Health insurance

AffApprentice

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Nov 19, 2009
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Hi all,

I'm getting to the point where I'm getting ready to leave my 9-5 job and go full time as an affiliate, so it's time to figure out health insurance -- I have a "pre-existing condition" so this is a big deal. For those of you who are self employed (I imagine many of you), what do you do for health insurance? Individual rates? Memberships? Just saying "fuck it" and hoping you don't get hurt / sick?

Since I have a condition it looks like individual rates are going to be pretty ridiculous, like $1k+ / month, so I'm trying to find an association I can join. Any ones you'd recommend?

Thanks a lot, your help is appreciated.
 


If you have a pre-existing condition, you're fairly screwed. At least until 2014. Your best bet is probably COBRA, which is a continuation of your existing health coverage plan under your employer. Your premiums will be what your employer paid. Federal COBRA lasts for 18 months. Depending on your state, you may be able to extend it longer. After that, you can look into whether your state has a high-risk insurance pool. Basically count on paying through the arse for your insurance. BTW, there are no associations that I'm aware of that you can join to obtain group coverage. That's pretty much a myth.
 
Thanks, Grindhard - good thread.
Thanks, pharmhand. (Apt name - are you a pharma affiliate or something?)

I figured as much, and I think COBRA probably is my best bet for now. I'm also thinking an association would be a good way to go, since you can buy insurance at a group rate. The only one I really know of is NASE (national association for self employed) though I hear their health insurance program is a scam.

Any other opinions out there? I feel like there must be a legit, high-value association for young entrepreneurs like ourselves that offers health insurance :)
 
If you have a pre-existing condition, you're fairly screwed. At least until 2014. Your best bet is probably COBRA, which is a continuation of your existing health coverage plan under your employer. Your premiums will be what your employer paid. Federal COBRA lasts for 18 months. Depending on your state, you may be able to extend it longer. After that, you can look into whether your state has a high-risk insurance pool. Basically count on paying through the arse for your insurance. BTW, there are no associations that I'm aware of that you can join to obtain group coverage. That's pretty much a myth.

This, in the OP's case. COBRA is the way to go with that pre-existing condition.

You could always run some comparisons at ehealthinsurance.com ... I'm about to be full-time AM too. Just need catastrophe support for myself though.
 
Yep, it's the ultimate kick in the balls.

It's also a serious hindrance to entrepreneurship / innovation. It keeps people in their jobs out of fear and prevents them from going out and starting new businesses, pursuing the American dream, etc.

But I'll save my rant :)
 
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For now, I would look into COBRA and maybe even considering keeping your existing job until 2014. My parents are self-employed and their premiums just jumped to over $20,000/yr for catastrophic only coverage. The HCR bill has some "emergency funding" for people that have serious conditions like cancer and can't get health insurance because of it. This starts immediately, but I don't know if you would qualify for this program. The best person to ask would be your representatives in congress. Their staff can advise you.

https://writerep.house.gov/writerep/welcome.shtml - House
U.S. Senate: Senators Home - Senator

The problem with COBRA coverage is that it is only temporary. You can call the COBRA people ask about your situation - their number is 1.866.444.3272. You only have a limited amount of time to apply for the coverage (14 or 60 days after job termination), so you need to get it done ASAP.

In 2014, insurance companies will no longer be allowed to discriminate against those with pre-existing conditions, and there will also be an insurance "exchange" or marketplace that you can go to to buy health insurance, so it should be a lot cheaper. The flip side of this is that you're also required to have health insurance. If you make up to around $50,000 and are living alone you qualified for federal subsidies and your insurance will be partially paid for by the government.
 
A few things to add:

1. If you live in a "guaranteed issue" state (ME, MA, NY, NJ, or VT), the insurance companies are not allowed to look at medical history, age, or current medical conditions.

2. If you don't live in a guaranteed issue state, you'll probably want to go with COBRA. After that, see if your state has a "high-risk pool". The cost will be high, but it is an option if you are unable to get traditional individual health insurance. 34 states have this.

3. If you are under 30, you may be able to qualify under your parents' health insurance. This gets tricky in terms of "dependant" status. If relevant, call your parents' insr company to find out.
 
Move to Canada or Australia.

<grins>

Every US state has some sort of high risk health pool. In my state (TX) it is fairly expensive - but maybe not more than COBRA. I am a licensed health agent in TX - and have directed my share of people to the risk pool when I used to actively write policies. (Which I don't now that I discovered the wonderful world of the internet)

Really, the best advice is the same as they give people looking for legal advice. Go find a a qualified and licensed health insurnce agent in your state and ask. Not every pre-existing conditions is an automatic decline. i.e. "controlled" high blood pressure may just get a rate up.

But yeah, COBRA is a good bet for 18 months. Fairly heathy people will probably get better rates with individual (what I have) because they can cherry pick. People think that group health is cheaper because their company pays a lot of the cost - but that is not always true at all. People have no idea how much health isurance costs until they get the whole bill when they go on COBRA or something.
 
Thanks for all the advice, everyone. I've never seen the dick-rolling WF community come together with so much thoughtful advice, makes me feel warm 'n fuzzy :)

But yeah, I need to get off my ass and figure this shit out because I'm getting to the point where it's time to think about going full time (basically equaling my current salary for a fraction of the work, want to see what I can do full time). And to a couple people's comments, I'm not really afraid of getting denied coverage (though I guess it's possible), I'm more afraid of paying tens of thousands per year for insurance + meds.

But I'm not going to quit yet, or even in the next month or two I'd think. Definitely not going to do anything rash.
 
How bad is your pre-exisiting condition? What I mean is, do you constantly need to go to the hospital for this? Is there any risk that you will need to go to the hospital for this? Or is it just doctor visits, specialists and medicine?

What I am trying to get at is can you self-insure yourself? This is what I do since I can't get any type of insurance whatsoever. I run a decent risk of being sent to the hospital but haven't for awhile, so it is a risk I have to take. But for less then $200 a month, I get medical supplies and medicine that I need for the month. However, I pay into a savings account $600 a month to build up a nest egg for doctors and specialists.

Also, with medicines, you can often see your doctor and they can help you get discounts and even hook you up with samples on a monthly basis. I live in a tiny town and my wife has seen our doctor since she was born, but many docs will do this. Good luck though, as I know how much of a pain in the ass health insurance is to deal with.
 
I wish we could buy across state lines, like the Republicans tried to push. That would be HUGE for us self-employed people. I moved from CT to NY last summer and my monthly premium went from $175 /month to $1,500 /month. I'm healthy (knock on wood) and in my mid 20's. It's absurd. When they told me the new premium on the phone I laughed at the woman and had her cancel on the spot.

Good luck.
 
@moratraffic - as preexisting conditions go, I'd say it's as "not bad" as it gets. basically i had this kidney disease a couple years ago that i've successfully treated with prescription drugs, but it takes forever to ween off them and i have to be on them for at least another year and a half. i don't have to go to the doctor for it really.

so my main concern is that the medication is super expensive, like hundreds per month, and my second concern is that any insurance company is going to bend me over since the thing i had a couple years ago counts as pre-existing. i'm in the process of getting quotes now and will see what i hear back from various providers, but i'm GUESSING my best bet will be a group plan through some sort of association, since i won't get dinged for my condition that way.

i need to look into COBRA, but since i have primo health insurance right now with low out of pocket expenses, i'm guessing the premiums are pretty high.
 
If you're pre existing condition is bad enough that you can't hide it and nobody will cover you, consider this.

Join the Coast Guard reserve, your medical care for the whole family will be about $150. The coast guard doesn't go to war, and you spend 1 weekend a month barbequing...I mean training. You get paid for it and have a bunch of other benefits.

It sounds like an odd thing to do, but you have to think outside the box. I almost did this myself, but finally got accepted into a regular plan. So now I pay 667 for a family of 4 which aint bad.