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Ask Slashdot: IT Contractors, How's Your Health Insurance?
An anonymous reader writes "In the tech industry, as the economy continues its downturn, IT folks in my circles who were either laid off or let go are turning to contract work to pay their bills. Layoffs and a decline in tech jobs has affected older IT workers the most. Many of us find it more lucrative and enjoyable in the long run and leave the world of cubicles forever. However, there is much to be said for working for a large company or corporation, and health insurance is one of the benefits we value most. But what happens to those who find themselves in this position at mid-career or later in life? Hopefully they have accumulated enough savings or have enough money in an HSA to survive a major medical emergency. Unfortunately, many do not and some find themselves in dire straits with their lives depending on others for help. I have been working IT contracts mostly now for the past 11 years and I've done very well. I belong to a group insurance plan and the coverage is decent, but as I get older, premiums and copays go up and coverage goes down. If you work contracts exclusively, what do you think is the best plan for insurance? Any preferences?"
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Treat insurance as insurance, not as a health care account, buy critical illness with a high deductible (maybe 10-20K), but make sure it covers 5-10 years of your expenses for sure. For the normal every day stuff just pay out of pocket.
You can't handle the truth.
the no pre existing condition/ no drop rule and exchanges (not tied to jobs) is a big boost.
I'm assuming OP is in the US, because in most other countries this is a non-issue.
This was the kind of situation that Obamacare is intended to address, by making the individual market a viable option for people who aren't getting insurance through their employment, eliminating exclusions for preexisting conditions and requiring no more than 20% overhead (for reference, Medicare runs at about 3% overhead and the VA closer to 1%).
Other approaches, while you're waiting for that law to fully kick in:
- If you're married, and your spouse is a full-time employee somewhere, use their group plan.
- If you've saved up a lot, which it sounds like you have, consider focusing on catastrophic coverage.
- If you're older than 50, consider the AARP. They provide all sorts of discounts, including on health insurance.
- If your life situation allows, you might be able to relocate to a civilized country. This is obviously a big change, so you wouldn't want to make this lightly.
- Put up with the higher rates and less insurance. It's not pleasant, of course, but it sounds like you can afford it.
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I contracted for 2 years. During that time, I purchased health insurance for myself, wife and 3 children from a health insurance company. It's actually really easy. I comparison shopped online, picked an insurer with a plan that had good coverage at a rate I could afford, called them up and bought a policy. The insurer did a check of our medical histories, which took about a week, and involved them calling doctors. Fine. The policy took effect about 2 weeks after the medical checks were complete.
I was paying about $300 / mo for myself, wife and my 3 kids - and that includes a kid with autism, which the insurer could not turn down, thanks to the Affordable Care Act (GObama! Sorry, had to :) ). They did charge me $10 extra a month for my autistic child, but that seemed more than reasonable to me. $300 / mo might seem high, but it's only about $50 more than what I pay when getting insurance through an employer. The copays were competitive ($10 prescriptions, $30 doctor visits and such). The other deductibles, co-insurance, etc were a bit higher, but not insanely higher than what you'd see through a plan from an employer.
There was one thing that stunk about the plan, though - if my wife got pregnant, the insurer would drop her coverage. That sucks. In fact, I couldn't find a single insurer that would cover pregnancy - nor would they cover things like IUD, birth control pills, etc. Basically everything you'd typically associate with a woman's health was completely not covered, which is ridiculous.
Once the Affordable Care Act goes completely "live" in 2014, though, insurers won't be able to deny women health coverage if they're pregnant, and they'll have to cover basic women's health care. Anyhow, wasn't trying to make this a political statement, it's just interesting how broken the current system is for women.
In my experience, High Deductible Health Plans from *major* carriers are quite good. I'm not talking about those discount $50/mo. plans you can get through trade organizations. I'm talking about "High Deductible" plans from Aetna, Blue Cross, etc... You might have to cover the first $2k - $3k per year out of pocket, but after that you're often covered at the 90% to 95% level with no upper limit for major medical events like cancer, etc...
If you're self-employed, you ought to easily have $2k - $3k per year available to pay pre-deductible health expenses. It's really not that much money.
My observation is that most people seem conditioned to have this totally irrational expectation that ALL of their health expenses should be covered, with maybe a nominal $20 "co-pay" at every office visit. That's silly! Why not just pay for ordinary expenses out of pocket, and save your insurance premiums for the truly disastrous stuff (i.e. broken bones, appendicitis, car accidents, etc...)?
I'm just continually blown away by two income professional households with $120k+ income who just absolutely can not bring themselves to shell out a few thousand dollars per year out of pocket to pay the doctor. What's the big deal? 5% of your income is too much out of pocket expense? They'll happily blow $1500/year on mobile phone service, but $2k - $3k / year on pre-deductible health expenses are too much? But I digress......
High Deductible Health Plan from major carrier. The only way to go.
I have a great job and my company affords me a fantastic health plan. Unfortunately, a close friend of mine got laid off after a head injury caused a concussion and after six months of short term disability he was fired from the job where he'd worked for 13 years. He had been making about $60,000 a year. His wife didn't work. He lives in good 'ol Massachusetts, and his unemployment is too high to warrant MassHealth, so he's paying $1,300 a month for Cobra to cover his wife and two children. His savings are almost depleted and he's still recovering (headaches, dizziness, contant pain). While I fully support a national healthcare plan, the one we have in place -- get healthcare or pay the fine -- ain't doing it. More needs to be done to help those in need of health coverage so they don't wind up going into emergency rooms for chronic illness care. Any study worth its salt shows preventative care is cheaper than reactive care.
"Require you to buy some" is hardly an insurance plan.
I think every state requires you to buy auto insurance and all mortgage companies require homeowners insurance. This is to prevent dumbasses from not doing something they really have to do.
But I'm perfectly okay with people who want to make their own choices, as long as they accept the consequences of their choices. Which means if you waaah about not buying health insurance, then when you're sick or injured...you stay home and help yourself unless you can bring cash or a valid credit card with $50,000 available on it to the emergency room. After all, you're the one in charge making the decisions, and the one you made is basically to die or fall on the charity of others WHEN something happens to you. And by the way, I ain't in the mood to be your freaking charity.
The problem we have with the world today is everyone wants choices, but when the consequences show up its someone elses fault and they need a bailout.
If people hate the 'socialism' of medicine, then I hope they're not driving on the interstates, sending their kids to public school, and won't be accepting social security and medicare, neither of which you 'paid for', but which are paid to you by others as your tax dollars paid for your elders as you worked.
I'm 51 and have a couple of minor pre-existing conditions that I've resolved by losing a lot of weight gained after suffering a back injury. Even though I'm pretty healthy now, if I lost my current group health absolutely nobody would insure me at any price. Even a high deductible plan and HSA combined with a serious injury or illness would destroy my family finances pretty much for good.
So shall we all stop weinering about coming to the same damn conclusion that just about everyone else on the planet has? People are too stupid and shortsighted to buy health insurance, but you have to have it, since almost nobody can pay out of pocket for a major car accident, cancer or a heart attack.
You can still have your choice. Pack up and go live in the new mexico desert or the deep plains of wyoming, far from a hospital. I'm quite sure nobody will come to your camp and make you pay.
If you cant afford it, you get it for free or cheap. Same general idea as what Romney did in MA. So lets stop the stupid bickering and random shenanigans and get on with what we grown ups need to do, shall we?
Ehhh...and so we stay on the right side of the fence, voted republican until GW's second term, have voted for Mickey Mouse since.
Actually, expect LESS increases due to "Obama Care"
The reason is more people will be paying in to plans because they have to by law.
I've paid for my own health care since I was 18. I require it due to having moderate to severe Psoriasis. I pay $1300 a month right now for Blue Cross Blue Shield in NY. Yes... Its fucking insane.
The same plan was $250 a month 15 years ago.
Every year they want to increase it about $150.
The theory with Obama Care is more people will now have to pay for a plan so more people paying in, should slow the increase in rates. However we will see if that happens in practice.
Initially the democrats fought for control over price increases but republicans and the insurance lobbyists obviously won that battle.
This country is out of control insane. If you are sick, you better be rich, or just die. That is how our country looks at people. We are burdens on society, and they would rather us all die than provide some kind of help. That is a fact.
America is a disgusting fucking country that I am ashamed to say I belong to. We simply do not care about doing the right thing.
Obama Care is a step in the right direction but its been corrupted by the insurance industry. The public option was eliminated. Single Payer universal Not for Profit insurance wasnt even considered. Big Money runs this place... and Big money sees us all as a burden and thinks the sick should simply die.
If you want health insurance in America. Either you have to pay very high monthly rates, or simply move to another country.
Funny you mention that because I did marry someone with health benefits, and I didn't really like her that much at the time. But to avoid paying $12,000 a year for health insurance...eh...I'm puckering up.
Seriously.
When health insurance and health care are sold as a for-profit products, it is inevitable that some people will go without insurance and/or care. Why? Because they can't pay enough to make it profitable to sell to them. The market is fine and all, but it can't survive without profit.
Your best bet now is to look very hard for some form of group insurance. The older you are, the greater the probability you will succumb to somthing that requires surgery and/or long-term treatment/rehabilitation. i.e., things that generate 6-figure bills. (Think about things happening that cost $500,000 to deal with. Think about pills that cost $100 a pop.) Better to have good coverage for that eventuality and poor coverage of things like routine doctor visits than vice-versa.
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This accords with what I have experienced. Generally we pay less than 50% of the sticker price for all medical care, if we offer cash.
When my latest was born in 2008, we got everything covered for under $5000 at a very good hospital, simply because we offered cash up front. In fact, we were informed that the price would triple if we couldn't pay the full amount up front--even if we paid all the remainder within a week. That's the nature of risk management in the medical business.
As a family man with 3 kids, we find that life is MUCH cheaper without insurance. If you have a generally healthy family, and actually bother to make sure your family eats well and exercises well (growing your own garden is a major plus), and if you bother to learn a little something about health on your own (my wife is a nurse), you can actually manage to live without constant "health care". Seriously, when did people start needing medical care as an ongoing service, like electricity and water? It's pretty easy nowadays to check your own blood pressure, cholesterol, heart rate, and quite a few other things. We only go to doctors when something doesn't add up.
I see the world today as gone somewhat mad about how to take care of the body. I know younger people in their 30s who are already on multiple medications--statins, beta blockers, blood-thinners, you name it. Diabetics are everywhere, and Coca Cola sales are exceeding forecasts. We are finding that "diet food" actually makes you fatter. We are finding that a certain amount of sun is actually good for you. We are finding that sitting all day in a cubicle is horrible for your health. It's time to start putting two and two together. If you want a healthier population, the first thing we need to do is get everyone exercising regularly, spending some time outdoors instead of under florescent lighting or the pallid glows of their LCD screens, and eating real food instead of the crap that comes from factories (and most grocery stores, unfortunately).
And this right here folks is what is wrong with our country, the "fuck you, I got mine" in the flesh.
This is why we have to force people to get car insurance, because this asshole wants to ripoff society. He can't possibly be expected to actual like a responsible adult.
Have you been to Japan? They are TINY! You can fit three inside a single MRI and no bits sticking out. Hell, if they bent their knees a bit, they can walk through.
Mean while the average American needs to go to the docks to get x-rayed in line with shipping containers.
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