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Health Insurance for the Self-Employed?
SharkJumper writes "Looks like this question has been asked before, but might be due for an update. I'm a self-employed programmer who is about to become a father. Previously, my family's insurance has come through my wife's employer, but she is eagerly looking forward to being a stay-at-home mom. We must look for that elusive low-cost insurance in order to enable her to do this. Losing her insurance is not a huge loss as, due to failed negotiations, the hospital in our city (3rd largest city in the state), along with most of the doctors that refer to it, is dumping the network (largest in the state) that our insurance uses. On the individual coverage plan front, my research shows story after story of deception, fraud, and general run-around or obfuscation by most of the major players and nearly all the minors. With all of the bad experiences out there, I've yet to see a good review of an insurance company. What does the Slashdot crowd use and recommend? Company and plan-type? PPO? HMO? HDHP + HSA (High Deductible Health Plan + Health Savings Account)?"
First, you are about to find out just incredibly broken our health care system is. I doubt if you will get private insurance, as they are denying older applicants out of hand, and if you have ANY problem forget about it.
Many states have an expensive health insurance pool that has high deductible insurance that will only take care of you in catastrophic conditions. If you go for the low deductible, expect to find very high premiums and equally high copays.
With the high deductible plan you can start a health savings account (who has money to save these days?), but that may be your best option.
Most important, keep your coverage with your wife current as long as you can as you may get your prexisting conditions covered without a waiting period.
In my circumstance at least, I have found that health insurance companies have no reason to want to insure anyone that may be a liability down the road. I do not see a political solution to this, as congress is corrupt. The best they could do was pass a bill that made it hard for sick people who got burried by medical bills more difficult to declare bankruptcy. And another program that was essentially a handout to drug companies that foisted a compkicated hard to use drug plan onto seniors. That's all they have done. This last congress was the most do-nothing congress ever. It seems the only thing they had time for was to take bribes from abramoff and hit up underage pages for sex and try to cover up the trail later. The health care industry is not much better with their costs outpacing inflation 3 to 1 at least.
I know neocons are not going to like what I'm about to say, and how important that it is fighting alquaida over in Iraq blah blah blah, but the fact is with what we have spent on this war to knock over a tin horn dictator I bet we could have paid for everybody's current medical expenses in the US, let alone making it affordable.
If you're healthy and have job, you probably will not won't give what I have to say a second thought. But if your sick as I am and can't find coverage or a doctor, you know how bad it is. If your self employed doubly so. Even if you do have coverage, you have got to be noticing how your insurance premiums are getting more expensive and its covering less, your deductible is more, and prescriptions are through the roof.
But the greatest crime of the Iraq war is that it has taken attention completely away from the health care crisis. I have talked to my politicians to no avail. Gratefully though, a challenger for state office DID talk about it and it got him elected.
We had no business screwing around in Iraq (esp. with the WMD big lie) without taking care of our own at home first. It's that simple. If things aren't working for you, it's important to let your politicians and everyone around you know how you feel. Only this way will there be hope for change.
BTW, make sure that the high deductible health savings account pays for 100% above a certain point. 80%, and you still could (likely)lose your shirt if you get sick.
Before you drop your wife's insurance let me tell you what I am currently finding out the hard way. You will be hard pressed to find an insurance policy on a pregnant woman. Group policies can be more forgiving, but so far everyone I've talked to says it is a 'pre-existing condition' and they won't cover my 7-weeks pregnant wife. If you are going to get a policy, your wife can't deliver for 11 months from the date the policy becomes effective or it's not covered.
I just got out of the Air Force and am now working as an independent contractor. Tricare does have a COBRA-type polkicy I can get but it's very expensive. I can't just get the coverage for my wife, I have to be on the policy, so I'm having to pay about $2200/3 months for it. At least it comes in 3 month chunks, so I won't have to carry it longer than I need it.
If there weren't that program available to me, I don't know what I'd do. In Georgia where I live there is a Medicade program for pregnant women, but I make too much money to qualify for that. If you make more than $1600/week with a family of 4 (they count the unborn) you make too much. My wife had to have a c-section last time and I saw the bill Tricare got. For everything throughout the pregnancy they paid out over $60k.
I have heard that if you can't get coverage and you talk to OB docs, they can usually work with you and sometimes you can end up paying less than if you had insurance. I have not looked in to that yet. Good luck!
One of the big ones is that a very small number of people spend an ASSANINELY LARGE AMOUNT of money. Some people are on drugs that cost $400,000/year.
As long as we are unwilling to say "You know what, it's too expensive to keep you alive", a lot of people are going to die because they can't afford to subsidize the healthcare costs of the extremely sick and therefore can't get even basic healthcare.
We need insurance plans that cap maximum expense - so you can sign up for death if you catch something that's going to cost 3 million to fix so you can survive the far more likely chance you get a disease/injury that costs $40,000 without going bankrupt.
paintball