Health insurance quandary (medical, plan, doctor, coverage)

[ccsutton]

I have a quandary I'm trying to think through and could use some help/reactions.

My boyfriend and I are planning on marrying later this year. He has run his own business for the past three years, and unfortunately the recession has taken its toll and he's having to shut it down. Due to the precarious state of his finances the past couple of years, he hasn't bought health insurance. So he is, today, uninsured and has no assets. I don't know how little one has to earn to be entitled to Medicaid but he's unlikely to qualify because he did earn approximately 30-40k last year; the costs of running the business, however, exceeded that.

I am currently changing careers and attending school for a second bachelor's degree. I am on the school's health insurance plan. I have a fair amount of savings that we're planning on living off of while I'm in school/making our nest egg.

Over the past few months, he's developed symptoms that have us both worried: frequent headaches, double/blurred vision, waking up in the middle of the night unable to breathe, and symptoms of an ulcer. These things could be related or separate incidents - who knows.

Here's the question: considering we're going to get married anyway, would it make more sense to a) go to a justice of the peace ASAP, put him on my insurance plan and then run the medical gauntlet?; or b) since he has no assets, should he go to the ER and (potentially) incur tends of thousands (or more) in costs if any/all of these symptoms are the result of something serious -- letting that debt stay with him as a single person?

I want to get him looked at as soon as possible, but in the most cost-effective way possible. What's the best way to do this so we get him help fast but don't torpedo ourselves financially?

Any thoughts appreciated. Thanks.

[Briolat21]

Tough decision. If you're fine with him filing bankruptcy due to medical reasons - then leaving him off your insurance to go it alone is reasonable. Technically this could be "nothing" or due to anxiety or something like that - it doesn't have to be something horrible.

However, if your insurance is reasonable in its coverage - then I think marrying now in a civil ceremony and having the real ceremony later is not a bad thing. I'm not sure if you're automatically responsible for his medical debt if its incurred after you marry. I think that may depend on the state. Where I have lived unless the spouse cosigns on the debt, it does not transfer to them. So you still would not be responsible for the debt even if it was incurred after your marriage...

Good luck either way - hope they are able to help him.

(Congrats on the upcoming wedding - whether you do it early or not.)

[christina0001]

Okay, rather than going to the ER, the most expensive option possible, it would be a lot cheaper to go to a family practioner (cost will be appx. $150 depending on where you live + cost of any tests the doctor runs).
I know where I live, if you go to the ER with a complaint like that, not only will they run super-expensive tests to assure he is medically stable, but they will also likely then just refer him to a specialist for follow up tests, medication, etc. So, the ER visit may not even resolve the complaint.
If you are both confident that you want to get married, then go for it! Otherwise I would personally chip into my savings a bit and send him to the doctor. I'd rather spend a few hundred on a doctor's visit, than have to deal with a ER bill that's double, triple, quadruple that amount at minimum.

[ccsutton]

Thanks to you both ... this is great. I guess the one question I left out is: if we send him to a private doctor now (i.e. before we marry) and something IS wrong, is he then then in that "pre-existing condition" situation? Let's say he has, God forbid, a brain tumor. If they turn that up when he's not on an insurance plan, can he then not get covered by my student insurance and we wind up facing thousands of dollars in medical liability?

I guess... based on the first poster's comment, an option the would be to then have him declare bankruptcy due to medical anyway, and our (my) savings remain untouched perhaps. So either way ("shotgun" wedding or not) maybe there's a resolution that protects our finances and still gets him attention.

Thanks!

[Briolat21]

Whether or not he can be covered right away on your insurance will depend on your insurance. Most employer based coverage (I know you are a student so yours may be different) will allow immediate coverage of a new spouse - with the exception of a waiting period of 3 months (sometimes 6 - but that's rare) for preexisting conditions if the spouse had a GAP in coverage.

That would be your boyfriend. So yes - in that case getting this diagnosed before he is covered would jeapordize his future coverage.

You will need to check with your health insurance (tell them you're getting married -- you are getting married, the question is just WHEN - and ask them what their policies are for adding a spouse, etc..) to find out what their policies are.

You may also want to find out what your state laws are regarding liability of spouses for medical debt. Every state is different -- you should be able to check with legal aid (almost every university has a free legal aid clinic to help students navigate common/simple legal issues) to find this out.

Personally - I would lean towards getting married now (civil ceremony) with a fancier ceremony for friends/family later - and get him covered on insurance. However - depending upon your state - that could give you some liability for the medical bills that are not covered by insurance. So you will definitely want to look into/think about that.

But to make sure you have all the info you need - check with your insurance about their policies for adding spouses and pre-existing conditions (you can say you think he had asthma as a kid or something like that..) -- and check with legal aid to find out what your state laws are on the spousal responsibility for medical debt.

Good luck!!