Health care question - self employed- Whats your plan? Advice Needed

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BCL78
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Health care question - self employed- Whats your plan? Advice Needed

Post by BCL78 » Sat Aug 25, 2018 6:04 pm

Question for those who are self employed -
After mortgage payment (2k) health care premium is my biggest family expense.
Long story short - wife and I are on individual plans via blue shield bronze Plan. Medical and dental - $472 each
Kaisar is cheaper but we much prefer sutter.
I rarely need to go to doctor. (I’m 39). I want to look for lower Plan for myself to save money and invest savings while my wife can stay with sutter.

What plans are self employed using ? (We live in ca )
Also - anybody try other network savings plans etc ?
Last edited by BCL78 on Sat Aug 25, 2018 7:01 pm, edited 1 time in total.

JBTX
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Re: Health care question - self employed

Post by JBTX » Sat Aug 25, 2018 6:35 pm

All I have to add that you may already know is that health insurance for self employed can be tax deductible if it meets certain criteria.

When I was self employed for a while I was on COBRA then later jumped on my wife's employer plan.

BCL78
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Re: Health care question - self employed

Post by BCL78 » Sat Aug 25, 2018 6:47 pm

Yes, I have an accountant that handles all that. We are both self employed to clarify.

22twain
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by 22twain » Sat Aug 25, 2018 9:55 pm

BCL78 wrote:
Sat Aug 25, 2018 6:04 pm
What plans are self employed using ? (We live in ca )
I've never had to deal with individual health insurance myself, but I understand that in some states at least, available plans and costs can vary from one area to another, maybe county by county. I don't know if that's true in California.
My investing princiPLEs do not include absolutely preserving princiPAL.

numberman
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by numberman » Sat Aug 25, 2018 11:23 pm

BCL78 wrote:
Sat Aug 25, 2018 6:04 pm
What plans are self employed using ?
In the past, my general approach has been to get the lowest-premium plan that qualifies for an HSA, and then max out the HSA contributions. This year, the cheapest plan for me was not HSA-compatible, and the cheapest HSA-compatible plan was significantly more expensive, so I went with the non-HSA-compatible plan and I'm skipping HSA contributions this year. I understand that an HSA is not as desirable in California, but I believe you still get benefits at the federal level. I currently use Cigna, and have used BCBS in the past.

I don't pay much attention to all of the other aspects of all the various plans, because I can afford the max annual out-of-pocket cost, and I don't care if I need to change my doctor (like you, I don't go to the doctor very much). I do try to check just to make sure there are some in-network providers somewhat close to me, but that's never been an issue so far.

To find/compare plans, I go to healthsherpa, healthcare.gov, or sometimes I look at the sites of the insurance companies themselves. Sometimes they have plans that are not listed on the healthcare.gov site for whatever reason, but I'm not sure if I've ever used one of those.

DaBombCat
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by DaBombCat » Sun Aug 26, 2018 12:02 am

I have a healthshare plan (Liberty Healthshare). It isn’t good for people who are pregnant or might get injured because of drugs/alcohol.

It costs $399/mo for a couple.
Their deductible (called the unshared amount) is $1,750 for a couple.
Coverage limit of $1million.
It allows you to be exempt from buying insurance.
They phase in coverage for pree-existing conditions or join a health coaching program to cover preexisting conditions.
Bills are submitted by the clinic/hospital using the same procedure as insurance submittals.
No networks.
Most providers and healthsystems nationwide seem to accept healthshare programs.
They negotiate down to similar rates as insurance companies, even if something isn’t covered.
You have to pay for many routine services that aren’t emergencies—pregnancies, contraception, vaccines, cosmetic surgery, etc.
Doesn’t cover injuries caused by vices—alcohol, drugs.

It isn’t insurance, but it seems be to what I picture health insurance should be. Works for me. Even paying for non covered expenses out of pocket, I’m saving about $8-10k/year over an ACA plan. Just don’t expect universal care.

Noalani
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by Noalani » Sun Aug 26, 2018 4:26 am

We live in Hawaii. My husband is self-employed and we have always used HMSA/Blue Cross Blue Shield. We are on the Silver Plan PPO. Premiums for both of us come to $1394/month--fully deductible on our 1040. We've been happy with BCBS over the years.

One lesson I learned this summer is not to deprive yourself of a quality health plan. Yes, you are young (39) and healthy, but that can change in an instant. My seemingly "healthy" brother (age 41) collapsed at work this past May. He was taken to the ER by his co-workers and the CT scan revealed a large mass on his brain. It turns out that he had a meningioma (benign brain tumor) the size of a softball growing out of his skull! This health crisis has required multiple brain surgeries, a month's stay in the hospital, weeks at a rehab facility, and he's not done with doctors and medical care yet. The first batch of medical statements that came in were over $300,000. That was just a portion of the billing. Luckily, his employer provides primary and secondary health coverage. We self-employed individuals don't have that same benefit.

Get the best plan that you can afford for you and your spouse. It's worth it.

Cigarman
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by Cigarman » Sun Aug 26, 2018 6:34 am

Today you are healthy, who knows about tomorrow.

We are in NC and have had BCBS as self employed couple. When initially looking at insurance we thought about a plan with a $5,000,000 lifetime coverage limit. As the agent said, $5,000,000 is a lot of coverage (well, it was almost 20 years ago.)

To date my wife has had a colon resection, back surgery, brain aneursym, shoulder surgery and now lung cancer. That is aside from what might be considered "normal, everyday" aches and pains. I am dealing with prostate cancer. While currently on a BCBS "transition" plan (because our old plan was non ACA compatible) we pay about $1200 per month with $5000 deductible. So, our total is about $25,000 out of pocket. Yes, it hurts until you see how much is charged for each treatment (the brain aneurysm alone topped $250,000). Even with that we sometimes have to fight BCBS for coverage.

I can't stress enough the need for a quality plan. If the HSA is more and you can afford to put aside the $5,000 per year, do it. Life can change in an instant and even cash discounts on health care are quite expensive.

BCL78
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by BCL78 » Sun Aug 26, 2018 11:17 am

Thank you for sharing your stories and wish all the best.
I certainly do not want cheap questionable coverage - just exploring if a better option to consider for myself.

BCL78
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by BCL78 » Tue Aug 28, 2018 1:44 am

Also- what is the best HSA account to open and invest ? Thx

harvestbook
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by harvestbook » Tue Aug 28, 2018 7:35 am

There are multiple threads on "best HSA plan" here, almost universally featuring posts by people who all think THEIR plan is the best! It depends on how you plan to use it--whether it's a stealth IRA for you, or you actually use your account for current expenses, how often you contribute, etc (some charge per contribution, others are great if you only make one lump-sum contribution a year, some have a lot of paperwork, etc.)

I am also in NC, wife and I self-employed, we use BCBS with premiums of $1,155 a month. We're almost certainly switching to an ACA plan next year, probably going down to a Bronze level, although we'd probably still save money keeping the Silver level since there is only one provider choice for us in a poor, rural county. Health care is now a third of our budget even with good health, and may remain a barrier to continued self-employment in my last decade toward retirement. Good luck.
I'm not smart enough to know, and I can't afford to guess.

danaht
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by danaht » Tue Aug 28, 2018 7:50 am

As a self employed individual in TX this year - health insurance became so expensive for me. It was a very easy decision to make when a mega corp offered me a full time W2 position.

Chris K Jones
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by Chris K Jones » Tue Aug 28, 2018 8:32 am

In my area, only choices were Kaiser or a new company offering private insurance for first time. All the other players opted out of the market. I chose Kaiser. I haven't had to use it, but my kids have. It is adequate, in my view, but not good. In January, Blue Cross is reentering the marketplace and I will probably choose Blue Cross if not too much more expensive. Best wishes.

WhyNotUs
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by WhyNotUs » Tue Aug 28, 2018 8:51 am

Every year for the last 30 or so, I buy less coverage for the same or more dollars. There is not silver bullet, especially for those over 50. Ridiculous deductibles and high monthly premiums. At least the ACA sets some standards for policies, now we have these goofy religious and share plans. What a pathetic mess.
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BCL78
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by BCL78 » Tue Aug 28, 2018 10:24 am

Anybody use coverage via "faith based plan" ...my parents- in 60s now- have used one last 2 years and has worked out w/ no hiccups, etc. Im always a little leary of a plan like that.

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dm200
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by dm200 » Tue Aug 28, 2018 10:27 am

BCL78 wrote:
Sat Aug 25, 2018 6:04 pm
Question for those who are self employed -
After mortgage payment (2k) health care premium is my biggest family expense.
Long story short - wife and I are on individual plans via blue shield bronze Plan. Medical and dental - $472 each
Kaisar is cheaper but we much prefer sutter.
I rarely need to go to doctor. (I’m 39). I want to look for lower Plan for myself to save money and invest savings while my wife can stay with sutter.
What plans are self employed using ? (We live in ca )
Also - anybody try other network savings plans etc ?
DW and I love Kaiser - low cost and high quality - in our opinions.

bhsince87
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by bhsince87 » Tue Aug 28, 2018 1:19 pm

Not the OP here, but I have a realted question.

For those who are self employed, I understand health insurance costs are deductable against income.

How does that impact qualification for potential ACA subsidies?

I'm toying with doing some consulting in early retirement. Current cost for an ACA policy for my wife and i is about $30k per year. If we keep income under $65k, that drops to $4k with subsidies. If I could write off teh full $30k, we could stay under $65k in income.

This seems sort of like a chicken or the egg problem to me.....
Retirement: When you reach a point where you have enough. Or when you've had enough.

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thatwhichisgood
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by thatwhichisgood » Tue Aug 28, 2018 1:28 pm

+1

Out of the blue spinal fusion this year... just one link, still a life changing event. :( $150k+
60 year old healthy till now surprise
Health Insurance... protecting your assets and addressing your quality of life and PAIN
Cigarman wrote:
Sun Aug 26, 2018 6:34 am
Today you are healthy, who knows about tomorrow.

We are in NC and have had BCBS as self employed couple. When initially looking at insurance we thought about a plan with a $5,000,000 lifetime coverage limit. As the agent said, $5,000,000 is a lot of coverage (well, it was almost 20 years ago.)

To date my wife has had a colon resection, back surgery, brain aneursym, shoulder surgery and now lung cancer. That is aside from what might be considered "normal, everyday" aches and pains. I am dealing with prostate cancer. While currently on a BCBS "transition" plan (because our old plan was non ACA compatible) we pay about $1200 per month with $5000 deductible. So, our total is about $25,000 out of pocket. Yes, it hurts until you see how much is charged for each treatment (the brain aneurysm alone topped $250,000). Even with that we sometimes have to fight BCBS for coverage.

I can't stress enough the need for a quality plan. If the HSA is more and you can afford to put aside the $5,000 per year, do it. Life can change in an instant and even cash discounts on health care are quite expensive.

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dm200
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Location: Washington DC area

Re: Health care question - self employed- Whats your plan? Advice Needed

Post by dm200 » Tue Aug 28, 2018 2:05 pm

Wouldn't it almost always be lower cost to have both married parties on the same plan? [BEFORE Medicare, of course]

DaBombCat
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by DaBombCat » Mon Sep 24, 2018 11:23 pm

BCL78 wrote:
Tue Aug 28, 2018 10:24 am
Anybody use coverage via "faith based plan" ...my parents- in 60s now- have used one last 2 years and has worked out w/ no hiccups, etc. Im always a little leary of a plan like that.
Hi BCL,
My earlier comment on this thread was on a “faith-based” plan. While the media and insurance companies disparage healthshare programs, they are not based on prayer. In fact, they don’t reimburse for prayer. They are a financial organization that delegates all clinical decisions to the patient/provider. Payments are reliable, they negotiate payments on your behalf, and many will phase in coverage for preexisting conditions. One reason that I have stuck with them is that every hospital, clinic, and ER in my area will accept healthshare just like insurance—I called all 4 systems in my city—madison WI. It’s not for everyone, but it seems like it would be a good option for some people.

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tfb
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by tfb » Tue Sep 25, 2018 12:26 am

bhsince87 wrote:
Tue Aug 28, 2018 1:19 pm
For those who are self employed, I understand health insurance costs are deductable against income.

How does that impact qualification for potential ACA subsidies?

I'm toying with doing some consulting in early retirement. Current cost for an ACA policy for my wife and i is about $30k per year. If we keep income under $65k, that drops to $4k with subsidies. If I could write off teh full $30k, we could stay under $65k in income.

This seems sort of like a chicken or the egg problem to me.....
It is a chicken or the egg problem but there's a math solution to it. If after writing off $30k your income becomes $63k, then you will receive $2k in subsidy and write off $28k to make your income $65k.
Harry Sit, taking a break from the forums.

furikake
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by furikake » Tue Sep 25, 2018 1:03 am

BCL78: we have a small group health insurance plan, it's a lot cheaper than regular individual plans, and it's tax deductible to the business. Depending on the setup of your business, if you qualify.

DavidRoseMountain
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by DavidRoseMountain » Tue Sep 25, 2018 9:47 am

bhsince87 wrote:
Tue Aug 28, 2018 1:19 pm
Not the OP here, but I have a realted question.

For those who are self employed, I understand health insurance costs are deductable against income.

How does that impact qualification for potential ACA subsidies?

I'm toying with doing some consulting in early retirement. Current cost for an ACA policy for my wife and i is about $30k per year. If we keep income under $65k, that drops to $4k with subsidies. If I could write off teh full $30k, we could stay under $65k in income.

This seems sort of like a chicken or the egg problem to me.....
Yes the health insurance cost is an above the line deduction, but then that lowers the AGI, which then in turn lowers the above the line deduction.
This becomes a circular calculation. The IRS has worksheets on how to do the calculation by hand.
Tax software is supposed to automatically do this.
I'm not sure what the exact MAGI cutoff is but you want to make sure that you don't go a $1 above that or you fall off the premium subsidy cliff.
Being self-employed, if you find that your income is too high you have a number of options to lower that MAGI.
You can invest some in your own Solo 401k plan, put money in a traditional IRA, also put money in an HSA if you choose an ACA plan that is HSA compatible.

bhsince87
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by bhsince87 » Tue Sep 25, 2018 10:05 am

DavidRoseMountain wrote:
Tue Sep 25, 2018 9:47 am
bhsince87 wrote:
Tue Aug 28, 2018 1:19 pm
Not the OP here, but I have a realted question.

For those who are self employed, I understand health insurance costs are deductable against income.

How does that impact qualification for potential ACA subsidies?

I'm toying with doing some consulting in early retirement. Current cost for an ACA policy for my wife and i is about $30k per year. If we keep income under $65k, that drops to $4k with subsidies. If I could write off teh full $30k, we could stay under $65k in income.

This seems sort of like a chicken or the egg problem to me.....
Yes the health insurance cost is an above the line deduction, but then that lowers the AGI, which then in turn lowers the above the line deduction.
This becomes a circular calculation. The IRS has worksheets on how to do the calculation by hand.
Tax software is supposed to automatically do this.
I'm not sure what the exact MAGI cutoff is but you want to make sure that you don't go a $1 above that or you fall off the premium subsidy cliff.
Being self-employed, if you find that your income is too high you have a number of options to lower that MAGI.
You can invest some in your own Solo 401k plan, put money in a traditional IRA, also put money in an HSA if you choose an ACA plan that is HSA compatible.
Thanks for the explanation! That helps a lot.
Retirement: When you reach a point where you have enough. Or when you've had enough.

bhsince87
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Re: Health care question - self employed- Whats your plan? Advice Needed

Post by bhsince87 » Tue Sep 25, 2018 10:07 am

tfb wrote:
Tue Sep 25, 2018 12:26 am
bhsince87 wrote:
Tue Aug 28, 2018 1:19 pm
For those who are self employed, I understand health insurance costs are deductable against income.

How does that impact qualification for potential ACA subsidies?

I'm toying with doing some consulting in early retirement. Current cost for an ACA policy for my wife and i is about $30k per year. If we keep income under $65k, that drops to $4k with subsidies. If I could write off teh full $30k, we could stay under $65k in income.

This seems sort of like a chicken or the egg problem to me.....
It is a chicken or the egg problem but there's a math solution to it. If after writing off $30k your income becomes $63k, then you will receive $2k in subsidy and write off $28k to make your income $65k.
Thanks Harry, that actually makes sense!
Retirement: When you reach a point where you have enough. Or when you've had enough.

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