Buying Private Health Insurance? Any tips or advice? (medical, plan, doctor)

[the_grimace]

I've been uninsured for 8 years now (since I was 18). In the last 4-5 years, I've really wanted to get health insurance, but every time I try to look at plans, I get super confused, and my general conclusion is that is a total ripoff and I'm better off just as self pay. (pending no huge emergencies). Background: I work as a contractor so I'm ineligible for benefits, I'm still looking for a full-time position.

This year I've had some health issues with my stomach and stress/anxiety, and I've been racking up the bills again getting bloodwork, tests, and doctor visits. (around $3500 this year so far and growing) I keep telling myself to get insurance already, but it just seems like a total ripoff. Not only am I looking at paying a couple hundred a month for an "average" plan, most plans seem extremely vague in what they cover and don't cover, with stuff you think that should be covered actually not being covered! Then you end up paying for this type of stuff out of pocket (till your deductible is covered) or having to buy an extra plan to cover these expenses. Not to count the costs they charge for tests with insurance is ridiculously high... I just got an ultrasound done and got a 70% discount for self pay. I still paid $500. With insurance, it would have cost around $1400!

It just seems obviously better to self pay, but I guess the point here is that I'm so uneducated on health insurance, I'm not really sure.

So what are my best options? Are there any services out there that act as "health advisors", someone that can help you get an insurance plan and explain exactly how it works? (in regards to what is covered or not, since I always find this the biggest gray area when looking at plans). Am I right to think it is actually cheaper to be self pay than have a health insurance plan right now? (I'm 26, but like I said have been having some heath issues with my stomach this year)

Someone suggested I just buy a "catastrophe plan" for real cheap, like $25-30 a month to protect me from emergency medical needs or surgery, and keep self paying for my doctor visits and tests.

All and all, I'm completely lost and confused about health insurance and not really sure who to turn to for help! Any advice is appreciated! Thanks!

[golfgal]

Your deductible is like self-paying, only that it stops after a certain point. You can pick what you want your deductible to be but at $3500 out of pocket already, you probably would have met a deductible by now. With the various exchanges coming out with rates now, you should get a good idea of what you will be paying for a plan. Given your age, in our state, a "silver" plan would run you about $150/month before any tax credits. Since you are self-employed, it may be possible to deduct some or all of your medical premiums too...

No one likes paying for insurance....until they need it.

[texdav]

Also remember that young people are required to make a pool(exchange) work. It requires a mix of younger less use and older more use to spread the risk(payouts).I forget but there was publish info; a few months ago of the per centage of younger people need ACA requires to make it work without huge increases in premimums as scored. The first year premiums will be based on actuary figures and could change. A lot also depends on managing use so as not to have excessive use such as emergency room for non-emergency.If they can't get the right mix or people abuse the premiums could go up a lot when second year comes around just like any insurance pool. Not much room if any for higher government subsidties really.Insurance companies don't have problem because they like now get 20% of cost based on claims. Only difference is they now refund while they lowered premiums before for next year based on contract terms. Unlike medicare they can't set price low and then rely on private insurance to subsidise that low price either like now.