Any thoughts on affordable health insurance?

[Tinkerbelle9980]

Would anyone be able to recommend a halfway affordable insurance company? The insurance we have currently through work has gone up dramatically so we have been given the option to cancel it. I have never looked for insurance on my own so I am a bit clueless. Thanks!

 

[dturner]

Would anyone be able to recommend a halfway affordable insurance company? The insurance we have currently through work has gone up dramatically so we have been given the option to cancel it. I have never looked for insurance on my own so I am a bit clueless. Thanks!

Good Luck!! Insurance is high. I've been looking for an individual policy for my DS(14) who lost his health insurance at the end of January when Unicare pulled out of Texas.

I used this site and put in my information, then it comes up with a lot of different health insurance policies and rates and you can compare them.

http://www.ehealthinsurance.com/individual-health-insurance

 

[woodkins]

Our state (NY) has a program called Healthy NY that small businesses and individuals can buy into. There are a few different insurance companies you can choose from and the cost is lower than if you tried to purchase it on your own. You can check and see if your state has something similar to it.

 

[Pakey]

Group policies through your employer are generally cheaper because the money is pooled. You can get individual policies for less money but your deductible/copays/coverage may change dramatically. Just make sure you are comparing apples to apples.

Also, don't be surprised that if you use a lot on your individual policy, your rates skyrocket next year.

 

[dis-happy]

If it's through work you're probably much better off keeping it.

Our family insurance is up to $1300. per month for an individual policy and doesn't cover everything that we had with group insurance.

 

[bjscheel]

Employer plans are not always a better deal than you can get on your own. We have always paid for our own and when we did a family plan it was a lot cheaper than through my work. Right now I am covered at work but we have to cover DH and the kids.

You probably can't get Wellmark in your state, but that's what I got DH and the kids on their website. When they were all on it, it was around $250/month. The deductible was $3400/year...until you get there, you pay for everything. Once you meet that, they pay 100%. We rarely have any medical bills and figure $3400 a year wouldn't break us if it came to that. Now the kids are on the state program (temporarily- I expect us to have to much income to renew), so DH is around $130/month with the $1700 deductible. I really don't think that's bad. You didn't say if you were looking for family or just yourself? What are the major health insurance companies in your state? Look at their websites and see if you can price some policies.

 

[MrsPete]

I think the problem with insurance is that typical policies have grown so large that people expect them to pay essentially everything. What's that saying about government? A government large enough to take care of all your needs is also large enough to take everything you have. Same thing's true of insurance: A policy large enough to take care of all your needs is large enough to cost everything you make.

Look into a major-medical only plan. This is the type of plan that DOES NOT pay for your normal doctor visits (i.e., strep throat, summer camp physicals, dermatologist), but it is there in case of something catastrophic (car accident, heart attack, surgery). In case of something catastrophic, our plan pays 80%, which brings the cost of a hospital stay or something else expensive into the "I can manage this" arena.

We have this type of plan, and it costs us about $40/month for a family of four. Yes, it's expensive to pay the full cost of doctor visits and prescriptions, but when you do the math, it's much less expensive than paying health care premiums every month. We've kept record for the years we've been doing this, and we have saved LOADS of money.

Before you commit to something like this, consider two things:
1. How many times are you likely to need to go to the doctor? For example, this might be a bad idea for someone with a small child who's still going for all those well-visits and immunizations.
2. Do you have the financial resources to pay for a doctor's visit or medicine any time you need it? You don't want to say to your kids, "Sorry you're feeling so bad. We'll go to the doctor after payday."


And one more related topic: A couple years ago a new vaccination was required for kids at school, and our school nurse recommended that we go to the county health department to get it for free. Since this was the first vaccination we'd had since changing to the major-medical only, I thought that was a pretty good idea. When I got there, I was VERY ANGRY to discover that a couple other vaccinations had been changed since my children were small, and my private doctor NEVER TOLD ME in all the times I'd been there. When my kids were 2-ish, the doctor told me that we were DONE until they turned 16, so I never thought about it again. We were in and out of the private doctor's office plenty of times, and surely they knew that I would've wanted the kids to have those shots. Score one for the health department.

 

[crisi]

I think the problem with insurance is that typical policies have grown so large that people expect them to pay essentially everything. What's that saying about government? A government large enough to take care of all your needs is also large enough to take everything you have. Same thing's true of insurance: A policy large enough to take care of all your needs is large enough to cost everything you make.

Look into a major-medical only plan. This is the type of plan that DOES NOT pay for your normal doctor visits (i.e., strep throat, summer camp physicals, dermatologist), but it is there in case of something catastrophic (car accident, heart attack, surgery). In case of something catastrophic, our plan pays 80%, which brings the cost of a hospital stay or something else expensive into the "I can manage this" arena.

We have this type of plan, and it costs us about $40/month for a family of four. Yes, it's expensive to pay the full cost of doctor visits and prescriptions, but when you do the math, it's much less expensive than paying health care premiums every month. We've kept record for the years we've been doing this, and we have saved LOADS of money.

Before you commit to something like this, consider two things:
1. How many times are you likely to need to go to the doctor? For example, this might be a bad idea for someone with a small child who's still going for all those well-visits and immunizations.
2. Do you have the financial resources to pay for a doctor's visit or medicine any time you need it? You don't want to say to your kids, "Sorry you're feeling so bad. We'll go to the doctor after payday."

The other trick here (and one that I think is going away with the health care legislation, but haven't paid much attention honestly) is you have to be careful you don't have and aren't at risk for chronic conditions.

A girlfriend of mine was just diagnosed with diabetes. That's going to be expensive to manage on her major medical only account, but now she has a pre-existing chronic condition, and won't be able to get insurance.

She's 40, a size eight, a martial arts blackbelt and a 30 year vegetarian who is big into whole foods. Not exactly the "high risk for diabetes" type.

 

[bettymae1121]

An 80/20 major medical plan is certainly better than nothing. But remember, 20% of a $500,000 major medical bill is still $100,000. A major crisis can easily cost that much. My DH had was in ICU for a few days and then another week in a regular room, and it was a good $300,000 total bill, and that was 8 years ago, today a similar crisis could easily cost $500k.

A better option might be a high deductable plan paired with a health savings account. A high deductable plan has, as it's name implies, a high deductable, let's say $10,000. You pay out of pocket until you hit the $10,000, and then the insurance kicks in at 100%. How you get the $10k is where the health savings account comes in. You put the money into a special savings account that is ONLY for medical related purchases, and it's tax deductable. When you go to the doc, you pay the doc out of the savings account. Break an arm? Comes out of the health savings account.

The beauty of it is that the monthly premiums are a lot lower than a traditional plan, and any money you put into the health savings plan is yours to keep forever (it's not a flex spend situation where it's use-it-or-lose-it), it just can only be spent on medical stuff.

 

[Tinkerbelle9980]

Thank you to everyone that has replied so far! You have given me a lot to think about. I don't need a great plan just one that I feel is worth having. The insurance is with my husband's work and it's just for the two of us. I don't feel that the new plan will do us much good. It now has a $10,000 deductible a separate $1000 perscription deductible and only 50% coinsurance all for $400 every two weeks. Of course my husband's work is considering changing companies, so I am hoping for that. Thank you all for your help! I knew I could count on everyone here to tell me what I need to consider.