Self Employed Health Insurance, who do you use?

[Our03z4]

It's that exciting time of year, the Market Place is open! Ugh. Cheapest plan costs almost $600 and is horrible coverage, and that's for no health problems or kids. Still pretty sour that I use to pay $200 for great coverage, but I know those days are over. Well anyway, who do you all use? Choose outside the market place? Right now we have Medishare, it's cheap but you don't recieve a tax write off and you can't use a HSA.

Any advice is greatly appreciated!

[Run Silent]

Are you asking those who are self employed, I assume?

I have BCBC, but my employer covers 100% of the costs for me and my family and offers an HSA with an immediate $1,000 match contribution, so I have no idea what it costs.

[Our03z4]

Thanks for pointing that out. Yes, self employed or those who have to pay for their own.

[Hawkeye]

Originally Posted by usshelena725

Are you asking those who are self employed, I assume?

I have BCBC, but my employer covers 100% of the costs for me and my family and offers an HSA with an immediate $1,000 match contribution, so I have no idea what it costs.

Damn, that is a nice perk. We still pay ~$70 / month for our HSA family plan and the company only contributes $150 to the HSA.

That isn't $600 a month I hope.

[Run Silent]

Originally Posted by Hawkeye

Damn, that is a nice perk. We still pay ~$70 / month for our HSA family plan and the company only contributes $150 to the HSA.

That isn't $600 a month I hope.

Yeah, I have some pretty serious medical issues so my typical annual medical expenses are in the 5 figures. It's a huge deal for me.

When I left my last firm, my family coverage was $680/mo out of pocket for me, spouse, and kid. When I took this job, it was a substantial raise and I had already decided to say yes to the offer when I found out about the gratis insurance. So it was essentially an additional raise of about $8,000 above and beyond the original expectation. Great company.

This year, I just got a letter in the mail that said the company felt that our deductibles were too high so they cut them nearly in half ($4,000 down to $2,400 for family and $2,000 down to $1,200) annually. What company does that? LOL.

[Hawkeye]

Originally Posted by usshelena725

Yeah, I have some pretty serious medical issues so my typical annual medical expenses are in the 5 figures. It's a huge deal for me.

When I left my last firm, my family coverage was $680/mo out of pocket for me, spouse, and kid. When I took this job, it was a substantial raise and I had already decided to say yes to the offer when I found out about the gratis insurance. So it was essentially an additional raise of about $8,000 above and beyond the original expectation. Great company.

This year, I just got a letter in the mail that said the company felt that our deductibles were too high so they cut them nearly in half ($4,000 down to $2,400 for family and $2,000 down to $1,200) annually. What company does that? LOL.

The answer is a company that values it's employees and wants to keep them happy.

[Run Silent]

Originally Posted by Hawkeye

The answer is a company that values it's employees and wants to keep them happy.

For sure - it is an amazing place to work. I literally never see a grumpy person all day. Everyone is pleasant.

[RickFLM4]

I have Florida Blue. $1,400 / mo. scheduled to go up to almost $1,700 / mo. for just my wife and me. High deductible. I need to spend a few hours researching (like I do every year) before deciding whether or not to switch plans yet again this year. Unfortunately, there are few plans from which to choose that have local hospitals and our doctors in the network. We are pretty healthy with no major heath issues but both recently turned 50 so healthcare is becoming more of a focus for us. It is difficult to find doctors we like so it really sucks to have to find new doctors who may be located far away due to changing networks. Yet we are paying an awful lot of money and consuming very little healthcare we don’t pay for anyway due to deductible. We will not go without insurance but the rate of increases is not going to work much longer so whether this year or a future year, I expect we’ll need to change to a different network and / or benefit schedule.

I used to be able to buy a small business plan for a group of 1 before ACA. We figured individual insurance might be easier to buy and be more competitive (wrong on both counts...) and switched over to individual once ACA eliminated the gap for preexisting conditions when going from group to individual. I guess we would have been forced to switch over anyway because I can’t find group of 1 plans any longer.

Best case is my wife goes back to work full time and they offer insurance, at least for her, if not both of us. I can only raise hourly rates so much, but at least expect a lower tax bill to help mitigate part of these costs. We’ll see.

Edit: Also I think the marketplace is useless you get a subsidy. I find plans to compare by going to different insurer web sites, seeing what they offer and compare whatever offerings I can find. Not every insurance plan available appears on the marketplace, at least in FL.

[Run Silent]

Originally Posted by RickFLM4

I have Florida Blue. $1,400 / mo. scheduled to go up to almost $1,700 / mo. for just my wife and me. High deductible. I need to spend a few hours researching (like I do every year) before deciding whether or not to switch plans yet again this year. Unfortunately, there are few plans from which to choose that have local hospitals and our doctors in the network. We are pretty healthy with no major heath issues but both recently turned 50 so healthcare is becoming more of a focus for us. It is difficult to find doctors we like so it really sucks to have to find new doctors who may be located far away due to changing networks. Yet we are paying an awful lot of money and consuming very little healthcare we don’t pay for anyway due to deductible. We will not go without insurance but the rate of increases is not going to work much longer so whether this year or a future year, I expect we’ll need to change to a different network and / or benefit schedule.

I used to be able to buy a small business plan for a group of 1 before ACA. We figured individual insurance might be easier to buy and be more competitive (wrong on both counts...) and switched over to individual once ACA eliminated the gap for preexisting conditions when going from group to individual. I guess we would have been forced to switch over anyway because I can’t find group of 1 plans any longer.

Best case is my wife goes back to work full time and they offer insurance, at least for her, if not both of us. I can only raise hourly rates so much, but at least expect a lower tax bill to help mitigate part of these costs. We’ll see.

Curious with regards to the marketplace insurance options. Do the rates change based on age and health? Wonder what it would cost for a plan on my in-laws. 73yo and prior heart attack with current breast cancer.

Cause if it's the same - then 1400-1700/mo isn't horrendous.

[RickFLM4]

Originally Posted by usshelena725

Curious with regards to the marketplace insurance options. Do the rates change based on age and health? Wonder what it would cost for a plan on my in-laws. 73yo and prior heart attack with current breast cancer.

Cause if it's the same - then 1400-1700/mo isn't horrendous.

Not sure. They definitely don’t ask about health issues - I believe they can’t price based on health.

I see big increases every year, not sure how much is inflation vs. age-adjustments. I do expect older people will pay more since we all consume more healthcare as we age. It’s a time consuming process to analyze every year and I haven’t messed around by changing age to see what happens with rates. To do that, I believe you need to start the entire pricing process from the start. I don’t think you can just change an age variable while looking at pricing. If I see I can when I get into research, I’ll give it a shot and see how much pricing changes.

[Run Silent]

Originally Posted by RickFLM4

Not sure. They definitely don’t ask about health issues - I believe they can’t price based on health.

I see big increases every year, not sure how much is inflation vs. age-adjustments. I do expect older people will pay more since we all consume more healthcare as we age. It’s a time consuming process to analyze every year and I haven’t messed around by changing age to see what happens with rates. To do that, I believe you need to start the entire pricing process from the start. I don’t think you can just change an age variable while looking at pricing. If I see I can when I get into research, I’ll give it a shot and see how much pricing changes.

Thanks. Legitimately curious, as my in-laws live out of the country. My wife and I have considered sponsoring them to come live in the USA, but haven't been able to figure out a reasonable cost option for health care, since they won't qualify for medicare.

[Z K]

Originally Posted by usshelena725

Thanks. Legitimately curious, as my in-laws live out of the country. My wife and I have considered sponsoring them to come live in the USA, but haven't been able to figure out a reasonable cost option for health care, since they won't qualify for medicare.

Do they have healthcare where they are? Many Asian countries have govt subsidized healthcare if you are citizens there. China and Taiwan come to mind. China has basic public healthcare for all citizens and Taiwan offers nearly free healthcare for all citizens.

[Run Silent]

Originally Posted by Z K

Do they have healthcare where they are? Many Asian countries have govt subsidized healthcare if you are citizens there. China and Taiwan come to mind. China has basic public healthcare for all citizens and Taiwan offers nearly free healthcare for all citizens.

They live in South Africa.

They have great health coverage there, but we can't work out an option if they immigrate to the USA.

[RickFLM4]

Originally Posted by usshelena725

Thanks. Legitimately curious, as my in-laws live out of the country. My wife and I have considered sponsoring them to come live in the USA, but haven't been able to figure out a reasonable cost option for health care, since they won't qualify for medicare.

I haven't forgotten about this...

Unfortuntely, there is no easy way to toggle age when looking at quotes. However, you can get some quotes through insurer web sites or places like einsurance.com to get an idea - there aren't many questions to answer. I wouldn't bother with healthcare.gov unless eligible for a subsidy (and I believe you need a social security number that can be validated through a credit bureau).

In our case, I think we are going to renew our existing plan with Florida Blue. The only cheaper plans they offer are in a different network that excludes nearby hospitals and at least one or two of our doctors. I looked into Ambetter but they exclude all our doctors. Molina Health is HMO only (also excluding our doctors). None of Cigna / Humana / Aetna offer plans in Palm Beach County, FL. United Healthcare offers only short-term plans and supplemental plans here.

[Run Silent]

Originally Posted by RickFLM4

I haven't forgotten about this...

Unfortuntely, there is no easy way to toggle age when looking at quotes. However, you can get some quotes through insurer web sites or places like einsurance.com to get an idea - there aren't many questions to answer. I wouldn't bother with healthcare.gov unless eligible for a subsidy (and I believe you need a social security number that can be validated through a credit bureau).

In our case, I think we are going to renew our existing plan with Florida Blue. The only cheaper plans they offer are in a different network that excludes nearby hospitals and at least one or two of our doctors. I looked into Ambetter but they exclude all our doctors. Molina Health is HMO only (also excluding our doctors). None of Cigna / Humana / Aetna offer plans in Palm Beach County, FL. United Healthcare offers only short-term plans and supplemental plans here.

Thanks. Will check into this. I looked into the Marketplace since we last spoke and prices were about $3000/mo for them, which isn't really an option.

Really needs to be $1000 or less a month to make sense.

[RickFLM4]

$1,000 or less / mo. will be tough but maybe an HMO will get them close.

[Run Silent]

Originally Posted by RickFLM4

$1,000 or less / mo. will be tough but maybe an HMO will get them close.

Think an HMO is a possibility at a grand a month each, or as a pair?

For reference:

73M, history of heart attack, bypass surgery at 60.
69F, history of breast cancer and diabetes.

[EnVe46]

Guys I posted in another thread I offer private, non ACA coverage. These plans are a ton more affordable and are still medically underwritten. IF you're healthy, I can get you much better coverage for the cost. Our plans are specifically catered to self employed people as well. For anyone interested, please PM me. It takes me about 5 mins to create a plan for you and then we an do a webinar to review your option. I already helped another forum member drop his $415 premium to $240.

[EnVe46]

Originally Posted by RickFLM4

I have Florida Blue. $1,400 / mo. scheduled to go up to almost $1,700 / mo. for just my wife and me. High deductible. I need to spend a few hours researching (like I do every year) before deciding whether or not to switch plans yet again this year. Unfortunately, there are few plans from which to choose that have local hospitals and our doctors in the network. We are pretty healthy with no major heath issues but both recently turned 50 so healthcare is becoming more of a focus for us. It is difficult to find doctors we like so it really sucks to have to find new doctors who may be located far away due to changing networks. Yet we are paying an awful lot of money and consuming very little healthcare we don’t pay for anyway due to deductible. We will not go without insurance but the rate of increases is not going to work much longer so whether this year or a future year, I expect we’ll need to change to a different network and / or benefit schedule.

I used to be able to buy a small business plan for a group of 1 before ACA. We figured individual insurance might be easier to buy and be more competitive (wrong on both counts...) and switched over to individual once ACA eliminated the gap for preexisting conditions when going from group to individual. I guess we would have been forced to switch over anyway because I can’t find group of 1 plans any longer.

Best case is my wife goes back to work full time and they offer insurance, at least for her, if not both of us. I can only raise hourly rates so much, but at least expect a lower tax bill to help mitigate part of these costs. We’ll see.

Edit: Also I think the marketplace is useless you get a subsidy. I find plans to compare by going to different insurer web sites, seeing what they offer and compare whatever offerings I can find. Not every insurance plan available appears on the marketplace, at least in FL.

I just sent you a PM. Give me a call.

[RickFLM4]

When you say non-ACA coverage, presumably you mean less than minimum coverage specified by ACA? Is there a website to identify what is covered or not covered and available healthcare providers?

Although we are generally healthy, wife and I will be 51 next year so not really looking for something designed for younger people who are highly unlikely to incur medical costs. We need insurance in case something unexpected arises. But I can look over information and see if it seems feasible.

[RickFLM4]

Originally Posted by usshelena725

Think an HMO is a possibility at a grand a month each, or as a pair?

For reference:

73M, history of heart attack, bypass surgery at 60.
69F, history of breast cancer and diabetes.

Hard to say, but that would likely be the only feasible avenue for someone with medical needs. I did see some HMO plans for $700 - $800 / mo. for the 2 of us, but we are approximately 20 years younger and not interested in changing providers or driving 20+ miles if we need a hospital. Technically, while their age will be a significant factor, I don't think the medical history is supposed to affect rates but that may not apply to someone moving to the U.S. or of a typical Medicare age, but not eligible for Medicare. Not really sure. Other than asking if we smoke(d) I haven't really seen any previous health care questions in the forms / applications I have completed.

[EnVe46]

Originally Posted by RickFLM4

When you say non-ACA coverage, presumably you mean less than minimum coverage specified by ACA? Is there a website to identify what is covered or not covered and available healthcare providers?

Although we are generally healthy, wife and I will be 51 next year so not really looking for something designed for younger people who are highly unlikely to incur medical costs. We need insurance in case something unexpected arises. But I can look over information and see if it seems feasible.

Correct. Minimal essential coverage is really just nonsense that the ACA regulation says a plan HAS to cover. Maternity, pre natal, drug/alcohol abuse, mental health, childrens dental and vision as well as pre-existings. Our plans don't force you to take these coverages.

Our plans are completely customizable so while I can give you my agent webpage, they aren't listed online. We have clients from 19-64, so it's not like the plans are designed for young, healthy people. They are there for people to build with coverages they like, want and need while not over insuring themselves.

It seems you've been spending lots of time researching. If you can spare another 15 minutes, Ill show you our plans. IF you don't feel its a good fit, we gave it a good shot at much more affordable coverage. Im guessing you're looking $700-800/mth.

Oh, and its offered on a Cigna PPO network, so the network is nationwide and one of the largest available