All, Iam looking for a new health insurance policy for my wife and
self.We are self employed buisness people.Ours has pulled out of the
state.I saw a thread on the subject and the jewelers group policy’s
seemed lame.Any other thoughts or leads would be helpful.We got
quotes for $800 a month with no pre existing condition coverage!
Way too high. Regards J Morley
Hello, J. Morley. This is a constant problem for me as well. I
live in Fla. and must buy my own health insurance. Due to a
pre-existing problem, I need to buy a group policy. The state of
Fl. requires that Insurance companies provide policies for “small
groups” of self-employed. I’m a small group of one. However, I pay
$344 per month for an HMO policy. I checked with SNAG, but they no
longer offer health insurance. As director of Florida Society of
Goldsmiths, I’ve tried to see if we could provide a group policy for
our members. The state of FL won’t allow associations to buy group
policies - only businesses. If anyone has any suggestions, I’d be
very grateful for the ! TIA, Gini
All, I am looking for a new health insurance policy for my wife and self.
Hello J;
I still think that the best policy is through Blue Cross/Blue
Shield. You can get into a group with the local Chamber of Commerce,
and it doesn’t cost much to join C of C. Is BC/BS the company that
pulled out of your state? Call the MJSA ( http://mjsa.polygon.net/ )
and see what they have going. You’re going to get a lot of
suggestions on this one. Good luck and keep us posted, there are
probably a quite a few others in your position.
David L. Huffman
J Morley, An $800/month quote is not at all out of line with what
most insurers are charging today. We work with Aetna and an
individual plan costs a little over $500/month. Aetna is not the
most expensive insurer in our region by any means. My family is
covered through my wife’s plan (a local operation only) and that one
costs about $800/month. You might consider contacting your local
Better Business Bureau or any small business organizations in your
area but I wouldn’t count on saving hundreds of dollars.
Daniel R. Spirer, GG
Spirer Somes Jewelers
1794 Massachusetts Ave
Cambridge, MA 02140
617-491-6000
@spirersomes
www.spirersomes.com
You might try NASE (National Assoc. for Self Employed) www.nase.org
They gave my wife and I a pretty comprehensive policy including
prescription, dental, vision discounts for 341.00/month. We chose a
$3000.00 deductible and we are 39 and 48 y.o.
Good luck,
-Mike
You might check with your Chamber of Commerce. Our county chamber
has a group insurance plan for chamber members.
Jim
James Binnion Metal Arts
I’ve also been looking at health insurance lately. My wife got layed
off a couple of months ago. Right now we are on Cobra, but that ends
eventually. Anyways, I haven’t seen anyone mention Medical Savings
Accounts (MSA). All of this info is from memory thats at least two
weeks old, so don’t expect it to be 100 percent accurate. Basically
if you’re self employed or work for a very small company, then you
can use this option. You buy a high deductible insurance policy
($3500-4900 for a family) Then you open an MSA. You put money into
the account tax free and when you use it to pay for medical expenses
it is spent tax free. The advantages aRe:
You get better insurance for less money with a high deductible. At
some point (age 65?) you can roll the money into an IRA. You can use
the account to pay (tax free) for medical expenses that are not
covered by your insurance-like dental or eye-glasses. These costs
don’t count towards the deductible. Medical expense are tax free even
if you don’t reach the %17 (or something like that) level of income
level that the IRS requires for them to me an itemized deduction.
Again, don’t take my word for any of the specifics since it’s been a
while since I did the research.
The only problem with them seems to be that they’re not widely known
and it’s hard to find companies that offer them. I’d love to hear from
anyone who has had experience with an MSA, since I’m leaning
strongly towards this option.
Good luck Kevin Ard
http://www.KevinArd.com
An MSA has it’s benefits. Basically, an MSA works like this–
You take out an individual, catastrophic policy on yourself and/or
your family. You can then set up a Medical Savings Account, into
which you can deposit a limited amount of funds on a tax-free basis.
The limit on the tax free yearly deposit is the lesser of 65% of the
deductible if you are the only insured, 75% of your policy’s
deductible if your family is on the policy. Out-of-pocket can be up
to $3,000 for individuals and up to $5,500 for families. Your
premiums are paid out of this MSA, which means that for practical
purposes a portion of your premiums are tax free. I say a portion
because the limit on the amount which you can deposit into an MSA
tax-free is such that it is unlikely to completely cover your
premium, let alone pay for active care.
Now a tax savings is always nice, but it is not what’s important
when you are looking for health insurance-- what is important,
vitally important, is that you research your prospective health
insurer to make sure that they are reputable. Health insurance
reimbursement is my day job, has been for roughly 20 years, and I can
tell you that I have seen lives ruined by sleazy health insurers.
Insurers peddling individual policies, unfortunately, tend to be the
worst of the lot. Common dirty tricks include lowball initial
premiums, unacceptably broad exclusionary riders, and the despicable
practice known as “underwriting on the back end.”
Be safe and contact your state Department of Insurance. Most, if not
all, maintain complaint statistics on insurers within their state.
Check out your prospective insurer on the Internet. If you have to
pay more for a reputable plan, do it. If you can get group coverage,
give it serious consideration. What little you will save now by
going with a cheap plan is a drop in the bucket compared to what is
at stake if you become seriously ill or injured and your insurer
deals in bad faith.
And if, heaven forbid, any of you do find yourself dealing with a
bad faith insurer here in the USA, feel free to contact me offline
for assistance.
Lee Einer
http://members.cox.net/appealsman/
Hi All,
I’ve been doing a lot of research on this topic for an article that
will appear in AJM. I wish I could say that I’ve found answers:
unfortunately, because of the way health care works in the United
States, there doesn’t appear to be any inexpensive answers – for
anyone.
A few things I have learned. It matters – really matters – what
state you live in. In some states, insurance companies can place
major restrictions on what they will cover for individuals and can
base their premium on expected cost of care. In other states,
restrictions are limited and the cost must be in line with the cost
of a group policy. In some states you can be rejected for health
insurance: in other states you can’t be. In some states, associations
can set up group policies, in other states they can’t. (Which is why
most national associations haven’t been successful setting up true
“group” policies – navigating 50 sets of very divergent rules makes
it next to impossible.) In all states, how much you will pay will be
largely a function of what health care costs in that state. As with
everything else, if you live in a high-cost-of-living state, such as
Massachusetts of California, you’ll pay more for health insurance
than a colleague in a state with a lower cost of living.
To learn about your rights and restrictions on health insurance in
your state, try http://wwwhealthinsuranceinfo.net, maintained by
Institute for Health Care Resarch and Policy at Georgetown
University, which offers downloadable consumer guides to health care
in all 50 states and the district of Columbia.
Different states also offer different options for those who cannot
afford health insurance. These plans are normally income-dependent,
but may be worth checking out. If you have children, you may be able
to get them health insurance through a plan of this type, even if you
yourself don’t qualify. To find your state health department, you can
try the Health Insurance Association of America at
http://www.hiaa.org, under consumer directories.
The harsh reality is that no matter how you slice it, health
insurance is expensive. There are wide variations from state to
state, but the bottom line is a health insurance policy costs a hefty
chunk of change. Many of us don’t realize how hefty because we’ve
been covered through an employer, who picked up a percentage of the
cost, which can mask exactly how expensive it is for everyone.
(Although the self-employed do have to shoulder certain expenses that
larger companies don’t, according to the NASE.) The costs are also
going up steadily. Whatever you think about the politics of health
care, that’s the reality of the moment. NASE (National Association
of the Self-Employed) is doing some lobbying on this issue for those
who would like to see political change that might reduce costs for
the self-employed: you can learn more about their positions on their
web site at http://www.nase.org. But at best, this is a long-term
approach, not an overnight solution, and involves primarily tax
relief for small businesses that would lower the real cost of health
insurance, not the end to high health insurance premiums.
The high cost of health care is the primary reason some 40 million
Americans lack it, according to the Census Bureau. And not having
health insurance can be just as expensive, if not more so. If you’re
healthy and stay healthy, you save money. But if you have a serious
illness, the hospital bills can bankrupt you, literally, and there is
some evidence you may not receive the same quality of care as someone
with health insurance.
Right now, if you’re simply trying to find a low-cost option, there
doesn’t seem to be any real solution – at least not one I’ve been
able to find. The only thing you can do is do your homework, find out
about your state’s policies, negotiate the best policy you can, and
maybe become active on the issue to influence your legislators to
address the problem in the way you deem most appropriate. I think
what is probably most frustrating, and frightening, for most of us is
exactly how little control we have over the situation – we either
pay up, or we take the risk of not having access to the health care
we need.
Anyone want to share their stories of being uninsured/trying to find
insurance in America? I’ve heard from some of you in the past, but
I’m always interested in adding more to my article.
In the meantime, good luck to you all.
Suzanne Wade
writer/editor
Suzanne@rswade.net
Phone: (508) 339-7366
Fax: (928) 563-8255