How to buy health insurance on your own?

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Sunny Sarkar
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How to buy health insurance on your own?

Post by Sunny Sarkar » Mon Feb 04, 2008 12:31 pm

I need to buy health insurance for myself, spouse, and one child. I'm ok with $2500-5000 deductables. I checked out permanent health insurance policies from a few well known providers like blue cross, and while their premiums seem reasonable for our age (mid thirties), I was surprised to find out that they would disqualify us in certain situations like maternity. It seems the only way to get maternity coverage is through group insurance policies, which, as far as I understand, are available only through employers. How else can I find family health insurance with reasonable comprehensive coverage on my own?

Thanks,
Sunny
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

philip
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Re:

Post by philip » Mon Feb 04, 2008 12:48 pm

Sunny,
Not sure it is helpful, but you may want to check this web site:
http://www.ehealthinsurance.com/
Last edited by philip on Mon Feb 04, 2008 1:21 pm, edited 1 time in total.

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dm200
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I faced a similar situation

Post by dm200 » Mon Feb 04, 2008 1:03 pm

last year. My employer plan was cancelled due to nonpayment of premiums (end eventual bankruptcy) and I was faced with a risky situation. My wife and I both have medical situations that make us more difficult to insure, but are not currently under treatment.

After some scrambling around, I dound that we were eligible for an individual HIPPA plan, which was more expensive, but we did have insurance with no exclusions for pre-existing conditions. We had to get this within a months or so of losing the other coverage, and we needed to be insured for a certain period under the employer sponsored plan.

Some states (not mine) offer no denial type of insurance during certain periods.

Increasingly, insurance companies do not want to insure individually anyone except the youngest and healthest folks.

dan

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rpike
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Just When Through This Myself

Post by rpike » Mon Feb 04, 2008 1:05 pm

when my last employee unexpectedly folded leaving me without the opportunity to continue under COBRA until I find a new job. [In Massachusetts, health insurance is now mandatory, otherwise they ding you on your state income taxes.]

Blue Cross of Massachusetts alone had some 3 dozen plan options for family coverage in Massachusetts varying in cost from ~$800 per month to up over $2000 per month with a wide variety of copays and coverages. Some included maternity; some didn't. Some included prescriptions; some didn't.

Plans in each state are different. They had a web site to compare the various options.

Another Rick

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Sunny Sarkar
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Post by Sunny Sarkar » Mon Feb 04, 2008 1:32 pm

I re-verified with Blue Cross. They will not cover any existing conditions (which is not an issue for us) and will disqualify us if we were to develop either maternity and mental health conditions (who knows whether that will be an issue for us). They said that the only way to get maternity & mental health coverage too is through group insurance.

Is there any way of getting group insurance coverage other than through employer.

Thanks,
Sunny

p.s. It might be helpful if I knew how much is the financial risk of maternity. I understand it can be a lot depending on the complexity of the case, but what's the ballpark cost?
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by neil » Mon Feb 04, 2008 2:06 pm

Sunny,
Are you a member or can you become a member of a professional organization that offers group insurance? I ask this because I was able to get group insurance with the American Society of Civil Engineers once my wife was pregnant, and the coverage included maternity. This was about 8 years ago, and my wife had insurance with her work, but we were moving, and the HMO didn't have any offices in the city we were moving to.

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Ted Valentine
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Post by Ted Valentine » Mon Feb 04, 2008 2:12 pm

I know what you're going through. Prepare to have riders attached to your policy based on anything anyone in your family has been treated with. Also prepare for a 1 year waiting period on most treatments. You won't even get the insurance discount for anything not covered even though you're paying the premiums.

Shop your local Farm Bureau. They usually offer group policies that are reasonable. You will have to pay a nominal annual fee to be a member.

ps - We paid about $15,000 total for a new baby last year. Most of that was not covered by insurance. That includes us begging for and receiving some discounts.
Although our intellect always longs for clarity and certainty, our nature often finds uncertainty fascinating.

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BogleFan
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Post by BogleFan » Mon Feb 04, 2008 2:15 pm

My kid was born with a normal delivery (5 years back). Bills totaled about $25,000

So, are you saying that if someone is not employed (say a businessman), he or she will spend that much amount for a childbirth?

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Ted Valentine
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Post by Ted Valentine » Mon Feb 04, 2008 2:23 pm

BogleFan wrote: So, are you saying that if someone is not employed (say a businessman), he or she will spend that much amount for a childbirth?
My sister had a baby six months prior to mine. She was unmarried when she conceived and a half-time employed student living on her own. She got medicare and I don't think she paid a dime.
Although our intellect always longs for clarity and certainty, our nature often finds uncertainty fascinating.

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Sunny Sarkar
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Post by Sunny Sarkar » Mon Feb 04, 2008 2:28 pm

Ted Valentine wrote:My sister had a baby six months prior to mine. She was unmarried when she conceived and a half-time employed student living on her own. She got medicare and I don't think she paid a dime.
Isn't medicare only for seniors? Forgive my ignorance.
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by Ted Valentine » Mon Feb 04, 2008 2:32 pm

Sunny wrote:
Ted Valentine wrote:My sister had a baby six months prior to mine. She was unmarried when she conceived and a half-time employed student living on her own. She got medicare and I don't think she paid a dime.
Isn't medicare only for seniors? Forgive my ignorance.
Excuse me. Medicaid. Forgive my ignorance. :)
Although our intellect always longs for clarity and certainty, our nature often finds uncertainty fascinating.

mvm
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Post by mvm » Mon Feb 04, 2008 2:48 pm

I can't say enough good things about the health insurance I bought for my family of 4. So, call me strange in this world of health insurance bashing.

I bought an HSA plan.

Here's why it is so good:

Covers everything at 80%, then 100% when out of pocket max is reached.

Has a $3500 family deductible - family, not individual. So every cost of every person builds toward the deductible.

Gives 65% discount on drugs.

TOTAL COST: $425/ month.

PLUS...I put $6,000 in a tax-deferred account each year and I deduct $6,000 on my taxes each year right off the top, like an IRA. The $6,000 can be used to pay for the deductible and other medical expenses, if you want - but you don't have to. We just leave it there to build up.

HSA.

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Post by mvm » Mon Feb 04, 2008 2:49 pm

oh, by the way, the money in the tax-deferred account is invested in various Vanguard funds.

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Sunny Sarkar
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Post by Sunny Sarkar » Mon Feb 04, 2008 2:50 pm

neil wrote:Are you a member or can you become a member of a professional organization that offers group insurance?
Assuming I can join IEEE, I checked out their insurance, and they had similar limitations:
Plan Exclusions
While policies vary by state, the following general summary outlines expenses that are not covered by this temporary health insurance plan.

* Pre-existing conditions
* Intentionally self inflicted sickness or injury
* Free services provided by a federal, veteran's, state or municipal hospital
* Dental treatment unless a hospital stay is required
* Eyeglasses, contact lenses, eye exams
* Artificial hearing devices
* Preventive treatment including routine physical exams and immunizations
* Normal pregnancy or childbirth
* Routine well-baby care including hospital nursery charges at birth or abortion
* Cosmetic treatment
* Treatment, repair or removal of tonsils or adenoids, except as an emergency
* Treatment or services required due to an injury received while engaging in any hazardous occupation or other hazardous activity
* Treatment or services required due to injury received while engaging in any hazardous occupation or other activity for which compensation is received
* Treatment or services required due to injury sustained while participating in any interscholastic or inter-collegiate sport, contest or competition or while practicing exercising, undergoing conditioning or physical preparation for any such sport, contest or competition
* Treatment or services required for Sickness or Injury resulting from consumption abuse or overdose of alcoholic beverages or any illegal or controlled substance
* Expenses incurred outside of the United States or its possessions or Canada
* Services or supplies for foot care, including care of corns, bunions or calluses

Exclusions may vary by state and by the terms of the insurance contract.
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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BogleFan
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Post by BogleFan » Mon Feb 04, 2008 3:00 pm

Sunny wrote:While policies vary by state, the following general summary outlines expenses that are not covered by this temporary health insurance plan.
The word "TEMPORARY" catches my attention. Why is this insurance temporary?

mvm
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Post by mvm » Mon Feb 04, 2008 3:01 pm

HSA

why more people don't get them, is beyond me

check it out at the US Treasury web site

Jay
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Post by Jay » Mon Feb 04, 2008 3:23 pm

What company did you get yours through?
mvm wrote:HSA

why more people don't get them, is beyond me

check it out at the US Treasury web site

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Post by donocash » Mon Feb 04, 2008 3:28 pm

"p.s. It might be helpful if I knew how much is the financial risk of maternity. I understand it can be a lot depending on the complexity of the case, but what's the ballpark cost?"

This may be easier than you think. Have your wife call her OB/GYN and ask. It is likely that you would get a rate comparable to what insurance would pay, especially if you are willing to pay up front. There is almost always someone in a physician's office these days who works exclusively or primarily with insurance companies, and they should be able to tell you what the routine laboratory and hospital costs may be for an uncomplicated pregnancy. Hospital costs may also be negotiable. For example, I know some hospitals give a 10% discount up front for some services if the bill is paid within a short time frame.

I do think that it is highly unlikely that you will get maternity coverage. Look at it from the insurance company's point of view. If they offer maternity coverage to young people, what would stop them from initiatiing coverage just before conception, and dropping coverge just after delivery?

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The untold story?

Post by rpike » Mon Feb 04, 2008 3:46 pm

You're not telling us the whole story. It's hard to help without fully understanding your situation.
  • Exactly why are you looking non-group insurance?
  • What insurance are you covered under now?
  • Do you have the opportunity to continue using it under COBRA and are just looking for a less expensive alternative?
  • Are you looking for a temporary plan to cover you until you have a new employer sponsored plan?
  • What state are you in? The specific plans available vary by state (even HSA's).
Under HIPPA law an insurance company cannot exclude coverage on a pre-existing condition if you were covered under an insurance plan within the previous 63 days and some other conditions. When you leave a plan, I believe they must send you a HIPPA letter attesting to when you were covered.

While I am between jobs an not eligible for COBRA coverage, I was looked at the least expensive plan, but my wife rejected it because it had no out of pocket max. She figures it's only a few hundred dollars a month more to avoid an unlimited liability and get prescriptions and preventative care with reasonable copays. If I find work soon, it won't be that much more and if I don't we would probably soon become eligible for some subsidized coverage with no income.

The plans listed on ehealthinsurance.com and the temporary plans from professional societies like IEEE are not available in some states such as Massachusetts.

Another Rick

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Post by sfleisch » Mon Feb 04, 2008 4:02 pm

There are some ways to get into group plans depending on where you live and what you do. In addition, while you may not qualify for Medicaid, many states offer easier access to Medicaid benefits for maternity coverage. So you may not qualify now, but if your wife were to get pregnant, some states have higher income limits for medicaid related to children and pregnant women. Having 4 children I can tell you that the fees paid to the OB are the least of your concern ($3000-5000). It is primarily the hospital fees that get very expensive and lead to numbers quoted above. Should there be any complications or hospitalizations those numbers go even higher from the hospital.
If you give a little more info about the situation - ie self employed, any employees, no job etc may help guide you a little better.
Steve

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Ted Valentine
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Re: The untold story?

Post by Ted Valentine » Mon Feb 04, 2008 4:09 pm

rpike wrote: Under HIPPA law an insurance company cannot exclude coverage on a pre-existing condition if you were covered under an insurance plan within the previous 63 days and some other conditions. When you leave a plan, I believe they must send you a HIPPA letter attesting to when you were covered.
I'm fairly certain the HIPPA rule only applies if you leave a group policy and join another group policy. Individual policies are excluded.
Although our intellect always longs for clarity and certainty, our nature often finds uncertainty fascinating.

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Re: The untold story?

Post by Sunny Sarkar » Mon Feb 04, 2008 5:35 pm

rpike wrote:Are you looking for a temporary plan to cover you until you have a new employer sponsored plan?
Bingo!

I'm working on a short term contract and need to buy my own health insurance for 6-12 months. The most likely scenario is that I'll move into a new employer sponsored plan within the year. Cobra is not an option.

Hence, a "temporary" "short-term" high deductible policy is OK for me, which I have now, but I was surprised to find out that it did not cover maternity & mental health. So I was looking for something more comprehensive.
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by Sunny Sarkar » Mon Feb 04, 2008 5:42 pm

mvm wrote:HSA

why more people don't get them, is beyond me

check it out at the US Treasury web site
Vanguard HSA page

You got me intrigued about HSA. Didn't know anything about it. Reading now.

Quick question: Does it apply to my situation described in my last post above?
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by Sunny Sarkar » Mon Feb 04, 2008 6:24 pm

Jay wrote:What company did you get yours through?
mvm wrote:HSA

why more people don't get them, is beyond me

check it out at the US Treasury web site
The Vanguard HSA page links to these guys:

http://www.hsaadministrators.com/index2.asp
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by mvm » Mon Feb 04, 2008 7:01 pm

I got my HSA through Lifewise of WA state...basically, Blue Cross/Blue Shield.

Every health insurance company has an HSA plan. But, you often have to ask...they don't like them because they don't make money on them...YOU make the money.

Then, I linked up with HSA BANK for the tax deferred account, then I switched to Vanguard through HSA Administrators. You can have the tax-deferred account held anywhere....lots of financial companies offer that.

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Post by mvm » Mon Feb 04, 2008 7:03 pm

Congress took a major step in the right direction in 2004 when it passed legislation which created a special class of tax deferred savings account - the Health Savings Account or HSA. The goal of this legislation is to put consumers back in control of medical expenses while providing insurance products that would cover high unexpected bills. Health Savings Accounts can only be set up in conjunction with the purchase of a qualified High Deductible Health Plan (HDHP). The HSA HDHP combination is a good way to go for individual and family plan purchasers, especially if you're overall health is relatively good.

The idea is to purchase a less expensive health insurance plan and then deposit the premium difference in a savings account. The higher deductible insurance plan creates financial incentive to control cost while providing financial relief should a major illness or injury occur. By depositing the premium difference in a Health Savings Account the consumer builds equity which can be used for healthcare costs which aren't covered under the medical insurance plan.

The beauty of the HSA is that contributions are tax deferred when you put money in, and tax exempt if you use the money for qualified purposes. I repeat: When you use the money you save for qualified medical purposes you never have to pay taxes on the money or on any earnings the money may have accumulated - this is huge! A number of banks have web sites to explain the intricacies of setting up a Health Savings Account. And, your insurance agent can help you select a qualified High Deductible Health Plan.

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Post by mvm » Mon Feb 04, 2008 7:22 pm

The Treasury Department released the 2008 HSA limits today. Beginning this year, the inflation-adjustment limits will be released every Spring, not every Fall (as is the case with other tax code provisions).

There is one juicy nugget in there that allows people to sock even more money away without taking on any additional risk.

The overall limits are the following:

Maximum HSA Contribution: $2900 for individual, $5800 for families

Minimum HDHP Deductible: $1100 self-only coverage, $2200 family coverage*

Out of Pocket Maximum: $5600 self-only coverage, $11200 family coverage

Post-55 "Catch-Up" Limit: $900

*This number is unchanged from the prior year. As a result, plans will not have to be amended to increase their deductibles. At the same time, higher contributions can be made in 2008.

This means that, for example, an individual might have a plan with an $1100 deductible, and could put away up to $2900 the first year. That's almost three years' worth of deductibles in one year!

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dm200
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HIPAA - Individual policies

Post by dm200 » Mon Feb 04, 2008 7:37 pm

I'm fairly certain the HIPPA rule only applies if you leave a group policy and join another group policy. Individual policies are excluded.
No, you are not correct. There are individual HIPAA policies. We have one now, and have had it for about a year. It is more expensive than the underwritten, approved individual insurance, but we were able to get insurance.

Check this site for one plan's info https://www.carefirst.com/eSales/conten ... hipaa.html

hogtied
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Post by hogtied » Mon Feb 04, 2008 7:53 pm

Join your local Chamber of Commerce as an individual and tap into their group plan for Blue Cross Blue Shield. This is allowed and a common practice around here. Chamber dues here are $70 per year.

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HSAs

Post by tibbitts » Mon Feb 04, 2008 8:05 pm

An HSA is not available to many people, who cannot qualify (medically) for the required underlying coverage.

Also, many people already pay no income tax - not everybody needs yet another deduction. Income tax deferrals (and even exemptions) are really not "huge" for many people.

Very, very few group plans qualify. We have a $2500 deductible on our group plan (no medical qualification), but ANY first-dollar coverage disqualifies the plan from an HSA standpoint. People who have group plans available to them have a limited number of plans, and you can't just demand that a qualified plan be made available.

Annual chamber of commerce membership here runs $375 or so, plus you have to be a two-plus employee business to qualify for health coverage. You have to be a real business and prove it with tax returns or other evidence of actual business activity.

Paul

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zzcooper123
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Individual Health Insurance

Post by zzcooper123 » Mon Feb 04, 2008 8:35 pm

I used an insurance broker and was pleased. One advantage of a broker is he can pre-screen the insurance companies before you apply. For instance , the broker will tell you if Aetna will turn you down if you have a history of depression or some other disqualifying condition. Being turned down by an ins. co. is reportable to the MiB( Medical Ins. Board). Recommend one check their MiB report. Read the book, "The Health Insurance Solution" by Zane Pillsner sp.?

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Post by BradMajors » Mon Feb 04, 2008 9:33 pm

In California, if you form your own corporation and have two employees (yourself and your wife) you can get group health insurance through your corporation and by law the insurance company can not take the health of the two employees into account.

Since you are self-employed forming your own corporation would seem to make sense.

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Post by bluemarlin08 » Thu Feb 07, 2008 9:09 am

Several companies offer individual policies that do cover maternity. A lot depends on the state you reside. Try to find an independent agent in your area that represents the major players in the individual market. Ask them to compare "traditional" plans with high deductible HSA qualified plans, sometimes the difference in premiums will fund the savings plan. However, one must adjust their thinking, paying for doctor visits and drugs out of pocket can be an adjustment. Good luck.

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Post by my name » Thu Feb 07, 2008 9:43 am

mvm wrote:The Treasury Department released the 2008 HSA limits today. Beginning this year, the inflation-adjustment limits will be released every Spring, not every Fall (as is the case with other tax code provisions).

There is one juicy nugget in there that allows people to sock even more money away without taking on any additional risk.

The overall limits are the following:

Maximum HSA Contribution: $2900 for individual, $5800 for families

Minimum HDHP Deductible: $1100 self-only coverage, $2200 family coverage*

Out of Pocket Maximum: $5600 self-only coverage, $11200 family coverage

Post-55 "Catch-Up" Limit: $900

*This number is unchanged from the prior year. As a result, plans will not have to be amended to increase their deductibles. At the same time, higher contributions can be made in 2008.

This means that, for example, an individual might have a plan with an $1100 deductible, and could put away up to $2900 the first year. That's almost three years' worth of deductibles in one year!
How does the post-55 "Catch-Up" limit work?

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Post by donocash » Thu Feb 07, 2008 10:01 am

My name

"How does the post-55 "Catch-Up" limit work?"

It simply means that if you are age 55 by December 31, 2008, the maximum contribution you can make to an HSA is $3800 ($2900+$900) for an individual, and $6700 ($5800+$900) for families

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Post by bjorka7769 » Thu Feb 07, 2008 10:35 am

I also recommend finding an insurance broker that works with all the local insurance companies. As for getting individual HIPPA policies, these do exist and are called conversion policies in my state. I live in one of those states that is silent on requiring maternity/mental health availability on individual plans. However, there is a little-known plan in one of my state's insurers that is well hidden and covers these items. It is a conversion policy, and changing jobs (therefore losing coverage) is certainly a qualifying event. Find a good broker and you'll find a good plan.

Good luck!
Andrea

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Post by cdelena » Thu Feb 07, 2008 12:48 pm

mvm wrote:I can't say enough good things about the health insurance I bought for my family of 4. So, call me strange in this world of health insurance bashing.

I bought an HSA plan.

Here's why it is so good:

Covers everything at 80%, then 100% when out of pocket max is reached.

Has a $3500 family deductible - family, not individual. So every cost of every person builds toward the deductible.

Gives 65% discount on drugs.

TOTAL COST: $425/ month.

PLUS...I put $6,000 in a tax-deferred account each year and I deduct $6,000 on my taxes each year right off the top, like an IRA. The $6,000 can be used to pay for the deductible and other medical expenses, if you want - but you don't have to. We just leave it there to build up.

HSA.
It depends upon the state... I have nothing near that good available to me. I have I high deductable plan with a HSA and it costs more, covers almost nothing until the deductable is reached, and excludes drugs altogether.

My wife and I had no illness last year but did have checkups and take some some common perscription drugs. Our health care expenses were about $10,000... I wonder how we will afford a year with real medical problems.

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Post by mikepru » Thu Feb 07, 2008 6:05 pm

Join Farm Bureau? Is it available in your state?

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Post by shelanman » Thu Feb 07, 2008 6:52 pm

BradMajors wrote:In California, if you form your own corporation and have two employees (yourself and your wife) you can get group health insurance through your corporation and by law the insurance company can not take the health of the two employees into account.

Since you are self-employed forming your own corporation would seem to make sense.
Be aware that starting a group health plan is a massive, massive pain in the ass in California.

Basically, you can't form a corporation just to get group coverage. It has to be a "real" corporation. Specifically, you have to file a bunch of paperwork, and in order to count as eligible owners, you must receive regular draw payments at least once per month in excess of the minimum wage for the period, assuming full-time work, and must certify that you work a minimum of 20 hours per week for the benefit of the company. You may be asked to provide two draw checks, and the company may impose a 60-day waiting period from receipt of the second month's draw.

If you have fewer than 25 employees, they can require each employee to fill out a health questionnaire and they can charge premiums based on that information. They can not, however, refuse coverage or refuse to cover pre-existing conditions, except for certain specific carve-outs created in the law.

(can you tell? I've done this recently! still doing, actually.)

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Post by dual » Thu Feb 07, 2008 7:41 pm

shelanman wrote:
Be aware that starting a group health plan is a massive, massive pain in the ass in California.

(can you tell? I've done this recently! still doing, actually.)
Also, my understanding is that all corporations and LLCs pay a minimum of $800/year fee to the state. Is this right?

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Post by Sunny Sarkar » Thu Feb 07, 2008 8:12 pm

Thank you to all who responded.

I finally ran out of time and settled for a temporary policy for a few months without coverage for pre-existing conditions, maternity, and mental illness. Being relatively young, I think we'll get away with it this time, but it's surely a good preview of what's ahead in our later years if our health care system doesn't improve.
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by bluemarlin08 » Fri Feb 08, 2008 8:43 am

Why go with a temporary policy? What if you have a change in health before the end of the temp insurance? What if there is a unplanned pregnancy? Risky plan, IMO. There are plans that cover pre existing cond by rating up, all depends on the condition. Be careful!

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Re: The untold story?

Post by Sunny Sarkar » Fri Feb 08, 2008 9:17 am

Sunny wrote:I'm working on a short term contract and need to buy my own health insurance for 6-12 months. The most likely scenario is that I'll move into a new employer sponsored plan within the year. Cobra is not an option.

Hence, a "temporary" "short-term" high deductible policy is OK for me
"Cost matters". "Stay the course". "Press on, regardless". ― John C. Bogle

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Post by bluemarlin08 » Fri Feb 08, 2008 10:13 am

I understand, but what happens if new employment doesn't work out, or you have a major change in health. I try to manage as many of the unforeseens as possible, but short term is less expensive for a reason.

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magellan
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Re: HSAs

Post by magellan » Fri Feb 08, 2008 10:44 am

tibbitts wrote: We have a $2500 deductible on our group plan (no medical qualification), but ANY first-dollar coverage disqualifies the plan from an HSA standpoint.
This may be apples and oranges, but DW and I have individual HSA plans from BCBS and they provide first dollar coverage on all preventative care (no deductible - 100% covered) .

To me this is a good way for an HSA plan to be constructed from a public policy standpoint. All routine expenses are paid in full without a deductible. This provides an incentive for people to get all the routine stuff done like annual exams, mammography, pap, colonoscopy, etc. In a perfect plan, you'd pay a surcharge if you don't get the maintenance stuff done.

Jim

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HSA

Post by Self Directed » Fri Feb 08, 2008 1:50 pm

I am 56 live in CT, and am self employed. My wife and I are in good health, so I elected to buy HSA coverage in 2004, the first year it was available. I bought it thru Anthem Blue Cross, but have switched it to Lumenos.

I have found that the premiums for my HSA have increased double digits each year, not only due to age creep, but also inflation. I have just learned that AARP is now offering an Aetna HSA which has dramatically lower premiums, if my wife and I can qualify.

Plus, our so called "bridge' funds to cover the $5,000 deductible we have, are in liquid funds, earning about 3.5% only, and we have to pay the custodian, Chase/Morgan, a fee of $3 per month.

Although we enjoy discounted medical and prescription drugs, our office visits are paid 100% by us. Certain preventative procedures, such as mammorgrams, annual physicals, colonoscopies, are covered 100%.

Anyone else over 50 experiencing exploding premiums on their HSAs?

Self Directed
CT

bluemarlin08
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Post by bluemarlin08 » Sat Feb 09, 2008 10:20 am

Self directed,
I understand your frustration. Many of us that sell HSA plans were led to believe that HDHP would be slower to raise rates because of the higher threshold for claims. Some carriers have held rates steady, some have done what you are experiencing. I am worried now because one of the popular carrier's rates for these plans are much lower than others and wonder if they plan to do the rate increase game.

tibbitts
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Re: HSAs

Post by tibbitts » Sat Feb 09, 2008 10:39 am

magellan wrote:
tibbitts wrote: We have a $2500 deductible on our group plan (no medical qualification), but ANY first-dollar coverage disqualifies the plan from an HSA standpoint.
This may be apples and oranges, but DW and I have individual HSA plans from BCBS and they provide first dollar coverage on all preventative care (no deductible - 100% covered) .

To me this is a good way for an HSA plan to be constructed from a public policy standpoint. All routine expenses are paid in full without a deductible. This provides an incentive for people to get all the routine stuff done like annual exams, mammography, pap, colonoscopy, etc. In a perfect plan, you'd pay a surcharge if you don't get the maintenance stuff done.

Jim
Jim is correct, there are some first-dollar exclusions. I shouldn't have said ANY.

Our plan is not an HSA but also does not provide first dollar coverage for things like a colonoscopy. I'm supposed to have (another) one, but am trying to wait until I break a leg or something, otherwise it'll cost the entire $2500+ and of course not be deductible (unless it costs much more than that.)

I assume that each company (BCBS in our case) has run the numbers and determined that most of these preventative procedures do not pay off, otherwise they would cover them. Essentially no preventative procedure is first-dollar on our policy as far as I can tell, although we do get to use the office visit co-pay if we get a check up.

There was a huge change a couple of years ago to where our BCBS will now not charge separately for labs done in conjunction with an office visit, so long as teh lab test is "routine" and not the result of a complaint. So, preventative lab tests are covered, but not diagnostic lab tests. There is some difficulty associating a lab done on a different day than a corresponding office visit, but so far we've gotten credit, which is huge for us, because we do have to have lab tests done frequently. Before BCBS did that we had to pay the labs out of our deductible - and they were a lot more expensive than the $30 office visit co-pay.

Paul

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RobertH
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Location: Bay Area

Portability of health insurance between states

Post by RobertH » Sat Feb 09, 2008 11:37 am

Another point to add to this thread: my wife and I were pleased to get health insurance through Blue Cross of California a few years ago. We considered maintaining that coverage until we retired. This fantasy lasted only a few months: our jobs took us to Washington State, where we found that we had to reapply for insurance. There was no reciprocity. I believe this is common practice.

Robert

bluemarlin08
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Post by bluemarlin08 » Sat Feb 09, 2008 12:17 pm

Robert,
Unfortunately many folks are discovering that problem when they leave their current state. I have a client retiring to Washington, he is 65, wife is 55, we applied for coverage and she wasn't accepted, can't qualify for COBRA, no HIPPA plan available.

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