Need Medical Insurance advice

[Wil Ferch]

Need medical insurance advice.

Background:

- worked for a major company for many years but was terminated in March. Had group medical / dental coverage with this company.

- was allowed COBRA continuation coverage for up to 18 add'l months...but I declined ( since it would expire at some time anyway)...instead, signed-on with my wife's plan sponsored by her employer. Used "life-event" clause to engage in wife's plan ahead of her normal yearly open-enrollment month ( November).

This is currently OK...but my wife may soon quit her job. This is also important. I live in New York state and many alternative programs ( offered elsewhere, in *other* states..natch)...are *not* available in NYS.

Curent family premiums ( husband/wife/ college child) are around $200-$300/month. Individual plans with the same coverage can cost $700-$2000/month. My current employer does not offer a medical/dental plan( employer is the US arm of a foreign company. I am the *only* US employee. If this small work US group was at least 2-10 people.... my employer would have a chance to offer some kind of package, but with one emplyeee, he can't).

Anyone out there with a suggestion on my particular situation, keeping in mind the special situations and unavailability of programs within New York State?

- Wil

[Wil Ferch]

Thanks, but wrong question..... next up, please ....

- Wil

[ChrisBennet]

Of course it may not apply to NY, but here in NH they made the "18 month" insurance infinitely renewable. I have catastrophic insurance with a $2500 deductable and I pay less than $900 a year.
-Chris

[Wil Ferch]

Chris, my 'ole buddy.....

That's the point...as I sort out all the angles, I think NYS might be a different beast.

I'm looking for more than catastrophic ( only) coverage..and my current plan (currently thru my wife's work... or my own previous plan with my prior employer)...gave me "regular" coverage at a more reasonable deductible.... plus dental /vision....for something on the order of $200-250/month. Individual policies that are not group rates kick this up to $800-$1000/month.

In the interim I found some intersting plays on the internet. Seems folks like 4-health-insurance-rates.com or ehealthinsurance.com offer a group rate ...trying to fill "slots" for people who have dropped out...but trying to keep the group population high. I entered some basic info into a web page indicating my home state and within 5 seconds I got a phone call saying that another NYS subscriber dropped and I can get the "spot" price of $180/month. I mentioned that I was simply investigating for the near future ( not for *now* !). The next time I call, I will be offered a different spot price depending on the number of open slots for your area. Need to check this out more......

- Wil

[on2wheels52]

Am in a similar position here, I'm getting quotes of $450/mo for coverage not as good as she is getting now.
Does anyone know how wealthy one needs to be for a reasonably healthy couple to self-insure for health insurance? Surely Warren Buffett doesn't pay any premiums. Where's the cutoff point?
Jim

[Jims5543]

Welcome to the hell of the small business owner. How any company can offer full benefits is beyond me.

I insure with a MSA or HSA as they are now called. I have an account I deposit into that I use in a medical emergency. I have a debit card that taps the account. I have 10K in my account all accumulated tax free. I have a $5000 family deductible and we foot the bill for the small stuff. My monthly cost is $350 for my family of 4 and we are normally healthy. So we rarely tap into the account.

If your self insuring and want the same coverage you had when you worked for a big corporation, good luck. Brace yourself for huge monthly costs.

We tried to cover ourselves like that and it was a huge waste of money when we broke it all down. We are healthy, we needed something to help us if something really bad happened. Se we went with a HSA.

[jyl]

How much does a night in a critical care bed cost? I suspect $10K could be eaten up in well under a week. With doctors and procedures extra. So I am skeptical that a HSA is protection against anything "really bad". Maybe it would be worth inquiring at your local hospital.

(My mother in law had a heart attack when visiting us, and spent three weeks in the local hospital, had bypass surgery and a pacemaker, lots of tests. I saw the bill, it was well over $100,000.)

[EdT82SC]

HSAs make you spend money out of the account first, but has insurance that kicks in, and pays the rest at some point. It's a really good deal for people who are healthy because you can save the money you don't spend each year for retirement. People who have any kind of chronic condition will spend through what they put in the account every year.

[Jims5543]

Originally posted by jyl
How much does a night in a critical care bed cost? I suspect $10K could be eaten up in well under a week. With doctors and procedures extra. So I am skeptical that a HSA is protection against anything "really bad". Maybe it would be worth inquiring at your local hospital.

(My mother in law had a heart attack when visiting us, and spent three weeks in the local hospital, had bypass surgery and a pacemaker, lots of tests. I saw the bill, it was well over $100,000.)

Yes its expensive if you end up in the hospital. That is why I like the HSA, I have a $5000 ded. then another 3K in expenses before the HSA kicks in with 100% coverage. So if I was to have a heart attack or something and it was running up a bill in the 50K range I lost 8K.

But if you look back at the last 7 years of saved money in premiums I have easily saved over 10K in premium payhments so I am WAY ahead of the game.

This works for now for me, I was hopefull one of the last 3 administrations would actually fix our broken health care and health insurance system in this country by now but it seems lobbies run deep and the interests of the lobbies takes precendent over the overage citizen. So here we are stuck with rediculas premiums and not many alternatives.

[Noah930]

Can't offer any NYS-specific advice. But you might not want to avoid COBRA this time. $200-300 per month is nothing. If it makes you feel any better, on my family COBRA plan, I'm paying $1300 per month. Granted, we're expecting a child in a couple months, so a few months of COBRA is worth it for us.

Also, reconsider your wife quitting until she has something (with health insurance benefits) lined up. I suppose that's easier said than done, though.

Finally, if you're healthy, those HSAs might be another good option.

In my cynical voice: why bother with health insurance at all? If you get sick, just do what alot of my (usually uninsured and unemployed) patients have done: plead that you have no money, ask for free care, give a fake address/phone to make it hard to be tracked down, and if all those fail, then arrange for some payment plan based upon the cheapest (usually Medicare) insurance rates accepted by the hospital/physician. It'll be a fraction of what a normal bill would be. It's like eating at Spago and then asking to pay Olive Garden prices--only it actually works in the medical world. Finally, if you don't care about your credit, just don't pay.

[jyl]

I'm sorry, I didn't understand how a HSA worked. Your arrangement makes a lot of sense. Yes, $8K self-insured followed by an umbrella is fine.

I'm interested to see how some of the state experiments in mandatory health insurance work. We need to fix this system.

Originally posted by Jim Cesiro
Yes its expensive if you end up in the hospital. That is why I like the HSA, I have a $5000 ded. then another 3K in expenses before the HSA kicks in with 100% coverage. So if I was to have a heart attack or something and it was running up a bill in the 50K range I lost 8K.

But if you look back at the last 7 years of saved money in premiums I have easily saved over 10K in premium payhments so I am WAY ahead of the game.

This works for now for me, I was hopefull one of the last 3 administrations would actually fix our broken health care and health insurance system in this country by now but it seems lobbies run deep and the interests of the lobbies takes precendent over the overage citizen. So here we are stuck with rediculas premiums and not many alternatives.

[Noah930]

Originally posted by jyl
I'm interested to see how some of the state experiments in mandatory health insurance work. We need to fix this system.

What?! You don't think OHP is the solution? [Aghast smilie]

[KFC911]

Subscribed, since I'll be losing my corporate health plan within a year and will be looking for alternatives.

[Wil Ferch]

Gosh...I'm feeling "warm all over" ( cynical smile...)

Lets' pedal back to those "spot" prices I mentioned in the prior response of mine. Anyone done that or has experience with this type of arrangement ???

- Wil

[KFC911]

Originally posted by Wil Ferch
Gosh...I'm feeling "warm all over" ( cynical smile...)

...just so long as it's not a fever you'll be OK