Today, I’m going to do something I’ve never done before. I’m going to use this blog as a means to do research for a forthcoming article for Entrepreneur magazine.
Your Money
I’ve been writing the monthly “Your Money” column for Entrepreneur for 2-1/2 years now, and it’s a lot of fun. It’s a chance for me to hone in subjects with laser-like focus. If you’ve read my stuff at Get Rich Slowly, some of the articles might be familiar. But I also get to cover new topics (like building a team of financial advisors).
The column is also fun because it’s a vastly different process than the one I’m used to. With blogging, there’s almost instant gratification. For instance, I’m writing this piece at 8:12 on a Thursday morning. It’ll be finished and online in about ten minutes. Nobody else will review it; I’ll just post it and let readers respond. Which you will. I’ll have feedback in half an hour.
With the magazine, however, there’s a long turnaround. My current article, for instance, is on peer-to-peer lending. I started doing research for that piece in early October, at the end of my trip to Turkey. I submitted the piece in early November. My editor polished the piece, it went to print, and it finally found its way online at the end of February. There’s one comment on the article. This article about that article may get dozens of comments.
So, as I say, it’s a different beast.
Anyhow, this is all a tangent. The real reason I’m writing today is to recruit your help for the article that will appear in the June issue of the magazine. I’m writing about how to find health insurance when you’re on your own.
Personal Health Insurance
There are a lot of perks to being an entrepreneur. When you work for yourself, you control your destiny: you pursue a project of passion while setting your own hours and working without a boss. But there are drawbacks too. Sure, you set your own hours, but you’re often working far more than you ever imagined. Many entrepreneurs are lonely, too, spending most of their days in isolation. And let’s not forget medical insurance!
In fact, I’d argue that medical insurance is currently one of the biggest barriers to entry for would-be entrepreneurs. I have several friends who are ready to leave their jobs to start their own businesses, but they can’t. They can’t afford the more than $1000 per month in medical insurance for their families.
Here’s a direct quote I jotted down from one friend last week:
If it weren’t for health insurance, people would be free to do so many things. My husband is tied to his job because we can’t afford to be without coverage. Even with health insurance, we pay a shitload of money for medical costs.
For many families, health insurance costs as much as housing.
In my own case, I’ve had to make some tough choices. When I was married, I was covered under Kris’s health insurance. I took it for granted. Now that I’m on my own, I carry an individual policy with a high deductible. That protects me from catastrophic crises (like a car crash), but I pay out of pocket for routine care. And I’m discovering that even routine care can cost a fortune.
Last week, for instance, I visited my allergist to discuss my rampant hay fever. The half-hour office visit cost me $250.50. The two-minute “surgery” to send a fiber-optic cable through my sinus passages cost $530. And the nasal spray the doctor prescribed to fight my symptoms cost $138.32 for fifteen doses. All told, I spent nearly $1000 to get temporary relief from my tree allergy. Next time, I’ll probably choose to suffer.
Or maybe it’s time to change my policy. I pay $144 a month, but I receive almost nothing in return. Maybe I need to bite the bullet, to pay $300 a month (or more) but have comfort in the knowledge that it won’t cost me $1000 every time I need to get allergy relief.
Share Your Story
So, here’s how you can help me. Do you pay for your own health insurance? Have you in the past? What sorts of advice can you offer other folks who need to do the same thing? If you’re willing to share your story (or to help others find affordable options), leave a comment on this article. And if you’re willing to let me chat with you for my article, be sure you use your real email address when commenting so that I can contact you.
I think there are a lot of folks out there who struggle with affordable health insurance, and this is a chance for us to help them. Let’s do it!
My husband and I work for a small business. Until the past few years, we had to purchase our own insurance on the open market. Since I had spinal fusion twice in my early twenties, I had what was deemed as a “pre-existing condition.” My past medical history made it almost impossible to get any type of insurance at all. The first policy that we bought when we got married would only accept us if they excluded my back from any coverage at all.
Then we wanted to have kids. I was about 26/27 at the time and couldn’t find a single insurance company to cover me even if I was willing to pay the ridiculous premiums that were being offered ($1000 per month and up just for maternity coverage). We tried and tried to get coverage but weren’t able to until I was finally able to leave my spinal fusion off of any health insurance applicated since it had been five years since I was treated. The result of all of this waiting is that we weren’t able to have our first child until I was 29. I wouldn’t change this fact because I love the children I ended up with. However, I do think it’s sad that insurance companies were able to dictate when we were “allowed” to have children. In a civilized society such as our own, this shouldn’t be okay.
A few years ago, we finally got group coverage at work. It has been a huge weight lifted off of us. Still, the premiums are over $800 per month with coverage that only starts after meeting a $5000 deductible.
I’m not sure what advice to give. Our healthcare system has become such a complicated mess.
I hear complaints of my parents who have a similar plan to what you have with a high deductible. I can’t speak to much of the details, but your doctor visit costs made me think about how they keep their costs down. There is a doctor in the area who simply won’t take insurance. He became frustrated with the process and started his own practice and others are following suit. You pay a flat rate, about $50 to walk in and see him. Obviously this isn’t going to work well for all visits, but for routine visits and to get prescriptions it works great. Maybe they offer something in your area?
I decided a few years ago to “become responsible” and get a health insurance policy. I applied for a high deductible policy and was denied due to my weight. Sure, I could get a policy, but it would no be economically feasible. So, I started putting the money I would have been paying for insurance and HSA into an online savings account. I may not have insurance, but I do have enough money for most medical emergencies.
So, keep the $144 a month policy, but put the other $136 into a savings account for the regular medical expenses. And check into an HSA for long term medical savings.
It sucks that you can’t get health insurance, but I love this idea, Jonathan! Kudos!
Great idea. I don’t think many people know about this option.
JD, your last comment about biting the bullet to pay $300 to save $1,000 is EXACTLY why so many people overpay for health insurance. How many times a year does a $1,000 item pop up? Is that really worth paying an extra $150 every month, just in case? People love paying $25 co-pays but don’t realize they are overpaying, potentially by hundreds each month for their crappy insurance. Health insurance should protect you from catastrophes, not day to day issues like allergies. Sorry if I’m being blunt.
Here’s our story:
I am not self-employed, but I am self-insured. My small company dropped health insurance 4 years ago and I found an HSA-compatible high-deductible policy online for $400/month ($100 of that is maternity coverage). It is HALF what we were paying through the group plan at work for virtually the same benefits – $5k deductible. We have negligible prescription coverage now but the old plan also had co-insurance after the deductible. It was a rip off. Yes, we are healthy, but the point is there are options out there if you look and get creative. Having this low cost coverage has made my dream of entrepreneurship (which I hope to do within a year or so) more tangible.
Also, always ask for discounts for paying in cash or immediately. We’ve routinely had 25-30% cut from the bill for this, especially with hospitals.
I agree with Kevin’s first and last paragraph here.
When we decided to search for new health insurance, we looked at our history. I was getting free health insurance through my part-time job, but I knew that my employer was paying over $1,200 per month for our family plan, even though I often ended up paying out of pocket for health care. After looking at how often we went to the doctor and how much we would have spent (by looking at our health insurance statements), it made sense for us to go with a high deductible plan.
MMM wrote an article about this, but I won’t put a link here.. you can see the web site if you’re interested. Our family plan (myself, my husband, and our son) costs $237 per month. We have a $10,000 per person deductible (up to 2 people) right now, so $20,000 for our family. The out of pocket max is $3000 per person or $9000 for the family. Coinsurance is 80/20. One of the things you need to know when shopping for health insurance is what all of this means. Once you understand everything, it’s pretty easy to run the numbers. I also know that this amount may go up next year. We’ll see by how much.
Our plan INCLUDES all well visits, which means you pay nothing for annual visits. That’s half of what we need right there. It also has a Deductible Credit (which I knew nothing about before) that allows you to reduce your future out of pocket expenses. Basically, if you don’t meet your prior calendar-year’s deductible, you get a credit the following year. After 3+ years of not meeting your deductible, your deductible is actually reduced by 50%. So, if all goes well, after 3 years on this plan, our deductible will be reduced to $5000 per person (for a max of $10,000 for our family). Then, if disaster strikes, we’ll pay less that year in deductibles. Sounds good to me!
So far, we’ve been to the doctor a few times this year and have even sometimes opted to NOT use insurance to pay for certain services, as it was cheaper not to use it. We know that if catastrophe strikes and everyone gets really sick, we can afford to pay the max of about $29K in a year. Right now, we are very healthy and a young family (ages 38 and 7 for the kid).
For others with special situations, health insurance may be crucial for them to keep things affordable. So, once you understand your family and how the plans work, you can figure out what makes sense for you.
i am hanging on to my job now just so i can keep my insurance. otherwise, it will cost me about $1,500/month.
I think this is the first time I’ve commented on your blog!
My husband and I both work for a small company that doesn’t give any benefits. Our health insurance for us (ages 29 and 31) and our toddler daughter is $983/mo and our mortgage is $996/mo, so they’re about the same in cost. That said, we do have an excellent policy (a copay policy with low deductible). Having a young child means we go to the doctor a lot for check-ups and sometimes sick visits, and I pay extra for optional maternity coverage in case we decide to have another child that’s $200 of the $983. I’ll probably have to have another C-section, and I know how much that cost for Round 1, so I feel like the value is there even though we could have a cheaper monthly policy.
When our employer dropped group coverage in late 2011, getting to that policy was a complete nightmare. At my postpartum checkup while I still had group coverage (the first time my Dr had seen me unpregnant and not puffy) my OB thought my thyroid “looked enlarged” and had some bloodwork done. Thyroid’s normal, nothing else needed. Well, apparently the Dr never formally put a note that it was fine in the file, which means I have a “toxic thyroid” for underwriting purposes when it came time to get an individual policy. Or so they say – I think there’s always something they will find to squeeze you. I got rejected from 5 companies because of this first rejection. It’s like one rejection sent off a spiral of them. I eventually filed appeals and got coverage, but at a 300% premium AND a thyroid rider. It took several months, which was super-stressful.
My advice would be: apply for insurance to every company you can find all at once, because once you get rejected, you have to disclose it in each application you do, which means the rejections will keep coming. And if you need to do an appeal, getting an agent might help. It might also pay to explore Cobra options. I thought they would be available to everyone, but apparently small employers’ policies may not be covered. That was a very unpleasant surprise.
Being in Malaysia, I may not be able to contribute to your article per se, JD. But should someone in the USA required some major operation, even if you have to pay it on your own, it is certainly much cheaper here. Thus the popularity of medical tourism in the country. Having said that, I do have medical insurances that cover hospitalization for both my son and I, at a very much lover rate of course. And when I travel out of the country I take travel insurances that also cover our medical needs. Yes, I’m kind of panicky in this matter, but to me better to have my bases covered.
I’ve had a sampler pack of insurance coverage in my life including iffy coverage in college, fab coverage with my job as a pharma rep, expensive Cobra when I was in-between jobs, and an HSA.
The best value for me and of no benefit to you, is the coverage I have with the much maligned NHS since moving to the UK.
I just renewed my prescription card for a year of prescriptions at a total cost of $156. That’s for any and all meds needed during the year.
Despite what many Americans say about the horrors of what they like to call socialized medicine, my experience has been great. It’s not a perfect system, but it’s very freeing for entrepreneurs. The US needs better options for folks like you or those who can’t afford coverage at all.
If I were in your position, I would go with HSA.
I’m covered at work now, but for the last few years when I was starting my small business, I had health insurance that cost me about $150 a month and had a $2600 deductible. I knew I had $2600 in savings, so that was OK by me.
I found my plan through Dave Ramsey’s network or Endorsed Local Providers — it’s a referral list through which you can find financial advisers and insurance brokers, including health insurance brokers. My dude had me signed up and ready to go within just a few days.
I have had such a different experience than other readers. I started my own practice just out of law school and have always had to pay for my own insurance, about 19 years now. I pay $130 a month and have a $10,000 deductible. I have $10,000 in a HSA to cover myself if something horrible happens. I guess I’m lucky that I got coverage early, stuck with it and have been healthy. I’m scared now that I will have to pay more because plans are required to cover more. I guess its just wait and see.
I do admit that if I have a cold or the flu – I will go to a minute clinic and not a doctor. But I like it better anyway – I’m in and out and can get my prescription right there.
We’ve done that too. If you’re paying out of pocket anyway, the minute clinic is the way to go for minor stuff.
I second the high-deductible plan with an HSA route. Deposits into the HSA provide a nice tax deduction that essentially acts as a roughly 25% discount on expenses. We’re self-employed with one toddler and are fortunate our state bar association now offers two providers with different plans. Our provider through last month just decided to stop writing health policies so we just applied and got approved for the one that offered a 10,000$ deductible 100/80% after for a total of $480 month. Still higher than I think it should be since we’re all healthy and fortunately have only required the usual pediatrician and gynecological appointments, but we have the HSA to pay for those and any unforeseen issues.
If something does pop up I might try to shop around first regarding prices, but at this point in time in our healthcare evolution process I realize that’s likely not to be too fruitful. Hopefully some day we can get to something resembling customer service in medical care.
I have been self-employed for the past 16+ years. Since then we’ve always had health coverage through my husband’s employer, whoever he was working for. The last employer paid 60% of the premium and our cost for health insurance was $500.00 per month for him, me & our two kids (now 17 & 19). He lost that job 3 years ago and up until this past August had only been able to find part time work, no benefits. When he was in between jobs we would go without insurance for a couple of months until he got a new job, but we live in Massachusetts and are now required to have health insurance or face having to pay a penalty when we file our income tax returns, per Mr. Romney’s health plan enacted some years ago. Massachusetts now offers a health insurance program that has several insurance plans to choose from with a tiered payment scale based on income. We each pay $78.00 per month for our medical coverage, the 17 year-old is on a state plan for children of uninsured/unemployed parents that costs nothing and the 19 year-old has had to get her own plan as she is no longer a minor and has also acquired coverage under the state’s plan. These plans allow for $20.00 office copays, mail order prescription plans and no copay for an annual physical exam with your primary doctor.
I would be interested to hear lostAnn just how people feel about the new med insurance program in you state now that it has been going for awhile. Could it help the rest of America out of its mess?
I’m also a MA resident who is on state health coverage, and it’s been great so far. At my income level, my health care costs are quite reasonable under the plan that I qualify for. I get to see my primary care doctor twice a year, routine tests and screenings are free, drug copays are quite reasonable, and I haven’t had to go out of network yet to get my health issues addressed. I don’t know enough about the inner workings of the state’s health plan to say whether it would scale up to work nationwide, but for MA, it’s holding up pretty well.
I have looked for individual coverage before the MA health care law went into effect, and the costs shocked me. The most affordable coverage I could find (this was about 15 years ago) was an HMO plan with a fairly high deductible and less-than-stellar service, so for several years while I was freelancing, I went without health insurance and hoped my generally good health would hold up until I took a job that offered benefits. It was a gamble that worked in my favor, but it was a gamble nevertheless. I’m older now, and I have ongoing issues that require more medical support and regular checkups.
Many professional associations offer basic health insurance coverage at a lower rate to their members, so that’s worth looking into if you’re eligible for professional association membership. The coverage may be no-frills, but it’s usually better than paying out-of-pocket for all your health care visits in a year. The annual membership dues are often worth paying just to get access to lower insurance rates.
There are also organizations that specialize in offering health insurance to self-employed people. The National Association for the Self-Employed (http://www.nase.org/) offers insurance coverage plus other benefits for sole proprietors, freelancers, and other self-employed people. Also, you can use your network of friends and professional contacts to find insurance brokers who specialize in serving self-employed people and others without health insurance through their employer. They can probably offer you a broader range of options than going directly to an insurance company.
One suggestion I have is to make a list of the types of services you need and use regularly (eye exams, dental care, chiropractic adjustments, etc.) to make sure the plans you are considering cover those services, or that you have affordable options to get those services directly if your new plan doesn’t offer coverage for them. Also, check ahead with your regular health care providers to make sure they accept the insurance you are considering, unless you’re willing to shop around for a new doctor and specialists as well.
I’m really scratching my head trying to figure out why other self-employed people pay so much more than I do.
I have an individual plan through Anthem BCBS and pay $165 a month for health, dental, and extra prescription/hospital coverage. (At my last “real job” I paid $120 per paycheck so I was thrilled with the amount.) I have office visit copays of $20 or $30 for a specialist, a deductible of $2500, and 80/20 benefits for surgeries or hospitalizations.
Of course I have no way to know anyone else’s health status, but I signed up for that plan at 28 years old and with no preexisting conditions. I have actually had a semi-serious medical condition come up since then but my out of pocket costs have been minimal and my premiums haven’t gone up. Where are people finding these mega expensive plans???
Costs can vary tremendously from state to state, for starters. Where are you?
Also, it may be that your state limits rate increases once a policy is in place. When I lived in New York, I had an individual policy for years through Oxford for about $300 per month, but by the time I left the state I would have had to pay close to $1000 for the exact same coverage had I been a new customer. In effect, I was “grandfathered” in to a more affordable rate.
I would be willing to bet that now, in your thirties (I’m assuming!) with a per-existing condition, a new policy would cost you a lot more than $165. You’re lucky–don’t change insurers unless you have to.
Andrea, it’s because you signed up while young and had no pre-existing conditions, and likely have a very clean health history. If you try to change your plan, you’ll get whacked with a much higher rate.
When my husband needed to buy his own plan (before we were married), he was only offered an $800 a month plan because he’d had a hospitalization in the last year. The hospitalization was because he was in a car accident (not at fault). He had no long-term care needs, but that didn’t matter.
In my case, they chose to use my ovarian cysts as a reason to make me pay more. I do not have PCOS, just had some cysts that were controlled with birth control pills. I also had one acute episode of asthma due to allergies, but do not have asthma. Both were cited as reasons to jack up my rate.
And here’s an even more ridiculous story. My brother-in-law had a catastrophic policy that didn’t cover doctor visits. He went to a low-cost clinic in NYC. Because he had insurance of any kind, his visit for an ear infection was $1000. If he hadn’t had any insurance at all, his visit would have cost $10.
Back in the dark ages, my employer offered a high-deductible health policy as part of its group plan. My husband and I, very healthy adults with no kids, signed up and established a Health Savings Account (HSA).
When I left that job it was with the intention of going freelance. So before I left we applied for a family high-deductible policy (HDP) offered by Blue Shield of California. We kept that policy even after I decided to go back to an office job, because the new job had only two options and both of them were more expensive than the HDP. (When your annual medical expenses average less than the amount of the deductible, you are *always* better off choosing a high deductible. It makes no sense to pay $600/mo for insurance if your annual medical expenses – retail value – are less than $600, as ours were. Our policy at this time cost at total of $300/mo for both of us.)
A subsequent job had better coverage, and we opted for theirs. It wasn’t an HDP so we couldn’t use the HSA. The money in that account just sat there.
Now I am at yet another job and again they don’t offer an HDP. We initially elected to join the group plan anyway; but when the premiums for the PPO went up unacceptably, we opted to secure outside coverage, this time with Kaiser – which is offering a new HDP. Now we can contribute to and use the HSA again, and we are paying $200/mo less than if we’d elected the cheapest plan offered by my employer (a total of just over $400/mo for both of us, versus over $600 if we were on the firm’s plan).
My advice to any self-employed person is to Google “high deductible health plans in [state]” and start there. A Health Savings Account is like an IRA that you can use for any medical expenses up to retirement age, and for any purpose after that.
I think you can continue to use the HSA even if you get a non high deductible health insurance – but you can no longer contribute to it.
I paid for my own health insurance in the past when I first moved to Portland from the SF Bay Area 3.5 years ago. OMIP (Oregon Medical Insurance Pool) was for me, a 30-year old woman with Multiple Sclerosis, about $375/month with a $1000 deductible + 20% on all services. Needless to say I ended up paying ~$700+ month on healthcare expenses for about two years until my Medicare kicked in. It wasn’t like I had the income to actually cover it being that I was on CA state disability at the time. Needless to say I accumulated a lot of non-consumer debt at the time.
I’ve had to pay for health insurance in the past, but it was far less. I wasn’t diagnosed with MS until January 2009, but I did (and still do) live with PCOS (diagnosed in 1999). The PCOS constantly took a bite out of heath care expenses until I was able to get it under control which for a few years lowered my healthcare costs.
Please be aware, legally you must be covered under a high-deductible healthcare policy in order to establish, contribute to, or pay medical bills with a Health Savings Account in the U.S.
http://www.irs.gov/publications/p969/ar02.html#en_US_2012_publink1000204020
This is, by the way, an outrage; everyone should be able to open one. Almost certainly the limitation was established under pressure from insurance companies. Write your congressperson. 🙂
Yep, I just reread that link you provided – once you have an HSA – you can use the money for medical expenses incurred after establishing it. Regardless of whether or not you can still contribute, the money is yours to spend on medical expenses.
The reason you can only contribute if you have a high deductible plan is that it is fundamentally a tax advantaged savings vehicle – so it’s costing the government in lost tax revenue, it’s a way to let people who pay out of pocket for most medical expenses do so with pretax dollars.
I think that’s fair.
I’ll be reading all these comments! Unfortunately I’ve been uninsured for 3 years except for the time during my second pregnancy when I had Oregon Health Plan. Luckily, our daughters qualify for the Healthy Kids plan in Oregon and my husband has insurance at work. We just haven’t been able to afford to add me to his plan (close to $400/mo I believe). I’ve been a stay-at-home mom, a daycare provider and more recently, starting a new small business.
I really should get a high deductible plan, so at least if something drastic happens, I’m covered. Luckily I’m a fairly healthy person. I do have severe allergies to grass: JD, check out acupuncture! I had to go every week my first year but now I only have to go in once or twice a year to control all of my symptoms. This is the only thing we spend money on for my health. (Oh yeah, and Planned Parenthood helps out in the birth control department.)
I do really like the high deductible with money in an HSA idea, I should probably try to squish that into our budget. Can’t wait to hear what others are doing!
I pay about $170/mo for an individual policy, but I need to shop around because I haven’t in awhile. I might raise my deductible, too.
J.D.–have you tried other solutions for your allergies, like using a neti pot regularly and sublingual immunotherapy? (Immunotherapy: http://www.hopkinsmedicine.org/sinus/allergy/sublingual_immunotherapy.html)
My husband and I both do those things now and barely have allergy problems…only when allergen counts spike and we haven’t been using these two things. We didn’t get drops specially made, just went to our local health food store. They have them at places like Whole Foods in the section with allergy meds.
You need to consider the changes coming in 2014. I’ve had a policy on my own. About $330 for a decent policy for a healthy woman in her 50’s. Currently I have insurance through an employer. I’m letting go of the job this summer and just spoke with an insurance co. They told me that only plans in force in 2010 will be grandfathered into the new system. If you change your plan now, you’ll have to change again in2014, choosing from an insurance exchange. The good news is that they’ll have to take everyone and can’t charge more for pre-existing conditions. The bad news is that it may be more expensive, especially for young and healthy males – who pay less now.
I have tried a bunch of different alternatives since leaving my corporate job in the beginning of 2000. One solution is get a part-time job at a company that offers benefits. Stay as long as you like after getting the benefits, then leave. You will be covered by COBRA for 18 months. This might not be the lowest monthly amount for a plan, but usually the benefits are good. Of course, this is not a long-term solution and you need to have a replacement before 18 months.
For another period of time, I worked at a small non-profit. I had them begin a policy for me and I paid for it with pre-tax dollars. This lasted for about 2 years.
Another alternative is to get a group policy through an association. I would buy one, but it is not permitted in NJ. From what I understand every other state allows group policies. All you need to do is to join some type of organization, such as a local Chamber of Commerce. The positive side, anyone can get a policy in NJ even if you have a pre-existing condition. Also, your children can be covered, even if the parents do not have a policy.
Currently, both my husband and I are self-employed. The rising cost of insurance and the lack of any control causes lots of frustration. We have a very high deductible plan that is so expensive, which only a few minor types of visits are covered until we meet the deductible is just sickening.
I did get a great tip from an insurance agent recently. She told me the best thing to do to reduce my health insurance is to hire a young male. Young men apparently do not go to doctors and drive a group insurance policy amount down.
On a final note, J.D. – You may want to look at a website called: http://www.allergyfreeandmore.com/.
Although, Debbie is in NJ, she may be able to recommend someone near you. She has an unique way of desensitizing people from allergies.
I encourage using an insurance broker if you need to buy health insurance on the market. The person I used walked me through the process for filling out applications and was able to get quotes ahead of time from several companies. She cautioned about the importance of applying to several companies at the same time so that none could use the others’ decisions to blackball my family. She didn’t charge anything (she works on commission from insurance companies, I guess), and I felt that I received a big benefit from having her assistance.
I’m not sure if they do this in the States, but in Canada it’s possible to purchase insurance through your professional organization. I’m not sure if the U.S. has an equivalent to the Professional Writers Association of Canada, but it might be worth a look? I’ve also learned that my alumni association offers discounts on supplementary health insurance too.
Right now I’m shopping around to replace the supplementary health insurance I had through my employer. It’s not the same beast as finding health insurance in the U.S., I realize, but I’m learning a lot about what provincial health care doesn’t cover and wondering what my chances are of needing certain services. (Like an ambulance ride, private hospital room, physiotherapy, etc.)
The health insurance landscape changes in 2014. It remains to be seen what this means to those who carry their own vs. employer sponsored.
JD,
Did your Doctor submit your medical bills to your insurance company? Sometimes you get the insurance negotiated rate even if you have to pay the whole thing because of the deductible. It can be as much as 50% off the cost.
Hi,
My family and I are thinking of moving to Miami, FL and the biggest question/ problem we have is Health Insurance. My son has a asthma and severe allergies so we definitely need it. Can anyone recommend or tell their experience of Health Insurance in FL? I will take any advice or any discussion.
Thank you.
I just bought my own policy after leaving my job last year. I’m still new to the game, but I used eHealthInsurance to select a policy from ODS. I pay $110 a month for a plan with a $5,000 deductible, and I, like you, feel like I get nothing in return for this premium.
I don’t really have much strategy beyond this other than to stay healthy the best you can. I eat well and exercise, and it’s done the trick so far in my life.
Long-term, I’m not sure what the strategy will be. Hope the system gets better? Just plan on paying more? It’s hard to say.
I found this article from Zen Habits thought-provoking: http://zenhabits.net/bet/ It’s hard to agree with his advice but definitely something to think about.
Oh and in terms of advice for others. Well, I’d probably say don’t buy your own policy if you don’t have to. The options just don’t seem that great, and benefits from a job just seem so much more valuable. But if you have no choice, just prepare to spend a lot on insurance.
I quit my job last year and my husband changed job around the same time. He was not eligible for insurance for the first 9 months. So most of last year I paid for my own insurance. I had it a little worse than a lot of people – (1) I am not healthy, most of last year and this January I ended up visiting the hospital on average 3 times a week, so high deductible plans won’t make sense to me and (2) I have pre-existing condition which made it a real pain to find insurance. I paid about $1450 a month for health insurance alone most of last year (I decided to go with just a discount plan for dental and vision and not get real insurance).
I don’t like linking to my post on any comment, but I am going to do it here as it outlines everything I looked at when I was looking for something that could be affordable for us. http://www.wealthinformatics.com/2012/04/13/affordable-health-insurance-self-employed-pre-existing-condition/
I even ended up getting some of my expensive tests done while I was India as it was so much cheaper over there.
Just wanted to add a little more information for people wondering how paying $1500/month would make any financial sense. My average hospital bills were ~$5000-$6000 a month. I did run a lot of scenarios and this ended up being the best option for our bottom line.
JD, I just wrote a long one about affordable health insurance for the unemployed, self-employed, or early retiree on my site. There are 4 options, and I found a really cheap one for myself.
Bottom line, the fear mongering politicians are just that. There are a lot of options! Come check out the article if you have time.
Sam
I am about to leave the world of education (I’ve been teaching for 12 years) and head out on my own.
My husband and I were both teachers and insured through our own school districts. When our son was born (Oct 2011), we put him on my insurance, as it was $200/month less than my husband’s. (It’s still over $500/month…). At the end of that school year (2011-12), my husband retired and is a stay at home dad. We looked into adding me and our son to his insurance (he has insurance through his district until Medicare kicks in), but his plan from his last year teaching is the only plan available. This means that the boy’s insurance will always be on mine, until he’s no longer a dependent.
I had Hodgkin’s lymphoma at 31, so I have a big ol’ red flag in my file. In searching for insurance, I learned that while my type of cancer has one of the highest “cure” rates of any, since it’s a blood cancer, it is, for insurance purposes, the same as leukemia (with a much higher mortality rate).
I did find a broker who said she could get affordable insurance for me once I was 5 years out from treatments. That anniversary passed in January. She won’t sit down and work out details until I actually need to buy the plan, and that won’t be for a few more months, so I can’t tell you for sure that the story has a happy ending. If you want to contact me in June, I’ll know more.
I’m inclined these days to use doctors who don’t typically take insurance anyway. You get way better care through a good naturopath than a decent PCP. But after seeing the bills I didn’t pay for cancer treatments, I wouldn’t go without again. (Dumb luck: if the diagnosis had been a year earlier, I would have been in between jobs and uninsured- a $200,000+ disaster.)
But I’ve already resigned my teaching job, taking the plunge… We’ll see!!
Just wanting to add JD……I hope that when you went to the Dr. that you told them you would be paying the bill yourself and could they please give you a discount as you would be paying it off with cash on that very day. Usually the savings is considerable. Not only at the doctors office but for xrays and blood tests etc.
$4,403 is the monthly premium paid by my employer for my family coverage. 55 years old, family of four. One pre-existing condition: I am a well controlled, type one diabetic (daily insulin shots). It is a “Cadillac” plan.
I work for a very small not for profit, with one FT employee (me). To say the least, I am very fortunate. I can’t help but wonder though that if the organization was not saddled by these high insurance costs, how much of that monthly premium would instead find its way into my salary, or better yet, pay for another staff member which would enable us to do more.
Health care has affected major decisions in our life from the beginning of our marriage until now. It’s affected everything from how many children we decided to have to where we’re living. Our current dilemma is deciding whether to relocate to a warmer climate in the next year or so. We currently pay about $44 a month for HMO coverage for a husband and wife plan through my employer. Out of pocket costs are $5 – $10 co-pays for doctors’ visits and about $180 in co-pays for prescription meds. Switching to my husband’s employer’s plan would cost us a few thousand dollars more per year in premiums and out of pocket expenses at our current usage of healthcare services. One emergency would bump that up several thousand more. My company is local so transferring my job when we move is not possible. His company is national so he could possibly transfer within his company if we move to a place where they have a presence.
Our best case scenario is thousands more per year in costs if he can transfer his job. I don’t think I’ll ever find a job with coverage as good and premiums as cheap as what I currently have so I’d not only have to worry about replacing my salary but also making extra to cover the increased healthcare costs. We’re both over 40 so I’m worried about finding a job at all without the health insurance worries thrown in.
Individual coverage isn’t an option for us under the current system or the new one in 2014 because we could never afford it. They would definitely exclude my occasional migraines, and the meds for that alone cost $30 per pill. Husband has a chronic health condition, and while his meds are much cheaper, the premiums would certainly be high if they would cover it at all. Under the new system we could get everything covered, but insurers will be allowed to charge smokers up to 50% more, and he is a smoker unfortunately (but trying to quit!) so the new health marketplace won’t be an affordable option either.
As Holly said in the first comment, it just isn’t fair when affordable health care dictates major decisions in life like where you want to live or when to have kids. We have almost enough money saved now to replace my salary for a year while I look for another job, but the fear that a medical problem could wipe that out quickly or that I won’t find a job with good coverage at an affordable price has us in limbo right now. It makes more sense financially to stay where we are, but we’d really like to move somewhere else while we’re still young enough to enjoy it.
I pay about $350 a month since moving to Anchorage in October. Haven’t used it yet. Hope not to use it except for my annual physical.
But I won’t go without insurance, because no machine runs for more than 50 years without some maintenance issues. Last year around this time I had to have my gall bladder removed. My share was about $2,000. If I hadn’t had insurance it would have been a lot more.
Nobody likes paying for car insurance, either — until there’s an accident. I view health insurance as a necessary evil.
I’ve been self-insured for most of my life post-college. In 2011 I went back on my parent’s plan due to Obamacare. But when I turned 26, it was back to the individual plan.
My advice, especially to young people, is not to be intimidated by the individual plan market. So many of my friends don’t have health insurance because they lack a full time job. Instead, they have several part time jobs… which don’t offer insurance to their workers. I used BenefitsCafe to choose my plan. They made it easy for me to compare coverage across different companies. Think about what your needs are. With Obamacare, a yearly checkup for women is covered under insurance. Birth control is also covered. If that’s all you need, then you can go with a high deductible plan and pay much less per month.
My last advice, and this is easier for young people, is to try to find your college health form before you fill out the application. The individual plan application is SO LONG. Seriously. They ask a lot of questions you probably don’t know the answer to, but the information your parents put down when you went to college should help. Also, don’t be afraid to call mom or dad, whoever knows your health history. I know this sounds silly, but the application was a big hang-up for me. I was overwhelmed by everything they needed to know.
My current plan is through Anthem Blue Cross in California. I pay $194 a month, and have a $2,000 deductible. My prescriptions are normally $15. When I first got an individual plan in late 2008, I did have a preexisting condition.
I’m 29 and haven’t had insurance since I graduated when I was 26. I’m self-employed, and “the idea” of having insurance is the number one reason I would consider getting a “regular job.” When I weigh the pros and cons I’d rather be without insurance than tied down to a job. Right now I can make decisions about my work load. Because of that I choose to make what I spend in a year, plus a little extra. If I were to pay for my own insurance that would mean I would have to EARN MORE which would lower my quality of life.
I know it’s a gamble, so are a lot of things in life. I’ve only been to the doctor once (actually it was 3 sessions) since being without insurance for having a tiny flake of metal taken out of my eye. I believe it cost me about $480 and I was given discounts and free medicine for not having insurance. If I were on JD’s plan I would have spent about $5,000 on insurance so far, and it probably wouldn’t have covered any of my $480.
If I were older I probably wouldn’t be as bold as I am now. But when I look at my medical history I just don’t believe I would be getting my moneys worth out of insurance. Sure, there is semi-piece of mind that “maybe” I will be okay in a catastrophe, but if I spend all my time worrying about the worst that could happen I, again, would be lowering the quality of my life. It’s better to live healthy, be aware of dangers and think positive, than to live in a culture of fear that makes so many people sick in the first place.
I think one of the major issues with health insurance in the US is that it varies so much depending on where you live. I’ve read through some of the comments to “just get X it only costs Y” and know that X in my area costs more like 4Y…. In my home state of RI there is ONE option if you need to buy insurance yourself (and are above state assisted income levels). Even our high deductible rates are very high.
My thinking on this has changed drastically in the past few months. My 28 year old daughter lost her health insurance when she changed jobs and her new employer (a small salon) didn’t offer it. She’s had depression and a thyroid condition for years, and those conditions meant she was denied by every commercial insurer. We thought we were fine, just helping her pay for the occasional doctor’s visit and her prescriptions out of pocket. Six weeks ago, she was diagnosed with aggressive breast cancer. We all think it won’t happen to us, but having no insurance and being hit with a terrifying – and tremendously expensive – diagnosis at age 28? Well, I certainly wish the Affordable Care Act had gone into effect January 1 this year. I will do whatever it takes to get her the treatment she needs, but I believe we ALL need health insurance. If we never need it great, but if we do, it’s there.
Margot – I am very sorry to hear about your daughter’s diagnosis. I hope they have caught it early and can get the treatment she needs to fight it.
I would suggest looking in your state’s insurance programs (including Medicaid). Some states have programs that specifically cover cancer (Delaware is one) and has very generous income levels.
Another thought is looking into Cobra of her old coverage – she has a time limit of how long she can get back on that insurance, and you have to pay the entire premium (I looked into it and it was very expensive), but it might be an option to avoid astronomical medical expenses.
Best of luck to you both.
Ugh, health insurance makes me anxious. We are looking for a new plan and having no luck. My student insurance ends in August. I’m pregnant and due in September. No plans in our state cover regular maternity care and delivery, although I did find one that covers complications, so I think we will go with something like that. I am also going to look into potential plans for small businesses.
Maybe we should have waited until 2014 when maternity care is a required part of plans, but we are both older and didn’t want to wait in case we couldn’t have another child. I hate this medical system. I scrutinize every bill we receive now – never did that when I just paid a $20 copay and moved on. What boggles my mind is the discount I get for having the insurance plan versus paying cash. Shouldn’t they want the cash they can get ASAP instead of waiting months and doing endless work for a reimbursement? How is this an effective system?
My husband changed private insurance last year and had to get a physical to be considered for the new plan. I called to ask the cost of a physical, and they said it depended on what the doctor coded the visit as for the records. Could be $100 or $1000 – wouldn’t know until afterward. They also wanted multiple visits first to form a relationship. I see my doctor for 10 minutes when I am sick – I don’t have a relationship with him. He ended up going went to a “doc in the box” for a physical, and he charged us $55. He was awesome. His clinic has the cheapest xray costs in the whole state – even cheaper than the vet’s office next door. He streamlined the process and tells you what to expect your costs to be. Should be that way for everything we do.
Can you Cobra your student health insurance? Even the Army is required to Cobra.
Are you young enough to be carried by your parents? (They can cover you up to 26 even married). Your child can be enrolled in state child health the minute they are born if your income qualifies.
I haven’t had health insurance for the past 3 years. I’m 27 now and was on a family policy during my first year of my full time no-benefit job. The following year, I didn’t have much of a choice and lost insurance because I wasn’t making enough money to cover individual insurance (NJ resident- why is everything here so expensive?!) and my student loans. The next year I was allowed back onto my family policy because of Obamacare, but again, I didn’t have the extra $350 needed per month to join that policy.
I quit my job and now doing a small amount of freelance work but again, not enough to cover an individual plan. For the past few years my health care has been provided by the CVS Minite Clinic and Planned Parenthood, which is fine to a degree but if I have any severe health issues I’m in trouble. I do have a decent emergency fund saved but I’m trying not to dip too far into it before I find a new job, and hopefully something that cares enough about their employees to provide health insurance.
Where does everyone live that they have $100-150 plans? I’m jealous.
Not entirely on topic, but I’ve always had rampant hayfever and it got a lot worse after recently moving to the country. After getting fed up with taking antihistamines, I tried giving up dairy and gluten for a few days. The results were amazing and I immediately stopped taking the antihistamines, even when doing tasks (such as cutting the grass) that would have made my eyes and nose streaming beforehand. I now eat the occasional bread roll and some cheese, but I’d really recommend trying out going gluten and dairy free.
Hello,
I’ve been self-insured for about a year, but luckily for me I live in France and pay 40 euros a month for a plan that covers almost everything, 100 percent reimbursable. For trips back to the United States I’ve had to pay about 150 dollars a month for emergency insurance with a high deductible. I’m worried about what I’ll be able to find when I move back for good, so thanks for posting this question.
Tom
My husband is a 59 year old independent contractor with a genetic kidney disorder. We met 24 years ago. I had always had medical insurance coverage through my employer. At the time we met, I was paying zero for my coverage. We married 6 years into our relationship mainly because he could not qualify for medical coverage and the cost of kidney surgery was expensive. Even 18 years ago his kidney medication was over $100 every month. By the time we got married, my employer had asked the employees to pay a “token” $5 per pay period for the single coverage. Adding my husband increased the premium to about $38 per pay period. I am still working for that same company I worked for when we met. I now pay $358 per pay period (26 x per year =$9,308 yr) to keep a $5,000/person deductible plan. We pay $40 per doctor visit and $50/$30/$15 for prescription medications. The crazy part in this equation is that my employer has paid 100% of my premium for the last 10 years…… the $358/pp that I now pay is ONLY for my husbands premium. I was never happy about having the government take over our health care system……but somewhere deep down inside, I am hoping (since it is law now) that since my husband will be “eligible” for coverage through an exchange service, which is considered “group coverage”, that our health care expense will go DOWN….. not up. That maybe there will be a little window of time before it all blows up in our face that he can be covered at a more reasonable price. Of course I know that we will all pay for this down the road, but maybe by then my husband and I will be too old to know how badly we have it….. sorry this was depressing