Personal health insurance. NA

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tom clark

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Tom Clark
Boy do I feel like a fish outta water. My cobra runs out next month and I need to get my own health insurance. I've been cruising the internet and seen plenty of plans and except for varying deductibles and prices they all kind of look the same. Humana looks like my best bet so far. Anybody gone through this recently? Any words of wisdom or landmines to look out for? After 30yrs of employer provided health insurance I don't seem to even know what questions to ask! Thanks for any advice! tc
 
If you or your spouse are over 50, join AARP and take a look at their plans. AFAIK, fairly reasonably priced. Beware, though, that some of their plans carry a 1 year exclusion for existing conditions.
 
Premium price is only a part of the story of any policy.....willingness to actually pay benefits without playing a bunch of games is the other part to shop for. If you find one you like, get some word of mouth from users on how well they have paid. Consider other things like, does your local hospital or doctors accept the insurance you are buying...some plans are 'good anywhere', some mean you have to travel to find the place that will accept your insurance.
 
Consumer Reports just did an article on the subject. They all suck about equally, in my opinion. Look into who has the least customer complaints.

We have Aetna, but if I were bold and daring, I'd do an MSA and get a catastrophic plan. As it is, my wife wants the "comfort" of the PPO plan and for now, she wins. She still hates the plan, though.

The only worse solution I can imagine is any of the plans the Democrats are proposing. (Sorry, didn't mean to spin it.)
 
Absolutely DO NOT LET YOUR POLICY LAPSE!!! (yes, I'm shouting!) If you have a lapse in coverage, they will get you for "pre-existing conditions" and exclude anything and everything you ever went to the doc for, at least in my experience.

I had very bad luck with Imerica (used to be someone else and I have a mental block on the name - based out of Milwaulkee) ... fought for over a year to get a surgery paid ...

I had a major medical policy with Aetna ($5k deductable) coupled with an HSA (not MSA - different animal) through my business before I took this employment position. Funds in an HSA do not "use or lose" at the end of the calendar year, unlike an MSA (see www.ustreas.gov/offices/public-affairs/hsa and http://en.wikipedia.org/wiki/Health_savings_account )

My wife was also much more comfortable with a PPO vs the High Deductable plan, but I switched my HSA administration to Wells Fargo who provided a debit card against the account. I funded the HSA to cover the deductable and then she was a little better with not "having to write a big check every time she went to the doctor"

There are tax advantages to the High Deductable plan + HSA in some cases - see your tax attorney.

Also, there are health insurance brokers out there - some are pretty good... some not so helpful ...
 
If I did not have to buy health insurance for my office staff anyway, I'd go with a catastrophic protection policy and HSA.

But I echo the shouted advice above: Get something in place before your COBRA coverage lapses.
 
I recently was in the same boat. I found a local group "Groups Benefits Limited" which is pretty much an insurance broker. Got a policy through them with Coventry. It's a catastrophic type of coverage, but at least it's something.
 
A hibernating brain cell just woke up ... Fortis was the company that became Imerica that gave me such grief in getting claims paid ... YMMV
 
I did the Humana HSA thing with lapsed insurance. They have a 90 day wait for preventive stuff and a 1 year wait for anything THEY consider pre-existing (IIRC).

I haven't had to use them yet, but I might start using them for my Malaria pills. Rumor control says my company wants to start providing us with cheaper, more side effect prone pills. I'm curious how they'll handle that since we're talking long about a long term (years) subscription.
 
One thing to remember about personal insurance.

$1M lifetime max.

Most all of them have it.
 
Anymouse said:
I did the Humana HSA thing with lapsed insurance. They have a 90 day wait for preventive stuff and a 1 year wait for anything THEY consider pre-existing (IIRC).

I haven't had to use them yet, but I might start using them for my Malaria pills. Rumor control says my company wants to start providing us with cheaper, more side effect prone pills. I'm curious how they'll handle that since we're talking long about a long term (years) subscription.
Click to expand...

IME, the Malarone pills we got, in the weekly dosage, caused scarier hallucinations than LSD or any other substance you can imagine. I had full on night terrors with the stuff. I think all of the anti-malarials have it (YMMV, not a doctor, did not stay at a Holiday Inn Express, offer not available in VT and NV)

Didn't get malaria, though, so I guess it worked out.

Cheers,

-Andrew
 
astanley said:
IME, the Malarone pills we got, in the weekly dosage, caused scarier hallucinations than LSD or any other substance you can imagine. I had full on night terrors with the stuff. I think all of the anti-malarials have it (YMMV, not a doctor, did not stay at a Holiday Inn Express, offer not available in VT and NV)

Didn't get malaria, though, so I guess it worked out.

Cheers,

-Andrew
Click to expand...

Malarone (aka Atovaquone/proguanil) is what I'm currently taking. The company wants to move us to Doxycycline. One of the side effects is photo sensitivity, so you need to stay out of the sun. I'm in Africa!! Nothing but sun here!!

Anyway, sounds like you were taking Mefloquine. I'm trying to stay away from that stuff for sure.
 
Tom, given my experience over the past year or so I can quote you chapter and verse on this subject. Before you do anything, do a GOOGLE search on HIPAA and learn your rights. I won't bore you with the details on my experience, but it was ugly.

First, as everyone has said, don't let your current policy lapse, it makes it much harder to get coverage. If your current coverage does lapse before you are individually underwritten by another company, and you can show you've had continuous coverage for the previous 18 months, (a certificate of continous coverage from your current insuror) the new underwriter must insure you without a pre-existing condition limitation, even if you have one. They can charge you whatever, but you must be accepted. If your policy lapses for just 30 days that's out the window. So put in an application asap, because it may take up to 30 days to get a policy if you have any sort of medical history at all.

Do not get a short-term health policy to buy breathing room. They do not count towards COCC and a pre-existing condition is what they say it is.

We finally ended up with an HSA from Carefirst with a 2500 individual/5000 combined deductible for my wife and I, and so far I'm pleased. The cost was about half of a PPO plan, with a 2 MM lifetime limit.
 
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