Self Employed Health Insurance

cognitivefun

Enlightened
Joined
Oct 27, 2004
Messages
600
I am self-employed and have been for ages, more or less. I have personal Blue Cross policies and have been very pleased. I have a high deductible and the benefit is that even if I have to pay out of my pocket since we don't meed the deductible, Blue Cross providers (everyone basically) agree to accept a negotiated rate, so I pay far less than I would without the insurance.

Yes, it is very expensive, but what choice is there? I had Blue Cross in California and it was excellent, and I feel the Blue Cross (CareFirst) product here in Washington/Virginia is also excellent. I recommend them.

The other option that is maturing is the HSA. Blue Cross is offering HSAs in more states and Virginia is going to be one of them. This is the way to go and I will switch over when I can.
 

BB

Flashlight Enthusiast
Joined
Jun 17, 2003
Messages
2,129
Location
SF Bay Area
I have Blue Cross for my family on and off (currently on) through the years and, in general, have been pretty happy with them.

HOWEVER, I am not so sure right now... 6 months ago took a daughter in for a normal checkup (outside of the deductible) and Blue Cross denied payment (had paid before--as I recall). The complaint is that I was never able to get them on the phone--no matter when I called.

I gave up (was not that much money)—but I would suggest that you check with your doctor before doing optional stuff and see how much it will cost. Also, I would try calling the 1-800 customer number (not the sales number they give you before you signup) a couple of times and see how long the waits are.

I currently carry a $2,500 deductible for my family, and the rates have been zooming higher rapidly. Blue Cross is now offering a $5,000 deductible now.

Drugs are not covered under any of the el-cheapo plans--that I am aware of. For that, I have been cruising the pharmacy websites, and have found Costco to be one of the better priced ones... However, you should look around if you have an expensive or maintenance prescription to see if you can do better.

I had an in-law that had to use doctors/hospitals in a couple of Asian countries recently and the care is the US is still much better.

-Bill
 

kitelights

Flashlight Enthusiast
Joined
Jun 8, 2002
Messages
1,377
Location
Richmond, VA
Excellent post. Taxes enjoy a very similar attitude.

If everyone who had health insurance, was required to pay their medical bills themselves and then submit the bills for reimbursement to their insurer, it would go a long way towards overcoming that mindset.

Likewise, if everyone received their gross earnings and had to pay taxes each pay check themselves - write a check, not have it deducted from your paycheck, there'd be a whole new sense of awareness.
 

Lebkuecher

Flashlight Enthusiast
Joined
Mar 5, 2003
Messages
1,654
Location
Nashville TN
Thanks everyone for offering ideas. The Costco and just major medical are two that I know that she was not aware of.

I have no problems expanding the thread to include healthcare issues but It’s would be nice to see ideas on how to fix the problem as a whole.
 

AJ_Dual

Enlightened
Joined
May 7, 2005
Messages
691
Location
SE WI
I'm flattered somebody actually read my "novel". I figured it's just interesting to just talk about the medical aftermath of depression wage fixing we're still living with now.

You're absolutely right, consumer education and information resources to make informed decisions in a medical free market would be critical. I thought about that, but I already was on way too much of a tangent. Changing to a medical free market would be an incredibly tough road, even if I do believe the results might be benificial in the long run.

Otherwise, to the original point. I still recomend anyone having difficulty with finding private payer health insurance, that they into a major/catastrophic plan. It could save you from bankruptcy or worse, lest you get into a car crash etc.

Even if you intend to get a comprehensive plan, having some catastrophic coverage while you're "shopping" could be an affordable way to cover the worst of the gap.
 

Hookd_On_Photons

Enlightened
Joined
Oct 28, 2004
Messages
647
Lebkuecher, if your friend has no ongoing, chronic medical problems, then a high-deductible "catastrophic"-type policy is probably the best option, in order to reduce the premiums.

There is no harm in discussing the necessity and cost of medications, tests, and procedures with a doctor. Some docs *might* take this as a challenge to their authority, so I'd recommend asking questions with a smile. If the doc is offended that you'd even dare to question his judgement, it's time to find a new doc.

Many docs fall into the habit of prescribing the latest/greatest wonder drug without thinking too much about the cost:benefit ratio. There are many old standby drugs available generically that are as effective as the heavily advertised high-profit recently introduced drugs.

The same goes for tests and procedures. It doesn't hurt to ask if you *really* need that MRI that will cost thousands of dollars. You'd be surprised how often tests and procedures are ordered simply to shield the doc from litigation.

I concur with the recommendation to use the Costco Wholesale pharmacy. Costco's markup for pharmaceuticals is usually modest, and compares quite favorably to most other pharmacies.

You don't have to have a membership to use the pharmacy at Costco Wholesale. You can even check prices at their website.

http://www.costco.com/Pharmacy/FrameMaster.asp?cat=678

Sasha might have some helpful suggestions with regard to obtaining inexpensive pharmaceuticals.


Basically, try to think of the health insurance like your car insurance. You don't want to file a claim for every little bump and ding on your car, but you need it for major catastrophes. The health insurance should be risk management, not carte blanche to consult a physician for minor maladies.

This is a decent, basic book for persons who have little or no knowledge about how to maintain their health. (link to Amazon):

YOU: The Owner's Manual

The American health care system is quite good at fixing most acute problems, but we actually do a terrible job with health maintenance. Would you want a mechanic who wouldn't tell you to change your oil, but was more than happy to overhaul your transmission after you'd worn it out due to insufficient lubrication? Because that's how many health problems are managed by our system. OK, I'll yield the soapbox to somebody else now...
 

BB

Flashlight Enthusiast
Joined
Jun 17, 2003
Messages
2,129
Location
SF Bay Area
Looks like Costco is beginning to test market a health care plan for their customers in So. Cal.:

It's Insurance a la Cart: Costco Stores to Market Health Plans

[ QUOTE ]
In a pilot program to be launched next month in Southern California, Costco will offer family and individual coverage to its customers who pay $100 a year for "executive" membership, company officials said. The insurance is aimed at people such as contractors, waiters and students who are self-employed or cannot sign up for plans at work.

Although other discount stores such as Wal-Mart and Target have begun offering limited health services in their stores, Costco says it will be the first to offer insurance to members. About 18 million households nationally belong to Costco, including 3.4 million who pay for executive membership.

Company officials would not quote premiums but said the insurance would be 5% to 20% cheaper than policies individuals could buy on their own. Costco expects to offer coverage statewide by the end of the year and may eventually make it available to regular members, said Dellanie Fragnoli, assistant vice president of insurance services at Issaquah, Wash.-based

[/ QUOTE ]
 
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