Author Topic: Dad refuses health insurance - what should I plan for?  (Read 5357 times)


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Dad refuses health insurance - what should I plan for?
« on: June 22, 2015, 07:39:37 PM »
I would like your input and advice to help me prepare for a financial conversation with my dad. My apologies for lack of information - we have never really talked about our personal finances and so Iím sure youíll be looking for details that I donít have yet.

My dad is mid-50s and divorced, lives alone. Heís stated several times that he opts out of his employerís health insurance plan because itís a waste of money. His reasoning is that he doesnít need a doctor to tell him heís sick. He has literally never gone to see a doctor since I have been alive, unless he is hiding it (which I doubt because heís almost proud of it.). He smokes and works as skilled laborer in a job that demands a lot from his body. Heís fit, but his diet is not great and I basically expect that when something goes badly it will go really badly, really quickly. His parents are in their 80s and live out of state basically off social security, my siblings are unhelpful and live out of the country. I am the one with nearby roots, assets, and a sense of family obligation. Do I start setting aside money? Do I offer to pay his

I want to understand what kinds of things I should plan for and what my options are, because I can imagine a situation where he falls ill and is suddenly hospitalized and unable to make medical decisions, and in all likelihood it would be up to me. He is eminently practical and Iím sure that, if he gave it any thought, he would assume that I would make the ďlogicalĒ decision and basically just leave him to die if there was some hospital scenario with a big bill attached.

I plan to just lay out for him that I understand his decision to forego health insurance for his financial position, but Iíd like him to be aware of how that may affect others as he gets older. And I want us to discuss what he sees for himself and his future because chances are good that I will be the one that is around when really is old. I am thinking it will probably be a good time to discuss his wishes if he were to die, too, even though that feels morbid with him being still so young. And honestly I am worried that my husband and I are putting away so much of our savings and it could easily be wiped out by a medical emergency with my dad. 

So my questions are:
  • If he is sick/hospitalized in an emergency situation and does not have means to pay, is there a chance I will be responsible financially? I mean legally held responsible, versus opting to help him after recovery. And what about his mortgage if he canít work? (He has no other debts, is a DIY-er, buys used vehicles in cash, lives very minimally.)
  • Is it possible to take out some kind of insurance policy without him knowing (long term care? others?) if he absolutely refuses to have health insurance or coverage of his own? I would probably inform him I was doing it. Weíre pretty straightforward with each other.
  • Should I start setting aside extra cash just in case or possibly offer to cover his premiums for him?
  • Is it possible he has some minimum coverage that I donít know about?
  • Any advice on how to go about this conversation? My dad is not the type to dismiss me simply for being younger, so that is an advantage I think. He is truly interested in knowledge,whatever the source.
  • What other kinds of scenarios should he and I talk about?
  • Am I overly worried and should I just not even bring it up?

Maybe I am overthinking it but since it popped into my head a few weeks ago I canít really get past it and all my googling led to info about ďseniorsĒ which I donít think he really is yet. Thank you for your advice!

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Re: Dad refuses health insurance - what should I plan for?
« Reply #1 on: June 22, 2015, 08:24:42 PM »
You should do nothing money-wise to fund anything for him. You are not responsible for your father's deliberate choice to not have health insurance. You are in no way legally responsible if he can't pay debts of any kind - unless you co-sign any loans or medical bills, you are free and clear. Obviously, DO NOT OFFER TO DO THIS.

He can get on his workplace's insurance during any open enrollment period as long as he's still working, and there are also bronze level catastrophic coverage that he could get if he's out of work but still under retirement age for Medicare.

You should absolutely have a discussion with him and ask what his plans are if something happens and he has no medical coverage. We plan for emergencies to be prepared, not because we 100% expect them to happen. Better to have a plan and not use it, than have no plan when a disaster strikes. Medical care in the U.S is stupid expensive without insurance, so he may be "penny wise and pound foolish."

I get that you love him and want him to take care of himself, but you need to distance yourself from feeling responsible for a grown adult's decision. It sounds like you've gotten yourself really worked up over a possibility that you might have to step in, and you shouldn't do this. You figure out what level of help you can give without putting your own life or your spouse/kids' lives in jeopardy.

There are things he can negotiate, even in the event that he runs up hundreds of thousands of dollars debt, but you should not have to be involved at all.

« Last Edit: June 22, 2015, 09:38:34 PM by Frankies Girl »


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Re: Dad refuses health insurance - what should I plan for?
« Reply #2 on: June 22, 2015, 09:15:39 PM »
I'm not sure whether your father is in the US. But if he is, the fee for not having health insurance is 2% of his income in 2015, and goes up to 2.5% next year.

It might be worth building the conversation around this. Maybe start by comparing the cost of insurance to the cost of being uninsured.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #3 on: June 22, 2015, 09:25:31 PM »
You are not responsible for any debts your father may have.  Hospitals must treat emergencies regardless of ability to pay, so that's something.  Follow up care may be hard to find.  If your dad goes to the hospital and cannot pay the bills, then he will probably declare bankruptcy.  DO NOT GET INVOLVED.  Do not sign any papers.  Do not give him money.  Find free or sliding scale clinics and sign him up if the need arises.  They are a PITA, but they do exist in every metropolitan area.  If he's still able to work after a situation like this maybe he can sign up for insurance during the next open enrollment. 

TL;DR Worst case scenario: Bankruptcy + free or low cost clinics.  You do not have to pay for his mistakes, just be there to guide him if he needs it.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #4 on: June 22, 2015, 09:32:42 PM »
You won't be able to make health or financial decisions for him if he becomes incapable unless he has created what's called a springing Power of Attorney for each. "Springing" means that it takes certification of the incapacitating event before his designee gains control. You will also need his medical records release. He also needs a Living Will document that details his choices of whether he wants extraordinary measures, including resuscitation, during a terminal illness. These 4 documents are crucial -- without them, you will have to go through an expensive & time consuming legal procedure to help your dad.

Expecting you to fund what is his responsibility is not fair to your immediate family. Take care of yourselves first.
You are not legally or morally responsible for paying for any of his care.
If he becomes disabled & can't pay his mortgage, he will eventually lose his house.
Getting disability or medical insurance for him without a medical examination will be about impossible.
If he becomes indigent he should qualify for Medicaid.

You are correct in thinking that without any medical examination & routine preventative measures, your dad is highly likely to succumb to something very quickly. As we age, most usually need some supplementation -- this is what has increased our life expectancy from earlier generations.  Tell him that when he finally feels ill, it will likely be way too late.

DH's cousin was like a brother but routinely ignored his health. He lived alone & was found in a diabetic coma; while he survived, he couldn't talk, needed a feeding tube, lost most cognitive ability, & lived from then on in nursing homes. His twin adult daughters had to arrange for an expensive guardianship. Since his prognosis was so bad, they sold his house & held a sale of all his belongings to raise cash for his care. He died about 2 years later.

A friend was diagnosed with lung cancer at age 60 & died 6 weeks later. She was a long time smoker & didn't "do doctors". My mother died at 70 from lung cancer, but did have medical care to help with her quality of life. She lived about a year & we had hospice care at my home at the end.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #5 on: June 22, 2015, 10:09:07 PM »
You won't be able to make health or financial decisions for him if he becomes incapable unless he has created what's called a springing Power of Attorney for each.

This has not been my experience WRT:  health decisions.  My dad's declined into dementia without providing a health-care POA and I am his decision-maker, welcomed as such by care providers (including his nursing home and two major hospitals in our area).  I think the context where problems arise (and clearly they can) is if there's a conflict among the next-of-kin in a situation where there is no legally designated POA.

I'm certainly not advocating against a health-care POA; I have one and understand that they are important.  But my experience in practice is that (again, as long as there's not a conflict among other family members) they are not needed.

As for the health insurance -- ugh.  Sorry, I have no advice, but plenty of empathy.  My dad relied on low-cost clinics until he qualified for Medicare (age 65+); he did have the sense to pay that premium, at least.  He's now on Medicaid (assists the poor elderly, disabled, or others who qualify -- generally not able-bodied adults without dependents, I don't think.  The ACA may have changed that.) to cover his nursing home care.  It's nerve-wracking.  I am always and perpetually careful to avoid signing anything that identifies me as the "responsible party," though I will sign as a decision maker (about what kind of care is needed/OK).

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Re: Dad refuses health insurance - what should I plan for?
« Reply #6 on: June 23, 2015, 03:04:32 AM »
I think you only need to worry about health insurance for your father if you want an inheritance from him.

Oops, that sounds cold.

But as long as you are living in a first world country (even in the USA), in an emergency he can go to an ER, or you can call an ambulance, and he will be treated first and asked for payment afterwards.  (If it's not an emergency, given your father's attitude you probably won't know about it until it has become an emergency.)

If there is an emergency and you are contacted by your father or by a medical provider, you will probably be upset, and worried, and feel harried and hassled and have to rearrange your life at short notice and with considerable difficulty in order to be present and perhaps make decisions.  It is at that point which you may be given a piece of paper to sign, quite possibly being told that it is routine, that it is necessary in order for you to be given information about your father's condition or in order to be allowed to see him or in order to be allowed to talk to the doctor or make decisions about what happens to him.  DON'T SIGN ANYTHING under those conditions.  And apologies for shouting there, but it would be very easy to make a mistake and sign in haste only to repent at leisure when you found that you had assumed responsibility for his finances.  Don't sign anything without assurance from a lawyer whom you personally are paying for the advice that it will not make you responsible for your father's medical expenses.

As long as you have not assumed responsibility for his medical expenses, it will be up to the medical provider to retrieve costs from your father.  Usually some arrangement can be reached.  If not, your father may become bankrupt through medical expenses, but that too can be dealt with.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #7 on: June 23, 2015, 02:15:17 PM »
Thank you all for taking the time to respond. I feel much more prepared now thanks to your comments and knowledge.

I still plan to have a discussion with my dad, but I have a better approach in mind now I think - just lending him another perspective. DH and I want to have some tiny humans pretty soon and we'd like them to know their granddad and get to spend lots of time with him, and we would like him to be healthy enough to enjoy that while they grow up. We are in the US, and I think the penalty is also a good topic that I hadn't considered. I will let him make his own decisions from there. If he is willing we can talk about his plans in case of an emergency. I had wanted to find a way for him to be taken care of if he gets sick but you're right - there is only so much that DH and I can be responsible for and soon (hopefully) we will have a little family of our own.

I'm also glad to know the kinds of things that might happen in an emergency so if something happens I'll be less likely to sign something stupid just because a doctor is putting it in front of me. Thanks again everyone! 


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Re: Dad refuses health insurance - what should I plan for?
« Reply #8 on: June 23, 2015, 02:37:13 PM »
A small, local non-profit never carried insurance due to a key board member's insistence that they were too small to need it. (Wrong.) Recently, the board member was traveling and his dear wife had a fall and injury that is going to end up costing hundreds of thousands, if not millions. Their health insurance + travel insurance is covering most, if not all of their costs. Sad situation indeed, but now he's looking into insurance for the non-profit.

Your dad is unlikely to change his mind without a similar epiphany. Help him with your words and deeds, not your money. Do not sign or co-sign for anything that he is responsible for. Resign yourself to the fact that you may never inherit anything from him, if that matters to you. Also, if he didn't insure himself for his own children's protection, the grandchildren argument probably will not fly either. Accept your dad for who he is and move on.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #9 on: June 23, 2015, 08:13:09 PM »
I just want to clarify some of the health care POA discussion, I'm a medical social worker and help people fill out advance directives daily. I'd definitely check your state's surrogacy laws (in Illinois it's called the Illinois Healthcare Surrogate Act for example). This will outline who will have legal decision making power and in what order if no advance directive, living will etc is in place. Usually a spouse is first. If there is no legal spouse (make sure the divorce is official! This comes up more than you think!), adult children are next and have equal decision making power. That doesn't necessarily mean that all your siblings have to be involved, they could defer their decision to you and as another commentator mentioned docs don't always do their due diligence and will talk to whatever child is there and go with it.

Just want to make sure it's clear that it isn't the case that you have no power at all if he doesn't fill out an advance directive. Yes it is important, yes it's helpful and will protect him/you, but there are also laws in place to designate who will make those decisions in the case that he never fills one out. It just gets really sticky if you aren't someone that would fall under those surrogacy laws, but you likely would as his adult child. I would check your state's specific laws so you are informed if the situation arises.

One recommendation - if you think you will end up being your father's healthcare power of attorney at some point, I always recommend people start having discussions with family members about what their end of life wishes are. These discussions can be difficult, but it might also help to get an idea of your Dad's perceptions of end of life and what he wants his end of life care to look like. If you get lucky - maybe slow discussions over time about these issues will help him think a little more deeply about what he wants and consider the impacts of his current choice to not have health insurance.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #10 on: June 24, 2015, 06:25:14 AM »
If something does happen to your dad and he wracks up a bunch of hospital bills but pulls through I don't think you are obligated to help him with the aftermath. But if you want to help, it might be better (and cheaper!) to wait for him declare bankruptcy and then help him get back on his feet rather than pouring money into try to avoid a bankruptcy.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #11 on: June 24, 2015, 06:41:17 AM »
This sounds idiotic. Refusing health insurance when you're 20-30 is one thing (although still pretty stupid), but when you're 50+ and doing manual labor? Holycrap, that's just asking for a $500,000 bill! Either from an accident or a heart issue or a million other things. Does he have his appendix? Even that could cost a fortune! I don't go to the doctor either, but catastrophic health insurance I consider a must. If he don't see this I doubt he'll listen to reason though.


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Re: Dad refuses health insurance - what should I plan for?
« Reply #12 on: June 24, 2015, 12:58:29 PM »
Thanks again for the follow-ups everyone. Yes, I think it's pretty stupid to be gambling like he is especially with the type of work he does. I guess we'll see what comes out of a chat when I see him next.

On the bright side, my mom just sent me this text: "Increased my retirement contributions to 50% so I can max it out this year. You got me working on it." Of course that has absolutely nothing to do with my dad's situation (they're long-divorced) but it was a nice thing to see. :-)