Individual Health care plans

[Monky]

Sooooo... piss poor decisions are going to basically make me have to go my own route for health care...

Anyone of us in this business?

I'd like to talk to someone who actually knows what a good plan would be.. provider really doesn't matter. Cost is the biggest factor, along w/ the actual plan. I don't want to jump through hoops for good coverage at a good price.

I do refuse to go with what the company plan is changing to.. it's going to be a shit plan, with shit coverage and a high deductible.

I don't even use the insurance right now, but I have it just in case. I go to the doc for screenings and all that..but.. I have never had any major issues... it's more of a just in case I need it kind of thing.

So any of you guys have a good plan that isn't through your company.. I know most of you have families.. Which makes it more expensive for you, but if you're happy with your plan i'd be glad to take a look at it.

[Bailey Guns]

Obviously I don't know your age or health history. But, assuming you're still fairly young (say under 40-ish) and healthy you might consider a catastrophic illness plan. You're covered if something really bad happens but you pay out of pocket for normal things...checkups, etc...

The wife is a nurse now and her employer provides a really good plan. But, there was a time not too long ago when we didn't have health insurance.

Around 04 or 05 wife was in nursing school and I ran my own business. We didn't have health insurance for about 15 months or so.

She called me at work one day and said she had a severe nose bleed. Turns out it was really bad and required a trip to the local clinic in an attempt to get it stopped. They worked on her for over 2 1/2 hours with no luck. The doctor said she needed to see a specialist and might need surgery. He referred us to an ENT in Greenwood Village.

Now, I had grabbed all the cash I could round up...about $850. It was pretty much every dime we had to our names at the time. The clinic visit cost almost $300 for the nearly 3 hours of work on her. I didn't think that was unreasonable. But when I heard "specialist" and "Greenwood Village", I knew that was gonna be a real problem. Especially for an emergency visit.

We got there and during check-in made it clear we were paying cash. The doc took her into an exam room, had one nurse assistant. He looked things over and said it could be handled easily but would technically require surgery...cauterization of the offending blood vessels. A little bit of prep and in less than 10 minutes total we were at the desk to pay the bill.

The receptionist said the total due was $48. I said there must be a mistake and asked if she was sure. She asked if we were paying cash and I said we were. $48. My jaw just about hit the floor. She told us because we were paying cash the procedure could be done at a reasonable cost. But if they had to take the time to file with insurance it would've cost several hundred dollars.

For about a year after that we paid for the routine stuff and saved thousands over what we would've paid in monthly insurance premiums.

So, the point is, it may be something to consider. Saving a few hundred bucks each month into a medical savings account (or some other way) and pay for the routine stuff with the catastrophic plan in case things go wrong.

[2ndChildhood]

You got lucky Bailey.
I just started a real job after 15 years of self-employement. Since I had a back injury in 1997, I got denied by regular insurance co's. The only coverage I could get was CUHIP 'Colorado uninsurable health insurance program' now called cover colorado. It's a state run program for which my cost is nominally 1 1/2 times a typical premium and insurers that want to do business in the state are required to participate (don't know exact details on that).

Bottom line I was paying $280 a month for $7500 deductible insurance which included like 50% copays for just about everything.
Lucky I never got sick or hurt bad because it would have bankrupted us.

Meanwhile the wife and kid could get regular insurance to the tune of $430 a month and it was better, only $5000 deductible and like 65% copay. lol

My opinion: the open market is a really crappy place to get health insurance. My new job doesn't pay any better than self-employed did, but we now have decent health insurance for the first time in over a decade and it's only costing us $400 a month. In my book, that's a $300 a month raise and better to boot.

So to the OP, unless you are young and really healthy, insurance that's any better than what your employer offers will cost you an arm and a leg on the open market. Good luck.

[JohnTRourke]

You got lucky Bailey.
I just started a real job after 15 years of self-employement. Since I had a back injury in 1997, I got denied by regular insurance co's. The only coverage I could get was CUHIP 'Colorado uninsurable health insurance program' now called cover colorado. It's a state run program for which my cost is nominally 1 1/2 times a typical premium and insurers that want to do business in the state are required to participate (don't know exact details on that).

Bottom line I was paying $280 a month for $7500 deductible insurance which included like 50% copays for just about everything.
Lucky I never got sick or hurt bad because it would have bankrupted us.

Well, Cover Colorado has gotten way better and is in fact about the ONLY affordable option in the individual market.
Everything in the individual market is high deductible, nothing is a regular plan as you think of it.
Cover Colorado is about 60% of what comparable individual plans were. 80/20, $2500 deductible.

In individual health insurance, Women cost MUCH more than men to insure. Age matters a lot. Company plans are ALWAYS better.

[Monky]

Well here is the thing.. Our plan is going from a decent one, with minimal employee cost per month.. to a pretty crappy HSA PPO plan, with a high monthly contribution, and a high deductible.

I actually started looking last night, and honestly.. I've found way better plans for cheaper than the $230/month it would cost me under the company plan... a family of 3 would be $600/month. Gladly.. I don't have that.

I'm pretty healthy, I haven't taken anything except Zyrtec for my damn allergies occasionally for about 7 years. I've gone to the doc for the typical check ups and that's about it...

I'm finding plans between $150-200, depending on the deductible I want.. I've yet to come close to hitting a deductible. Out of pocket I paid a total of $75 last year.

I'm going to look into that catastrophic thing bailey.. cause I would like to be covered just in case, and I have heard that paying cash is CONSIDERABLY cheaper for the normal visits... So that might be the route I take.

Was just checking if anyone knew of any good individual plans..

[ghettodub]

When I was just a contractor, I had an "oh shit" plan from Anthem, and it was really pretty reasonable. I only paid around $50 a month for it

[Beprepared]

Welcome to the effects of Obama-care. Our family premiums jumped 50% this year (a bit more than the usual 10%). We have always had high deductible plans, but that seems to be all that is left on the market, (I sold insurance for a 'very' short time). Go for catastrophic coverage with a tax sheltered HSA- Health Saving Account (if you can even find one these days) keep at least a few grand in the account. Find a doctor that deals in cash
(you can negotiate a 10-60% discount). The wife is a nurse, and its amazing how much you can save dealing in cash. If you need to have something large done, surgery or whatnot, If said procedure is not covered, tell them you can give them what Medicare would pay them(and they are the problem not the insurance companies). They'll probably counter with 10% higher, but that still saves you 40-50% of the bill.

Recap, catastrophic coverage, HSA, deal in cash and negotiate.

Oh yea if you move away from your employers plan, you will be buying a plan that is not 'grandfathered in' entering deeper into Obamacare.

[Zundfolge]

Company plans are ALWAYS better.

I've heard this bovine scat for years and I have only take a company plan once in my life.

I have basically the exact same private plan through Humana that I could get through my employer and even with my employer paying half of my premium buying it myself is still cheaper.

Except for a short period of time about 15 years ago I have found this to be the case with every job I've had.

Shop around ... find a good insurance broker ... save money.

Most of the time you can find a plan that is less expensive than a company plan (unless you work for a company that pays 100% of your premium).

[Hayes]

I have Anthem (BCBS) and it's been good so far. I've had it for over a year now and haven't had any problems.

[CO Retriever]

I'm a benefits guy by employment, been in the business for 12 years. Work for the largest healthcare company in Colorado. When comparing benefits you have to compare apples to apples.

While there are some good individual policies out there, you need to understand what your needs are, whats important, and how much can you afford to pay "if" something happens.

Feel free to PM or catch me on Skype at bmouton09 and I talk you through the maze of options.

Oh, and the others are right Obamacare is causing a lot of issues for employer coverage due to the way the legislation is setup. There are lots of variables that go into the cost and coverage.