who works out 5 days a week 30 minutes a day. Taxing your body on a regular basis like elite runners do leads to far increased medical attention, as a group. There are of course always outliers. Insurance companies must know that while runnnig 120 miles a week will make you healthier in many regards, it makes many sonewhat less healthy or at least needing more medical attention, in other regards.

Why does an insurance company need to know you run 120 miles a week? If you're a 2:16-7 guy you are probably not making a full living off of running and have a part time job. So you are a part time employee at _____ and you want to buy health insurance. Why do they need to know your weekly mileage or that you are an "elite" athlete at all?

Is there a cutoff. If your marathon PR is such and such you're an elite and you can't buy health insurance, but over that and you can? [sarcasm/]

The real question being asked is how does a person who works part time and maybe runs some marathons recreationally gets health insurance. Your mileage or how fast you run shouldn't affect anything. I've never applied, but if the question really asked how much do I exercise I wouldn't answer truthfully and say 120 miles a week and how would they know the difference?

sponsored athletes are not employees. no coverage unless you are top 10 in the world. Even Haile G had issues with a bum knee some years back, and adidas does not cover his medical. had to wait til he was in NYC, days before the marathon for MRI. NYYRR covered these costs.

HSA is the best option for sub elite types looking for coverage unless their employer pik up a portion of a usual plan

Jeff Wigand wrote:

buffet rule not wrote:

Maybe it was. I don't know. Are there a lot of private clinics in Canada with MRI machines? I can't imagine that there is a huge market in Canada where people come out of pocket $2K for MRIs.

That's really just about the best system available, isn't it? Everyone has a minimum level of coverage, no one goes bankrupt from medical problems, if you want a procedure or test like your friend did with his MRI, he can go the private route to get it done sooner and the per person cost for health care is a fraction of what it is in the US.

On the surface, yes, it seems better. However, Canada has a tiny largely homogenous population that is relatively healthy. In America, we have an obesity epidemic and an enormous segment of the population that is completely unfit. Why should I subsidize the millions of people who weight > 300 pounds, smoke, drink too much and eat fast food at least once a day? One of the biggest jokes of Obamacare is that it prohibits insurance companies from charging fat people higher premiums. How about we start charging much higher premiums to people with extremely high BMIs or who do hard drugs? My guess is that you would see a marked improvement in the overall health in the US.

Glycerin Runner wrote:

sponsored athletes are not employees. no coverage unless you are top 10 in the world. Even Haile G had issues with a bum knee some years back, and adidas does not cover his medical. had to wait til he was in NYC, days before the marathon for MRI. NYYRR covered these costs.

HSA is the best option for sub elite types looking for coverage unless their employer pik up a portion of a usual plan

Thanks bro. What is HSA?

guest1 wrote:

If you list your job as professional athlete (even if it's running) many insurance companies will deny you coverage. I know this for a fact because I used to be a professional runner.

Also many of these affordable plans people are talking about have really high deductibles and copays which is fine for most people who never go to the doctor, but it can be very expensive if you have weekly chiropractor or PT visits, or are seeing the orthopedic doctor for an injury.

The USOC health insurance which is available for athletes who have finished in the top 2 at USAs technically doesn't even cover running related injuries; those expenses have to be filed through a secondary USATF insurance company. It is a crazy system.

This is all correct. After having really decent insurance for 10 years through my job with a big corporation (EDS), I lost that when I got laid off in 2002. I got a different job (in a small business) where I paid my insurance but it was pretty terrible. It was about $190 a month and I didn't go to the doctor for most of 2003 and 2004. When I started going again in 2005 I found out that they didn't cover more than one office visit per quarter, and everything had a 25% co-pay.

I thought this was a rip-off and just decided to stop my insurance and take my chances. A couple years went by and I really felt like it wast irresponsible to no have any so I went shopping for it again. To purchase it as an individual, is really difficult and really expensive (In my opinion).

I applied to several different companies (through an agent), and they had questionnaires that would ask about previous illnesses, surgeries, heart conditions, STDs, and YES even acne.

This was a big wake-up call, as I had always had great insurance as a kid through my Mother (State employee), and then through EDS. Their coverage started out great in 1992 and gradually eroded to just satisfactory by 2002. Well, one company after another DENIED me. My agent, who is a friend of mine, told me it was going to be the same answer every time and I would have to apply to BCBS. They accept anyone, regardless of history. I picked that insurance up in 2009.

They are able to accept anyone because of this:

1- No claims paid for ANYTHING you have been treated for before you have 6 months of premiums IN.

2- My deductible is $2500.

3- My premium is $195 (I am 42)

4- No mental health benefits at all.

5- They only pay for TWO office visits per year.

6- There is a 25% copay for EVERYTHING once you meet your deductible.

7- The RX copay is so difficult to understand I have given up. But I still pay $175 a month for a covered prescription that used to be $70 under my old insurance.

SO between the deduc. and my premiums I am in for $4900 a year guaranteed. If you have to see a specialist, it is $90-450 per appointment. So, once you have seen two in a year, that can be THOUSANDS.

In 2010, I had some was hit with some major illnesses that they had a hard time diagnosing. On my tax forms at the end of 2010, I added it up for the first time:

$16,000 spent on premiums/labs/off. visits/RX in one year.

I only make $33,000 a year.

The moral? Don't lose your insurance. If you do, get some new insurance. Don't get sick, if you do, read the rules VERY CAREFULLY, so you know what is covered and what is not.

Better yet, marry a teacher, or a professor, or a Government employee. Use the hell out of their insurance for as long as you can.

I still don't know what Health Care Reform will really mean to the middle class, or to me, but if it is an improvement over what I have experienced over the last 10 years, I will welcome it.

It's a fcked up system. There's no question about it.

Im wondering if we serious runners and post collegiate olympic hopefuls who want to work part time and train our ass off for fun can get decent health insurance to cover for running injuries? If anyone's interested we should all get together and present a plan before an insurance underwriter and see if they'd be willing to start a group plan for us.....As serious distance runners we are healthier in many ways than the rest of the population, but are more prone (probably) to short term musculoskeletal injuries from time to time. Together we could be very profitable for the insurance companies overall. Please respond below if you are interested in joining as part of such a group plan pool. We can make this happen!

I understand your frustration with lots of obese Americans. I don't think you would see any improvement by doing that though. Some people are obese because of an actual disease that causes swelling and not simple lack of discipline. To exclude those people would be unfair.

I believe the US supreme court is supposed to be coming out with a decision on the mandates within a few months.

i have a hard time believing that a group of post collegiate runners would be profitable to an insurance company. yes, such a group likely would not have many very expensive medical treatments (eg, cancer, heart issues, diabetes, etc) but it's almost guaranteed that some (most?) of the group will be injured and injured often. the almost certain cost of MRIs, doctor fees, PT, etc would eat up whatever premiums are paid. moreover, such a group would be microscopic in the big picture (maybe 100 or 200 people) to an insurance company. the big money for insurance companies is guys in their 20s who pay their premiums and never see anyone in the medical world. that's not a group of serious runners.

buffet rule not wrote:

the big money for insurance companies is guys in their 20s who pay their premiums and never see anyone in the medical world. that's not a group of serious runners.

Yes, but those people lose their jobs, get excluded from their plans when they get sick from sitting for too many hours in an office chair.

haha yo (super cereal) wrote:

I understand your frustration with lots of obese Americans. I don't think you would see any improvement by doing that though. Some people are obese because of an actual disease that causes swelling and not simple lack of discipline. To exclude those people would be unfair.

Wouldn't most policies would make you pay more if you'd had, say, cancer, or not cover you at all.

Answering your question from the previous page, I pay $2,070 per year to insure myself and my son. I'm eligible to go on my wife's state provided policy but that would actually double my cost.Where does your friend live that he's paying $900 a month. Massachusetts (last I checked they had the most expensive insurance in the country)? Has he shopped around? Whenever my provider jacks up my premiums, I change companies.

Jeff Wigand wrote:

That's really just about the best system available, isn't it? Everyone has a minimum level of coverage, no one goes bankrupt from medical problems....

Regarding Canada, the part about nobody going bankrupt isn't true. The second leading cause of bankruptcy in Canada is medical costs. The provincial health insurance doesn't cover everything. In fact most of the plans don't cover cancer drugs beyond the initial treatment because they're very expensive.

To the other posters who think something magical is going to happen in 2014 to make insurance more affordable. Basically 2 things will happen:

1. Insurance companies will no longer be able to deny you for a preexisting condition. While that will make it easier for someone who has been denied to get insurance, the net effect for the vast majority will be to make insurance much more expensive.

2. It will be a crime for you to not be insured. If you don't have insurance you will be fined by the IRS. If you don't pay the fine, men with guns will come to your house and haul you off to jail.

Land of the free my a**.

He was in California. I don't know much beyond what I wrote. He also had another one on the way at the time.

As long as people can receive medical care without any concern to their ability to pay, stick the hospital with the bill or declare bankruptcy because of medical expenses, something will need to change. And it's not going to be the EMTALA.

Would you prefer a single payer system? It's really no different than if you don't pay your taxes in 2012. Eventually, they can take you to jail. Find me a society in the history of humanity that wasn't based on redistributing wealth.

Jeff Wigand wrote:

As long as people can receive medical care without any concern to their ability to pay, stick the hospital with the bill or declare bankruptcy because of medical expenses, something will need to change. And it's not going to be the EMTALA.

Would you prefer a single payer system? It's really no different than if you don't pay your taxes in 2012. Eventually, they can take you to jail. Find me a society in the history of humanity that wasn't based on redistributing wealth.

If your argument is that the health care system in the US is a mess and needs to be fixed, I wholeheartedly agree with you. But I think Obamacare is the worst system ever devised. It will make healthcare even more expensive. And for the first time in US history it will be a crime for you to not engage in commerce.

Would I prefer single payer? No, that won't stop bankruptcies and leads to rationing. Reducing government regulation combined with tax credits to buy insurance would solve the problem for most people. For the relatively small number who honestly can't obtain insurance, you'd could cover them with an expansion of medicaid. This would be far cheaper than what Obamacare will do.

Also, I don't buy your premise that every society has been based on the redistribution of wealth. You have to look no further than the first century of our country's existence. We didn't start taking money from people to give to other people until the late 19th century.

Blowing.Rock Master wrote:

You have to look no further than the first century of our country's existence. We didn't start taking money from people to give to other people until the late 19th century.

What do you call tariffs?

haha yo (super cereal) wrote:

Im wondering if we serious runners and post collegiate olympic hopefuls who want to work part time and train our ass off for fun can get decent health insurance to cover for running injuries? If anyone's interested we should all get together and present a plan before an insurance underwriter and see if they'd be willing to start a group plan for us.....As serious distance runners we are healthier in many ways than the rest of the population, but are more prone (probably) to short term musculoskeletal injuries from time to time. Together we could be very profitable for the insurance companies overall. Please respond below if you are interested in joining as part of such a group plan pool. We can make this happen!

If your plan would be "very profitable for the insurance companies overall," then wouldn't we, on average, be paying more money under your plan than we currently pay out of pocket?

more expensive than if you took a job at a grocery store and joined a group plan? maybe so. but at least you'd have that option of paying more in premiums so you wouldn't have to work and you wouldn't get excluded for preexisting trying to buy individual health insurance on your own.

Jeff Wigand wrote:

Blowing.Rock Master wrote:

You have to look no further than the first century of our country's existence. We didn't start taking money from people to give to other people until the late 19th century.

What do you call tariffs?

a form of revenue to help pay for the government. i think you missed the part about REDISTRIBUTION of wealth that didn't start until just over 100 years ago. in 1800, if you were lazy and/or stupid, you lived in a shack and hopefully were good with a gun to shoot your meals. there were no handouts. in 2012, if you are lazy/stupid, you get free healthcare, free food, free education and even free outright money.