Web Worker Daily

Kelvin Ludbrook says: November 19th, 2007 8:51am

Move to Canada.

Although our health care system is not perfect at least you can get it at a reasonable price.

Mary says: November 19th, 2007 8:57am

I think the answer to this question is driven by your locality. Here in the Philly area there are two major players: Independence Blue Cross and Aetna. Docs around here don’t know what to do with anything else. I’d suggest that you simply find out what insurers local employers use – then call those insurers directly and find out what they offer to individuals. I got lucky – IBX and Aetna offer an HMO here that is somewhat reasonable.

I also tried via the area Chambers of Commerce – the quotes were quite expensive and had a bizarre policy of only accepting new customers that have been uninsured for 3 months prior to the effective date (I’m NOT making that up). Also watch out for pre-existing clauses. My understanding is that if you are coming off a group policy, you should be ok – but ask… and ask again.

Until America gets around to adopting a sane health care system, that is the sort of nonsense you may need to deal with. In short – don’t assume anything to be true – especially if it appears to make sense.

Good luck!

Paul Carney says: November 19th, 2007 9:02am

Check out NASE – National Association of Self-Employed (nase.org). You can get decent health benefits through their group (usually underwritten by Mega Health Insurance). We used them for 2 years before I sold one of my product lines to a company and joined into their plan.

Isaac says: November 19th, 2007 9:06am

For the Bible-believing web workers, the company that I use for my health care is a need sharing organization called Samaritan Ministries. It’s a great alternative to costly health insurance… and the monthly amounts are very reasonable!

You can check them out at SamaritanMinistries.org.

Steve Thorn says: November 19th, 2007 9:42am

The Christian Brotherhood is another faith-based program that I use. Low monthly cost. Catastrophic coverage. I still can’t get my company to pay for the $35 single-coverage monthly fee – though I’m saving them nearly $600 a month by not participating in the company health plan. Downside: $5000 “deductable”. Upside: did I mention the $35/month?

Steve Hollasch says: November 19th, 2007 9:51am

I was laid off with a bag-o-money a couple of years back, and had to make this transition for my family (wife and two children). I stayed on COBRA much longer than I should have, with premiums costing about $1300/month towards the end. This was a continuation of Microsoft’s health plan, which is very good (covered anywhere, pretty much no deductable, et cetera).

Fortunately, I’d had ACL surgery the year before, so had a good benchmark for catastrophic expenses as well as preventative only. I created a spreadsheet with every medical plan available to me, for a bunch of different ratios of catastrophic-to-nonevent years.

I could go on, but here are some observations from my perspective. First of all, you have to realize that everybody pays for medical insurance, but typically the cost is hidden to you. As an employee, my employer withholds money from my paycheck so they can cover my premiums. In government-sponsored systems, the government withholds your money. It’s just that when you become a direct customer, those costs are finally made transparent.

Anyway, here’s the bottom line. For all scenarios, all plans, I found that high-deductable policies win handily. Right now (WA state) I’m paying about $385 to cover my entire family, with a 75% deductable plan, and most doctors covered in their network. Some preventative visits are covered. The thing is, if I have a doctor visit and am still covering my deductable, I still come nowhere near what my monthly COBRA premiums were. You just have to get used to whipping out your checkbook more often, but you still have fewer dollars leaving your household.

One more thing: what makes high-deductable policies quite tenable is the MOPE (Maximum Out of Pocket Expense). I wasn’t aware of this until I did my research. You have four phases of spending: (1) covering your deductable, (2) covering your non-deductable [like, say, 25%], (3) paying nothing [once you've hit your MOPE], and, God forbid, (4), you’ve hit your lifetime maximum, and you’re on your own. Our mope is something like $10000. Once we’ve co-paid that much (through deductables, co-pays, and everything else), insurance covers everything. Key point: a high-deductable policy won’t leave you penniless due to catastrophic expenses.

Finally, whatever it takes, don’t leave yourself uninsured. Once you’re hit with a big illness or medical condition while uninsured, you are locked out. That’s a very foolish risk to take.

Dan says: November 19th, 2007 9:52am

Private Health Insurance was a lot more reasonable than I had expected. It helped that I’m single, but the rates for a spouse were decent. It does get pricier when you start talking kids, although I can’t compare it to what a company’s plan would cost.

Mark says: November 19th, 2007 9:53am

I quit my job while my wife was pregnant and continuity was VERY important to me. At the time I had one option with my current provider – their non-group rate. $1200/month for the two of us with the same coverage. I took it. (It went up to over $1300 after the baby arrived.)

We have a new law in Massachusetts that you may have heard of – it essentially makes anyone without coverage a criminal (in reality they just lose a state tax credit). The state had to provide options to people who couldn’t afford to suddenly acquire insurance, and just a month ago our provider opened up a slew of options for non-group rates. A family can get good HMO coverage for as low as $750 with HIGH deductibles. In our case, we migrated over to the plan that matched our non-group rate in coverage, the second from best HMO plan, and the price went down a bit. I think we’re paying around $1250/mth now for us and the baby.

Far from ideal. I’m not bound to a Chamber or anything, though.

http://www.freelancersunion.org/ now offers coverage in many states. It was previously limited to NY. You can sign up there and get a group rate through them. Unfortunately they weren’t able to extend to MA.

stoweboyd says: November 19th, 2007 10:13am

Look at the Freelancers Union (www.freelancersunion.org) for the chance to get health insurance in 30 states, explicitly not including Massachusetts.

Anne Zelenka says: November 19th, 2007 10:47am

There’s a ton of good information here, thanks everyone!

It’s definitely dependent on where you live. For example, in Colorado you can get a “business group of 1″ policy that offers a guaranteed coverage if you meet certain self employment requirements. I found, however, that those policies were far more expensive than getting medically underwritten (i.e., not guaranteed, looks at past usage of health care) individual coverage for my family of five.

We made the compromise to get a policy that doesn’t cover brand-name prescription drugs (we weren’t offered brand-name coverage due to prior usage, especially my usage of Imitrex for migraines). This is not too terrible but leaves us uncovered in case of some sort of health disaster like a cancer that would be best treated by some fancy new drug. Long term, it’s not something I’m willing to keep gambling on so in the new year hope to make other arrangements. May have to go for the expensive BGO1 policy.

I second Steve Hollasch’s suggestion that you look at high deductible health plans. That’s what we’ve gone with for a family of five and the price was shockingly low (granted, without brand name prescription coverage though). With an HDHP, you can also open a health savings account to which you can make tax-deductible contributions then use that money to pay for whatever’s not covered. You don’t lose the money so if you don’t use it and keep saving year after year, you could create a nice little health care savings cushion for yourself.

I’d recommend that if you’re looking for your own health insurance, find a good broker in your area who understands the options both from a legal perspective (e.g., Colorado’s BGO1 coverage) and from the perspective of which insurers in your area are likely to provide good plans. In Colorado, check coloradohealth.com — the broker I worked with there really knew her stuff.

vmgillen says: November 19th, 2007 11:09am

If you’re located in NYC, check http://nyc.gov/html/hia/html/home/home.shtml . This is a round up of insurance options. The advantage: a lot of tiny insurance packages get wrapped into one consolidated package – giving solos and small companies the leverage of the megas.

Laura says: November 19th, 2007 12:47pm

I pay only $700 a year for health insurance but I am young, healthy, childless, and my deductible is 5k. There is some affordable health insurance out there, unfortunately it seems to be only available to the select few. Still there is definitely a misconception out there that NO ONE can afford to buy their own health insurance, and I think a lot of young freelancers go without for this reason.

Darren Meyer says: November 19th, 2007 1:41pm

With no children to worry about, and assuming you are reasonably healthy individuals, a Health Savings Account (HSA) is a pretty decent option. You can fund an HSA with pre-tax dollars, but unlike other pre-tax accounts you get to keep what you don’t spend. Your HSA dollars can be used for prescriptions, medical expenses, and towards the deductible on a high-deductible insurance policy.

High-deductible policies are cheap compared to the alternative. I have an employer who offers decent health insurance, but getting an HSA on my own has been significantly cheaper than paying my share of the employee benefits package.

If your health is not great, you have expensive prescriptions, or are planning on expanding your family, check out the NASE — one of the major benefits they offer is affordable health insurance for self-employed folks.

Clara says: November 19th, 2007 3:26pm

@Laura: $700/YEAR? How do you manage that?
I thought I was lucky to be taking advantage of MA’s new laws with $126/month for a barebones, high-deductible, under-26 only plan.

matthias muenzer says: November 19th, 2007 4:32pm

I can only recommend HSA coupled with high deductible plans. You have more control over your money, you don’t automatically hand it all over to the HMO. you have more control. If you are young and work on staying healthy and have little medical costs, you get to keep the HSA money. It rolls over to the netx year, and in a few years you may have aved so much that you can pay your medical bills just from the interest you are earning.
How cool is that?

Rob says: November 20th, 2007 4:35am

If you look into getting your own plan and end up getting one with a high deductible (about $1,000 or more) you should look into opening a Health Savings Account (HSA). It is essentially an IRA for your medical expenses. There is a maximum amount you are allowed to contribute each year, and you can deduct the contributions off your taxes (if you were employed, and your company had an HSA, you could contribute pre-tax). All of your earnings are tax free as long as you use them for eligible expenses. And unlike Flex Spending Accounts, the money rolls over from year to year.

FMG guy says: November 21st, 2007 4:46am

Check with your local Chamber of Commerce. They usually have insurance plans for small businesses that are affordable (considering the price of insurance these days), joining the Chamber can help you network and get new business at the same time. It’s usually a win-win!

Star says: November 21st, 2007 7:38am

Even as a chamber member, you will have to pass underwriting standards to get the insurance.

2008 New Years Resolutions | Business Wife & Life says: November 22nd, 2007 1:26pm

[...] You have the vision. You have the resources. You have the support. Yet there’s one thing holding you back from following your dreams…health insurance. [...]

Neal Watzman says: November 23rd, 2007 3:49pm

Up until 4 years ago, I had to provide health insurance for my family. Over the years, I tried a variety of options that usually worked for a year or two. Cincinnati Chamber of Commerce was one. Policy rates kept going up and got to the point where I could do better elsewhere.

Since we were a healthy family, we ended up at the end with a $2500 deductible plan for a reasonable, but annually increasing plan. It was workable, and kept our out of pocket manageable.

Until my wife, bless her heart, took a job as a teachers aide with a district offering a pretty darn sweet health plan. Medical with $20 copays, dental, mental health. The pay isn’t good, but the benefits to our family more than make up for it.

Web Worker Daily » Archive Web Worker 101: The Insurance Question « says: November 30th, 2007 11:00am

[...] No Comments When we talk about insurance for web workers, we’re usually worrying about health insurance – and with good reason, considering how expensive health care and the associated [...]

R-Bro says: December 3rd, 2007 6:11am

My problem is that the rates are constantly going up. I signed up my family for a plan that was around $330/month, and within two years the premiums had gone up to nearly $500. The only claims we’d filed were for basic office visits and the like.

Then we switched over to MEGA (via the NASE), and a year later, here we go again: the rates are going up $30/month. Is that just the nature of the health-care beast?

The return of “Top English WP Blogs” « conduong.co.cc says: December 16th, 2007 2:47am

[...] How Do You Handle the Health Insurance Dilemma? A reader asks: I am looking at striking out on my own and working for myself freelance. However, leaving the security […] [...]

Web Worker Daily » Archive Health Insurance Outlook for U.S. Soloists Not Entirely Awful « says: January 8th, 2008 1:56pm

[...] more advice on health insurance for the self-employed, check our open thread where readers shared their experiences. And let’s hope that America’s next president takes decisive action to help those who [...]

Jonathan Pletzke says: February 8th, 2008 6:37am

My story involves finding insurance for my family of 5, and going from a $1200 a month COBRA payment to a $300 a month plan that has great coverage and lets us sleep well at night.

Like many people, I find the number of choices to be overwhelming. I’ve made some bad choices in the past when buying health insurance, and even been scammed. When I left my job nearly 3 years ago, I decided that I was going to buy health insurance properly. I went to the library, and couldn’t find a book to answer all my questions. I went online, and found much confusing, misleading, and wrong information. So I set out to figure out what the best choice was for my family of 5.

In the end, I found out so much that I put it into a book, a website, and a blog. My mission is to share this information with people so that they can make the right choice. I’d love to help everyone to find their best choice and not get ripped-off. Please visit http://www.besthealthinsurancebook.com and make use of the free resources, discussion board, and blog.

-Jonathan

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off and website http://www.besthealthinsurancebook.com

CARRIE says: February 23rd, 2008 7:29am

http://www.asihealthcare.com or call 1-800-929-8344 and give them referral id# 239416.

You can get an affordable healthcare plan and a free cell phone with clear reception and get 250 minutes added each month!

d says: July 16th, 2008 11:14am

In this thread, many people have recommended high-deductible plans with an HSA. In NY, that combination may not be available. What about high-deductible plans without an HSA?