Health insurance - any recommendations?

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Health insurance - any recommendations?

Postby jonny781 » Wed Jun 26, 2013 5:25 pm

I am about to be 26 years old, self employed, and need to have health insurance in place within the next month. Wanted to see if you guys had any recommendations of companies / websites to get quotes and compare information.

I don't have any medical problems and don't go to the doctor much. I have done some research but see most plans don't cover Emergency Room visits until deductible paid, which seems like could be problem as any serious health issues would probably result in an ER visit compared to anything else. Any ideas or recommendations on options you guys have picked?
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Re: Health insurance - any recommendations?

Postby chaz » Wed Jun 26, 2013 5:37 pm

Try Blue Cross.
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Re: Health insurance - any recommendations?

Postby pennstater2005 » Wed Jun 26, 2013 5:44 pm

chaz wrote:Try Blue Cross.


Agree. I have direct blue. I'm 34 and pay $125 a month with a $250 deductible. That is 90/10 coverage. I didn't think that was too bad.
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Re: Health insurance - any recommendations?

Postby jonny781 » Wed Jun 26, 2013 5:48 pm

pennstater2005 wrote:
chaz wrote:Try Blue Cross.


Agree. I have direct blue. I'm 34 and pay $125 a month with a $250 deductible. That is 90/10 coverage. I didn't think that was too bad.



How did you find that insurance plan? Seems like every plan I'm looking at starts with deductibles of at least $1-3k
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Re: Health insurance - any recommendations?

Postby dsanders79 » Wed Jun 26, 2013 5:51 pm

Costco now sells health insurance in certain states. If my memory serves me correctly, they are reselling Aetna. When I did a quick glance, it seemed pretty competitive to what I get at my work.

If you're eligible, USAA also has some options.
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Re: Health insurance - any recommendations?

Postby pennstater2005 » Wed Jun 26, 2013 5:55 pm

jonny781 wrote:
pennstater2005 wrote:
chaz wrote:Try Blue Cross.


Agree. I have direct blue. I'm 34 and pay $125 a month with a $250 deductible. That is 90/10 coverage. I didn't think that was too bad.



How did you find that insurance plan? Seems like every plan I'm looking at starts with deductibles of at least $1-3k


Highmarkbcbs.com
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Re: Health insurance - any recommendations?

Postby jonny781 » Thu Jun 27, 2013 8:02 pm

Unfortunately that site doesn't service California. All the plans I'm seeing have deductibles starting in the thousands. Could it be that California is just very high health insurance state?
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Re: Health insurance - any recommendations?

Postby dsanders79 » Thu Jun 27, 2013 8:47 pm

Are you maybe looking at high deductible / hsa plans? If so, you may want to read what the wiki has to say about them.

http://www.bogleheads.org/wiki/Health_Savings_Account
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Re: Health insurance - any recommendations?

Postby jeffyscott » Sat Jun 29, 2013 8:58 am

jonny781 wrote:Unfortunately that site doesn't service California. All the plans I'm seeing have deductibles starting in the thousands. Could it be that California is just very high health insurance state?


If you are in California, this http://www.coveredca.com/calculating_the_cost.html
gives an eztimate of $236 per month for a "silver" plan, with no subsidy.

If you wanted to use the exchange, you could get a temporary policy to cover you to the end of the year.
press on, regardless - John C. Bogle
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Re: Health insurance - any recommendations?

Postby jonny781 » Mon Jul 01, 2013 10:36 pm

Thanks for the link Jeffy, I already checked that. Those still have the couple thousand deductibles and then out of pocket expense max around 6-7k. It seems that Cigna and Blue Cross offer better plans at the moment than what the exchange is estimated at for 2014. It seems that I might just have to bite the bullet as it looks like California health insurance is just higher than many other states.

Right now I'm considering just getting a Healthnet PPO at $99 a month with a $4k deductible (out of pocket max is the same and includes deductible) and 2 office visits to DR at $50, unlimited $50 CVS MinuteClinics and other than that then have to pay until deductible. I could afford to pay more but it just doesn't seem like most plans offer much for the higher amounts if you don't expect to see the doctor too much (my biggest concern is for emergencies / ER).

Another possibility I saw is Healthnet HMO at $205 / month with no deductible, $50 dr visits, $300 ER visits but without knowing much about Healthnet,I'm not sure if that would be risky trusting in their HMO.
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Re: Health insurance - any recommendations?

Postby dm200 » Tue Jul 02, 2013 10:21 am

If you are in one of its service areas, I highly recommend Kaiser Permanente HMO. Since Kaiser is both the insurance company AND medical provider, there will not be claims to file, waiting for reimbursement and arguments between doctors and insurance company.
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Re: Health insurance - any recommendations?

Postby englishgirl » Tue Jul 02, 2013 10:31 am

jonny781 wrote:... I have done some research but see most plans don't cover Emergency Room visits until deductible paid, which seems like could be problem as any serious health issues would probably result in an ER visit compared to anything else...


Just a comment on this - they generally won't PAY until after your deductible is paid, but that doesn't mean you can't go there. If your first visit of the year to any healthcare provider is to an ER after a car crash, and the ER charges $50,000 (say), and your deductible is $5,000, then you have to pay the $5,000, and the insurance would kick in on the next $45,000 of the charge - paying however much of the fee the plan has agreed to. [As far as I know. I'm still learning.]

Generally, people suggest to look at ehealthinsurance.com. I tooled around on that site for a bit but ended up going straight to Florida Blue (the new name of our Blue Cross/Blue Shield company), as they had plans which suited me better and were actually cheaper. That Healthnet PPO plan you mentioned looks good, though. Also check if your local hospitals are in network or not.

And don't be tempted by any sales nonsense about getting the plan in ahead of Obamacare. I had a sales person call the other week (I just opened a business, so they are trawling, and I didn't tell them I already had individual coverage), and they were trying to tell me that if I buy now, I'll be grandfathered in and won't have to change my plan next year. Which a) is incorrect as far as I know, because I think you have to have bought the plan before whatever date in 2010 to be grandfathered in with no changes, and b) my plan doesn't meet the minimum standards under Obamacare, so I wouldn't mind getting better coverage as long as it's not too much more money.
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Re: Health insurance - any recommendations?

Postby bluemarlin08 » Tue Jul 02, 2013 10:46 am

For most policies, one doesn't have to be in compliance with ACA until the renewal date in 2014. It can make sense to change to a carrier that has the first renewal date of December 31, 2014.
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Re: Health insurance - any recommendations?

Postby JMacDonald » Tue Jul 02, 2013 10:50 am

dm200 wrote:If you are in one of its service areas, I highly recommend Kaiser Permanente HMO. Since Kaiser is both the insurance company AND medical provider, there will not be claims to file, waiting for reimbursement and arguments between doctors and insurance company.

I also have Kaiser and am very happy with it. If you are in a Kaiser area, check it out to see if it will work for you.
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Re: Health insurance - any recommendations?

Postby dm200 » Tue Jul 02, 2013 11:15 am

JMacDonald wrote:
dm200 wrote:If you are in one of its service areas, I highly recommend Kaiser Permanente HMO. Since Kaiser is both the insurance company AND medical provider, there will not be claims to file, waiting for reimbursement and arguments between doctors and insurance company.

I also have Kaiser and am very happy with it. If you are in a Kaiser area, check it out to see if it will work for you.


I think that Kaiser offers something like a high deductible plan as well, if lower premiums and being able to pay a higher deductible fits your needs. I know there are a lot of individual options in most (probably all) Kaiser areas.
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Re: Health insurance - any recommendations?

Postby fandango » Tue Jul 02, 2013 1:32 pm

Go to a local insurance agent and have a discussion about your insurance needs with them.

Their services usually do not cost you anything (paid by insurance companies), and they have a wealth of knowledge to guide you through this process.
Plus they are usually very famliar with local insurance networks and customer service from various insurance companies.

I have found them to be most helpful to me.
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Re: Health insurance - any recommendations?

Postby jonny781 » Tue Jul 02, 2013 3:30 pm

Thanks for everyones feedback and help. I spoke with some local insurance agents and seems Healthnet at $105 / month, $4k deductible/max out of pocket is best option for now.

Dental and Eye care seem to be a whole different discussion but general consensus seems to be that they usually are never worth the money. Looked at some discount plans instead for Dental but even then it seems that just paying cash might be best.
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Re: Health insurance - any recommendations?

Postby pennstater2005 » Tue Jul 02, 2013 8:55 pm

jonny781 wrote:Thanks for everyones feedback and help. I spoke with some local insurance agents and seems Healthnet at $105 / month, $4k deductible/max out of pocket is best option for now.

Dental and Eye care seem to be a whole different discussion but general consensus seems to be that they usually are never worth the money. Looked at some discount plans instead for Dental but even then it seems that just paying cash might be best.


As far as the eye care goes if you don't require anything special I can recommend Americas Best. I got two pair of glasses and the eye exam for a grand total of around $75. They will try and up sell you everything in the store but if you just get the glasses/exam and get out you'll do ok. Assuming you have America's Best in your area.
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Re: Health insurance - any recommendations?

Postby dm200 » Wed Jul 03, 2013 9:55 am

jonny781 wrote:Thanks for everyones feedback and help. I spoke with some local insurance agents and seems Healthnet at $105 / month, $4k deductible/max out of pocket is best option for now.

Dental and Eye care seem to be a whole different discussion but general consensus seems to be that they usually are never worth the money. Looked at some discount plans instead for Dental but even then it seems that just paying cash might be best.


Some health insurance plans include some degree of dental and eye care. These are usually discounts on services or purchase. There might be, for dental, some kind of small actual benefit, perhaps for cleaning and examination. You might factor that into your analysis. In my area (Washington DC), the Kaiser plans have such dental benefits (if the dentist is in their network - mine is). Kaiser also includes (at least in this area) optometrist services in their plans, as well as reasonable/discounted glasses and contact lenses. In this area at least, these Kaiser eye and dental benefits are part of the plans, and no "extra" premiums.
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