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Yep, it does vary a lot state-to-state...my DH and I are both in good health, no health conditions, rarely go see a doctor, are self-employed have catastrophic with $2500 deductible for each of us and our premium is approaching $700....we're older, and live in a state that doesn't have the healthiest population...our premium goes up every birthday for each of us...even without any claims...
And we have the choice of only one provider in our small community...
E-health insurance does niot provide insurance, nor are they even a broker. They are sort of like Lending Tree for getting a mortgage. They just alert insurers that you are shopping.
What will happen next is you will start getting calls from health insurance brokers all offering you some version of that plan but prepare for bait and switch. It will not look anything like what you just described.
Also, prepare for the fact that your family members' medical records will be audited and any medical condition for which they have received treatment will be excluded and then some. For instance, a minor who takes medication for depression or any other mental health reason will be excluded from all insurance.
What state are you in? I've been self-employed, and therefor self-insured for most of my working life. Excellent health, good cholesterol, BP etc. I've been paying over $250/month for catastrophic coverage. That means no Dr. Visits, no prescriptions, $5,000 deductible, then 80/20 after that. Are you telling me you're getting two people with all the stuff you listed for $300?
If so, I'd say good luck with ever getting to collect anything. Lots of companies promise the moon, they just never deliver.
No kidding! Plus they're smokers! That's an almost guaranteed refusal here. I can remember when we paid insurance companies and, when needed, they paid our claims....makes you wonder how they stayed in business.
As a lot of you may know (it's been mentioned a few times in here), I'm self employed and we currently have no health insurance. The last time I priced it was about a year ago, when we started our business. The plans I was looking at then were all over the map, as we weren't sure how fast the business would take off and how much money we'd have to spend on insurance.
With all the talk about health insurance these days, and with all the threads going here discussing the "health care crisis" we are or aren't experiencing and the alleged outrageous cost of plans for those whose employers aren't bearing the brunt, I decided to take another look at the options available and their cost.
What I found was that as long as you're not wanting every single nickle and dime covered, the plans are actually pretty affordable. You do, of course, have to look at the details and really understand what it is you're signing up for, but then, shouldn't you always do that when you're entering into a contract? I would think that would be particularly important when dealing with something as significant as your health. I say this because a big part of the argument for some form of government run health care is that the insurance companies try to weasel out of providing care, and often the care in question isn't covered by the plan. Most people don't read what they sign...
Here's the basics of the plan that best fits our situation. We may or may not purchase this plan in the next month or two - I need to do some more shopping around. The comparison tool I used this afternoon was eHealthInsurance.com. The quote is for two adult smokers and two teenage boys.
Office Visits: $35, 2 per year per person
Specialists: $35, 2 per year per person
Coinsurance: 20% after deductible
Annual Deductible: $5,000, $2,500 per person, two persons max
Rx: Generic: $15 copay, no brand name coverage
Annual out of pocket limit: $3,000 per person + deductible
Lifetime Maximum: $3,000,000 per person
Out of network coverage: Yes
Out of country coverage: Yes, emergency only
Primary Care Physician Required: No
Specialist Referral Required: No
OB/GYN: Basics are 20% coinsurance after deductible
Emergency Room: 20% coinsurance after deductible, $500 copay if not admitted
Lab/X-ray: 20% coinsurance after deductible if performed within 2 weeks of surgery
Outpatient Surgery, Hospitalization: 20% coinsurance after deductible
Maternity: Not covered
Cost: $306.94 / month
There are some things in the list I'd like to see tweaked, but it's really not that bad of a deal. It's certainly not indicative of a "crisis." Would it be a free ride if there was a major accident or illness? No. Would it bankrupt us? No. There's enough coverage there to ensure that we'd get the care we need, and we'd just have to tighten our belts for a while.
I do agree that some things could be done to reduce the cost of health care, but I am, and always have been, convinced that there is no "health care crisis" in this country. Despite all the propaganda being thrown about these days, I still haven't seen anything that even comes close to convincing me that the Federal government should get involved. It's not their job, plain and simple, and if they're going to be sticking their hands into an industry that represents as much as 1/6 of our economy, they're going to have to provide a heck of a lot of proof that it's absolutely necessary. If the states want to experiment with some sort of UHC or mandatory coverage ideas, such as Massachusetts has, more power to 'em. I'm all about states' rights, and they have the right to do stuff like that. The Feds don't. It's not their place, and they absolutely should not get involved.
Thanks for the post... I may be opening up myself for ridicule but I don't understand all of the terminology. I've had employer provided insurance for so long that I haven't had to investigate these things much over the last 30+ years. If you don't mind... I'm hoping you could explain some of the terms to me.
First, am I correct in thinking that nobody has a preexisting condition?
Then....
Office Visits: $35, 2 per year per person
Specialists: $35, 2 per year per person
I assume that would be 2 per year for each of the 4 of you? The two adults and two children.
Annual Deductible: $5,000, $2,500 per person, two persons max
There's 4 people being covered... what do they mean by two persons max? What about the other 2?
Coinsurance: 20% after deductible
What's coinsurance? You pay 20% of the bill after the $5000?
I think if you answer that I'll be able to understand the other terms.
I hope you don't mind... I just don't understand all of the terms.
No one wants to hear that, swagger. They only want to hear how horribly unaffordable it all is.
Really, letting people from one state buy insurance in another (every time I pull up plans here in Texas, they are totally reasonable) would really, really help.
No one wants to hear that, swagger. They only want to hear how horribly unaffordable it all is.
Really, letting people from one state buy insurance in another (every time I pull up plans here in Texas, they are totally reasonable) would really, really help.
Is crossing State lines on the table from either party pertaining to health insurance reform?
I don't quite get the deductible and the co-pay. You may end up paying more than you expected. They may find a way to make you pay the entire deductible before you get these $35 dr. visits (the $5000). The lab/X-ray is minimal, if only paid within 2 wks of surgery. The rest will not even count towards the deductible. No brand name drugs? Some have no generic equivalent.
I am fairly healthy, and I only go to the dr. 1-2X/yr. But I take several meds. I have to have regular (twice yearly) bloodwork. That is a lab that would not be covered under your plan. If you get injured and need an X-ray, if it doesn't result in surgery (most don't) , you will have to pay for the X-rays.
As a lot of you may know (it's been mentioned a few times in here), I'm self employed and we currently have no health insurance. The last time I priced it was about a year ago, when we started our business. The plans I was looking at then were all over the map, as we weren't sure how fast the business would take off and how much money we'd have to spend on insurance.
Well, good luck. It looks like you are shopping for a business, rather than individual. My husband and I shopped for an individual plan: we checked with local doctors offices and found more than half of them are not accepting new patients at all, so we limited the search to plans which our current doctor accepted. Out of about 6 plans, we had 3 that we liked, and two of those were well recommended.
Both of them turned us down flat (I have had high blood pressure for about 10 years, controlled by one pill a day, and the spouse had a colonoscopy with a non-cancerous polyp removed 10 years ago, with no further polyps).
Fortunately my husband's former employer had an option for laid-off employees to pick up a catastrophic plan, which we did. Almost $1,000 a month for the two of us, no coverage at all until we hit a $5,000 deductible (per person). And that's all we can get.
We had to question whether it was even worth it - that's almost $17,000 (between the monthly payment and one person's deductible a year). Would it be better to just go without insurance and make up the difference out of savings?
Our neighbor recently went to the hospital with chest pains, and the bill was $7,000. We COULD cover that one bill. One the other hand, the other neighbor has cancer and bills (which Medicare is paying) on the order of $125,000 in the last year +. That we can't cover, not without seriously denting our ability to live retired.
The spouse is looking for another job with insurance, but at 58 in an area with 12% unemployment, that's not happening. I've worked as a contractor for a decade and no job I ever worked had health insurance.
So the final choice is to roll the dice, since we're both in our 50s, and hedge against catastrophic illness by paying $12,000 a year with the expectation that we're probably NOT going to use it. If I could look back 10 years, I wouldn't even bother to carry insurance - we'd never have used this plan. But I have to look forward until we're 65, and that just isn't a good bet.
Last edited by PNW-type-gal; 08-04-2009 at 04:20 PM..
Reason: Wrong per-person deductible: fixed
Well, good luck. It looks like you are shopping for a business, rather than individual. My husband and I shopped for an individual plan: we checked with local doctors offices and found more than half of them are not accepting new patients at all, so we limited the search to plans which our current doctor accepted. Out of about 6 plans, we had 3 that we liked, and two of those were well recommended.
Both of them turned us down flat (I have had high blood pressure for about 10 years, controlled by one pill a day, and the spouse had a colonoscopy with a non-cancerous polyp removed 10 years ago, with no further polyps).
Fortunately my husband's former employer had an option for laid-off employees to pick up a catastrophic plan, which we did. Almost $1,000 a month for the two of us, no coverage at all until we hit a $7,500 deductible (per person). And that's all we can get.
We had to question whether it was even worth it - that's almost $20,000 (between the monthly payment and one person's deductible a year). Would it be better to just go without insurance and make up the difference out of savings?
Our neighbor recently went to the hospital with chest pains, and the bill was $7,000. We COULD cover that one bill. One the other hand, the other neighbor has cancer and bills (which Medicare is paying) on the order of $125,000 in the last year +. That we can't cover, not without seriously denting our ability to live retired.
The spouse is looking for another job with insurance, but at 58 in an area with 12% unemployment, that's not happening. I've worked as a contractor for a decade and no job I ever worked had health insurance.
So the final choice is to roll the dice, since we're both in our 50s, and hedge against catastrophic illness by paying $12,000 a year with the expectation that we're probably NOT going to use it. If I could look back 10 years, I wouldn't even bother to carry insurance - we'd never have used this plan. But I have to look forward until we're 65, and that just isn't a good bet.
[wing nut hat on] Sux to be you! [/hat off]
swagger can get a family policy for $300/month, so there is no problem with the health care industry. Duh.
Well, he can get a web quote for that, it remains to be seen if he can actually get a policy even remotely like that. Especially if he's ever sneezed.
With all the talk about health insurance these days, and with all the threads going here discussing the "health care crisis" we are or aren't experiencing and the alleged outrageous cost of plans for those whose employers aren't bearing the brunt, I decided to take another look at the options available and their cost.
What I found was that as long as you're not wanting every single nickle and dime covered, the plans are actually pretty affordable...
DM me the name of the company, and I will pass it down to someone I know in Henderson. She could use it.
Thanks.
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