Health Insurance

[Brookenstein]

Does anyone know where I should start if I want to buy my own health and dental insurance?  My husband has coverage for the entire family that is 100% employer paid, but we end up spending close to ten thousand dollars each year out of pocket (they have a crappy plan).  I'm wondering whether or not it would be beneficial for us to get a second coverage for at least myself and the kids.

My 6yr old has a dentist appointment tomorrow to the tune of $2k out of pocket.    Good thing I have a tub to relax in....

[badval]

http://www.ehealthinsurance.com/ is where I looked.  You put in your family's info & spits back quotes.  Should get you an idea of what's in your state.

I ended up staying with what I have thru work.  The coverage gets less & the cost goes up every year, but still cheaper than buying my own.

[Brewman]

Another option would be to visit a few independant insurance agents in your area and see what options they can offer.  
 You'd have to face a sales pitch or two, but if you find a good agent he might be able to come up with some creative ideas to either replace or supplement your existing coverage.

Do either of you have the ability to defer some of your income into a flexible medical spending account?  At  least you'd be able to save some money on income taxes.
 

[In Canada eh]

Move to Canada

Publicly funded health insurance

[Brookenstein]

We use flexible spending each year... in years in which we expect expenses (like me pregnant) we saved quite a bit... but this year we didn't think we'd have any expense besides routine well child visits and my husbands medications.  After tomorrow I've probably spent $5k YTD and we only saved $1200 this year.  It seems we always have medical expenses we don't expect... but I just know the one year we put in a lot of money we'll suddenly have no problems and we'll waste all that money.

My 6 yr olds mouth is now worth enough that I could have had a boob job, a tummy tuck, and possibly some lypo...  

Believe it or not, we actually considered moving to Canada a few years back, but instead moved to California.  Kinda think we made the wrong choice.

I will find out Tuesday if I got a PT job... once I know that answer to that, I will ask how many hours I have to work to get benefits and what they offer... I'm kind of hoping something will work out that way.

[Brewman]

My 6 yr olds mouth is now worth enough that I could have had a boob job, a tummy tuck, and possibly some lypo...  

 I feel your pain.  We have a daughter with Cystic Fibrosis.  In the past 15 years, we've probably incurred close to $2,000,000 in medical and drug expenses.
 Thankfully we have insurance.  Still, our out of pocket costs are thousands of dollars per year beyond what insurance pays.  

[Brookenstein]

My 6 yr olds mouth is now worth enough that I could have had a boob job, a tummy tuck, and possibly some lypo...  

 I feel your pain.  We have a daughter with Cystic Fibrosis.  In the past 15 years, we've probably incurred close to $2,000,000 in medical and drug expenses.
 Thankfully we have insurance.  Still, our out of pocket costs are thousands of dollars per year beyond what insurance pays.  

Wow, I feel really crappy for complaining now.  Have you had any problems with lifetime max issues?  I know our insuranance has a lifetime max of a mil per person.  That sounds like so much, but when you have a chronic condition that can be gone so quickly... then what?

[96SC]

My DW works in the insurance industry (Allstate).  I know insuring yourself is terribly expensive, like someone else mentioned.  I'll see if I can get the names of some health insurance companies and post them in here (may not be until Monday)  A lot depends on your deductable, what coverage you want etc.  When our oldest son turned 22 he fell off our work coverage and had to get his own, but I don't recall the premium, it aint cheap.

[imp etc]

Brookenstein,

I have Kaiser and am pretty happy with it - (more or less) self-employed so I went the self-insured route. I'm also pretty healthy so only use it for routine and preventative stuff.

I'm pretty sure they're active in SoCal, and they can give you a quote at www.kp.org

Hope that helps!

[Brewman]

My 6 yr olds mouth is now worth enough that I could have had a boob job, a tummy tuck, and possibly some lypo...  

 I feel your pain.  We have a daughter with Cystic Fibrosis.  In the past 15 years, we've probably incurred close to $2,000,000 in medical and drug expenses.
 Thankfully we have insurance.  Still, our out of pocket costs are thousands of dollars per year beyond what insurance pays.  

Wow, I feel really crappy for complaining now.  Have you had any problems with lifetime max issues?  I know our insuranance has a lifetime max of a mil per person.  That sounds like so much, but when you have a chronic condition that can be gone so quickly... then what?

That wasn't my intent with that post- you have every right to feel as you do.  
Fortunately, my employer provides us with pretty good health insurance.  The lifetime max per person is $5,000,000.  If you hit the cap, insurance coverage STOPS.
DONE.  NADA.  And it's quite likely that the person who is this unhealthy is not insurable under a new policy anyway-  No insurance company in the world will take a person with CF- she can't get life insuance for the same reason.
Except that employer provided health insurance has to accept  them- it's private insurers that would decline coverage.  So then you go to the medical assistance programs and see what's there- medicaid, state assigned insurance pools, stuff like that.  We will be facing that dilema in a couple more years when she becomes inelligible for coverage because of her age.  Children roll off at age 19, extends to 24 if they are full time students or dis-abled.  She's considered disabled since she's now 22.

[NWHotTubber]

 My husband has coverage for the entire family that is 100% employer paid, but we end up spending close to ten thousand dollars each year out of pocket (they have a crappy plan).  I'm wondering whether or not it would be beneficial for us to get a second coverage for at least myself and the kids.

My 6yr old has a dentist appointment tomorrow to the tune of $2k out of pocket.    Good thing I have a tub to relax in....

Depending on what size of company your husband works for you may want to talk to the admin. and see if they are willing to review the current group policy or see if there is another company the employer would consider.  May even do a little research on GP and submit it.

If it is a small company this is a fairly easy task... if it is a larger company, probably a waste of time.  Unless you are in good with the office staff  

Then you might be able to find supplemental coverage.  

That just sounds huge out of pocket...

[ORANGEPEEL]

Brookenstein:
I am in the insurance and financial planning arena.
One thing I can share is that individual health insurance is in generally VERY EXPENSIVE !
One thing that you should check out is a Health Savings Account (HSA).
Not alot of people are aware of it, and also alot of insurance agents don't understand how it works.
Far too in-depth to discuss in this forum.
You can access the basics of it on the U.S. Treasury Dept. site: www.treas.gov,
click on the link for HSA.
There are alot of benefits for an HSA Acct., it may or may not be of benefit in your circumstances.
If you do work with an insurance agent, make darn sure they know what they are doing in regards to an HSA.
Meanwhile, enjoy your tubbing.

[dkersten]

I am no insurance expert but I can say that with the way prices are today, $1000 a month for family coverage is not unreasonable.. at that price, depending on company size, it is possible that the company he works for is "self insured" and they are kicking in a portion to the pool.  It is not uncommon for a single 25 year old to get personal medical insurance for about $1200 a month premiums.  

My family company has about 95 employees now, and we are "self insured".  what this means is we charge the employees on the plan a premium, and kick in the same amount to the pool.  The pool pays a premium to a self insurance program that will kick in if any individual exceeds $35,000 in a year, or if the overall goes over something like $500,000.  I think about half the employees are on the plan, and some have their families on it.  I believe its about $900 a month for a family with 3 or more kids. (I am not on the plan because my wife's insurance is cheaper and better).  There is no eye coverage, and the dental is minimal.  Last fiscal year the company had to kick an extra $254,000 into the pool to cover the costs.  I believe that was the max before the self insurance policy kicked in and covered the rest, which was pretty much nothing after that.. the 50% from employees and 50% from the company was over $250,000 short.  We had a good year, so we didnt take that money from the profit sharing program.  This fiscal year we will, which means everyones 401k and bonus profit sharing will be severely lowered if medical costs are that bad again.  

It may seem like a lot to spend $1000 a month for insurance but keep in mind that if one of your kids breaks an arm, it will likely cost around $1800-$10,000 depending on if they need surgery.. it might even go higher if the break is severe enough.. Most moms these days will take their kids into same day care or emergency room for fevers and vomiting, and sometimes even for sore throats.  Most of the time its a common cold or even flu, and sometimes an ear infection or strep throat.  Emergency room visits these days cost insurance companies around $500-$800 if nothing more is done than seeing the doctor and getting examined.  Add x-ray, ct scans, throat cultures, stitches, etc and the price climbs.  If moms would schedule regular visits to the family doctor, the price drops dramatically, but in the world of fast food and fast internet, people also want fast cures.  Also, so many people figure that they are spending $1000 a month for insurance, why not go to the emergency room, its only a $50 co-pay right?  Unfortunately thats the reason insurance is so high to begin with.

HSA's are fairly new, and are way better than flex spending, but you usually cant get in them unless the HSA is part of the medical insurance.. the allowable contribution is based on the number of people you have insured.  The great thing with an HSA is it collects interest and doesnt go away at the end of the year.  Flex plans and cafeteria plans are great if you know how much you will spend in a year on medical expenses but if you overestimate you lose the money.  

I do about $3000 a year to a flex plan and if I dont use it I stock up on over the counter medicines and such as well as glasses for everyone.  There was a thread in the hot tub section about a week or two ago about deducting the price of your hot tub as a medical therapy expense, and in talking to my flex provider, it seems that if I had a note from a doctor saying that he recommended hydro-therapy then I could use flex money for that.. I might try that when it comes time to upgrade my tub..

[imp etc]

It is not uncommon for a single 25 year old to get personal medical insurance for about $1200 a month premiums.  

$.02 . . .

That seems way weird . . . my Kaiser (I am 43) costs $192/month. If I added my Spice, it would be about $400. We don't have kids.

As I said previously, so far (counting blessings) I am fairly healthy so I have a pretty high deductible - I think it's $1500/year.

I'm also covered by Blue Cross which Spice gets at work for free.

[hotubinn]

I am self employed also.  I insure myself and my two children with Blue Cross Blue shield.  My wife's employer covers her (too much dough for all of us).  I pay less than $500 per month for myself and a 6 yr old and 4 yr old.  Very reasonable.