Health Insurance, Self-Employed?

Figured I’d see if anyone has good suggestions on a good health insurance company. I am a personal trainer and the company I work for does not have a good health insurance reduction. They want me to pay around 250 a month plus deductable. I have found one from State Farm which is 120 a month with a 2100 deductable after which insurance covers 100%. This seems ridiculous to me and as someone who is in shape it is tough to stomach paying this much money even though I will hardly ever go to the doctor anyway. Just curious if anyone else had some good suggestions.

IMO, there is no such thing as a good health insurance company. They pretty much fuck you over one way or the other. I don’t know the exact figure, but for my brother’s family and myself it’s something like $1300/month.

Office visits are $35 co-pay, ER visits are $50 co-pay, and we have a 3 tier system for prescriptions, $15/$30/$50 depending on what you get. The last time I was at the doctors office for some cold/flu shit they wanted to give my some antibiotics which where in the 3rd tier($50), I decided to take a few days off and rest and keep my $50.

And god forbid you have to have an operation or something, they only pay up to 75%.

That is why I think health care is a big issue with the election; 2 years ago I had a kidney stone. That was $5000 that would be the premiums for a couple of years, and there would have been a deductible. So in my opinion if you are self employed and in good health, pay your bills and if something catastrophic happens declare medical bankruptcy

You pay for health insurance for two reasons IMO.

  1. In case the shit hits the fan.

  2. For capitation. Paying street rate sucks.

Depending on how much you earn a HSA is probably the way to go. You will be mostly out of pocket unless the shit hits the fan but you will benefit from reduced rates (capitation) based on the provider you choose and can save cash tax deferred which is nice particularly when you are doing well.

I have had both blue cross and assurant, which is who State Farm uses. Both plans are pretty decent.

Don’t really agree with Pittbull, but to each his own. Declaring bankruptcy is a pretty poor contingency plan, IMO.

I always figure I get back about a third of my premium every year just in the spread b/t blue cross’s negotiated rates and the street rate (I have a wife and kids so use fluctuates from year to year.)

Bro as a self employed person and just having to have an over $10,000 surgery to fix a bicep tendon this topic is close to my heart and pocket book. I now have insurance.

The things you really need to focus on are not the little things the regular check up etc screw them most times those visit you dont really need and could afford and can likely be done at an walk in Minor med type place.

What you want is to worry about the BIG enchilada things that will cost a ton making sure they are covered. get a fairly high deductible what ever seems fair to you something you could cover with out breaking the bank a few thousand in deductible is much better then 20-30,000 or more even hundreds of thousands. This will also keep your payment down.

Then a nice co pay on prescriptions is nice just knocks off some of the out fucking rageous over pricing of meds.

Then the UNplanned this is where the plan I got really sold me. Anything UNPLANNED. any unplanned surgery as in emergency, say you have a stroke, a heart attack, break a leg, your back any accident its a $100 deductible.

IMO thats great its that I was worried about and like stated above most planned surgery is going to be HUGE cost wise so paying the 2-3000 is cookies in comparison and keeps the payment low. mine is $84 a month and they had one a bit cheaper with an bit higher deductible and same accident coverage

any way thats what Id look for
Phill

Phil pretty much summed it up. Assuming you are healthy and can afford a large detuctible should an emergency happen, go with as high a detuctible as you can. Don’t worry too much about copay, how many times do you go to the doctor per year anyways? I would also decline dental and vision.

Health Insurance gets so abused these days, that’s one of the reasons why there are so many problems in the industry. It is intended for EMERGENCIES. Hence the term ‘insurance’. Okay, enough of a rant.

Your State Farm quote seems pretty good. I would recommend getting a quote from Blue Cross Blue Shield too, they seem to have good rates. Remember though, rates also depend on what demographic the company is competitively marketing towards, so you may want to get 4-5 quotes.

I am assuming this is just for you and not a family policy.

Awesome advice, thanks guys. Phil what company do you use?

[quote]tedro wrote:
Phil pretty much summed it up. Assuming you are healthy and can afford a large detuctible should an emergency happen, go with as high a detuctible as you can. Don’t worry too much about copay, how many times do you go to the doctor per year anyways? I would also decline dental and vision.

Health Insurance gets so abused these days, that’s one of the reasons why there are so many problems in the industry. It is intended for EMERGENCIES. Hence the term ‘insurance’. Okay, enough of a rant.

Your State Farm quote seems pretty good. I would recommend getting a quote from Blue Cross Blue Shield too, they seem to have good rates. Remember though, rates also depend on what demographic the company is competitively marketing towards, so you may want to get 4-5 quotes.

I am assuming this is just for you and not a family policy.[/quote]

I agree 100%.

High deductible Major Medical - no co-pay/prescription/vision/dental crap.

You can more than make up the high deductible difference by just budgeting for medical expenses each month and saving what you don’t spend.

Best advice I have received on SE health insurance came from Dave Ramsey.

I have health insurance through Anthem, got it 5 years ago and what I pay has literally doubled since then, and I haven’t filed a single claim. I’ve talked to a few other people that this has happened to, the rate starts off reasonable, then they jack it up. Maybe you just have to shop around, can’t stay with one company too long, I don’t know.

I do know something has to change in the next election. I know people in Great Britain and France who are the first to admit that their systems aren’t perfect, but anything is better than this.

Here’s a great site to learn about HSA’s.

http://www.health--savings--accounts.com

I’m going to get my wife on one as she’s self employed and it costs me $340/month to have her on the insurance. About the only thing she ever uses the insurance for is birth control and I still have to come out of pocket for $45 when the medication cost about $55. It is important to have health insurance.

These HSA’s are high deductible plans between $2k and $5k typically and your premiums are lower. These accounts are like retirement accounts that you can save a maximum amount per year ($2400 I think) in an interest bearing savings account or investment account.

The only bad thing is that the funds saved can only be used towards health costs. But if you don’t use it now it accrues interest and you will be thankful you had the savings later in life when you need them. This could also only a temporary solution as you cant have an HSA if your covered on any other insurance so if you move onto a job with a better insurance plan then you will have to stop contributing to the HSA plan.

not sure I understand why people think skipping vision and dental coverage is a good idea. I can understand forgoing the former if you don’t use corrective lenses but never the latter.

[quote]chillain wrote:
not sure I understand why people think skipping vision and dental coverage is a good idea. I can understand forgoing the former if you don’t use corrective lenses but never the latter.

[/quote]

Going to the dentist and paying out of pocket twice a year is cheaper than the premium you will pay for dental insurance. Unless you think you are likely to need major work, it’s simply not worth it.

I can get a vision exam, glasses and contacts each year for less than 600 bucks. Why bother with monthly premiums for “insurance”. I get to see the optometrist of my choice - and I don;t have to mess with a single page of fucking paper work.

The bigger the profit center for the insurance company - the less it is needed by the customer.

[quote]rainjack wrote:

chillain wrote:
not sure I understand why people think skipping vision and dental coverage is a good idea. I can understand forgoing the former if you don’t use corrective lenses but never the latter.

I can get a vision exam, glasses and contacts each year for less than 600 bucks. Why bother with monthly premiums for “insurance”. I get to see the optometrist of my choice - and I don;t have to mess with a single page of fucking paper work.

The bigger the profit center for the insurance company - the less it is needed by the customer. [/quote]

The only caveat to this is dentall insurance when you have a young family. Last trip to the dentist 2 of my kids racked up $1100. Total amount overall for the whole family was about more than $1600. I could easily be looking at more than $2500 a year in OOP.

I am looking into programs right now. Delta dental is looking pretty good.

[quote]pittbulll wrote:
That is why I think health care is a big issue with the election; 2 years ago I had a kidney stone. That was $5000 that would be the premiums for a couple of years, and there would have been a deductible. So in my opinion if you are self employed and in good health, pay your bills and if something catastrophic happens declare medical bankruptcy[/quote]

Aaa, no! That’s not good advice. Purchase an indemnity plan that just covers major medical issues, hospitalization etc. These are fairly cheap (approx. 80$/month), but you are then covered if something really bad occurs.

I myself am self-employed, what I did is spare 20 hrs a week to work part-time at Starbucks. One is considered a full-time employee for averaging 20 hrs a week for a quarter.

There is also a retired lawyer who does the same, we only work there for insurance at a rate of 108.00 a month for full coverage on the entire family.For dental and vision its an extra 25.00 a month. Not bad for a whole family of four. If you are single it comes out to around 50 bucks a month for everything.

If you have the time to spare, find a job somewhat alike. The insurance itself is worth the extra work for me and my family, plus your getting paid with all the free coffee you would ever want. ( Bad thing is the Liberals that lurk…think Lixy ).
Just a thought, its working out well for me. Plus it a great company.

[quote]tedro wrote:
chillain wrote:
not sure I understand why people think skipping vision and dental coverage is a good idea. I can understand forgoing the former if you don’t use corrective lenses but never the latter.

Going to the dentist and paying out of pocket twice a year is cheaper than the premium you will pay for dental insurance. Unless you think you are likely to need major work, it’s simply not worth it. [/quote]

Well you’ve obviously done the math, and everyone should take the 2 minutes required to determine their best option.

I don’t have employer coverage currently and my dental add-on is $17/month ($204/year), so it’s a no-brainer for me even for routine cleanings only.

[quote]Shadowzz4 wrote:
Awesome advice, thanks guys. Phil what company do you use?[/quote]

LOL had to go look

Assurant Health, and on the dental I think it was an added 15 dollars a month to get in on the plan I havent yet

Phill

Lots of good information on this site.

Not to toot my own horn but this is what I do for a living. I am an agent in almost every state and sell products custom designed for people who are self employed or difficult to insure.

There are many problems with the system but a good agent who knows what his client needs and has resources can help you. Not to bore everyone with the details but if you want more info or help looking, send me an e-mail.

Flint

[quote]Lorisco wrote:
pittbulll wrote:
That is why I think health care is a big issue with the election; 2 years ago I had a kidney stone. That was $5000 that would be the premiums for a couple of years, and there would have been a deductible. So in my opinion if you are self employed and in good health, pay your bills and if something catastrophic happens declare medical bankruptcy

Aaa, no! That’s not good advice. Purchase an indemnity plan that just covers major medical issues, hospitalization etc. These are fairly cheap (approx. 80$/month), but you are then covered if something really bad occurs.

[/quote]

You need to send that insurance man right over:)