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Old 08-04-2009, 03:44 PM
 
Location: Tyler, TX
19,949 posts, read 20,709,513 times
Reputation: 11477

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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.
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Old 08-04-2009, 03:49 PM
 
Location: Over There
5,124 posts, read 5,114,066 times
Reputation: 1207
We need to open up the limits on where you can buy it also. So if I live in NJ I can buy my plan from a company in PA. It would help end the monopoly that some ins companies have in some states and make the insurance portable.
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Old 08-04-2009, 03:51 PM
 
Location: Here
11,544 posts, read 12,999,197 times
Reputation: 6846
You're a liar and probably being paid by the Right Wing/AMA to post here.


(You knew it was coming )
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Old 08-04-2009, 03:52 PM
 
3,553 posts, read 7,350,732 times
Reputation: 2340
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.

golfgod
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Old 08-04-2009, 03:53 PM
 
Location: Tyler, TX
19,949 posts, read 20,709,513 times
Reputation: 11477
Quote:
Originally Posted by dcadca View Post
We need to open up the limits on where you can buy it also. So if I live in NJ I can buy my plan from a company in PA. It would help end the monopoly that some ins companies have in some states and make the insurance portable.
That's been my #1 point when debating government intrusion into the industry - we need to remove the barriers that keep insurers from crossing state lines. That one action would do more to lower costs than any other single thing could.
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Old 08-04-2009, 03:55 PM
 
Location: in my imagination
12,277 posts, read 19,808,531 times
Reputation: 8733
Swagger that does sound like a decent plan.However do me a favor,next time you contact them tell them you once had a melanoma removed a couple years ago.

Unless rules for insurance is different in your area I would wager that after 15 tries you would come to the conclusion you won't be getting health insurance and if you can it will be a astronomical fee
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Old 08-04-2009, 03:56 PM
 
Location: Tyler, TX
19,949 posts, read 20,709,513 times
Reputation: 11477
Quote:
Originally Posted by golfgod View Post
What state are you in?
Nevada. That's where "Las Vegas" (look up a little and to the right ) is.

Quote:
Originally Posted by golfgod View Post
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?
Four, actually.

Quote:
Originally Posted by golfgod View Post
If so, I'd say good luck with ever getting to collect anything. Lots of companies promise the moon, they just never deliver.
Oh, I see. Since it's not outrageously expensive, it must be a scam.

Good little liberal cheerleader. Rah! Rah! Rah!

There is no health care crisis.
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Old 08-04-2009, 03:58 PM
 
Location: California
34,145 posts, read 37,665,370 times
Reputation: 30803
That is $306 for two adult smokers and two teenagers? WOW. That's about what it costs for me alone. And I don't smoke!

Congrats on a good deal.
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Old 08-04-2009, 03:59 PM
 
Location: Tyler, TX
19,949 posts, read 20,709,513 times
Reputation: 11477
Quote:
Originally Posted by lionking View Post
Swagger that does sound like a decent plan.However do me a favor,next time you contact them tell them you once had a melanoma removed a couple years ago.

Unless rules for insurance is different in your area I would wager that after 15 tries you would come to the conclusion you won't be getting health insurance and if you can it will be a astronomical fee.
Like I said, this was just preliminary price shopping. I have no preexisting conditions, and they didn't ask. If I did, however, I would obviously expect to get a different rate once the formal application had been submitted - all I did here was list ages, genders, heights and weights. You can check out the tool yourself - ehealthinsurance.com.
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Old 08-04-2009, 04:00 PM
 
Location: Redondo Beach, CA
7,524 posts, read 7,731,673 times
Reputation: 7969
Quote:
Originally Posted by swagger View Post

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.
Lucky, lucky you. I wouldn't be able to have a policy like that. Two doctor's visits per year? Two specialist's visits per year? No brand name drug coverage? Even if I weren't excluded due to several pre-existing conditions, this policy would cover me for less than a month. And it wouldn't cover the only treatment that works for my Hashimoto's Disease, since generic drugs don't affect my symptoms. But bully for you for not supporting a program that might help other people, just because you don't need it.
Quote:
Originally Posted by swagger

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.
Pretty much no one, including Republicans, believe any of that nonsense. The agreement is practically universal that our current system is broken.
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