OT- Medical Coverage Advice sought

[GANJIRO]

I found out yesterday at my termination meeting that my medical, dental, and vision coverage will all be canceled, this will be the first time in my life I or my dependents will not have any medical insurance (starting March 15th). Those of you here who are self employed or otherwise must directly pay for their own medical (not thru employer) what medical insurance plan due you use and recommend? Thanks you.

[gcs]

I think the medical portion can be kept for 1 year under COBRA, this would be the same plan you have, or had, now.
This would give you time to research other options.

[RKrodle]

JI, I have mine with the National Association of the Self Employed. (N.A.S.E.)
The insurance is with Mega health and life.

[Rusty]

MY son recently sign up with Blue Cross and Blue Shield, but I would think that coverage will vary from state to state. Major medical with a large deductible is what he got.

[Hairy Clipper]

There is no question medical insurance is VERY EXPENSIVE after you hit the 55 mark. Mine just went from $858/quarter to $1,266/quarter. That being said, I do carry Blue Cross & Blue Shield of Minnesota. I ended up with them as a result of my former carrier pulling out of our state and my insurance man found these guys for me. This was a blessing! They do indeed pay claims, billings go directly to them from the hospital/Dr. and once the deductable has been paid you don't see a bill. Expensive, but, I have been very happy with their no hassle service!

Good Luck & Best of Health my friend!
Hairy

[PJA]

I believe COBRA is good for 18 Months.
Pete

[El Chivo]

I once knew someone who had COBRA and I couldn't believe how expensive it was. So much for government programs.

The last time I paid for my own, I found an ad in a weekly paper for an insurance agent that could choose between several carriers/plans. For instance you could skip the pregnancy coverage. At that time I had Blue Shield, it was the cheapest and best. High deductible, etc.

I found a link for United Healthcare which is an alliance of several carriers:

https://www.ehealthinsurance.com/ehi/Al ... d=Gol23570

I ran mine just for grins and my best rate was $114.00 per month through Aetna (I'm 49).

[dr walker]

I have a blue cross blue shield plan for my family, it only covers major medical expenses, but I am paying 129 per month for 3 of us.

[NE1022]

COBRA on account of job termination is for 18 months. If insurability is not an issue I would highly recommend an HSA compliant high deductible medical plan with BCBS, United HealthCare (Golden Rule), Humana or Assurant (Time). I am currently w BCBS but had my best luck with Assurant (they had a provision where your renewal rates were discounted if you could sign a good health statement each year).

I would personally steer clear of the association plans as they all seem to run their course over time. When new or a carrier switch is involved premiums are often competitive in an effort to drum up new business. As time passes and claims become creditable, rates have to rise, good health risks leave for greener pastures and rates go up precipitiously to cover the remaining risk. Eventually the association plan folds or a new carrier steps in. The association plans are started with good intentions but eventually greed takes over and you can't tie those good risks to the group over the long term.

Depending on where you are located, and as a last resort, your state may have a guarantee fund for uninsurables. Again, that would be a last resort and you may have to prove declination by more traditional sources to qualify for coverage.

BTW - the HSA (Health Savings Account) can be a great tax planning and wealth accumualltion tool, better than IRA's.

[GANJIRO]

I think the medical portion can be kept for 1 year under COBRA, this would be the same plan you have, or had, now.
This would give you time to research other options.

COBRA will cost me $805.89 A MONTH for my family to keep current plan, ARGH that's more then one disability check!

[GANJIRO]

JI, I have mine with the National Association of the Self Employed. (N.A.S.E.)
The insurance is with Mega health and life.

Just checked their website they had nothing available for someone in my circumstances.

[Old Ironsights]

Get a high-deductable MSA. It's the only rerasonable option for somone who doesn't have a taxpayer-subsidized "Health Plan" (which ALL non-MSA "health plans" are....)

[jazman]

Sign up for the COBRA until you figure out what you want to do to avoid a lapse in coverage. I think if you have a lapse when you do hook up with someone new they can mess with you over existing conditions.

[GANJIRO]

I once knew someone who had COBRA and I couldn't believe how expensive it was. So much for government programs.

The last time I paid for my own, I found an ad in a weekly paper for an insurance agent that could choose between several carriers/plans. For instance you could skip the pregnancy coverage. At that time I had Blue Shield, it was the cheapest and best. High deductible, etc.

I found a link for United Healthcare which is an alliance of several carriers:

https://www.ehealthinsurance.com/ehi/Al ... d=Gol23570

I ran mine just for grins and my best rate was $114.00 per month through Aetna (I'm 49).

$581.00 a month thru Kaiser for family excluding eldest son. ARGH

[Marlin .35]

JI!! I don't know if you ever served in the military, but there is always the V.A. Thats what I use. Andyou do not have to have been in combat!! Good luck! Art

[GANJIRO]

Hi Art, no i'm not a veteran, just a son of one.

What do you self employed guys do for dental coverage (besides medical)?

[deerwhacker444]

Absolutely, take COBRA for now just so your coverage doesn't lapse. If you lapse in coverage it will be a hassle to get coverage when you get a new job at a reasonable price and you and your family will probably have to take a physical (hassle).

When I was out of work I used COBRA for a full 18 months. It kept the insurance I had at a reasonable level.

If you lapse in coverage, they will mark you as high risk if you have any pre existing conditions or surgeries and charge you more.

[Hobie]

Hi Art, no i'm not a veteran, just a son of one.

What do you self employed guys do for dental coverage (besides medical)?

I've almost never had dental coverage. When I did the cost exceeded the payout. Dropped it. Don't have it now and I go every 4 months.

[Leverluver]

United Healthcare........you can probably find this sort of thing with any company but it is worth reading. It scared me away.

http://www.google.com/search?hl=en&q=Un ... gle+Search

[rimrock]

JI,

Check out any associations you belong to in Hawaii. Some of the absolute best coverage I've seen in Texas at affordable rates was made available through the Texas & Southwestern Cattle Raisers Association by Blue Cross of Texas. Heck, even NRA may have something better than COBRA. IIRC, you were injured in an on the job accident. Hawaii's market of last resort could also be a good bet for you if you have an illness some insurers would shy away from. Check with your state Department of Insurance about the market of last resort. For COBRA, you will most likely have to pay up to 102% of the premium charged under your previous employer's coverage. Coverage costing $200 bucks a month before would cost about $208 under Cobra. If you're going to stay in the employment market, it's important that you stay with COBRA as long as you can (if you can afford it) so you will have credible and portable coverage under ERISA at the next employer. The 62 month period for preventing a break in coverage for credibility and portability I think starts at the end of the COBRA period. Credible coverage keeps some pre-existing condition exclusions from applying.

[brucew44guns]

Quite a bit said here about being on COBRA for now, I agree. When you least expect it, just out of no where, here comes an emergency, kid breaks an arm or leg, gets scratched up, just any little fluke that causes you to go in to the emergency room, and then stay for a couple more nights, and you can sell your house if that coverage has lapsed. You're going to get a new job pretty soon, you have to---no choice. You can recover what you spend on insurance later.

[Old Ironsights]

The "cost of insurance" for a Health Savings account is rediculously small... the key is setting it up properly.

First thing to remember is that all money going into an HSA is PRE-TAX-DOLLARS. So you "get" another 15%-20% right off the top.

You use a check/debit card from your HSA account to pay for medical expenses. Those covered under your "plan" get added to your deductable. When you hit your deductable, 100% of covered expenses are, well, covered.

The upshot is once you pay $2500 pre-tax dollars, your medical care is covered... and if you don't use it, you get to keep it.

Your HSA dollars gain tax-free interest, just like a ROTH, and if you never use them you get to (are forced to) cash them out when you hit decrepitude.

The secret is to NOT set up a "family" plan. When you set up a "family" HSA your deductable doubles.

Each non-dependant member of the family should have their own HSA.

Each HSA holder is elegible to put up to $2680 (this year) pre-tax/tax free into the HSA.

Plan Deductables vary, but at 40 I get a $1500 deductable 80/100 Network plan for $115/mo.

I put $100 per pay into the HSA, so the "monthly cost" for me is $332 - BUT $216 OF THAT IS MINE AND GAINS INTEREST EVERY MONTH.

So I suggest you calculate out your "real" medical costs for the entire family and see whether or not a "high deductable" plan with an HSA makes sense. In most cases it does. You just have to get past the first year of "filling" your HSA cushion.

[AJMD429]

I agree with the high deductible plans or HSA's. Insurance basically HAS to be more expensive than the average per-capita expense, so if you want 'everything' covered you'll pay at LEAST that much (I think it is about $4,000 now). The more of that you're willing to self-pay, the less you'll spend on insurance (if you agreed to pay the first $3,999 the company would know on average that you'd likely cost them $1)

Without any employer portion paid for me (I'm self-employed) I usually pay about $16,000 to $19,000 per year for a $5,000 to $2,000 deductible family plan. The actual cost of the insurance would be the same for a hypothetical twin brother & family if he was working for FedEx or someplace, even though he'd say 'it only costs $25 a month' or some such nonsense. The problem is the employer isn't likely to give you the extra $1,500 a month in pay if you decline their insurance, so you think it's a good deal because it's the 'only' deal...

Most of the fancy plans STILL don't cover much - our average total office visit was $26 20 years ago, when no insurance covered it; now the overhead has risen from $14 to $70, and the charge averages $140 but we 'donate' $54 back to the insurance in forced discounts, making $16 on the visit now vs. $12 back then. A 'wash' for us. For the patient, ALSO a 'wash' as far as the office; most are paying a 'co-pay' that is about $30 anyway, so all their fancy insurance did was take alot of their hard earned money and waste it on our overhead.

Same with prescription coverage; most plans nowdays generously 'cover' generics, but you can get them for $4 per month without insurance. If you dare take a brand medication, the copay (if it is even covered at all) is likely to be $45 or more. Before insurance 'covered' prescriptions, the manufacturers wouldn't DARE introduce a product for more than $30 a month. So, same thing - patients spending lots of paycheck and pre-paycheck dough on a product that doesn't do much except raise prices.

Get insurance for the big stuff - CT scans, ER visits, surgeries, MI's - the primary care/preventative stuff is too cheap to insure cost-effectively; our average patient's total expenses (out of pocket and direct) are under $400 per year for complete primary care. Insuring that would be like having your homeowner's insurance cover replacing lightbulbs.