[NA] Private Health Insurance

[CJones]

Disclaimer: I have no desire for this thread to become a debate over privatized vs. government paid vs. HSA's. I am simply asking for information regarding my personal situation. Please don't move this thread so far that it gets moved to the spin zone -- I have the spin zone blocked, and I won't see the replies that I want to see.

Now..... the rest of the story....

I quit my full-time job at the end of June so I can return to school full-time this fall. This means I am no longer eligible for company sponsored health insurance. I got the COBRA letter in the mail, but they want $1,000/month to continue my previous coverage. That is WAY out of my price range considering my wife and I are very rarely sick - in the two and half years I had company health insurance, I went to the doctor maybe 3 times. Basically, all we really need is 'disaster proof' insurance to cover us if we got in a car accident, broke something, appendix, etc.

I called my Home/Car insurance company and they sent some info that looks like they simply printed some quote off of Assurant Health's website. I went to their site myself, and I can get basically the same screen they printed out and mailed to me.

So here are some questions:

1.) Should I go through my Home/Car insurance company (State Farm) for health insurance as well? Will I get better coverage/better price if I go through them?

2.) Got any recommendations in regards to companies to go with or stay away from? I seem to remember hearing about Assurant being sued because they were VERY stingy with paying claims.

Once we are in school at ISU, we can use the "Student Health (death) Center" for normal doctor visits. So all I really need is coverage for severe needs and preferably maternity care (just in case ).

Thanks for any info and directions...

 

[AdamZ]

Chris, its all relative! I'd like for my premium to "only" be $1000 for me and my family. As for health insurance companies I think it really depends on where you live. I am here in the Philly area and the big two are Blue Cross/Keystone and Aetna/US Healthcare. There are some smaller players too such as United Health Care.

I cannot speak for Iowa but here the Blues are across the board less expensive and I think they have more plans to pick from. Aetna may however be less expensive if you are a young healthy individual. Ya just gotta check it out. My Law partner has a United HSA ( Health Savings Account) Many of the insurers Offer HSAs. Its a great was to save $$$ if you are young an health. The theory is that you pay for your healtcare expenses upto a certain dollar amount say $3000 and after that the insurer kicks in. They are trying to get folks back to the old days when the patient paid for regular doctor visits and the insurer paid for the "major medical" ie hospitalizations.

Which ever way you go make sure not to forget a prescription drug plan. Med can get SUPER expensive.

Some places to look for health insurance are through various associations. My Bar Assn has a deal with the Blues. Many Churches, Synagogues and fraternal or hobby orgaizations offer plans as well.

Best of luck.

 

[flyersfan31]

Can't you get full (i.e. major medical) coverage from the school as well? Some have it, some don't. If not, go for an el-strippo major medical coverage from a Blue Cross or an HMO. If you're healthy, and you have access to student health for garden variety problems, all you need to cover is the worst-case-scenario requiring hospitalization. Call a couple big names and see. I don't even think State Farm does medical insurance, do they??

My advice, worth what you pay for it: Don't get the missus pregnant during school. My dad did it. My brother did it. Makes life tough.

 

[CJones]

Can't you get full (i.e. major medical) coverage from the school as well? Some have it, some don't. If not, go for an el-strippo major medical coverage from a Blue Cross or an HMO. If you're healthy, and you have access to student health for garden variety problems, all you need to cover is the worst-case-scenario requiring hospitalization. Call a couple big names and see. I don't even think State Farm does medical insurance, do they??

My advice, worth what you pay for it: Don't get the missus pregnant during school. My dad did it. My brother did it. Makes life tough.

We're still waiting to get all our last-minute paperwork from the school. I think they have some sort of health plan. Last time I was in school, I was still under my parents' insurance, so I always just info about insurance in the garbage.

I just went to Assurant's website and ran numbers identical to the info State Farm sent me. Apparently they (SF) is using Assurant as their pass-through provider of some sort. The numbers I put in gave me the same premiums as what SF quoted me. No discount there!

NOT getting a little one on the way is a VERY high priority for us. Her brother and sis-in-law had an 'oops' about 6 months after getting married. We've seen how THAT works. No thanks!

 

[tonycondon]

i seem to remember throwing away a bunch of insurance crap from ISU as well.

 

[CJones]

Chris, its all relative! I'd like for my premium to "only" be $1000 for me and my family. As for health insurance companies I think it really depends on where you live. I am here in the Philly area and the big two are Blue Cross/Keystone and Aetna/US Healthcare. There are some smaller players too such as United Health Care.

I cannot speak for Iowa but here the Blues are across the board less expensive and I think they have more plans to pick from. Aetna may however be less expensive if you are a young healthy individual. Ya just gotta check it out. My Law partner has a United HSA ( Health Savings Account) Many of the insurers Offer HSAs. Its a great was to save $$$ if you are young an health. The theory is that you pay for your healtcare expenses upto a certain dollar amount say $3000 and after that the insurer kicks in. They are trying to get folks back to the old days when the patient paid for regular doctor visits and the insurer paid for the "major medical" ie hospitalizations.

Which ever way you go make sure not to forget a prescription drug plan. Med can get SUPER expensive.

Some places to look for health insurance are through various associations. My Bar Assn has a deal with the Blues. Many Churches, Synagogues and fraternal or hobby orgaizations offer plans as well.

Best of luck.

I didn't even consider Blue Cross/Blue Shield. I just assumed that they would be out of my price range. I'll have to check them out for a quote. Thanks for the info!

I'll check into the HSA as well. I've heard very scattered info about them so I'll have to research more.

 

[SCCutler]

Also, Chris, you might want to be sure that you are aware of all of your options before you allow your COBRA option to expire; you may find that new coverage is a lot easier to buy if you are already / still covered. YMMV.

 

[KennyFlys]

Being self employed and too stubborn to ever go to the doc, I just went with a basic health plan. There are no doctor visits, no RX, no extras. It has a $7500 deductible and its only planned use is for catastrophic coverage. I'm paying $117 a month for it but I'm 46. I'm sure it would be much less for someone in their thirties or even coverage for a married couple.

If you want just coverage for catastrophic circumstances, that may be a good option for you.

 

[mikea]

I didn't even consider Blue Cross/Blue Shield. I just assumed that they would be out of my price range. I'll have to check them out for a quote. Thanks for the info!

I'll check into the HSA as well. I've heard very scattered info about them so I'll have to research more.

Each Blue is an independent organization. Any advice you get from someone not using yours won't be giving apples to apples. In my case, BCBSIL was supposed to be the primo but they always shafted me and fellow employees, with stuff like not paying for the physical the hospital required. A co-worker's wife got cancer and they were almost bankrupted.

You should look to join any group coverage you can. If you can get student coverage that would do it. Some chambers of commerce and such have group plans for members.

 

[Ken Ibold]

BCBS of Florida is notorious for losing paperwork on claims. It happens with such regularity I swear it's an intentional effort to get you to say "the heck with it" and pay the doc bills out of pocket. And some of the deductibles are ridiculous. We have what is billed as the best plan available, yet when my son got beaned with a line drive and needed a CAT scan, we ended up out of pocket almost $2000.

When the system works "right, " the bills typically are something like:
Doc charges: $1850
Negotiated discount: $1200
Insurance pmt: $250
You owe provider: $400 (which is really what the service should have cost, anyway.)

The presence of the negotiated discounts is critical, and in fact is as important a part of the plan as the deductibles and copays. It's a complicated nightmare.

 

[mikea]

BCBS of Florida is notorious for losing paperwork on claims. It happens with such regularity I swear it's an intentional effort to get you to say "the heck with it" and pay the doc bills out of pocket. And some of the deductibles are ridiculous. We have what is billed as the best plan available, yet when my son got beaned with a line drive and needed a CAT scan, we ended up out of pocket almost $2000.

When the system works "right, " the bills typically are something like:
Doc charges: $1850
Negotiated discount: $1200
Insurance pmt: $250
You owe provider: $400 (which is really what the service should have cost, anyway.)

The presence of the negotiated discounts is critical, and in fact is as important a part of the plan as the deductibles and copays. It's a complicated nightmare.

Yeah. Here we go where CJ didn't want...

One stupid thing is the people that can least afford it pay full retail.

 

[gkainz]

I fought Assurant for over a year over a claim for surgery. They get a thumbs-down from me. BCBS has always been good to us, and Kaiser was satisfactory, as well. My son was offered Health Insurance from University of Colorado when he started there last year (as I recall, it was an automatic add-on unless he proved he had other coverage).

You might want to look into a Major Medical policy (also called High Deductable plan) coupled with a Health Savings Plan (HSA) ... NOT a Medical Savings Plan (MSA) however, as these expire and wipe clean each year. An HSA does not have the "use it or lose it" clause.

 

[wsuffa]

Shop around. You will find a wide variety of plans and costs.

Check the "Blues", and check any professional organizations you might belong to. When I ran out of COBRA and until I got covered on another employer-sponsored plan, I took insurance through IEEE. It was NOT cheap (about $500 for self), but it was better than no coverage, and it was about $150/mo more than COBRA. IEEE also offered some high-limit plans, which work well if you have money set aside for an emergency (or you are able to do an HSA). Those might also be acceptable if the school coverage is OK.

$1,000 seems high for self-coverage, it is about par for family or self+wife.

If you qualify (even as a student) for an organization like IEEE, it's worth the money to join and get group coverage for insurance. I think there are also some student plans available - it's worth a call to the appropriate office (student affairs, student benefits, etc) at the school - those plans may be less expensive.

You'll always pay the highest possible amount for a non-group, individual plan.

A word of warning: if you have anything that can be considered "pre-existing" conditions, do NOT let your coverage lapse. Under the law, a new group plan MUST cover existing conditions, as long as you were covered for something like 22 out of 24 of the prior months.

A second word of warning: avoid, if possible, the short-term plans that are offered. These are quite limited, and often hesitate or refuse to pay.

 

[gkainz]

A word of warning: if you have anything that can be considered "pre-existing" conditions, do NOT let your coverage lapse. Under the law, a new group plan MUST cover existing conditions, as long as you were covered for something like 22 out of 24 of the prior months.

I cannot DITTO this strongly enough. You would be amazed at the things they will try to correllate with "pre-existing conditions". Imerica tried to deny payment for cholecystectomy (gall bladder removal) as "pre-existing" because I had visited the doc once before for "abdominal pain" (food intolerance and reaction). ER initially labeled me as "abdominal pain" when I presented with the gall bladder and stones causing pain. However, they also noted "chest pain" and screened for heart attack, right along side the abdominal pain note. Took over a year of arguing with them to get them to pay, all because I had let my insurance coverage lapse for a short time.