Finding Affordable Health Insurance When You’re On Your Own

In America's current healthcare system, in most cases, you're better off with the crowd. Usually, that crowd is your employer or a government pool like Medicare or Medicaid. But sometimes, due to choices you make, or circumstances you can't control, you end up on your own, with full responsibility for your healthcare expenses. Here are some circumstances under which you might end up needing to seek affordable individual health insurance:

  • You lose (or quit) your job.
  • You have insurance through your spouse or partner, and they lose or quit their job.
  • Your employer or your spouse's stops offering insurance for you or your family.
  • You change jobs, and your new employer has a waiting period before you become eligible for coverage.
  • You take early retirement.

In some other circumstances, you may have the option to participate in group medical insurance, but it's not in your financial interest to do so.

  • You are young and healthy, but your employer group has a lot of older, sicker people in it, and your employer makes you bear much of the premium cost for either yourself or your dependents. Keep in mind that if you find yourself in this situation and you opt for your own insurance, you help yourself, but also make it harder for your employer and your co-workers to afford coverage.
  • The group plan you are eligible to participate in doesn't meet your needs. For example, it does not cover doctors or hospitals where you live, or it does not cover particular health condition that you have or are at risk for, or the plan offers richer benefits than you want to pay for.

In any event, if you are shopping for individual health insurance, you need to keep in mind several important things.

Initial considerations
First of all, if you're choosing to voluntarily switch from group to individual coverage, you need to carefully consider what you're giving up: government protection from discrimination by insurance companies.

In the group insurance market, the government prohibits discrimination against people by age or health condition. Your employer can't legally charge you more in premium, deny you coverage, or offer you a reduced benefit plan because you're sick. In the individual market, insurance companies put you through a process called, “underwriting,” which means they'll only offer you coverage if they think they'll get more from you in premium than they'll pay in claims.

You can look at it as a gamble — the insurance company is betting that you'll stay healthy (if it's not a good bet they'll deny you coverage); you're betting that you'll get sick and need healthcare. Underwriting helps them detect if you're trying to “game the system,” by looking for insurance while you're expecting big medical bills.

The side effect of this is that older or less healthy individuals end up paying higher premiums, and can even have trouble obtaining any coverage at all. So the game is very different if you're a 50-year-old female who smokes and suffers from diabetes (you can pretty much forget about getting commercial insurance) than if you're a 25-year-old male with no previous health problems (companies will be lining up to offer you coverage).

This is one of the wonders of America's healthcare system — those who need coverage the most are least able to obtain it. It's also the Achilles heel of presidential candidate John McCain's health reform proposal — his plans would drive more people into the individual insurance market without adequately addressing this issue. (The Democrats' plans have problems of their own.)

Shopping for insurance
But right now, you're not trying to solve the nation's health care crisis, you're just trying to take care of yourself. Here are some things to consider as you shop.

  • How much risk can you accept? If you can handle a higher deductible, you will save on premiums, and if you stay healthy, you get to keep the money.
  • How much premium can you afford? In individual health, you have to keep paying the premium, or you are no longer covered.
  • How able are you to save? If you have trouble saving, you will want a lower deductible, or you'll need to have an emergency fund so that a surprise medical bill doesn't put you in financial trouble.
  • How important is choosing your provider? If you want more choice of providers (doctors and hospitals) and treatments, you'll want to make sure your doctors are in the insurance plan's network. If saving on premium is the most important, you may want to consider an HMO. HMOs can provide excellent care at a low cost—they often do a better job at coordinating care than other carriers. But if you disagree with the HMO's decisions about your treatment plan, you might end up unable to get the treatment you want. (There's also some risk of that with other carriers).
  • Is having coverage for alternative or complimentary medicine (such as massage, chiropractic and acupuncture) important you you? Is it covered? Subject to what limitations? If coverage for these services is optional in your state, it may be cheaper for you to save for them yourself.
  • What's the reputation of the insurance company? Any insurance company is going to have some unhappy customers, but you do want to look for a reputable carrier.
  • Tax implications. If you're considering a lower-premium plan with a higher deductible, make sure that it's a Qualified High Deductible Health Plan. With such a plan, you can open a Health Savings Account, where you can save pre-tax money on the condition that, when you withdraw it, you use it to pay for medical expenses. These medical expenses can be used for expenses that apply to deductible, or even for expenses simply not covered by your insurance plan. Depending on your tax situation, this can give you substantial savings.
  • Discounts. Insurance companies typically get discounts from providers through a Preferred Provider arrangement. This benefits you because you won't end up stuck with the bill if your doctor's charge is over what the insurer considers reasonable. The downside is reduced provider choice. Large insurers, or those who give strong financial incentives for you to see a limited group of health providers typically get the best discounts.
  • Utilization patterns. Insurance companies have learned from experience that people with higher deductibles and co-pays use fewer health services. Getting less medical care can be good, because unnecessary treatments don't help, and might harm your health. It can also be bad if you avoid getting treatment or preventive care that you need to stay healthy. If you choose a higher deductible, or a plan without preventive care benefits, make sure you budget enough money to get care for any chronic conditions you have (you don't want them to get worse!) and get regular checkups to make sure any new conditions are detected early, when they can be treated effectively.
  • Maternity care. If maternity care is optional in your state, the only people who buy it are likely expecting an imminent pregnancy, and rates are set accordingly. You may be better off just paying cash for maternity care.
  • Other riders. Your agent will likely offer you accident riders and other forms of supplemental coverage. These can have low premiums, but they're low risk to the insurance company as well.
  • Finally, look for limits on the plan. Many plans offer lifetime maximums of $2 million or more. Other limitations can include mental health care, chemical dependency, chiropractic care, physical therapy and diagnostic care. Beware of plans that limits your benefit to only a few hundred dollars a year. For example, I had some friends who signed up with a high deductible plan to save on premiums, but discovered too late that their plan had a $300 annual limit on benefits for diagnostic care. Once that limit was met, they were on there own. You can't buy much diagnostic care in today's healthcare environment for $300.

What if you cannot find coverage?
Now that you've done all this work, you still could find yourself in a situation where you can't afford — or simply can't purchase at any price — health insurance that meets your needs. You're not alone. In 2006, 47 million Americans found themselves in a similar bind, and the number has only increased since then as costs have risen and employers have reduced coverage. You still might be able to find help. Here are some options for you to consider:

  • If you have a low income or are disabled, look for government assistance. Medicaid benefits may be available. Even if you have a moderate income, Medicaid or SCHIP coverage may be available for your children, as a lot of attention has gone to the needs of the uninsured.
  • If you have health conditions that make you an unattractive risk to commercial insurers, look into these options:
    • COBRA or continuation coverage from your last group health plan. It's expensive, and it only lasts 18 months, but it's better than no coverage if you face a significant health risk.
    • A state high risk pool or mandated basic plan. (Contact your state department of insurance for details.) Insurers aren't going to line up to tell you about this, but your state may require them to accept you for a certain health plan. Again, premiums will be high, and benefits may be limited.
    • Look for work at a employer (preferably a large one with lots of young, healthy employees), who offers better health benefits.
    • If you're disabled, see if you qualify for Medicare disability. Medicare isn't just for the elderly, it's also for people who are disabled.
    • Move to any other industrialized country, and you're covered cradle to grave.
    • Move (or travel) to a developing country, where you still might not be afford insurance, but medical care can be much more affordable. Surgeries costing tens of thousands of dollars might be available for hundreds to thousands of dollars in Mexico or India (plus airfare), with excellent quality. If you're nervous about the cultural and linguistic barriers, look at it this way. There's a good chance your doctor here has a foreign accent too.
  • If you can't get insurance at all, ask for a cash discount. Some providers will give you a discount similar to what insurance companies receive if you pay cash up front. Point out to the provider that they won't have to haggle with the insurance company or wait for payment if they take your payment right away. Some providers will give good discounts if you ask. Others actually charge more if you don't have commercial insurance.
  • Some services that you could fomerly only get in a doctor's office are increasingly available at drug stores and Wal-Mart. Make the most of these services.
  • When you do visit the doctor, make the most of it, and ask lots of questions. Take notes, either during the visit or after. Ask the doctor how you can stay well, not just how to treat what's wrong with you at the moment.
  • Manage chronic conditions. If you have asthma, heart disease, diabetes or another chronic condition, learn all you can about it. Manage it yourself, with advice from your physician. You'll end up saving.
  • Take care of your health. Exercise. Eat healthy amounts of healthy food. If you smoke, stop. You'll feel better, and you'll probably spend less on health care.

Does this seem daunting? For more and more Americans, it is. Seem hopeless? For many people right now, it might be.

An archaic system
The reasons for this state of affairs are complex. It's based on a patchwork of systems that has grown up over time, and changing technology has made them obsolete. Long-term, more and more people are going to face this difficulty — not just poor people. Medicare is projected to run a deficit in 2018, and Medicaid coverage will need to drop unless more money is made available.

While this article has been focused on how to meet your current needs, perhaps my best advice is to write your elected officials and urge comprehensive change. To effectively solve our health care problem we need comprehensive reform, which must include cost controls (conspicuously lacking in the proposals from the Democratic presidential candidates) as well as coverage for everyone (conspicuously lacking from the Republicans' proposals).

In the meantime, the best you can do is to research your options, and make the best choices you can.

More about...Health & Fitness, Insurance

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TosaJen
TosaJen
12 years ago

Amen. I know a number of folks who achieved financial independence, and kept their jobs solely for the benefits. They went from “wage slaves” to “insurance slaves” to maintain coverage for dependents with preexisting conditions.

Something needs to be fixed.

Noam
Noam
12 years ago

One thing I’d love to hear more about is what to do *before* you move to individual health care. What preventative care should you take care of while you are still covered, such as check-ups, dental work, optical, etc.? What prescription drug arrangements let you take out what you need for a long time?

Anne Keckler
Anne Keckler
12 years ago

Putting the government in charge of it has never been the answer to anything. It amazes me how many people hate the way the government is handling certain things now, but think it is the best solution for health care!

B Smith @ Wealth and Wisdom
B Smith @ Wealth and Wisdom
12 years ago

JD-Timely blog. I’m looking at insurance as I plan to eventually be fully self employed.

@Anne Keckley-Wow, that comment could be incendiary in today’s political environment. You are stepping on a few political toes.

Personaly I agree with you, but not for political reasons. My personal belief is that we need to take responsibility for our own lives. Government run programs go in the opposite direction.

Tim L
Tim L
12 years ago

Cost Controls? Please no, that will cost us more! So that I can truly upset everybody let me first explain my political leanings. I call myself a conservative with liberal concerns. So, for example, with healthcare, I love that the Democrats are concerned and want coverage for all, but I absolutely hate their solutions. To start our frame of mind right, have you watched the Lasik surgery explosion this past few years. Notice all the people that have had it. Notice the huge expansion of its availability yet notice how costs have lowered (not risen like the rest of healthcare)… Read more »

Funny about Money
Funny about Money
12 years ago

Please urge readers to be careful about opting to leave the country for health care. Mexican health care is NOT “excellent”! Two friends of mine have died at the hands of Mexican health-care providers, with injuries or ailments that would not have been especially life-threatening in this country. If you are going to leave the US to obtain adequate health care coverage, go to a developed country. And before you do so, be sure foreigners are covered. In the “shopping for insurance” department, look into medical savings account plans. These leave a lot to be desired–effectively, the huge deductible leaves… Read more »

TosaJen
TosaJen
12 years ago

Just want to clarify — I’m intensely hoping that affordable, universal access to insurance and reasonably-priced medical services become widely available for all American citizens, regardless of employer. I agree with a lot of what Tim L said. I’m all for transparent competitive pricing for medical services. And for requiring that medical entities charge everyone the same rates (not higher rates for people without insurance). So many people are completely black/white in arguing about this: the broken profit-driven system we have vs. completely government-run medical system. There is a lot of room for improvements that aren’t at one end of… Read more »

Michael
Michael
12 years ago

We must learn to consider prices when hospitals recommend treatments. Doctors and nurses never mention the cost of anything they give patients. In fact, they make patients feel guilty and paranoid for not doing everything possible, as if the hospital is free. It is not free. Imagine a waiter mocking you for “trying to be a hero” because you refuse dessert, or your lawyer telling you it’s “policy” to do six extra billable hours of work as if policy means “mandatory” when it really just means “what they try to do to everybody.” When we, individually and voluntarily, stop letting… Read more »

Emily C
Emily C
12 years ago

Can I suggest another option nobody mentioned? It’s one that my husband and I just decided on.

Join the Army, Air Force, or Navy Reserve. (I prefer the Air Force for length of possible deployment)

We get very competitive insurance coverage for the whole family, with GREAT rates, and no pre-existing conditions. Including pregnancy.

Obviously it’s not for everyone, but it is an option for some. Especially if you’re still in school and need a little extra help with tuition, etc.

Cheap Like Me
Cheap Like Me
12 years ago

The situation the author doesn’t mention is when you are self-employed — a big time for buying your own insurance coverage.

It’s not so bad to pay for yourself, even in a high-deductible plan like I have … but you have to be disciplined and consider medical costs a budget item that you plan for every month, so the occasional $200 or $800 bill doesn’t put you back too much. The health insurance premium is just part of the total cost.

NJR
NJR
12 years ago

I’m with Anne Keckler, B Smith and Tim L. (thanks Tim – your comments were more valuable to me than the post to which it was attached!) Why does wanting to avoid depending on government to take care of me equate to being a political decision? I’m with the folks who prefer to make their own decisions and take responsibility for themselves. I have a sincere interest in my life and well being – the folks in Washington, regardless of party affiliation, do not.

elisabeth
elisabeth
12 years ago

Yes, this is a really fraught subject. Those who want health insurance to be an “individual responsibility” and those who want government out of everything, are, perhaps, people who have never looked at the bills that even a curable cancer diagnosis creates. I have great health care insurance through my job at a state university — and great health care from the teaching hospital attached to that U — but I was stunned and shocked when I saw the bill for the single shot of white cell booster I was given as part of my chemotherapy. I called to say,… Read more »

Chris McKenzie
Chris McKenzie
12 years ago

I normally enjoy this blog, but today’s call for socialized medicine is completely inappropriate. Much of the reason that that healthcare and insurance costs so much today is because of government intervention. As only one small example, insurance costs are driven up by requiring that all insurance providers cover a range of services, many of which customers would not pay for on their own (I wouldn’t want chiropractic coverage).

I respectfully suggest that before encouraging others to clamor for more government “help” that the author read some material at http://www.WeStandFirm.Org and http://www.FreeMarketCure.com

Debbie M
Debbie M
12 years ago

Many professional organizations offer group insurance plans. And of course you can be a member of a professional organization even if you are unemployed, uninsured, or retired, etc. I have been a member of some of these even when I wasn’t in the profession yet, because I wanted to join that profession.

I don’t know how good their rates would be, but at least you get the benefits of group insurance.

Dan B
Dan B
12 years ago

I was wondering if anyone has heard of http://www.gradmed.com. I will be leaving my job at the end of june and heading to grad school at the end of august. I’m trying to find something that will cover me for those two months. People have mentioned COBRA, but that seems overly expensive for someone who is 23 and healthy. All I want is something affordable with a high deductible that will cover me in case I break a leg or something over the summer. Gradmed seems like a decent option, though I’m not sure about the price. Any suggestions are… Read more »

Daniel
Daniel
12 years ago

Maybe the answer isn’t the government taking charge of it but it sure isn’t working with the insurance companies in charge of the system. I personally think that we should have the right to pay for insurance comparable to a non qualifying group plan w/o having to be tied to a job. I also believe that the government should provide a minimum standard of health care to its citizens. In this country, we should have the right to be healthy, the right not to die just because we are poor or have the audacity to work for ourselves. It’s insane… Read more »

Flaime
Flaime
12 years ago

We have a terrible health care system for cost and devlivery. Right now, with the way it is built, the United States spends between 16 and 18% of GDP on health care. No other industrialized nation is even close to that. Sweden only spends 10% of GDP on health care. France, which is widely viewed as having the best health care in Europe, only spends 8% of GDP on health care. Yet, both have better research facilities and health care delivery, over all, than the US. What I am saying is that we in the US should be looking to… Read more »

J.D.
J.D.
12 years ago

Chris wrote: I normally enjoy this blog, but today’s call for socialized medicine is completely inappropriate. I am baffled. Do readers really view this article as a call for socialized medicine? What is it about the article that leads you to believe that? While editing this piece, I was careful to be sure it remained focused on facts, not opinions or politics. This wasn’t difficult since Jason steered clear of these himself. I feel like this article does a fine job of laying out the options for those who need individual insurance; I don’t feel like it’s a call for… Read more »

J.D.
J.D.
12 years ago

(That being said, I have no problem with a debate regarding various insurance systems in the comments.)

TosaJen
TosaJen
12 years ago

@JD: My comments, at least, are in response to the last paragraph of the article.

J.D.
J.D.
12 years ago

Ah, I see now how that paragraph could be interpreted as advocating government control. I don’t think that’s what Jason means, though. I think he’s saying that the system needs to be revised, and that the government is going to have to instigate the revision at the behest of consumers. Not that they’re going to have to control health care, but that change has to start there.

Tim L
Tim L
12 years ago

JD I did not see a call for socialized medicine. I”m not sure where that came from. I do disagree with price controls. And just to be clear, I am for government help when needed. I just think other solutions that involve being consumer-directed health care should always be the top priority. And yes there are shots that are $2000 and more (I am a critical care RN). I am more than happy to do my part to help offset such extraordinary costs. But that doesn’t change the basic problems that I highlighted. It would be much easier to help… Read more »

Sue
Sue
12 years ago

I appreciate my “socialized” medicine that Canada offers me. I didn’t pay to have my babies, I don’t pay if my kids have asthma attacks and need to go to the hospital, even for the ambulance ride. I don’t have to watch my neighbours struggle to pay for their kids medical bills. I don’t have to choose between health care and groceries. I don’t even have to worry if I can’t speak, I know that I’ll recieve medical care. It’s not perfect, but at least its not economic discrimination. In Canada all people recieve good medical treatment. It’s not all… Read more »

The Financial Philosopher
The Financial Philosopher
12 years ago

The fact that people are concerned and confused over health care choices is a symptom of a disease called ignorance and, as J.D. implies, this post attempts to cure that disease. The government preys on our ignorance and, all conspiracy theories aside, politicians would have us believe that we need them for solutions. Being self-employed (and healthy), I actually pay less now than I did with a highly rated group insurance plan with a large and publicly-owned company. Here are some points to consider: 1. Ask your physician for the “self-pay” price. My family physician cuts the price in half… Read more »

Ken
Ken
12 years ago

Comments such as “Move to any other industrialized country, and you’re covered cradle to grave.” definitely hint to the authors beliefs on the subject. I was also off put by what seems like a very liberal-leaning post. Universal health care might sound like a great ideal, but I don’t see it as realistic or right (why should I be forced to pay for somebody else’s bad lifestyle choices?) @elisabeth (12) – i do sympathize with you regarding your healthcare costs. I am currently debating a genetic test which is going to cost me ~$10,000 out of pocket. Even though the… Read more »

TheMightyQuinn
TheMightyQuinn
12 years ago

I also appreciate “socialized” medicine that Canada offers. All those Canadians coming down to the US for operations really helps the hospitals’ bottom line!

Chris McKenzie
Chris McKenzie
12 years ago

J.D. asked: “I am baffled. Do readers really view this article as a call for socialized medicine? What is it about the article that leads you to believe that?” To effectively solve our health care problem we need comprehensive reform, which must include cost controls (conspicuously lacking in the proposals from the Democratic presidential candidates) as well as coverage for everyone (conspicuously lacking from the Republicans’ proposals). At this point the author crossed the line from offering advice on how to find insurance to advocating specific political positions which are in effect socialized medicine. His “bi-partisanship” consisted of blaming both… Read more »

TosaJen
TosaJen
12 years ago

@The Financial Philosopher: What are your plans for when you are no longer “in decent health”?

My DH has pre-existing conditions, so this is an issue for us. Our options for self-insurance would be limited and expensive.

J.D.
J.D.
12 years ago

Ken writes: Comments such as “Move to any other industrialized country, and you’re covered cradle to grave.” definitely hint to the authors beliefs on the subject. Ha! Okay. Good point. 🙂 Just a quick note: In general, I try to keep politics out of Get Rich Slowly. That’s not always possible of course, but it doesn’t usually matter. I’m all over the board politically, neither liberal nor conservative. My guest posters, however, have their own opinions. And while I try to tone down the political aspects of certain posts, I’ve published articles that were blatantly conservative and I’ve published articles… Read more »

J.D.
J.D.
12 years ago

Also, I contacted Jason for clarification. His response: “Socialized medicine is one possible solution to the problems I described. There are others. I’m open to either.” I think Jason just wants people to have access to quality, affordable health care, and he doesn’t think the current system in the U.S. is particularly effective at delivering it.

Barbalith
Barbalith
12 years ago

Just a quick note on COBRA: While it is true that you pay more out of pocket for this coverage this is only happening because you are paying your share pluss what your employer was paying.

Teresa A
Teresa A
12 years ago

I would like some opinions and thoughts about CHOOSING not to have health coverage. What if I chose to put the money I currently pay for my health insurance premiums in a savings account instead? What if I paid my family’s minor visits and such out of that fund, and for higher cost visits, emergencies, hospital stays etc., I made payments to the doctor or hospital instead of into an insurance plan? As long as I am making regular payments to the doctor or hospital I would think I am still being financially responsible? And that as long as I… Read more »

Ken
Ken
12 years ago

@Theresa

JD has actually written about something similar to what you’re asking before, and I’m considering this as well. I wouldn’t ditch the insurance all together, but find a low premium, high deductible health insurance plan for emergencies, and then open a health savings account to do as you state with.

The benefits here are that the high deductible insurance gives you coverage for the catastrophic stuff, and enables you to open the HSA in which deposits can be made pre-tax.

The Financial Philosopher
The Financial Philosopher
12 years ago

TosaJen:

You asked, “What are your plans for when you are no longer ‘in decent health’?”

My health plan, while individually purchased, is done through a network of primarily self-employed individuals, such as myself.

While there is no such thing as a “guarantee” in any health plan, my contract does not refuse care or drop my coverage for health conditions arising after the initial contract date.

As long as I pay the premiums, I’m covered, both in sickness and in “decent health.”

If you want more information, contact me through my blog…

Cara
Cara
12 years ago

FYI, in many states, if you are already a USAA insurance customer (house, car), you can also add reasonably-priced health insurance. My brother discovered this when he was between jobs; COBRA was outrageously expensive, USAA was about 50% less.

Jason Gingerich
Jason Gingerich
12 years ago

Looks like some great discussion. In response to the comments that I’m advocating “socialized medicine”, I want to offer a couple of comments. First of all, we already have half-socialized medicine. Medicare and Medicaid pay for about half of health care costs in this country. Our tax code gives tax break to employers who offer insurance as a benefit to employees. So it’s a bit ignorant or dishonest for some people to oppose changes because it would be increased government involvement. While the article focuses on what to do under the current environment, I really would like to see a… Read more »

Kristi Wachter
Kristi Wachter
12 years ago

I just wanted to highlight Jason’s comment on pregnancy and maternity coverage.

If you choose not to have children (or any additional children), dropping maternity care can save you a lot of money. I’ve heard that brand-name drugs and maternity costs are the two largest cost categories for insurance companies, and they’re very happy if you don’t need to take advantage of either of those.

Heidi
Heidi
12 years ago

@Ken “Comments such as “Move to any other industrialized country, and you’re covered cradle to grave.” definitely hint to the authors beliefs on the subject. I was also off put by what seems like a very liberal-leaning post. Universal health care might sound like a great ideal, but I don’t see it as realistic or right (why should I be forced to pay for somebody else’s bad lifestyle choices?) @elisabeth (12) – i do sympathize with you regarding your healthcare costs. I am currently debating a genetic test which is going to cost me ~$10,000 out of pocket. Even though… Read more »

Teresa A
Teresa A
12 years ago

@Ken: Yes, I have looked into HSA’s extensively. They seem a much better way to go for most people that are in reasonable health. Certainly, they could save you tons of money should something major happen instead of being uninsured and being socked with the whole balance. If my insurance goes up again this year (who am I kidding? it will!) then I will definitely go the HSA route. Still, I can’t help but wonder if I would be further ahead by paying for my medical expenses myself, while saving for possible major medical costs (instead of making insurance premium… Read more »

Frugaliscious
Frugaliscious
12 years ago

I agree, I can’t find in the article a call for socialized health care. My husband falls into the category that no one will insure him because of his pre-existing condition he has had since he was 4. We opted for COBRA and not state assistance when we were between jobs.

What amazes me is how many people just leave their jobs thinking they are healthy and assuming they can purchase health care. That is not always the case. This article was great. Thank you.

Jim
Jim
12 years ago

Teresa, Choosing to go without health insurance entirely and instead save money on your own takes on considerable risk of very high health care bills. Major medical costs can be truly astronomical. Sample prices: Heart Bypass $130,000, Hip replacement $30,000, liver transplant $650,000. While its not likely you will have to go through any of these procedures, there is always a risk that something serious could happen. Would you really be able to afford a major procedure simply by saving your own money? Its unlikely. If you do not have insurance then a major medical expense would likely wipe out… Read more »

JBS
JBS
12 years ago

A friend of mine recently posted on his blog a breakdown of his experience buying insurance for his family of 5. An interesting story for sure and I only wish that my company would move (quickly!) to a catastrophic insurance system like what he describes.

Tyler
Tyler
12 years ago

To follow up on what Jim said, there’s another good reason to get individual insurance now even if you are healthy. Insurance companies are not legally allowed to increase your premiums because you get sick (this only applies to individual policies). That means that if you get a good rate before you develop an expensive condition, you’ll still be able to get cheap health insurance for as long as you’re willing to pay the premiums. There are some exceptions to this, but in general the cost of individual health insurance premiums can not be increased beyond that of the rising… Read more »

jeffreyz
jeffreyz
12 years ago

I have been self-employed for years. I have had individual policies in the past but found that the best approach for our family (2 adults, 4 kids) is to set up a group policy through a corp or llc. As long as there are two officers in the corp you can get a group policy through Blue Cross or similar providers. You then don’t need to worry about the problems associated with individual policies. That said, the policy we have is twice a expensive as an individual policy. However, one of my childen had a pre-existing condition and would likely… Read more »

Judy
Judy
12 years ago

If you are on an individual insuance program make sure you OPEN EVERY PIECE OF MAIL FROM THE INSURANCE COMPANY AND READ IT. Several years ago, my family got booted off an insurance contract because I didn’t, and I missed a “re-enrollment” form that needed to be filled out. We had not missed a single payment.

Ken
Ken
12 years ago

@Heidi: “Do you consider Cancer a lifestyle choice? Or a baby born with AIDS, oh wait, it was his parent’s lifestyle choice, right? As for not wanting to subsidize someone else’s cancer treatments, you should probably also not subsidize the police department, fire station, your local schools, and the highway department either – I mean, its other peoples lifestyle choices that cause the need for these, right?” If you had read my comment you would see I didn’t say that..cancer is not a lifestyle problem, nor is the CADASIL which I go through (google it). I don’t expect her to… Read more »

Judy
Judy
12 years ago

I can tell you that it is a nightmare dealing with insurance issues when there are health problems involved. The cobra for my 3 person family was $1400/month. It took three months for all the companies (previous employer, payment service and insurance company)involved to talk to each other so that we would have our coverage. It finally required a number of calls to the Department of Labor to get the companies to cooporate. During that time I had to pay for everything out of pocket, even though I had paid for my insurance. Then getting reimbursed has been next to… Read more »

Tom
Tom
12 years ago

First: Heidi, thank you for being a voice of reason. And might I add, “why should I pay for the military when I don’t agree with how they are being used?” Government is about being responsible for others. The alternative is anarchy. You think government is bad? You would REALLY hate anarchy! Second: Under our current failing system, affording health insurance is also only half the battle. The other half is when you get sick, and the insurance you’ve been paying for years denies coverage for the treatment you need, or creates a bogus reason to deny payment of your… Read more »

Judy
Judy
12 years ago

One more story – my father-in-law was downsized at the age of 61. Their health insurance costs were $34k/year (after cobra ended until medicare coverage began). How many of you would be able to afford that? Trust me, the worst case scenario can happen to anyone and our medical system in obscene. We definitely need health care reform and I for one, would be totally in favor of socialized medicine. It is only a matter of time before insurance becomes too costly for any but the biggest employers to subsidize.

Judy
Judy
12 years ago

Saying that you don’t want to “subsidize someone else’s cancer treatments” is immature and shows a real lack of understanding. Insurance is a financial device for spreading the cost and “subsidizing” healthcare. So you are already doing it. Surely @Heidi, there is someone in your family who need healthcare at one time, and if they weren’t sleeping in a cardboard box at the end of it then the “subsidy” worked. Even you will one day grow old and need healthcare. The biggest problems are out of control costs for prescription drugs, hospital procedures and companies who weigh the cost benefits… Read more »

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