Quote:
Originally Posted by evan_us56
Hi everyone,
I am looking for health insurance. The plan I have now is no good and it costs too much. So I want to know about some others plans that give me better coverage. Can anyone help? Thanks in advance!
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I'm an independent broker who'se specialized in health insurance for 20 years. I can tell you that availabiliity and affordablility will greatly depend on your state regulations. If you live in the Northeast except for NH and CT, most of those states are in TERRIBLE health insurance crises and people pay double or triple what they'd pay in a "normal" state. The good news is that most states tend to be reasonable except for most of the Northeast with a few exceptions.
Contrary to what another poster said, choosing what you think you want as far as plan design is not usually in your best protective or financial interest.
Insurance companies know that plans with low office visit co-pays are what "everyone" thinks they want. So every company, even those which offer the identical plans WITHOUT an office visit co-pay (where the office visits are covered subject to the deductible being met -- meaning they can be applied to the deductible) but these plans would still have a $2000 or $3000 deductible IN ADDITION to co-pays -- cost on average 20% MORE than the same plan that would cover the office visits, ER visits and urgent care visits 100% once the deductible was met. Whereas, the more expensive plan (ironically) would still have the deductible AND UNLIMITED co-pays. Imagine having had surgery and having paid out your deductible(with either plan) but still needed ongoing physical therapy, which plan would you have chosen, the more expensive one where the physical therapy sessions would cost $20 each and you'd pay higher premiums, or the other one with the same deductible that cost 20% less, where your physical therapy visits would be covered 100%? Most people stupidly go for the co-pay plan because they are SO BRAINWASHED and think they are better when they are really not even as good as a plan that will eventually cover everything 100%.
It's really a NO BRAINER when you closely analyze the coverage, out of pocket exposure and premiums of a plan compared to another. It's amazing how many accountants, lawyers and even prize winning New York Times best selling economists who write books about health insurance can't figure out how to evaluate a health insurance policy. It isn't as complicated as it may seem.
However, the more co-pays a plan has the higher premium you'll pay and the least protection you'll get (since the co-pays go on and on forever).
Usually your best bet is to go with a high deductible HSA (health savings account) compatible plan. The premiums are much lower and the protection is MUCH better than co-pay plans (It's 100% FOR everything INCLUDING Rx once your deductible is met.) In all the nearly 20 years I've been in this business, I have YET to see a co-pay plan that provided better protection for the money than a non-co-pay (deductible or deductible and coinsurance) plan.
Make sure you get a PPO plan NOT an HMO plan (where you have to go through a primary care doctor and have no coverage outside the network). The PPO plans let YOU decide which doctor to see and also with PPO plans, you can go outside the network. Look for a PPO that has a national network to reduce your need to ever go outside the network.
If you have questions, you can send me a private message and I can be more specific. I'd need your age, a health history, an idea of height and weight and your town and state and zip code. If this is for a family plan, I'd need the parents ages, heights and weights, smoker or not(for you too) and health conditions especially medications taken and dosages and for what---and the number of children and any health issues they may have. With this info I can ask hypothetical questions to underwriters from various carriers to find out what your chances are of being accepted and what your rates might be -- to give you an idea of whether it would be worth your while to apply while maintaining your privacy with carriers that wouldn't be a good fit or who might reject you (which you want to avoid at all costs).
Some carriers allow you to rider certain pre-existing conditions (that you are sure won't be a problem--- but if they cover them it will jack up your rates by 100% or more or less.
I can give you a link to a site where you can customize actual plans that you might qualify for and get rates right on line as well as see the descriptions of the policies.
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