Best place to find individual Health Insurance ??

[Zeratul]

I just got back a crazy quote from Anthem. I was denied reg coverage and offered a 80 20 plan for $850.00 a month. I am active, healthy and am a big boned guy so wieght was a factor too but i dont have much to lose. I pay 100 bucks a month on another anthem policy through work. Since I am changeing jobs soon I am looking for an individual plan that doesnt consider me dead! Is there hope?

[Janknitz]

Probably not. As someone with apnea, you are in a "high risk" category. You now have a "pre-existing condition". You're lucky you can get any insurance underwritten at all.

Actually, $850 a month is not bad. Ask your employer how much they are paying for your Anthem policy, it may be close.

When you leave your job, UNDER FEDERAL LAW they are required to allow you to continue your coverage with the current plan for up to 18 months. This is known as COBRA. They cannot deny your claim because of a pre-existing condition. Fasten your seat belt, it will definitely cost more than $100, but it's totally worth it to hold you until you get insurance with your new employer (usually 3 months after you start).

It's EXTREMELY important that you do NOT LET YOUR INSURANCE LAPSE. If you allow a lapse, you can be denied insurance, and you can be denied coverage for pre-existing conditions. That could be a very big problem--don't let it happen!

[Janknitz]

You might check with your state. Many states have "high risk pools" where you can get insurance if you have a pre-existing condition, but it's usually outrageously expensive.

[jonquiljo]

Yes, it depends on your state. My wife and I are on an individual BCBS plan and pay about $5500 a month now for the two of us. I am 57 and she is 59. With current rate increases and the fact that I will turn 60 in 2013, my premium then will be likely $8,000-$10,000 a month or more - that's if we are lucky. This is for a crappy high deductible plan. I am not kidding about these premium figures! Our claims these days are minimal - I didn't even bother use insurance for my CPAP machine - they just would have raised my rates more.

This is because California does nothing for individual subscribers. We get thrown to the wind. There are states with better regulation. I believe to get into the high risk pool here you have to be uninsured for 6 months - not a good idea at our age. And the premium wouldn't be that much lower. Luckily our income is good and we own our house.

With the current mark-up and mark-down games of health care, it is dangerous to go without it. Uninsured pay generally 2-5 times as much as insurance companies do. When I hear $800 a month for an 80-20 plan it makes me jealous. In 2010 we had about $1400 a month in premium increases alone. When we started our plan in 2000 we paid $500 a month. So - $500 a month to $5500 a month in 10 years! Looking at my current plan figures, I think the age 60 "jump" alone is another $2000 a month. And we are not ill - in fact we are in better shape than most people our age.

Why do you think there are so many uninsured? Much of it is from situations like ours, when you get on individual plans - if you make a claim or two, you are history. They will raise your rates constantly until you drop out. When you hit 50 - they never want you, and over 60 - forget it! A simple OSA diagnosis - even for someone compliant and using their machine is enough to get you effectively thrown into the "get rid of them" category.

So how many million in the bank does it take to stay insured in this country? We are really pathetic.

[brian964]

In my experience it is cheaper getting quotes online. Some of the bigger companies offer discounts when ordering online, because it is less work for them. But to be safe you could compare quotes online, pick the best offer and try a local agency to see if they can match it or do better.

I recommend this site for online comparing: http://www.quotes-center.com/average-co ... -insurance

[jonquiljo]

I put my zip code (in California) in the site you linked. Only Medicare supplement quotes come up. When I put in a zip code of Massachusetts, then it will quote regular health insurance.

The reason for this is simple. California and lots of other states do not regulate the individual insurance market. Basically, no one will sell you a policy unless you are young and spotless medically - and usually not online. State like Massachusetts have regulations prohibiting insurance companies from charging too much beyond a point - and require them to insure most or all applicants. These states will allow that site to make quotes.

Basically it's a question of where you live. It makes the difference between night and day.

[Pugsy]

I also tried the link for comparisons. Missouri Only one medicare supplement shown. I happen to know that there are tons more medicare supplements in Missouri because I used to sell them..

[sleepycarol]

In December my employer (I teach school in Missouri) had to go through the process of deciding about insurance coverage. The premium for Anthem Bue Cross Blue Shield was $900 a month for single coverage (and for spouse the premium was the same). This was fora deductible of $500 (if I remember correctly) 80/20 policy. Our board pays a flat $300 a month and we pay the rest. The board decided to use United Health Care at a price of $500 a month. This has a $2000 deductible and 80/20. Only trouble very few doctors in this region accept this insurance -- you have to travel approximately 75 miles to get a primary care doctor that will accept United.

I was lucky and able to get on my husbands plan. He has Blue Cross and has $500 dedictible and 80/20 and his employer picks up most of the cost.

[TooGroggy]

I was speaking to someone the other day and he complained about the 20% increase he experienced in his health care premiums "because of ObamaCare". He's now paying $110 a month. I just had to laugh.

If everyone who's opposed to the Affordable Care Act looked into what their life would be like if they were to loose their employer-provided insurance they'd sing a different tune.

[Mr Bill]

In Colorado, they have a program called 'Cover Colorado'. The program is available for any person that has been denied insurance for any reason by a private insurance company. See if your state has something similar.

[imtired]

Reading this thread makes me very happy to live in Canada.

[Kahfree]

I purchased Aetna Health coverage as an individual in 2006. At the time, it was $115.00 a month. 5 years later, it is $252.00 a month, but in December, it was $259.00 a month but I was told my rates were actually dropping, not going up. I am grandfathered in with an existing plan since the plans have changed due to the new regulations. My DME coverage is $2,000 a year. The current coverage for someone who purchases this same plan is now just $750.00 a year. That's quite a difference! I have not had any experience with my Sleep Apnea changing my rates, yet. I hope they don't do that. I am 48, so who knows what will happen when I turn 50. My copay at the doctors is $30.00 and the specialist is $40.00. My deductible is $2,500 a year and my coinsurance is $5,000 for a total of $7,500 a year. Last year I met that and they covered my Sleep Study 100%...thankfully! By the way, they reduced my rates AFTER I met my deductible. Not sure if this is the norm or not.

On a side note, I can not get disability insurance because I am self employed with a home daycare and can write off a lot, just about zeroing out. So, due to that, no one will sell me disability since I do not show income. Instead, I purchased Aflac under my daycare business name as a group (established my own group, even though I am one person) and purchased 4 plans. Accident, Hospital Indemnity, Cancer and Specified Events at a cost of $177.00 a month and the rates are guaranteed as long as I own and pay my policies for life. This is what I consider my disability insurance. If I get sick, have an accident or go to the hospital, I will be paid money from ALL four policies. So far, I have received $600.00 since June when I enrolled due to different tests, etc.

I am hoping my rates do not go up further...but if they do, they sure are lower than what I am hearing on this board.

Kelly

ps. I am in California. Also, I use to have an insurance license, but no longer do. So, I am not advising on any policy, but can tell you that rates for medical are the same across the board and do not change from agent to agent for health. It is set by the State and they need approval to change the rates. At least that is the last I knew. So, if they quote you a rate, it is suppose to be the same rate they would quote other people with the same condition.

[linagee]

I found mine at ehealthinsurance (It's a search engine for several insurance providers.) I pay about $60/mo and have a $5,000 deductible. (CPAP was entirely out of pocket.) I mainly have the insurance as my disaster insurance. (If I need major surgery or something.)

[jonquiljo]

ps. I am in California. Also, I use to have an insurance license, but no longer do. So, I am not advising on any policy, but can tell you that rates for medical are the same across the board and do not change from agent to agent for health. It is set by the State and they need approval to change the rates. At least that is the last I knew. So, if they quote you a rate, it is suppose to be the same rate they would quote other people with the same condition.

All I know about is BCBS in California. In BS we have been designated "Tier 5", mainly because my wife had some spinal procedures a while back. Since then, our rates go up and up and up. Once you are in tier 5, you supposedly stay there. It's the highest possible rate they can charge by law (ha!) and it generally goes to people who they want to get rid of. I consider myself and my family "lucky" in that we still can afford this. I know of way too many "well off" people long since overwhelmed by the costs of insurance - and since have dropped to uninsured.

I have even thought of buying a small business that would allow me to purchase a group policy at a fraction of our current rate. The reason that can happen is that California regulates health insurance (somewhat) to small businesses, just to individuals. As long as you buy a business in good faith, you legally can get a health plan and the rates that go with it. I can be a corner candy store - nothing enormous or expensive - just a bona-fide business.

Obamacare - I don't know the official name of the act - is still "pending" as far as I can see. I think it's a terrible law (too much bloat and not enough regulation), but of course, want it to take effect so that my rates will go down to 1/5th of what they are (or will be). A lot can happen between now and the implementation of Obamacare, so its a crap shoot. But we are talking about the greater part of my income after taxes - all of which goes to health insurance. But the insurance companies are all raising their rates in anticipation of all of this. By "raising the bar" beforehand, they start out with a higher "base" to charge customers when they do get some regulation and are forced to compete. Enacting the major points of the law in 2010 for 2014 (major) implementation, just gives these people 4 years to set themselves up to screw us over. Congress was stupid on that one.

Now Medicare is a different story. After Obamacare I expect it will be slowly gutted in benefits - perhaps even before. At least it will serve as a base for self-insuring --i.e. -- covering catastrophic things, and the rest is out of pocket. That's 90% of the value of any insurance. But it looks as if Obamacare is going to be torn apart over th next few years. It also bases a lot of coverage on Medicaid given to people who are not insured. But Medicaid is (partly) paid for and administered by the states, most of which are beyond broke. Let's say the whole thing will be a mess at best. Hillary Clinton had a better plan in 1993. The insurance companies have been preparing for this since then - and they know exactly what to do in all contingencies. The providers do as well.

Kahfree: When you turn 50, your rates will go way up. From 50 on at 5 year intervals (50, 55, 60, 65) you get major increases. Your OSA diagnosis could take a couple of years to affect your rates. Frankly if you were an individual subscriber in California, I would pay for that on my own. The same is true if you have ever taken an antidepressant (Prozac, Paxil, Lexapro, etc.). You can kiss your low premiums goodbye! There are certain "triggers" that will get your rates raised, and once they have been triggered, they don't go back and see if you are making those claims anymore to potentially lower your rates. It's very much a one way street.

I am someone who is totally against too much government intervention into business. But in the health care field, I see nothing but a mess needing Federal guidance. Unfortunately, Obamacare does little to help that. Yes, it pays for lots of free insurance, but it does not address the root of the problem - i.e. - providers and insurers that play this game of charging lots, increasing overhead, and defensive medicine. The countries with socialized systems are not doing that well with them financially (they tend to go broke), so I think i's the wrong time in our history for the government to get into the health insurance game. If we did, we'd need a much stronger leader than Obama to make it really work. All the "difficult points" of implementation will happen after Obama is re-elected. At that point, he will not have to do anything, and can blame the failure on everyone else. Remember, he is on to his other projects, even though health care is far from overhauled - nor will it ever be.

[jonquiljo]

I found mine at ehealthinsurance (It's a search engine for several insurance providers.) I pay about $60/mo and have a $5,000 deductible. (CPAP was entirely out of pocket.) I mainly have the insurance as my disaster insurance. (If I need major surgery or something.)

This is good and should be an option to all Americans. Let me revise it a bit ... it needs to give the subscriber access to the insurance negotiated rates. For instance a simple arthroscopic knee surgery list price is $50,000. (all included), but the real cost to the insurance company is generally less than $5,000. A policy that would give people the negotiated rate even if they paid out of pocket, would be more helpful that people ever realize.

Insurance companies rarely lose money on people except in case of catastrophic illness. They set rates low and negotiate costs low. Most people, even if they make claims, never pay in less than the insurance company "pays out". They will raise your rates before that happens. The insurers set the odds and costs in their favor.

The problem is that without a third party payer (i.e. - an insurer) it is hard to get health care without going to great lengths to prove that you can pay these people in advance. So a catastrophic policy along with Federal regulations that force providers to post the cost of services (a rate sheet, something) would do lots of people wonders. For many people this puts the burden of what they do on their shoulders not the insurers and medical providers. But this would mean enacting some really gutsy federal legislation - more tough than ever - and I don't see our politicians scrambling to do that. Given that we are going broke as a country, if Obamacare is destroyed, we need gutsy alternatives that can be inexpensive to the government.

The problem is that the words "politician" and "gutsy" never come together.