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SportsShooter.com: Member Message Board

Health insurance for self employed photographers
Phil Hawkins, Photographer
Fresno | ca | usa | Posted: 10:02 PM on 08.17.09
->> I'm sure this subject has been covered here before, but I did a search and got a bunch of responses that didn't help. Plus, the health insurance industry changes constantly and what was true 6 months ago is not necessarily true today. So, please, no flames for asking a question that has been asked before.

As I am now going to be on my own for health insurance, are there any groups or photog associations one can join to help keep the cost down? As it stands, at my age, 56, my premiums for individual plans for Blue Cross, etc are stratospheric.

What's everyone doing in this regard?

Thanks
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Sandy Huffaker, Photographer
San Diego | CA | USA | Posted: 10:10 PM on 08.17.09
->> I haven't found a single one that offers a decent plan. I'm doing the Blue Cross with a huge deductible. I'd be interested as well in hearing from others.
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Hassel Weems, Photographer
Locust Grove (Atlanta) | GA | USA | Posted: 10:29 PM on 08.17.09
->> We have a HSA plan through the carrier the PPA uses. The premiums are far less for basically the same coverage I had with BC-BS. You have to be a PPA member but that has other benefits that are well worth the membership fee.

Everything before the deductible is 100% out of pocket but the premiums are so much lower that I am out less money at the end of the year.

This has been a rough year for us, medically speaking, and we are still way ahead of where we'd be with a co-pay and brutal monthly premium from BC-BS. We are very happy with our HSA.
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David Bailey, Photographer
Flower Mound | TX | USA | Posted: 10:34 PM on 08.17.09
->> Yes, I use Humana with a big decutible and I'd say they are o.k. at best. They question just about everything.

I tried to use the PPA referral and the rep they referred me to didn't seem too interested in helping and said I had the best I could expect.

I ended up using ehealthinsurance.com and it allowed me to compare different companies.
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Allen Murabayashi, Photographer
New York | NY | USA | Posted: 10:37 PM on 08.17.09
->> try looking at this:
http://www.freelancersunion.org/
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Preston Mack, Photographer
Orlando | FL | USA | Posted: 10:58 PM on 08.17.09
->> This is why I am hoping for major health care reform.

It is nearly impossible to get good coverage for an affordable rate as a self employed photographer.
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Debra L Rothenberg, Photographer
New York | NY | USA | Posted: 10:58 PM on 08.17.09
->> Alan,
you beat me to it
I have several friends who went with the freelancers Union and they are very happy
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Jon Wright, Photographer
Wayzata | MN | USA | Posted: 11:05 PM on 08.17.09
->> Sometimes I feel like a tightrope walker. Not being able to have affordable health insurance is a price I pay for doing what I love. I accept that, but I'm aware that I could fall off that wire at any time. Two years ago I spent one night in the hospital for the price of a trip around the world.
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PJ Heller, Photographer
Santa Barbara | CA | USA | Posted: 11:18 PM on 08.17.09
->> Some suggestions:

— Look into a HSA policy (for some info on them, try reading
http://www.bobhopperinsurance.com/, who is a strong advocate for them.

— You might look into forming an LLC and then, if you have yourself and another employee (or even a family member who you could hire), you could apply for a group policy. It may set you back the same amount as individual policies, but from the little that I know you won’t be turned down for things like preexisting conditions.

— Move to Canada, France, New Zealand or one of the many other countries that have national plans and become a citizen there.

— Hold out hope that health care reform will be enacted and that it will provide coverage for everyone who wants it.
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Robert Hanashiro, Photographer
Los Angeles | CA | | Posted: 11:19 PM on 08.17.09
->> Great question Phil and obviously very timely and of big concern for everyone.

I hope that a lot of you contribute to this with information and experiences so it can stand as a resource for others ... and the future.

When I started Sports Shooter 11 years ago one of my goals was to create a forum where professional photographers and students have a place to go to share their stories...and information.

Thanks for those of you that have already comtributed...and thanks in advance to those of you that will add to this topic.
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Steven Mullensky, Photographer, Photo Editor
Port Townsend | WA. | USA | Posted: 12:42 AM on 08.18.09
->> Don't laugh, but I think the Kaiser HMO beats everything hands down. I've had them for over 20 years.
The physicians actually make the decisions regarding needed tests and treatment and not some bean counter for a profit driven plan. That's my opinion, what's yours? (to coin a phrase)
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Phil Hawkins, Photographer
Fresno | ca | usa | Posted: 1:43 AM on 08.18.09
->> Someone else recommended Kaiser to me and I looked at the plan and saw only 30% coinsurance for hospitalization. If I am understanding the term "coinsurance" correctly, 30% sounds like a very low figure to me. I have got to be missing something.
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Phil Hawkins, Photographer
Fresno | ca | usa | Posted: 1:45 AM on 08.18.09
->> I wonder if SS could qualify as a "group" for purposes of offering a plan. Just thinking out loud.
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Khai Le, Student/Intern, Photographer
Riverside | CA | USA | Posted: 1:58 AM on 08.18.09
->> The 30% would be what you would cover with the insurance co. covering the remaining 70%.
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Derek Montgomery, Photographer
Duluth | MN | USA | Posted: 2:17 AM on 08.18.09
->> Anybody ever have to deal with insurance companies while having a preexisting condition? I have Type-1 diabetes and while I have not gone out and found a plan because the VA covers all my diabetic related costs, it would be nice to know the experiences of those with such conditions in dealing with health insurance companies.

The twist for me is that the VA will cover everything related to diabetes, but if I fall off my bike and break my arm then I have to handle the expenses. So my conundrum is finding a plan that will cover me for the odd mishap here and there. Is there any way to purchase a plan for a reasonable rate by telling the company they won't have to pay a dime for my diabetic supplies/issues and still get run of the mill coverage?

I've talked to a few people here and there who don't seem to know so I thought I'd throw it out there and maybe some of you might know.

Thanks in advance!
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Marvin Gentry, Photographer
Birmingham | AL | USA | Posted: 8:34 AM on 08.18.09
->> Phil, SS would qualify as a group under Alabama law because the group was not put together just for insurance. I am sure you would find someone to write a policy for it. I have BC through my wife so guess I will stay married a little longer LOL.
PLEASE NO OBAMA health care reform. Yes it needs reformed but not by the government!!!!
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Gray Quetti, Photographer
Jacksonville | Fl | USA | Posted: 9:40 AM on 08.18.09
->> Phil, I'm in the insurance business in Florida and I know that finding a group that can offer a health plan at discounted rates and guaranteed issue is just about non-existent. The suggestions you are getting from those in other states are probably very good.

It seems to me the best bang for the buck these days (provided you are healthy and pre-existing conditions isn't a big issue) is the HSA's. Even if you have pre-exs you still might get coverage. If you don't use your plan very much and hardly ever meet your deductible then why pay the insurance company a lot of money for a low deductible. I think taking the highest deductible you feel comfortable self-insuring yourself for is the practical way to go. Try to get a plan with 100% coinsurance so you know that whatever your deductible is will also be your out of pocket maximum. If the unfortunate happens and you're hospitalized you can probably find a way to pay, charge, beg or borrow the deductible. There are guaranteed issue plans out there but you will find the coverage very limited.

There are a lot of good insurance companies with private plans. In Florida the popular ones are BCBS, United (underwritten by Golden Rule), Aetna, Humana One, Assurant and just recently, Cigna has entered the individual market. Those carriers are probably available in your state as well.

Good luck. Email or call if I can answer any questions.
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Shelly Castellano, Photographer
Huntington Beach | CA | USA | Posted: 11:10 AM on 08.18.09
->> I know all health insurance companies are not the same, but you might not want to go with CIGNA.
http://savestevesfamily.blogspot.com/
Help if you can.
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Wes Hope, Photographer
Maryville | TN | USA | Posted: 12:51 PM on 08.18.09
->> Having health insurance is just about the only thing I miss about working for The Man. And I'm not going to lie; it's bad enough that it's made me consider finding another job just so I don't have to deal with it.

At one point our little family was paying more for health insurance then we were for our house each month. Talk about depressing. Luckily we found a similar plan with a smaller, regional company (Bluegrass... only in KY and parts of TN right now I think) and our monthly rate dropped ~$300. Enough to take the pressure off. We're just gambling that this company will stick by us if the crap hits the fan for one of us medically and not pull a CIGNA.

It's an unfortunate necessary evil. Every now and then when I'm going over bills I grumble about how much we pay *in case* we get sick. And then we have months like this one where all four of us have been sick and had to make multiple trips to the doc (we have two kids, one of which is 1) and I'm thankful that we have insurance. Stupid Catch-22.
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Stephen Voss, Photographer
Washington | DC | USA | Posted: 1:16 PM on 08.18.09
->> Not sure if you'll find any great deals, but definitely check out: http://www.ehealthinsurance.com/

It allows you to enter your info and get instant price comparison between all the companies.

One point I'll make on this is that I chose the lowest monthly premium, and in the 3 years I had insurance through the company (Aetna), it more than doubled, despite me being in good health and doing nothing more than regular doctor visits.
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Albert McCracken, Photographer
Lockport | NY | USA | Posted: 1:49 PM on 08.18.09
->> Hey, Phil
Check this out
http://www.tcpinsurance.com/
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Davis Barber, Photographer
Fullerton | CA | USA | Posted: 2:05 PM on 08.18.09
->> PJ offers great advice. Earlier this year I converted my business into an S Corporation. Aside from the various tax benefits and liabilities, an S corp requires a board of directors, and a board of directors qualifies you into getting group health insurance. It doesn't solve the cost of insurance, but it makes it easier. Plus you'll take yourself and your business more seriously, too.
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Shelly Castellano, Photographer
Huntington Beach | CA | USA | Posted: 2:13 PM on 08.18.09
->> Great advice Davis!
I used
http://www.shopcomparebuy.com and spoke directly with Steven at 800-880-1451 He is very thorough in looking at all of your options and stays updated with the change of policy terms during each year. Give them a try.
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Brian Blanco, Photographer
Tampa / Sarasota | FL | USA | Posted: 2:29 PM on 08.18.09
->> Gray,

I took your advice and spent the day shopping for insurance and you're 100% right. After a day of searching, comparing and getting educated by agents. I found that the HSA's are by far the most appropriate plan for someone in my situation. If you're fairly young (I'm 34) and in decent health then the HSA's make a lot of sense and have some decent tax benefits too.

Thanks for mentioning them. Your advice was worth the $25.00 price-of-admission and then some.

-Blanco
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Gray Quetti, Photographer
Jacksonville | Fl | USA | Posted: 2:51 PM on 08.18.09
->> Brian, young males get the best rates and as young as you are you might be able to take a little lower deductible and keep your premiums in line. When they hit you with an increase on your anniversary then you can go back to a higher deductible.

Some have mentioned above that you could incorporate and add a second employee and get a group plan. True, just be prepared for the sticker shock for a family group plan.
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Jim Colburn, Photo Editor, Photographer
McAllen | TX | USA | Posted: 4:12 PM on 08.18.09
->> When I had Kaiser coverage I found them to be excellent. Far better than any Blue Cross/Blue Shield plan I've ever had. You have to go to their clinics with their doctors but the docs and the staff were some of the nicest, most competent, medical personnel I've ever dealt with. I wish I could have Kaiser now.
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Michael Granse, Photographer
Urbana | IL | USA | Posted: 4:33 PM on 08.18.09
->> Have you considered getting a high deductible insurance plan with a medical savings account? For anyone who is unfamiliar with these, the following link will take you to a brief explanation:


http://tinyurl.com/laepdg
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Michael Granse, Photographer
Urbana | IL | USA | Posted: 4:34 PM on 08.18.09
->> Oops! In scanning for medical savings accounts I missed that HSA's had already been brought up.
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Diana Porter, Photographer
Houston | TX | USA | Posted: 12:23 AM on 08.19.09
->> Health insurance companies are looking for any reason not to insure you. I have high cholesterol, but take medication to keep it manageable. It was still too high (185) for the insurance companies and with no other health problems at all, I am now uninsurable. I have two kids with ADD and their rates were going to be 600.00/mo just for the two of them with a $7500.00 deductible. I'm finding it easier to go without insurance and use my bargaining tactics at the door. Usually come out for less than what I would have paid with insurance and I'm done. $6000.00 cardiac stress test - I walked out for $373.00 because I paid at the door. If you ask and beg enough, they will come way down in price.

Case in point- immunizations for the kids: With insurance $250.00, without insurance, all you pay is the state injection fee of $7.00.
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Phil Hawkins, Photographer
Fresno | ca | usa | Posted: 1:39 AM on 08.19.09
->> Diane, interesting you mention negotiating your health care fees. My allergy shots were $150 w/ insurance, $15 if I had no insurance.
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Shane Bevel, Photographer
Tulsa | OK | USA | Posted: 12:43 AM on 08.20.09
->> Just the opinion of a young, fairly healthy, new freelancer here.

I looked around at some of the different plans. Of course Cobra was insane, and getting on my wife's plan wasn't much better. After shopping it around, I settled on an HSA plan. Here is why:

1. My premium is ~$75 a month and once my deductible is met, I pay nothing up to 3 or 5 million dollars (don't recall which) and I also have a $300 allowance for a once a year physical.

2. It gives me a $3k tax shelter. I can put $3k a year away in a special account to pay my expenses. I have a plain old debit card for this account. Want to go see the doc? Just go and swipe the card. Unless I spend it on medical expenses, I never lose this money. It's mine

3. My deductible is $3500 and my maximum contribution to my HSA account (tax free) is $3k. Leaves only $500 liability the first year and two months into the second year it leaves no liability (unless I have an expense of course)

4. If I spread out my contribution to my HSA account over the year I pay nearly the SAME amount as being on my wife's plan. The difference? If I don't get sick.... I have $3k in a savings account that I can treat like an IRA when I retire. Add that up over the few years between now and when we start thinking about a family and that is pretty significant.

When we start having kids I might have to rethink it. But then again I have a friend who insures his wife, himself and three kids with an HSA. Stacks away $10k a year in the HSA. I think his premiums are ~$350

Again, just my opinion. A reasonable national plan might change all that.
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Nick Morris, Photographer
San Marcos | CA | United States | Posted: 3:31 AM on 08.20.09
->> Hey everybody, mind if I chime in here for a moment. I'm going to tell you what I have done and it works for me. Now it could be better by far but for now it seems to keep the wolves at bay. My wife and I started a beverage catering business 17 years ago when we met. It started off as a part time thing for fun money and it grew into quite the big business, We actually contracted with LaDanian Tomlinsons to do his wedding. I can go on as far as high end people but my point is we made it to the top of our industry. I no longer work the business it's my wifes thing. I focus on photography. Anyway we needed self employed insurance and to get cheaper insurance you need more employees. Well we fixed that by hiring some of our friends and relatives who were for one reason or anohther un-insured. We became a small co-op and our rates went down. I would love to see SportShooter do the same thing. Robert if you approach Kaiser or whoever you choose with all of the members,by the way where are we right now with membership ? 30,000 I don't know I'm just guessing but if you approach an insurance company with our numbers we can create a situation where we all get extremely cheap insurance. It's just a thought. If we all do it it becomes VERY cheap. Maybe we should think about it. We could pay a flat fee yearly as members and have health insurance. Can we check into it at least?
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Gray Quetti, Photographer
Jacksonville | Fl | USA | Posted: 10:27 AM on 08.20.09
->> Nick, that sounds good in theory but I believe it would be more than SS would ever want to undertake when you have to form an Association, and most probably a Trust of some sort and go through the different states for approval. To have a health plan like that guaranteed issued there would probably be participation guidelines for the members and that would probably not work in its present form.

The best that SS could do is just to offer a service to its members with a carrier sponsored plan that would not be discounted and would be fully undewritten which would mean the plan is subject to pre-existing conditions and/or limitations.

Dealing with multiple states would be difficult. I deal with an Associaton of 85,000 members in Florida and we market multiple group products for them but medical insurance is the only one we can't get guaranteed issue.

High deductible HSA's are a good bang for the buck right now, especially if pre-exs aren't an issue.
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Stanley Leary, Photographer
Roswell | GA | USA | Posted: 9:18 PM on 08.20.09
->> I was with Blue Cross, but found out if I got hurt on the job, they don't pay. They assume you have worker's comp. Also, if you are self employed your healthcare will go up and up.

I finally switched to Great-West healthcare. www.mygreatwest.com It is a PPO and similar to the same network that Blue Cross covered for us.

You join an association and even with this fee built it’s less expensive than Blue Cross.

I want health care reform so much. By the time I add my taxes and all we spend on healthcare each year I am close to 50% of my income.

Through any of the photography associations they have healthcare options. I am now becoming more aware of how important disability is to have as well. One of my photographer friends had a detached retina and could not work for almost a year. What they paid out for him more than covered all he ever paid for insurance and all the membership fees for his lifetime. He was in his late 50s when this happened.

I am noticing most of us are taking out what I call catastrophic insurance with some wellness visits built into the program. Usually like 6 or so visits they cover for example. However, as most of you will notice the higher the deductible the less you spend if you are healthy. If however something terrible happens once you meet your deductible you will have spent the same in most cases as the program with a lower deductible once you match the higher deductible. So, if you pay $250 moth with a $5,000 deductible you’re out of pocket will be equal to those who choose the $10,000 deductible if you have expenses to the $10,000 amount.

What I have noticed is that insurance companies all go up. Some will say they don’t go up but about 10% a year, but try find this in writing.

Also, for procedures you can schedule always ask what the cash price is for a procedure. You can shop around and really lower some of these if you try.
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Diana Porter, Photographer
Houston | TX | USA | Posted: 10:06 PM on 08.20.09
->> So what options are out there for someone who may have a pre-existing condition? Or a family member with one. HSA's don't help me at all because of my son's school. It is medically necessary so everything I do is a write-off anyway because we have already met the 7.5% rule. I am stuck in this hole where I make too much to get on the state plan but insurance won't cover me even if I could afford it. Looked at the coverage provided thru PPA and NASE and it's more expensive then if I just went out on my own.
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Stanley Leary, Photographer
Roswell | GA | USA | Posted: 12:27 PM on 08.21.09
->> Diana--you are the prime example of what everyone seems to agree about when it does come to healthcare reform. The pre-existing condition from what I can tell will most likely be changed. It appears that both sides seem to be in agreement on this one.

I haven't heard of anything for someone like you. There maybe something. I would contact the state insurance commissioner for Texas. They may have some where to point you.
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Ron Hawkes, Photographer, Photo Editor
Rockland | ME | USA | Posted: 10:20 PM on 08.21.09
->> Derek, to answer your question, I have twice now dealt with insurance companies while having an existing condition. Both times I had to go a year without any coverage on those conditions or any condition that may be associated with them. Both times the insurance paid for everything else and one even allowed my prescription rate for a pre-existing condition.

As for everyone else so far that has responded, at least you have insurance, here in Maine they make it so insurance companies do not even want to do business here. We have very limited choices and all very expensive.

Our state insurance plan is so full and has such a long waiting list that it is closed for now to new enrollments, but my taxes help pay for it even thought I cannot get it.

Health reform must happen soon. We need to find a better way to take care of everyone in this country.

Phil, great topic thanks for bringing it up.
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Lane Hickenbottom, Photographer
Omaha | NE | usa | Posted: 1:10 AM on 08.22.09
->> Two things I've done:

Joined my state's Farm Bureau for a discounted rate on BC/BS insurance. The Farm Bureau membership costs $50/year. You don't have to be a farmer to join.

Second, I've enrolled in a Sec 105 health reimbursement program.

Basically what it does is allow me to do the following: As a soul-proprietor I've hired my wife to help with the business. Once she's on payroll, I can offer her employee health benefits that include 100% of her premiums and out-of-pocket medical expenses for her ***AND HER FAMILY MEMBERS*** (me).

Since this benefit to my employee (my wife) is a business expense, my family's insurance premiums and out-of-pocket expenses are all tax-deductible.

This company administers the plan for $250/year, which includes dealing with an audit if one occurs.
https://www1.tasconline.com/buytasc/bizplan/
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PJ Heller, Photographer
Santa Barbara | CA | USA | Posted: 2:42 AM on 08.22.09
->> Lane:

I see the tax advantages with the BixPlan, but that still leaves the question of finding insurance for your spouse (and yourself). How did you manage to get her employee health benefits with you being a sole proprietor (I'm sure you're also a soul provider). I thought you would have to be at least an LLC to apply for employee health benefits.
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Philip Bowen, Photographer
Kampala | UG | Uganda | Posted: 5:38 AM on 01.03.10
->> Bringing this thread back to life to see if there are any new ideas in the last few months...I hear there was some legislation passed recently :)?

My wife is finishing her job here and we're moving back to MN. Our heads just about exploded when we saw what the cost of her University plan would be with her working at 50%. Ouch.

We're in our low thirties with a 17-month-old. A BCBS HSA is looking pretty appealing right now, but there is no maternity coverage for the first 18 months, and hopefully she'll need that. So maybe the boy and I will go for the HSA and she'll find something with better coverage.

Anyone out there have advice that hasn't already been mentioned above?

Thanks for your help!
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Angus Mordant, Student/Intern
Sydney | NSW Australia | Australia | Posted: 6:22 AM on 01.03.10
->> Or just come down and join us down under where we have very good public health care that is compulsory (Costs 3.2% of your pre-tax income) covers almost everything except Ambulance transport.
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Derek Montgomery, Photographer
Duluth | MN | USA | Posted: 8:53 AM on 01.03.10
->> Thanks Ron. I do know I am very fortunate that the VA will cover my diabetic related expenses, but that's as far as they will go. I'm thinking about incidental charges such as going to regular appointments to meet your doctor or if you are riding a unicycle down a hill and crash (something completely unrelated to your condition). Those are the things that aren't covered. I always like to have something in case that happens as most people on this board do.

For those who can't get health care, you can look into "Group of One" plans. Here you would basically incorporate or become a business and if your state has "Group of One" legislation passed then health insurance companies cannot deny you coverage. In these group-of-one states, rating limits apply to the premiums that can be charged to small employers including groups of one. By contrast, in most state individual health insurance markets, you can be turned down or charged substantially more for coverage based on your health status (preexisting conditions).

To find out if your state is covered under a "Group of One" policy, check here...

http://www.statehealthfacts.org/comparetable.jsp?ind=350&cat=7

Either way, I hope some reform is done to provide access to people with preexisting conditions to health insurance so they are not crippled by a sickness or injury when it arises.
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Jeannette Merten, Photographer
Oshkosh | WI | USA | Posted: 10:09 AM on 01.03.10
->> Self-employed, we are in our 50's, have a HSA and pay $480/mo for a family of four through American Community with a $10,000 deductible, can see any doctor we want, crazy amount of money, I know. Yet I don't feel so bad now after seeing what others are paying. State to state the rules are different, but here in WI the rules recently changed that a dependant older than 23 up to 27 can stay on your family plan, which is a good thing if you have kids in college. I looked into it and the plans that colleges offer are junk, yes they are cheap but covers nearly nothing and so restrictive.

We also make a even contribution tax-free into the HSA bank account quarterly and that is what covers the day to day health expenses, from dental to buying aspirin and doctor visits. The catastrophic health plan covered our butts when our daughter had ACL knee surgery. Better than being $35,000 in the hole.

We jumped on the band wagon when HSA accounts were first introduced many, many years ago when only a few banks offered it. Now they all do. It did take a couple of years to build it up that account to make it work.

One thing our insurance agent told us right from the beginning is negotiate your fees, which we do. You tell them you'll be paying cash (out of the HSA account) and they'll slash the cost many times up to 50%.

The disadvantage is you're constantly out there bickering prices and not my favorite thing to take time to do. But, it does work. You need to find a good agent to guide you through the process.

This is not to say the current system is good, nor would a government run plan be the answer. It's the educated that will do ok with the current system and the uneducated on the subject (or refuse to be) that will slip through the cracks and bring everyone else down.

Being accepted with a pre-existing condition is definitely a problem in my eyes, I don't like it. It does take extra time and energy, but by contacting your legislators in your state is the best way to make a difference. Don't just complain, give an constructive idea. You may think your voice is unheard, but if there are enough out there that are saying the same thing, the rules will change again, and then again and again. Good luck on your search.
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Jeff Stanton, Photographer
Indiana | IN | USA | Posted: 10:26 AM on 01.03.10
->> A $10,000 deductible. That sounds pretty reasonable. :o(

And I thought our plan at work was awful. $1000 deductible, prescription plan is tiered at $10/$30/70 and major medical is now a 70/30 split. I guess I should feel lucky.
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Jeannette Merten, Photographer
Oshkosh | WI | USA | Posted: 10:43 AM on 01.03.10
->> Jeff, you are lucky working for someone else. Your employer is picking up the rest of the tab for you. You may not be seeing it in your weekly/monthly paycheck, but it is there as a benefit. You are not self-employed, big difference.
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Jeannette Merten, Photographer
Oshkosh | WI | USA | Posted: 11:29 AM on 01.03.10
->> Phil, here is a link that might help in your search.

http://www.daveramsey.com/elp/health-insurance/
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N. Scott Trimble, Photographer
Lake Oswego | OR | USA | Posted: 1:23 PM on 01.03.10
->> We just got of my COBRA and are now on BCBS Plus for the three of us paying $421/month for $2500/7000 deductible. It sucks, but better than nothing. We did lose dental though, and of course, now my wife has a toothache. I had to eliminate my life insurance to get this, so if I die, I guess my family is screwed.
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PJ Heller, Photographer
Santa Barbara | CA | USA | Posted: 2:23 PM on 01.03.10
->> Jeannette:

Re your comment about having to negotiate prices when paying cash. My understanding of HSA accounts is that the doctor would first bill the insurance company, which would turn down the claim (since you're on a HSA) but the actual rate you would then be billed was the rate negotiated with the insurance company. Or are you bypassing the insurance billing step altogether?
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Michael Durisseau, Photographer, Assistant
Santa Fe/Houston | TX | USA | Posted: 2:32 PM on 01.03.10
->> I'm interested, possibly, in the pre-existing condition stuff...though I do have something called 3-Share which does help...I've had a kidney transplant 22 years ago, and was originally told that I was not eligible for that coverage...
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Jeannette Merten, Photographer
Oshkosh | WI | USA | Posted: 4:12 PM on 01.03.10
->> PJ, not true about billing to insurance company first. Some doctor offices may say that is what they need to do. You are the customer and you will take care of the bill. I'm talking about routine office calls, smaller stuff, not major surgery that will easily bust above your deductible. Best to talk to them before you have something done.

You bypass, don't submit to insurance. Should you ever go over that magic deductible number in receipts in a calendar year, then you would submit those receipts into the insurance company directly. But of course, you would need maintain a record of all that paperwork, I know, yuk. But it is all about taking control.

The cost of just going to see a doctor and any medical tests and treatments are simply out of control. Many miss out and don't realize the power of cash in hand. Offices are usually willing to negotiate so they get paid. And I'm not the type of person that enjoys doing it, it feels like it's a fight every time and would rather avoid it, but it is one way to lower your healthcare costs.

It does take a few years to build up that HSA fund, cross your fingers nothing big happens to deplete it. But once it is established, you'll be happy you did along with the tax advantages. Last I heard is you can put into a HSA account up to $6000/yr tax free in WI. Check with your own state.
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