non-group health insurance

[mx547]

are there any bargains out there? i just found out that my health insurance through work is going up $178/month. i just can't pay it. about a year ago, our company started a policy that the employees pay for each cost increase in full. if i want, i can take the portion that my company pays for my insurance as salary and purchase my own insurance. presently, they pay $748/month. if i could find coverage for that amount or less, i would be ahead. plus, it would be tax deductible. anyone know of anything worth checking in to or am i just screwed? fyi, it's forty-five year old me, my wife and two kids and my wife has ms.

 

[MikeT]

This is going to be a good thread. My health insurance has gone up tremendously in the past three years each and every year. I am looking to going out on my own and get my own insurance also because I keep seeing all these ads that have MUCH lower rates than I am paying now. I also believe the co-payments should be better. Currently I pay $20 for a Dr visit, $40 for a "specialist", $150 for the emergency room and $500 for a hospital visit PLUS 20% of the total bill. Medicines are $10, $25, and $45 depending on generic, name brand and the high one (not sure what that is). The cost per month is about $500 out of my pocket.

I too am wondering if there is anything better.

 

[dirt bike dave]

My family and I have been getting pounded by out of control premium increases and out of pocket expenses. We just switched from Blue Cross (good riddance!) to a new plan by Mid-West National. We will save about $100/month (from $650/month to $550 for a family of 4) and lower our deductables on the new plan.

To qualify for this 'group' plan, we joined a group called 'Alliance for Affordable Services' which is basically a group of self-employed people that are banding together to get group rates on insurance and other benefits. The group has a one-time fee of $125, but there are other benefits like a vision plan and dental, too.

I have not been to their website as we signed up through an insurance agent, but their page is www.affordableservices.org

 

[Reesknight]

Odd that this thread comes up right now. I just accepted a position at a company in Missouri so I'll be moving from East TN to SE MO. My salary increase was decent but not substantial but one of the things that was taken into consideration was health insurance. The company I am leaving does not offer very good coverage but the new company pays 100% of my family's premiums and $300 per year maximum out of pocket for family! :yeehaw: This increases my take home income <b>substantially</b> and was a big factor in my decision to make this relocation. :cool:

 

[Imabiggin]

I've been in the insurance industry for many years and I'm always somewhat amused by how people view their insurance costs. Darn right the costs have been going up. But it's not because the insurance companies are making big profits. It's the medical costs that are driving the increases. For those that are looking to buy individual coverage versus group coverage, here are the things to remember: if you have a pre-existing condition you may not find an insurance company that will take you or at the least they will rider off that exposure or have a lengthy waiting period before they will cover the pre-ex condition or raise the rates to cover the condition, the only time some one "beats the price" of their group coverage is when they are very young and the group is primarily older, individual policies are never as good as group policies, individual policies go up every year too and they can be sur-charged as much as 165% a year if you develop a serious conditon. If you're in really good health, look into a Health Savings Account. An HSA lets you put money into an account pre-tax and if you don't use it you can keep accumulating it like an IRA. So much for my rant. Good Luck!

 

[nephron]

Yeah...if you think your group insurance is high, check out what you would have HAD to pay without insurance next time you're discharged from the hospital. At the clinic, a couple of employees had fairly serious illness' --a joint replacement infection, and I can't recall the other. Our insurance went up 200 grand.

Imabiggin's got it all right. Insurance companies are more likely to go broke than make a ton of money. BC/BS is thinking of pulling out of this area for that same reason. So where's the money going? Are hospitals making it? Nah. Many are in the red or breaking even. They have to charge as much because they've got to pay for that new 20 million dollar MRI-SPECT machine. And they had to get the MRI-SPECT machine because if they didn't, people would go elsewhere/doctors would refer elsewhere. Ultimately, it's probably the tech companies getting rich.

The other problem--I'd bet at LEAST 20% of what I do is church work (free). Like it or not, people who have no insurance and no money get free healthcare...end of story. You pay for it, as the hospital raises rates to cover it with the insurance companies following shortly thereafter.

 

[gwcrim]

I'm with immabiggin. If you leave your group policy for an individual policy, where do you go when you develop a pre-existing condition and the individual policy goes up 200%? Group policies provide more protection in as far as continuation of coverage.

Neph, I'd suspect that your malpractice insurance costs are a sustantial portion of the reason that health care is so expensive. But hey.... all those PI attorneys need that 6000 SQ foot house in Vail, new Mercedes, Hummer, yacht.........

 

[Nevada Sixx]

if you do switch to another company, dont drop your old just yet till you see if you like the new one

 

[MikeT]

If you leave your group policy for an individual policy, where do you go when you develop a pre-existing condition.........

How do you develop something that is pre-existing?

Sleazy insurance companies will look for anything to deny paying. :|

 

[gwcrim]

Mike, it's all written in the policy.

Assume you're insured by Joe's Bar & Grill Insurance Co. because the premiums are half of the other's. Several months later you suffer a heart attack when you watch your kitten get run over by a punk on a kwad. JBG Insurance then renews your poicy next year w/a 300% premium increase because they had a large loss with you. When you shop around for new coverage, you now have a "pre-existing heart condition" and no one on planet earth will insure you, except maybe Lloyds of London and they want your entire net worth as one year's premium.

You can't blame the insurance company for trying to make money. That's why they're in business in the first place. There are no easy, fun, warm, or fuzzy answers. But being educated on the issue can help one avoid extremely costly mistakes. One huge hospital bill can be a catastrophe in itself.

 

[zio]

I'm only a licensed agent in CA. Each state has different rules & regs. Imabiggin, in CA the individual carriers can't increase your premium or cancel you based on claims. Once you're in, you're in. If they want to raise your rates, they have to do it for everyone in that plan. Blue Cross of CA is especially sneaky. They constantly come up with new plans, offer the plans to the healthy people already covered by them, usually at the same time they raise the rates on their current plans. Everyone who doesn't qualify (based on health status) is stuck in the old pool, the claims for that pool go up (because it's filled with "sick" people), and so Blue Cross can raise the rates by a much higher percentage to cover the claims. The sick people get screwed. It's not anything I can say they do on purpose. And all carriers do it, to an extent. The good ones will cancel the old plan altogether and move everyone into the new plan, albeit at different rates. But at least everyone is in the same pool, so when the rate increases come they're all hit with the same percentage. Ugh.... I could go on and on and on.......... :bang:

HIPAA (Health Insurance Portability and Accountability Act) has a provision for folks who are currently covered by a health insurance plan, develop a pre-ex condition, and then are forced to switch to a new carrier (i.e. job change). It states that once you're covered and have had continuous coverage for... oh heck, 6 or 12 months- can't remember just now- that you can't be denied coverage byt he new group plan, and those pre-ex conditions cannot be subject to a new waiting period. The intended effect is for easy "portability". Also, individual health insurance companies are required to offer a few (2, I think) of their "most popular" plans on a guarantee issue basis for HIPAA folks. The guidelines for "most popular" are pretty loose and the companies usually find their crappiest plan. Also, the guidelines for premiums are loose on these HIPAA plans, and you can expect rates that are through the roof. So MX547, there is a provision for your wife to switch to an individual plan on a guarantee basis, but the coverage will suck and the rates will probably be similar to what you're paying out of your paycheck now. I doublt any carrier would consider her with MS, but that's something for an underwriter to decide. It never hurts to apply.

I'm a little rusty on my individual insurance stuff, so anybody can feel free to correct me.

As far as insurance costs go, it's been covered pretty well in the above posts. Sucks, huh? How'd you like to be the fella giving the bad news year after year? The only consolation I can give is it's happening to everyone. Large employers, small employers, and individuals. I'm at least thankful that our government has managed to keep their mitts off it, or else we'd really be screwed, eh? ;)