baddog

If so, who is your carrier, are they HMO or PPO and are you satisfied?

Trying to narrow this search down today.

cybermike

Paying out of my ass for a single payer one in NY 400 a month for a 2k deductable and its a shitty hmo too.. fucking ny sucks for Health Insurance

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baddog

$400/mo is pretty cheap. I am guessing your employer must be paying a portion as well, right?

Is that 2k annual out of pocket?

Jim_Gunn

I use a large HMO here in FL called Vista for my health care, which runs me about $200/month. Has reasonable deductibles for catastrophic care, and modest co-pays for doctor visits, plus discounts on prescriptions & on dental care.

Phoenix

we got healthcare for everyone here in the office...we go through sunlife...it is for the extras up here...dental...special care in the hospital...coverage abroad...prescriptions etc
glasses...massage...special shoes if you need them

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96ukssob

Aetna has good deals for self employed people. I pay $112/mo for a decent plan. I dont go to the doctor that much so I didnt need a huge plan.


2500 PPO:
$30 co pay
$40 co pay hospital
$2500 deductible
$15 generic drugs

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cybermike

Well I'm single and I work for myself so no employer.. the 2k is whatever I end up paying doctor visits, tests etc.. I think they include an annual checkup.. this is my 2nd year on it.. first year I was paying around 330 a month.. so who knows how much they will jack it up each year...

This is through oxford.. I did it through ehealthinsurance.com here are my choices

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TheSenator

Paying close to 1500.00 a month for a family of 5. Horizon HMO, 30 co-pay, 100 emergency, 50% prescription drugs, 300 per day at hospital, etc....

That is single payer health insurance. It sucks because if I ever change coverage or anything else my rates go up to $2030.00

I feel like I am being robbed and penalized for being a small business. Also, I don't really go to the doctor unless I have to because I don't want my health insurance finding out I had a pre-existing condition or that I have a gene that causes cancer.

Anyway, you can only get group rates if you work for a big company. They may say you get group rates when it is five people but it doesn't save you much.

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MikeSmoke

Don't want to go into all the boring details here, but if you have a *lot* of medical expenses each year (which we do) I found a plan that's sensational from Anthem Blue Cross of CA - if that fits you and you're interested give me a holler.

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baddog

That's the thing. My medical expenses each year are zilch and have been consistent for 20+ years. I am not really getting it for me.

Anthem is one I am looking at, but they are PPO and seems to have more out of pocket expense than the HMO's which it the primary consideration for those I am insuring.

undersoul

health insurance costs are crazy high. i only go for checkups over past several years. should be better rates for those that are healthy.

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Way3

Check out Goldenrule.com.

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directfiesta

healthy pays for the sick ...

basic principle of insurance

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MikeSmoke

Well the program I found is a PPO (which we need) and it doesn't sound like the kind of thing you're looking for.
This program basically costs us a total of $13K out of pocket a year and everything after that is free; but before this we were paying $18K+ just for premiums, and then everything else had copays that added up to a minimum of another $10K+ a year. So this was a godsend for us; but obviously not for lots of people; it's basically for people with tons of medical expenses.

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tony286

We have individual kaiser plans and they arent bad. Whats nice about kaiser you go to their docs so there is no bullshit claim denied.We pay about 500 a month for both of us. with a 5 grand deductible if something serious happens.

baddog

Yeah, that is the thing about the PPO vs the HMO options. I haven't spent one year's deductible in the last 20 years combined. I don't have a problem being referred by a primary care physician. If I ever decided to visit a doctor I guess a regular GP is where I would head anyway.

baddog

I don't want to drive that far.

tony286

I can see that, they are only 5 miles from my home.

epitome

When I had what fit into the definition of a group, I had us signed up with Carefirst, a BC/BS company. They never did me wrong.

It averaged about $220 per individual for an HMO with no hassles. Cheap co-pays and great prescription plan. I have Crohn's Disease and rely on unconventional treatment (just one medication was $500 a week and required in-house infusion by a nurse). I am a red tape nightmare waiting to happen. I had no such nightmares with them. It was like a PPO at an HMO price.

This was a little less than two years ago.

http://www.ehealthinsurance.com is the way to go when pricing out your options. They have straightforward pricing, inclusions, exclusions, disclosures, etc. It is all presented instantly online and nobody will hassle you with a sales pitch unless you want them to. They are essentially an online broker and when you decide to pull the trigger, they will get you setup in no time.

We may not see eye-to-eye on many things, but when it comes to health insurance, I am an expert. I have seen and experienced it all. Naturally, I would prefer that *NOT* to be the case, but it's reality. I'd be happy to help you the best I can.

epitome

A bad HMO can be your worst nightmare if you ever get sick.
A great HMO can be your wallets friend without sacrificing quality.

As long as the referrals aren't a hassle for you (and they never really are), an HMO is your best bet, IMHO.

abshard

paying 218/month for me and my wife ppo 2500 from blue cross

they wont cover some stuff on my wife from a prior surgery

hope when obama's done i will be able to get better coverage and they cover everythnig for the same price or cheaper

I was paying about 300/month for the same coverage for just me in CA 2 years ago with blue cross

baddog

Been going through them. Picked them because someone told me that their agents will filter through the b.s. and direct you to the best. That is what I wanted. Someone to say, "here, this one is the best."

Hoping for too much I guess. I need to find out why my quotes are so different from what I am reading here.

epitome

You may want to explore your options.

I don't know if it's a federal thing or just a state thing for me, but pricing for a small business is done solely based on the age of the participants in the plan. They are not allowed to take anything else into consideration when pricing for a small business < 50 employees.

I learned this because an old employer of mine was getting coverage for the company and we were both concerned that my own health care costs would make it unaffordable for the company. This was about a decade ago. At the time I was incurring about $50k a year in expenses but the premium was based on the fact that I was 20 years old and nothing else.

baddog

See, that is the thing . . . the average is +$800 per family.

epitome

Feel free to email me your quotes and I'll at least tell you what I think makes the most sense based on my own experiences. It would be one additional filter for you. I've been around the block a few times when it comes to these things.

epitome

One bit of advice to anybody that may be shopping for coverage...

From my own experiences, NEVER skimp on the prescription coverage.

All it takes is one minor diagnosis that requires a script that doesn't have a generic available to get you to start punching yourself in the face.

Perfect example in my own life this very moment:

My boyfriend was recently diagnosed with ulcers. 20 years old. Ulcers are almost unheard of in 20 year olds -- took a year to get the diagnosis because it's so rare. His script, Nexium, is an extremely common drug and still runs us about $400 a month. The worst part is that it doesn't even seem to be working after three months on. They'll probably end up switching him to another expensive drug. Money down the toilet...

Edit: Before the actual diagnosis was given based on an endoscope they started him on Protonix "just to see if it would help." That was another expensive drug.

2012

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epitome

Well, health care premiums have been skyrocketing at something like 15% per year, right? That is at least what I recall larger employers bitching about for awhile.

So even an individual rate as low as $200/mo. two years ago would be $260 today.

As I understand it, the family rate is based on four people. That would mean that my plan, as a family plan with no discounts in place would be $1,040 or more per month in today's numbers.

$800 to $1000 or more sounds about right. I am no good talking about family plans because I ended up with a company full of gays (purely by accident).

Although I cannot discuss family plans, I can divide whatever they're offering by four and see if it still makes sense.

MikeSmoke

Yep, that's the major determining factor - obviously no one knows what *might* happen, but I had HMO coverage for years and it was more than fine. It sounds like you don't need anything more than an HMO, and you're fortunate for that. And it sounds like Epitome can help you sort out the confusing plans and prices, which can drive you nuts. (My insurance broker didn't even find the plan that we're on now, I found it myself and then he told me what a great just I did )

We just have a situation where a Cadillac plan is a necessity since we know in advance that our medical costs are enormous (Mrs. Smoke is disabled and has several difficult/rare medical conditions where we need to see "the best" specialist in each field, and she's on 16 different meds that cost a ton of money). I'm just hoping that if there's someone unfortunate enough to be in a similar situation, knowing that there are plans that can save them a lot of money can help them out.

(Our family plan is $842/month for three of us, two adults and one child - the way we set it up, though, is that it's based on my wife as the primary member - since the pricing is largely based on age and she's a lot younger than me, that's one reason we ended up doing so well with this plan. Our previous plan was almost $1700/month.)

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